CEN RESPIRATORY Flashcards by Linsay AugustinCRNA

How can a nurse determine if ego phony is present in a patient?

_If the patient says “e” and “a” is heart over a particular area

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Bronchophony : ask the patient to say ____in a normal voice. Expected finding is that the words will be _____. It is present when the word is heard

_99; indistinct ; Clearly

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Whispered Pectoriloquy: Ask the patient to whisper a sequence of work such a _____normally only ______ sounds are heard. Over areas of tissue abnormality, the ______sounds will be _____ and _____

1, 2, 3; whispered,; clear and distinct.

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Factors that could impair the accuracy of pulse ox

Increased bilirubin
Black,blue, brown, greens and gold nails polish can alter pulse ox readings. RED WOULD NOT AFFECT
Ambient light , motion artifact , edema and PIERCED EARLOBE.

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Predominant symptoms of acute bronchitis

Cough

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Finding found specific to hyperinflation of the lungs and

HyperRESONANCE OF lungs

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A complication of CPR in elderly or frail patients is

sternal fracture

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When you hear bowel sounds in the thoracic cavity , you would suspect what kind of injury? Because

Diaphragm rupture ; herniation of abdominal contents into the thoracic cavity.

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Sing of Diaphragm rupture

bowel sound in the thoracic cavity

undigested food or fecal matter in the chest tube drainage system.

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Severe pain will cause a patient to HYPERVENTILATE thus causing what acid-base imbalance

Respiratory Alkalosis

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In respiratory alkalosis, the pH is _____and the pCO2 level is ____

high; Low

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Common causes of noncardiogenic pulmonary edema:

ARDS, kidney failure, SUBMERSION INJURY, high altitude pulmonary edema, drug overdose.

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Virchow’s Triad describes 3 COMMON risk factors for thrombosis formation which are

Venous stasis
Endothelial injury
Hypercoagulable states

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the MOST FREQUENT cause of upper airway obstruction in CHILDREN

Acute LARYNGOTRACHEOBRONCHITIS (CROUP)

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Coup mostly occur during which season ?_______and affect kids from ____ and ___. There is _______ most frequently at ______ accompanied by a ___________ —– focough. May experience _____and ________

Winter; 6 months; 3 years. Respiratory distress; large barking cough; Tachypnea; tachycardia.

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Asthma is characterized by these 3 thing

Hyper-reactivity
Airflow limitation
Inflammation

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Four classification of asthma

Intermittent asthma

symptoms 2x/week or less
nighttime sx 2x/month or less
inhaler 2x/week or less
Symptoms does not interfere with activity

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Four classification of asthma

Mild Persistent asthma

symptoms more than 2x/week or less but less than once a day
nighttime sx 2x/month or less
inhaler more than 2x/week but not daily
minor limitation with activity

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Four classification of asthma

Moderate Persistent asthma

symptoms daily
nighttime sx more than once a week but not daily
inhaler daily
some limitation with activity

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Four classification of asthma

Severe Persistent asthma

Continual daytime symptoms
Frequent nighttime symptoms
limited to no control of symptoms
Limitation with normal activities.

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Use to located a bleeding site withing the chest

Laryngoscopy

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Symptoms of ARDS include

dyspnea
tachypnea
Tachycardia.
Anxiety

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To create an emergency airway, where would you do it?

CRICOTHYROID membrane

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Infants have _______ oxygen reserve due to _____ oxygen consumption

less; GREATER

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Extension of neonate's head may cause what ?

Tracheal extubation

Flexion of a neonate's may lead to ____

Mainstem intubation .

Treatment of CO include

Administration of 100% oxygen

CO can lead to ____________; and the antidote is ________because it decreases what?

tissue hypoxia; 100% oxygen ; the half life of CO

This can also be given for CO poisoning

hyperbaric oxygen ; patient breathes oxygen under increased atmospheric pressure.

Pleural effusions can either be

Transudative | Exudative

Transudate fluid is seen in

LV failure Cirrhosis of liver hypoalbuminemia Constrictive pericarditis.

Exudative fluid

Pancreatitis | pneumonia with pus (empyema)

What causes transudate fluid?caused by __________________fluid leaking from the _________ into the pleural space. As a result of ____________ ________pressure or ___________oncotic pressure

Water and protein-free fluid ; capillaries ; Increased intravascular hydrostatic pressure; decreased oncotic pressure.

During expiration , the diaphragm ______ and the intercostals _____

relax; relax

During inspiration, diaphragm ______ , the thorax increases in _______and the lungs are ______

contracts; size; stretched

the lungs lobes are separated by

fissures

How many lobes does the right lung have ____ and how many segments_____

3 lobes; 10 segments

How many lobes does the left lung have _______ and how many segments ____

2 lobes; 8 segments.

