Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

D-Third semester > DoneCHA1- exam 2- respiratory > Flashcards

DoneCHA1- exam 2- respiratory Flashcards

1
Q

Metabolic disorder

change in what

A

-change in the bicarb concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Respiratory disorder-

change in what

A

change in the CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Metabolic acidosis-

ph
bicarb

A

pH < 7.35

bicarb less than 22 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Metabolic alkalosis-

ph
bicarb

A

bicarb- pH > 7.45

bicarb > 26 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Respiratory acidosis-

ph
paco2

A

pH < 7.35

PaCO2 > 45 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Respiratory alkalosis-

ph
paco2

A

pH> 7.45

PaCO2 < 35 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

normal levels

ph
hco3
pac02

A

ph-7.35-7.45

hco3-22-26

pac02-45-35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

acidic levels abg

ph
pac02
hco3

A

< 7.35 ph

> 45 paco2

<22 hc03

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

alkalosis levels abg

ph
pac02
hco3

A

> 7.45 ph
<35 pac02
26 hco3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

primary imbalance

acid base imbalance

A

caused by one source

either resp or met

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

mixed imbalance

acid base imbalance

A

caused by both met and rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Compensation-

A

how the body attempts to return homeostasis. It wants to balance the pH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Primary imbalance

A

source of the problem

it is what is causing the imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

compensation how fast

respiration
renal

A

resp can happen quickly

renal takes longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

compensated

ph where

PaCO2 / HCO3 where

A

If pH is NORMAL,

PaCO2 and HCO3 are both ABNORMAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Partially Compensated

ph where

PaCO2/ HCO3 where

A

If pH is ABNORMAL,

PaCO2 and HCO3 are both ABNORMAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Uncompensated

ph where

PaCO2/ HCO3 where

A

If pH is ABNORMAL

PaCO2 OR HCO3 is ABNORMAL =

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ABG Interpretation
1- ph
2 pco2/hco3
3if both
4look at/is pt

A

Is the pH normal, acidotic or alkalotic?

Is the pCO2 or HCO3 abnormal?

If they are both abnormal, which one deviates the most from the norm and is causing the change in pH?

Look at the Po2, is the pt hypoxic?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RO

when ph is up
when ph is down

ROME

A

Respiratory Opposite

When pH is up, PaCO2 is down = Alkalosis

When pH is down, PaCO2 is up = Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ME

when ph is up
when ph is down
ROME

A

Metabolic Equal

When pH is up, HCO3 is up = Alkalosis

When pH is down, HCO3 is down = Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

acids to what to hydrogen

bases do what to hydrogen

A

Acids- release hydrogen in solution

Base- accepts hydrogen in solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

low ph=what=how much hydrogen //levels

high ph=what=how much hydrogen //levels

A

Low pH = acidic-more hydrogen-<7.35

High pH = alkaline-less hydrogen >7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Volital acids

how eliminated

A

can be elimated as a gas

such as carbonic acid from lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Non volital acids

