Chapter 58 Flashcards
Type two aveoli cells in the walls of the aveoli produce ______________ a phospholipid protein that reduces the surface tension in the aveoli without it the aveoli will collapse
Surfactant
Allergies, chest injuries, crowded living conditions, exposure to chemicals, exposure to infectious disease, frequent respiratory illness, residence or traveling, smoking,viral syndrome
Can all be described as..
Risk factors for respiratory disorders
Specimen obtained by expectoration or tracheal suctioning to assist in identification of organisms or abnormal cells
what procedure is this
Sputum specimen
Sputum specimen
What time of the day is best to collect?
Does the client have to rinse mouth out before specimens collected?
How many ML’s of sputum must be obtained?
You have to collect specimens before client begins what?
Post procedure one specimens collected when does it get transferred to the lab?
Morning Yes 15 ML's Before antibiotic therapy begins Transport to the lab immediately
Which Bronchus is slightly wider and shorter and more bird vertical?
The right
What procedure enables the direct visual examination of the larynx trachea and bronchi with a fiber-optic bronchoscope?
Laryngoscopy and bronchoscopy
Laryngoscopy and bronchoscopy What is the first thing you obtain Since when is the patient NPO Why do you have to asses coagulation studies What do you remove Does the patient have an IV started
Informed consent
Patient NPO midnight before
To see how quickly your blood coagulates it is not good it to coagulate to quickly during a surgery.
Remove jewelry necklaces and dentures
And Ivy is started and pain medication is administered. Always have emergency resuscitation equipment available
Priority actions: identify for which procedure.
Explain procedure
Place client in a preposition
Hand hygiene don protective garb
Prepare suctioning equipment and turn on suction
Insert catheter without suctioning
Once inserted apply section intermittently while rotating in and withdrawing it
Hyper oxygenate
Listen to breath sounds
Document procedure
Priority actions for respiratory suctioning
Laryngoscopy and bronchoscopy: post procedure
After you assess vital signs how do you maintain the patient?
You must keep the patient NPO until what returns?
What complications can arise from this procedure?
When do you notify the healthcare provider?
Semi Fowler’s position
Gag reflex returns
Bronchospasms dysrhythmias hemorrhage hypoxemia noble thorax bronchial perforation
Fever, difficulty breathing
Describe the following procedure.
Tissue samples are obtained from central long masses and lymph nodes using a bronchoscope with the help of ultrasound guidance.
Endobronchial ultrasound (EBUS)
Endobronchial ultrasound (EBUS)
Why is this exam performed?
Is it very invasive?
Post procedure what are you monitor the patient for?
Tissue samples are used for diagnosis and staging lung cancer detecting infections and identifying inflammatory disease that affect the lungs like sarcoidosis
No it is minimally invasive done on an outpatient basis
Monitor for bleeding and respiratory distress
Identify the following procedure.
And invasive floor scopic procedure where catheter is inserted through the be more opening into the pulmonary artery. Iodine contrast is used.
Pulmonary angiography
Pulmonary angiography
What is the first thing you obtain
You have to assess for what type of allergies
Maintain patient NPO for how many hours before procedure
Why do they do coagulation studies?
You establish intravenous access through which artery
Instruct the client that once the dye is injected they will feel the urge to
Informed consent
Seafood allergies
Eight hours before procedure
The blood should not coagulate so quickly so they do the studies in case they have to give anticoagulation meds
The femoral artery aka antecubital
They may have the urge to cough, flushing ,nausea ,or salty taste following injection of dye
Pulmonary angiography. Post procedure
When it comes to taking BP what do you have to avoid?
What else do you assess on the affected extremity?
What are you monitor due to the dye?
Avoid taking blood pressure for 24 hours in the extremity used for the injection.
On the affected extremity monitor neurovascular status
Assess bleeding in the injection site
Monitor for anaphylactic shock due to dye
Describe the following procedure.
Removal of fluid or air from the plural space via thoracic aspiration.
Thoracentesis
Thoracentesis
Where is the first thing you obtain for procedure
Why do you assess coagulation studies
How secure position the patient?
How’s it you position the patient if you cannot sit up
What should the client not to during the procedure
Informed consent
So the blood one clot too fast
Sitting upright with the arms and shoulders supported by a table at the bedside
If patient cannot sit up the client is placed lying in the bed towards unaffected side with the head of the bed elevated
Client should not cough, breathe deeply or move
Thoracentesis: post procedure
What do you assess
Monitor for signs of what
Assess vitals and puncture site for bleeding and crepitus ( peculiar grafting or crackling sound)
Monitor for signs of air embolism pulmonary edema and Phuemothorax
Describe the following procedure.
Test used to evaluate lung mechanics gas exchange an acid-base disturbance through spirometric measurements, lung volumes, blood gas levels
Pulmonary function test
Pulmonary function test
When you administer an analgesic, what do you have to find out?
You need to ask the doctor whether or not you will withhold which medication
Does the client need to void before procedure?
Before the procedure is done the client is instructed to avoid what?
Find out if it depresses respiration
Ask doctor if you’re going to withhold bronchodilators
Yes Void
Heavy meals and smoking
Identify the following procedure.
A transbronchial biopsy and a transbronchial needle aspiration may be performed to obtain tissue for analysis by culture or cytological examination done in the OR
Lung biopsy
Lung biopsy
What is the first thing you obtain for this procedure
Will there be general or local anesthetic?
Can the patient eat?
