Complex: Respiratory/Pulmonary Flashcards
Pulm: Discuss the rationale of performing high quality oral care for mechanically ventilated patients
Oral care should be performed using a suction toothbrush at least every 12 hours on patients who are mechanically ventilated in order to prevent Ventilator Acquired Pneumonia.
ABG: analyze the following ABG
pH- 7.25
PaCO2- 29
HCO3- 14
Partially Compensated Metabolic Acidosis
ABG: analyze the following ABG
pH- 7.50
PaCO2- 36
HCO3- 18
Uncompensated Respiratory Alkalosis
Pulm: Describe the expected finding of a chest tube suction control chamber and water seal chamber
Gentle, continuous bubbling of the suction control chamber is normal and expected. Bubbling in the water seal chamber during exhalation or coughing indicates that air is being pulled from the pleural space. The bubbling should not be excessive or continuous. If it does, there is an air leak somewhere in the chest tube
Pulm: Describe why a patient with a spontaneous pneumothorax is at risk of developing a tension pneumothorax
Air in the pleural space compresses the vessels in the chest cavity and compromises blood return to the heart. As more air accumulates, there is greater risk of displacing the trachea (tension pneumothorax). This is an emergency.
Pulm: Describe the rationale for placing a patient who was recently extubated in the semi-fowler’s position
Patients who are extubated are at high risk for airway compromise due to the trauma in the airway. The semi-fowler’s position is safest for the patient because it maximizes ventilation and comfort for the patient
Pulm: Describe the circumstances and rationale for placing a patient on a specialty bed that rotates to prone position
Patients with ARDS, COVID-19, and other profound respiratory compromise benefit from frequently being placed in the prone position. This promotes gas exchange and decreases the risk of secretions which can cause other complications
Pulm: Describe stridor
Stridor is the high-pitched sound made by a patient with a significantly compromised airway. This is an indication of laryngeal edema that can occur after extubation and is considered an emergency
Pulm: Explain the post-op priorities to conserve lung health
Ambulate early and often
Turn, cough, deep breath
Use incentive spirometer at 10 times per hour
Describe the rationale for prioritizing airway management when a patient is moved into prone position
The process of moving a patient into prone position places risk to the vulnerable lines and tubes
Describe symptoms of pulmonary embolism and how a PE is diagnosed
Patient’s with a new onset PE will manifest with symptoms like dyspnea, diaphoresis, and signs of hypoxia diagnosed with a CXR, ABGs, and an EKG to rule out underlying cardiac problems
Describe why a nurse might use an ambu bag to manage a patient on mechanical ventilation.
A nurse may use an ambu bag to mainain an artifical airway of a patient with mechanical ventilation when they are transporting to another department and when a ventilator malfunctions and a respiratory therapist is preparing an alternative ventilator for the patient
Pulm: Explain concepts of maintaining the chest tube drainage system
The chest tube drainage system depends on gravity that allows the negative pressure to pull unwanted air or fluid from the pleural space. Therefore it is important to keep the drainage system below chest level.
Suction control chamber- continuous, gentle bubbling lets us know that the suction is working
Water seal chamber/air leak- Gentle tidaling of the water in this chamber occurs normally with breathing and indicates that the lung has not reexpanded
Collection chamber- document volume every shift
Pulm: Describe the type of breathing treatment used for pneumonia and the rationale
Bronchodilators are used in conjunction with other medications for pneumonia to help with dilate the constricted bronchioles.