how excreted

A

must be excreted as body fluids like lactic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
excess acid k c d buildup h
ketones-dka,starvation cell death- trauma, lactic buildup hypoxia
26
excess base(alkolotic) a loss
-antacids loss of gi fluids-vomit, di suction
27
Body has 3 different systems to maintain normal pH
Buffer system-in the fluids Respiratory system Renal system
28
buffer system what does it do
prevent major changes in pH by either removing or adding H ions-
29
When acidic buffer system
- binds with hydrogen to minimize ph change
30
When alkalotic- buffer system
releases hydrogen ions and restores ph
31
repository system does what how fast
Regulates levels of carbonic acid (CO2- works quickly
32
respiratory system in metabloic acidosis
rr and depth of lung increases to relase co2
33
respiratory system in metabolic alkalosis
alkalosis- rr and depth of respiration decreases and retains co2
34
renal system how fast term
Kidneys respond more slowly to pH changes Long term regulation of acid base balance
35
renal system in respitory acidosis
kindeys excrete hyodren and retain bicaronate
36
renal system in repository alkalosis
kidneys retain hydrogen and excrete bicarbonate
37
where are abg drawn
radial artery
38
Nursing interventions- ABG p education apply place
painful- education, what doing and why doing, apply pressure for 2-5 minutes after puncture, place sample on ice
39
what does abg measure
ph pco2 bicarb
40
PaCO2- relfects what regulated by what normal values
reflects respiratory component of acid base regulation Regulated by lungs Normal values 45-35
41
PaO2 normal under that = evaluates/not what's
Normal PaO2 80-100 <80= hypoxemia Evaluates respiratory function-not acid base balance what's available to cells
42
Serum bicarbonate- abg reflects what component normal level
reflects renal regulation of acid base Metabolic component of ABGs Normal bicarb level: 22-26
43
Metabolic Acidosis what level bicarb what level ph what fixes
<22mEq/L- pH < 7.35 (resp. tries to fix)
44
Acute lactic acidosis- Risk Factors for Metabolic Acidosis
tissue hypoxia from shock or cardiac arrest
45
D a/c excessive Risk Factors for Metabolic Acidosis
Diabetic ketoacidosis- -ketones Acute or chronic renal failure--impaired excretion of HCl Excessive bicarb loss from GI loss-intestines, diarrhea or an ileostomy.
46
Accumulation of metabolic acids Pathophysiology of Metabolic Acidosis
- ketones, aspirin, lactic acid, fever, etoh
47
Excessive loss of bicarbonate- Pathophysiology of Metabolic Acidosis
diarrhea, ileostomy
48
Increased level of chloride Pathophysiology of Metabolic Acidosis
iv solutions, renal disease
49
GI- 4x Manifestations of Metabolic Acidosis
Anorexia, nausea vomiting, Abdominal pain
50
nuero x4 Manifestations of Metabolic Acidosis
Decreasing levels of consciousness Weakness fatigue/ headahce
51
Cardio- 2x Manifestations of Metabolic Acidosis
dystyrhmia, bradycardia
52
skin 3x Manifestations of Metabolic Acidosis
Warm, flushed dry
53
respiratory manifestations 2x why Manifestations of Metabolic Acidosis
Hyperventilation (Kussmaul respirations-labored deep rapid).- compensatory to blow off
54
Metabolic Acidosis diagnosis ABGs- Serum electrolytes- ECG- - Blood glucose- Renal functions-
ABGs- less then 7.35 Serum electrolytes-elevated k ECG- hyperkalemia- peaked t Blood glucose- elevated Renal functions- cause
55
Medications to Treat Metabolic Acidosis
Sodium bicarbonate- if ph less then 7.2- reduce acidosiss and affect on heart-
56
Diabetic ketoacidosis- Medications to Treat Metabolic Acidosis
insulin and fluid
57
Alcoholic ketoacidosis Medications to Treat Metabolic Acidosis
-saline solutions and glucose
58
Metabolic acidosis secondary to diarrhea Medications to Treat Metabolic Acidosis
- providing fluid/ electrolyte replacment
59
Metabolic acidosis decreases myocardial contractility- monitor monitor montior nursing interventions
monitor vs, pulses and cap refill moinotor ecg for changes(k like changes) monitor labs- creatinine and bun
60
As pH falls, mental function decreases- monitor safety precautions keep metabolic acidosis