The primary functional units of the Lungs are

Lobules.

karate kick injury or CLOTHELINE Injury to the neck MOST LIKELY result in

Tracheobronchial disruption

Acid gain leads to

Acidosis

Acid loss leads to

Alkalosis

After failed intubation, the nurse should prepare the patient for

CRICOTHYROTOMY

What the MOST COMMONLY SEEN rib fractures?

ribs 4 through 9

What is the total volume of air that the lungs can HOLD?

5500-6000 ml

What is the total volume of air that can be inhaled?

3500ml

What is the total volume of air that can be exhaled?

4500ml

What is the most common and potentially LIFE THREATENING chest injury>

Pulmonary contusion

Blood pH level less than 7.35 is _____ and the process that creates it is called __________

Acidemia; acidosis

Blood pH level less than 7.45 is _____ and the process that creates it is called __________

Alkalemia; alkalosis.

RSV is the MOST COMMON Virus responsible for CAUSING which pediatric illness

BRONCHIOLITIS

Vocal fremitus decreased, causes could be

bronchial obstruction emphysema pleural effusion pneumothorax.

Vocal fremitus INCREASED causes could be

``` Pneumonia overly large airways Tumor Pulmonary infarction pulmonary fibrosis ```

ARDS characterized by

Diffuse alveolar injury loss of surfactant DECREASED LUNG compliance

Emphysema will cause an increase in

Intra-thoracic volume

What can cause increase in intra-abdominal volume?

Abdominal distention Ascites pregnancy Hepatomegaly

Tumors lead to pleural effusion by

Obstructing the flow of lymphatic drainage.

An acute infection of DISTAL airways, lung interstitium and infection of alveoli is knowns as

PNEUMONIA

2 most common causes of PNA

Streptococcus Pneumoniae | Haemophillus Influenzae

SUBMERSION injury AKA _________ leads to respiratory impairment from submersion in liquid

near-drowning

Treatment of submersion injury or near-drowning is

slowing and preventing the progression of neurologic impairment

Breath sound that sound like "snoring " are

Rhonchi

Grating or scratching breath sound are called

Pleural friction rub.

High pitched whistle that you DONT NEED A STETHOSCOPE to hear

STRIDOR

Normal calcium level for a child______and for adult _____

8. 8-10.8 | 9. 0-10.5

When pH is decreased what happens to the respiratory rate?

Rate and depth increases

The most important lab for CO poisoning

Carboxyhemoglobin level.

Vesicular breath sounds

Soft intensity, low pitch, rustling quality

Broncho-vesicular breath sound

medium intensity, medium pitch, breezy quality

Bronchial breath sounds

Loud intensity, high pitch, hollow quality,

The most common AIRWAY OBSTRUCTION in children

Tongue.

Percussion tone most likely heard in normal lungs________and in Hyperinflated lungs

RESONANT; hyperresonant

The upper portion of the trachea that connects the trachea with the LARYNGOPHARYNX

LARYNX

Airway passage located through the vocal cords

Glottis

Obligate nose breathers are

0-6 months

Most appropriate intervention for infant with FB

Administer 5 back blows | and 5 chest thrusts.

An _________myocardial workload is an indication for oxygen therapy not a (n)_____

Increased; decrease

Whooping cough is associated with________patient should be _____precautions; it is caused by _______- ______

acute bacterial infection with an incubation period of 7-10 days; droplet; Bordetella pertussis.

Bronchi are supported by

Cartilage | Smooth muscle

What is the most IMPORTANT chemical buffer of acid-base regulation

BICARBONATE

HyPOPNEA defined as

Shallow ventilation or SLOWER than normal rate

Regular ventilation with slow rate

BRADYPNEA

Diffusion is the

movement of gas between ALVEOLI, RBCs, and plasma

Perfusion is

Movement of blood through the pulmonary capillaries.

Ventilation is

movement of air between the atmosphere and alveoli.

__________ is an acid regulated by the lungs

carbonic

___________is an acid regulated by the stomach

Hydrochloric acid

__________is an acid regulated by the muscles

Lactic

__________ acids build protein from food

Amino

What are the four sinuses that surrounds and drain into the nasal cavity?

Ethmoid Frontal Maxillary Sphenoid

An initial indication that the patient has hypoxia is ____________ which is then followed by ______

restlessness; confusion

If there is a new _______the ventilator may alarm

pneumothorax

Meningitis, encephalitis, and head trauma may causes of which respiratory rhythms

Biot's

Kussmaul's respiration caused by

metabolic acidosis | Peritonitis

What are the 3 D's of Epiglottitis

Drooling Dysphagia Distress.