Although they will have anesthetic use for the needle biopsy, will they feel anything?
informed consent
Local anesthetic
NPO
The patient will feel pressure during needle insertion and aspiration
Lung biopsy post procedure
After you monitor the vitals what do you have to apply to the biopsy site?
Monitor for signs of what?
And apply dressing to the biopsy site and monitor for drainage or bleeding
Monitor for signs of phneumothorax and air emboli if suspected call HCP
Identify the following procedure
This scan evaluates blood flow to the lungs. Determines the patency of the pulmonary airways that abnormalities in ventilation
Ventilation perfusion lung scan
Ventilation perfusion lung scan
What is the first thing you obtain?
What is injected into the patient?
What has to be removed?
What you need to have available?
Informed consent
Radionuclide
Jewelry around the chest area
Recessitation cart
In a ventilation perfusion lung scan, after the radionucleid are injected how long before they leave the body?
Eight hours
A skin test is used to determine hypersensitivity or previous reactions to skin test.
Where is the injection done for this test?
How many hours do you have to wait for to get results?
Injection is done at the upper third of the inner surface of the left arm
24 to 72 hours
Describe the following procedure.
Measurement of the dissolved oxygen and carbon dioxide in the arterial blood, helps indicate the acid-base state and how well oxygen is being carried to the body.
Normal arterial blood gas values ABGs
What should you avoid before drawing an ABG?
You should not suction the patient before DRAWING ABGs because this will deplete the clients oxygen resulting in an accurate ABG results.
State The normal ABG values
PH. Research more on what these gases are Pco2 HCO Po2 02 Hemoglobin dissociation curve
7.35 to 7.45 35 to 45 22 to 27 80 to 100 mm Hg 96 to 100 No shift
Describe the following test
It is a noninvasive test that registers the oxygen saturation of the clients hemoglobin. Records it in a form of oxygen saturation (Sao2). In a lurch the nurse to an impending hypoxemia before clinical site.
What are the mobile values
Pulse oximetry
96% to 100%
Where can he pulls oximetry be placed to get a reading on a patient
Where should you not put it?
With what readings do you contact the health care provider
What happens if it’s below 85 or if it’s below 70
Earlobe finger for his toes nose. Maintain at Hartnagle do not select extremity with impediment true blood flow.
Below 91%
Below 85 oxygenation to the body tissues is compromise below 70 it is life-threatening
What type of respiration involves decrease in accessory muscles promoting CO2 illumination diaphragmatic breathing
What type of breathing retraining is this?
Pursed lips
Effective coffee technique that conserves energy reduces fatigue and facilitates mobilization of secretions take three or four deep breaths using pursed lips and diaphragmatic breathing leaning slightly forward the client should cough three or four times during exhalationThe client may need to split the thorax for maximum cough. What is this technique called?
Huff cough
Describe the form and technique.
Percussion vibration and postural drainage technique form to loosen secretions and the effect of lungs and move them into the central airways.
Chest physiotherapy (CPT)
When a patient has unstable wireless increased intracranial pressure bronchospasms history of pathological fractures rib cage fracture chest incisions what technique do not perform?
Chest physiotherapy (CPT)
Which devices being used on the patient?
Place tonight in the upright position please my tightly around the mouth piece of the device and he’ll slowly to race and maintain the flow rate indicator between 600 and 900 marks tonight should hold it for 5 seconds repeat the process 10 times an hour
Spyrometer
What type of insulator alarm Will leave here as a result of this?
Increased secretions in the airway Weezing bronchospasm and endotracheal tube displaced, ventilator obstructed because of water or kink or client coughs gags or fights the oral endotracheal tube tonight anxious or flights the ventilator
High-pressure alarm
What type of alarm will go off in the ventilator due to the following reasons?
Disconnection or leak of the ventilator for the client airway cough, the client stop spontaneous breathing.
Low-pressure alarm
What is it called when numerous alarms are always sounding from the ventilator resulting in the noise desensitizing nursing staff and causing them to ignore alarms even disabling them.
Alarm fatigue
Supplemental oxygen delivery system. Identify
Use for a client with chronic airflow limitation in for long-term oxygen use.
Assess nasal mucosa from drying effect
Assess skin integrity due to tubbing irritation of the skin
Add humidifier and check water levels to prescribe
Nasal cannula for low flow
Supplemental oxygen delivery system. Identify
Use for hypoxemic clients in mild to moderate respiratory distress .
Nasal high-flow (NHF) respiratory therapy
Identify the following supplemental oxygen delivery system.
ensure mask fits remove saliva mucus from mask provide skincare provide emotional support for claustrophobia
Monitor for risk of aspiration
Simple face mask
Identify the following supplemental oxygen delivery system.
Used for client experiencing acute respiratory failurekeep the air entrapment port free of obstruction to ensure oxygen delivery mask should be snug and on face make sure the tubing doesn’t have any kinks because the F10 2 can be altered assessed nasal mucosal for irritation humidity what Aresol be added
Venturi mask
Identify the following supplemental oxygen delivery system.
Useful when the oxygen concentration needs to be racist not prescribed for client with chronic obstructive pulmonary diseaseit has a mask with a reservoir bag, if the bag deflates this will result in decreased oxygen delivery and rebreathing of exhale there
Partial rebreather mask with the reservoir bag
Identify the following supplemental oxygen delivery system.
It is used to deliver high humidity and the desired object into the climb with a tracheostomy the T-bar or t peice is used to deliver the desired F102 to the client with a tracheostomy laryngectomy or endotracheal tube
Tracheostomy collar and T-bar or t piece