-monitor loc and muscle strength safety precautions-low bed and position alarm keep familier objects at bedsode- clocks calanders// orainet to time and place
61
Metabolic Alkalosis ph bicarb what tries to fix
pH- greater then >7.45 Bicarbonate- greather then>26 Respiratory system tries to fix- slows rr
62
Risk factors- metabolic alkalosis h h tr
hospitalization, hypokalemia, treatment with alkalinizing solutions- bicarbonate
63
GI loss of H ions 2x Pathophysiology of Metabolic Alkalosis
- vomiting, gastric suction
64
Increased renal loss of H ions due to what Pathophysiology of Metabolic Alkalosis
hypokalemia shifts out of cells
65
Excess bicarbonate- ingesting overzealous Pathophysiology of Metabolic Alkalosis
ingesting antacids, or overzealous administration of bicarbonate to treat metabolic acidosis
66
nuero x3 Manifestations of Metabolic Alkalosis
Confusion Decreasing level of consciousness Dizziness
67
cardio x2 Manifestations of Metabolic Alkalosis
Dysrhythmias Hypotension
68
mimics what Manifestations of Metabolic Alkalosis
Hyperreflexia Trousseau sign Muscle spasms. Numbness and tingling around the mouth, fingers, and toes Tetany Seizures
69
respiratory h respitory Manifestations of Metabolic Alkalosis
Respiratory failure hypoxemia respiratory acidosis
70
ABG electrolytes urine ph ECG Diagnoses of Metabolic Alkalosis
ABG- ph greater then 7.45 Serum electrolytes- hypokalemia, decreased chloride Urine pH- low-1-3 ECG-hypokalemia- depressed st , u
71
restore administer administer treat Medications to Treat Metabolic Alkalosis
Restore normal fluid volume Administer potassium chloride Administer sodium chloride Treat underlying cause
72
Respiratory Acidosis vent ph pac02
Hypoventilation pH less than <7.35 PaCO2 greater than 45
73
3x Risk Factors for Respiratory Acidosis
Acute lung disease- pneumonia Chronic lung disease copd/ cystic fibrosis Depressed ventilation
74
depressed ventilation risk factors resp acidosis
Narcotics Airway obstruction Neuromuscular disease- MS
75
what retention what accompanies Pathophysiology of Respiratory Acidosis
Carbon dioxide retention caused by alveolar hypoventilation Hypoxemia frequently accompanies respiratory acidosis
76
Sudden ventilation failure- c t aspiration acute over Acute Respiratory Acidosis
chest trauma, aspiration of fierign body, acute pneumonia, overdoses or narcotics
77
S/S of acute respiratory acidosis mental vision c I cardia
- mental cloudiness, blurred vision confusion , irritability, tachycardia
78
Chronic Respiratory Acidosis associated with
Associated with chronic problems-COPD, asthma, cystic fibrosis, or multiple sclerosis
79
acute Manifestations of Respiratory Acidosis h I m c loc v skin pulse
headache, irritability, mental cloudiness, loc decreased ,vfib. , skin warm flushed, elevated pulse
80
chronic Manifestations of Respiratory Acidosis w d h s d d s i m p c
weakness, dull headache, sleep disturbances, daytime sleepiness , impaired memory, personality changes
81
Diagnosis of Respiratory Acidosis abg-ph / c02 serum electrolytes pulmonary function test cxr
ABGs- ph less then 7.35// c02 >45 Serum electrolytes- elevated k Pulmonary function tests- cause CXR- looking for pnemonua or pnemothroax
82
b a n Medications to Treat Respiratory Acidosis
Bronchodilators- open airways Antibiotics- infection Naloxone- reverse narcotics
83
Respiratory Support severe resp acidosis may__ cautious p h resp acidosis
severe may require intubation /ventilation cautoius admisntrtaion of 02 pulmonary hygiene
84
Pulmonary hygiene respiratory acidosis
- breathing tx, percussion, drainage, hydration
85
Impaired gas exchange- assess frequently evalaute place as ordered resp acidosis
assess rr, frequently assess loc, evaluate abg, place in semifolwers, admisnter oxygen as ordered
86
Ineffective airway clearance- ausculate lip encourage admisnter resp acidosis
ausculate breath sounds, pursed lip breathing , encourage fluid intake, amdinster bronchodialters
87
Respiratory Alkalosis ph pac02
pH greater than 7.45 PaCO2 less than 35
88
Risk factor- Respiratory alkalosis 1 risk factor examples of it
hyperventialtoion –pain, fear, infection,anxiety, faulty mechanical ventialtion
89
how will kidneys help Pathophysiology of Respiratory Alkalosis
compensate by eliminating bicarb
90
Look for Manifestations of respiratory Alkalosis
hypocalcemia- Tremors, positive Chvostek’s and Trousseau’s, tingling around mouth
91
L p d c s loss Manifestations of respiratory Alkalosis
Lightheadedness Panic, difficulty concentrating Seizures- loss of consciousness
92
respiratory x2 Manifestations of respiratory Alkalosis
Dypnea hyperventilation
93
ear Manifestations of respiratory Alkalosis
tinnitus
94
cardio x 3 Manifestations of respiratory Alkalosis
Chest tightness Tachy cardia/ hypotension palpitation
95
diagnosis respiratory Alkalosis abg paco2
ABGs ph >7.45 paco2 <35
96
Medications- a p a respiratory Alkalosis
, antianxiety, pain reliever, antibiotics
97
Respiratory help respiratory Alkalosis
- breath slowly
98
Tidal volume- what is normal
Amount of air that moves in and out of lungs- normal amount of air in is 500 ml
99
vital capacity
total max
100
Inspiration- how does it work
diagraphm and intercostals contract and cause air to flow into lungs because pressure drops
101
Expiration- how does it work
muscle relaxes, cuases positive pressure, and mvoes air out of lungs
102
f c m t all do what Respiratory passageway resistance: Factors that affect breathing
friction, constriction, mucus tumours– all will increase resistance and decrease air flow
103
Lung compliance- how what what decreases Factors that affect breathing
how structurally the lungs and ribs are elasticity will decease with age and disease
104
Sputum studies- can give afb culture used when Respiratory Diagnostic Tests
can give cancer diagnosis afb- tb culture used for bacterial infection
105
AGBs- can tell Respiratory Diagnostic Tests
can tell ph, co2 , 02, bicarb
106
cxr Respiratory Diagnostic Tests
CXR-abnomralties of chest and lungs
107
MRI Respiratory Diagnostic Tests
MRI -masses or fluids
108
CT scan- Respiratory Diagnostic Tests
images and cross sections
109
PET- Positron emission tomography- why Respiratory Diagnostic Tests
PET lung cancer and meds
110
pulse ox Respiratory Diagnostic Tests
Pulse oximetry- can be inaccurate
111
V/Q scan inhales reduced in used if Respiratory Diagnostic Tests
- inhales a radioactive gas , reduced uptake in pe- used if allergic to contrast in ct scan and need to diagnose pe
112
Bronchoscopy visualization what to pt remain Respiratory Diagnostic Tests
-visalstion of bronchioles- sedate pt, remain npo for 2 hours pre op
113
Lung biopsy through Respiratory Diagnostic Tests
- through chest wall or in surgery
114
Thoracentesis- Respiratory Diagnostic Tests
- needle removes fluid from pleural space
115
Respiratory Assessment Demographics- Family history- Personal history- Occupational history- Lifestyle- Auscultation- Pulse oximetry- Breathing
Demographics-age/comliance Family history-asmtha Personal history-what job Occupational history-job Lifestyle-sedentary, smoke Auscultation- lung sounds Pulse oximetry-can be inacurate Breathing effort
116
laryngeal tumor s/s- changes h dys breath neck e Nursing Care for Client’s With Upper Respiratory Disorders
usually from laryngeal Cancer s/s Changes in voice, hoarseness, dysphagia, foul breath, lump in neck, earache
117
Total larygnectomy s/s require
- speech loss, require permanent trach
118
Partial larygenctomy- have sounds
have some speech , sounds different
119
apply what with largenctomy do what for speech promote what
cold ice packs give alternative speech things like paper and pencil promote swallowing
120
Pleuritis- s/s s s pain where
stabbing sharp pain in neck or shoulder
121
Pleuritis treatemnt
nsaids and analgesics splinting
122
Pleural effusion-
fluid in pleural space
123
Transudate plural effusion from what x4
- from heart failure , renal failure, liver failure or malignancy
124
exudate plural effusion
-from inflammatory response such as infections
125
pleurale effusion may require what does what puts pt at risk for what how much
Thoracentesis- removes fluid – puts pt at risk for pneumothorax 1200-1500 ml at one time
126
risk for pneumothorax- check put where pleural effusion
check dressing , put pt on unaffected side for 1 hr afterwards
127
Pneumothorax what types
Accumulation of air in pleural space Spontaneous- Traumatic- Tension- Hemothorax-
128
Spontaneous Pneumothorax related to what onset
Can be related to air pressure changes- flying, SCUBA diving, TB, ARDs Onset- abrupt
129
s/s Spontaneous Pneumothorax pain where breath breath sounds
chest pain, sob, decreases breath sounds on affected side
130
closed Traumatic Pneumothorax examples
no obvious opening in thorax- fall, cpr, mva
131
open Traumatic Pneumothorax exmaples
obvius stab wound, gun shot- has chest open and punctured lung
132
s/s of Traumatic Pneumothorax pain where d breath
chest pain, dyspnea, absent breath sounds
133
Tension Pneumothorax why need to know what happens
EMERGENCY-LIFE OR DEATH CARE NEEDED! Chest wall or lungs allow air to enter pleural space but prevents it from escaping
134
Ventilation compromised- causes what in Tension Pneumothorax
causes increased pressure on heart and cardiac output drops
135
S/S- tension pneumothorax bp rr hr neck veins breath sounds tracheal
bp drop tachypnea, tachycardia, , neck veins distended, absent breath sounds, tracheal deviation to unaffected side
136
Needle Decompression- treatment Tension Pneumothorax
18/16 guage- puncture into rib and md will let out air
137
after needle decompression-> what what does tension pnemo
chest tube removes out air and equalizes air into negative suction to allow lungs to reexpand
138
what to watch for in chest tube
pneumothorax sob
139
Hemothorax what is it result of
Blood in pleural space Usually result of trauma or surgery
140
treatment for all types pnemothroax
Chest tube Surgery
141
Pleurodesis-what does utilize other treatments Hemothorax
stops fluid or air to enter plueral space/ utlize doxycycline or talk to roughen up pleura and allow it to stick to thorax
142
Rib fracture pain when no what what when coughing more significant Other Thoracic Injuries
- pain with inspiration- no wrapping, splint when coughing more significant in elderly
143
Flail chest- what need to know multiple chest wall Other Thoracic Injuries
painful and dangerous- multiple fractures of rib on one side of rib - chest wall sucks in with inspiration and outward with exhalation-paradoxical movemeents
144
Pulmonary contusion- what is it may not Other Thoracic Injuries
internal bruising from trauma - may not see s/s until 12-24 hrs of trauma
145
Smoke inhalation what damage what poison what damages monitor airway why Other Thoracic Injuries
-thermal damage to airway , carbon monoxide poisoning, chemical damages- monitor airway In pt because it can cause edema and airway to close
146
Near drowning- Other Thoracic Injuries
afixiation and aspiration
147
Pulmonary Embolism what happens stems from what
Particulate matter enters venous circulation and lodges in pulmonary vessels Usually stemming from DVT
148
Pathophysiology of PE what embolisms what accumulates//causes that leads to what what's impaired what enters circualtion results in
Clot embolizes Platelets accumulate and chemicals cause vasoconstriction Pulmonary vasoconstriction leads to pulmonary hypertension Ventilation and perfusion are impaired Deoxygenated blood enters arterial circulation Hypoxemia
149
PE Risk Factors history oral prolonged wt age what disease what else
History of dvt Oral contraceptives Prolonged immobility- bedrest/surgery/flyingBirth Obesity edlely Mi/heart failure fractures
150
Respiratory signs and symptoms s c t Assessment for PE
Sob cough tachypnea
151
Cardiac signs and symptoms- what pain cardia tension neck veins decreased Assessment for PE
chest pain tahcycardia hypotension distended neck veins decreased co
152
Lab tests- d a Assessment for PE
-d dimer- elevated means positive dvt/pe Abg- resp alkalosis
153
Diagnostics- c c v Assessment for PE
,chest x ray chest ct with contrast vq scan
154
Management of PE what therapy/what else check what
Oxygen therapy and ABGs VS- ABCs
155
Anticoagulation- x2 Management of PE
heparin drip, warfarin
156
Thrombolytic therapy treats give what does it do Management of PE
- treats massive pe – give tpa at site breaks down clots
157
Support cardiac output iv positive Management of PE
– iv fluids, positive inotropic drugs like digoxin to increase co//
158
Surgical intervention- what main one what filter Management of PE
elbolectomy- get clot out IVC filter catch clot and will catch clot before gets into lungs
159
Medications for PE Treatment what//based on what original bolus-> followed by what->
Heparin- bases on wt and patients repsonse Heparin therapy initiated as bolus(5000-10000 units) followed by continuous infusion( 1000-1500 per hour
160
monitor what with heparin what will it do to that level what normal what's therpatic check how often PE
PTT monitored frequently- increases ptt normal 30-40 seconds- theraptic 1.5-2x that- check every 2-6 hours
161
antidote heparin how does hep work PE treatment
protamine sulfate hep prevents more clots from forming
162
examples usually used route risk Medications low molecular wt heparin PE treatment
Enoxaparin, Deltaparin Usually used to prevent and treat venous thrombosis Route: Administered SQ Risk for bleeding
163
PT- normal- therapeutic INR normal- therapeutic low molecular weight heparins
PT- normal 10-15- want it to be 2x grater then that INR- normal- 0.8-1.2- want ot to be 2-3 for therapy
164
warfarin alters what therapy how long antidote Medications for PE
Alters vitamin K synthesis Therapy for 2-3 months Antidote- vitamin k and ffp
165
warfarin monitor what labs how often first 3 weeks then how often goal of inr Medications for PE
Monitor PT levels and INR- daily for 3 weeks then 2-3 times per week Goal of INR -2-3
166
New Anti-coagulant Drugs r d a is there reversal agent
Rivaroxaban () Dabigatran () Apixaban () No reversal agent yet
167
Prevention of PE what med range a avoiding stop utilize
Prophylactic heparin Range of motion Ambulation Avoiding pressure points Stop smoking TEDS and SCDs
168
when stop anticoagulation preop
3-5 days pre-op
169
may need what if Hx of DVT in less than 1 month Pre-operative Care of Client on Anti-Coagulants
May need heparin or LWMH
170
after surgery what anticoagulants how quick to adminster anticoagulants
heparin IV or LMW and oral warfarin 12 hours after surgery
171
teaching with anticaogualnts what precautions what meds d s e/s s
Bleeding precautions Pain relievers- nsaids can cause thinning Dentistry Sports Enemas/suppositories- might bleed Shaving
172
Pulmonary Hypertension changes in leads to increased
Changes in pulmonary artery leads to abnormal vasoconstriction increased pulmonary artery pressure
173
Pulmonary Hypertension increased risk increases workload leading
Increased risk of clot formation Increases workload of right ventricle, leading to heart failure
174
S/S- Pulmonary Hypertension d f fatal when
dspynea, fatigue , fatal 3-4 years later
175
complications Pulmonary Hypertension s/s
right ventricular hypertrophy right sided heart failure and chronic cough with dyspnea
176
treatment Pulmonary Hypertension
sildenafil(viagra) relaxes blood vessels and allows blood into tissues
177
Caused by Legionnaires Disease
bacteria in water, circulating in air, fountains, shower heads, AC
178
Legionnaires Disease Causes what treat that with what
Bronchopneumonia-\ treat with floxins and mycins
179
Persons at risk-3x Legionnaires Disease
smokers -elderly, compromised status
180
Legionnaires Disease Signs/symptoms what cough d f h a
-dry cough, dsypnea , fever, headache, anorexia
181
Histoplasmosis- caused by (f/c/d) Fungal Lung Infections
causes by soils from birds or bat droppings fever cough or dyspnea
182
Coccidioidomycosis- where found s/s-if Fungal Lung Infections
mold in soil- asymptomatic- if do appear then look like fever with rashes
183
Fungal Lung Infections Tx- not compatible can cause x4
strong amphotericin b- not compatible woth normal saline can cause n/v/hives and skin blistering
184
Acute Respiratory Failure s/s always failure of x2 normal
always hypoxic oxygenation/ventilation failure normal ventilation w/ decreased perfusion
185
Causes acute respiratory failure a ao c e a c
-asthma, airway obstruction, copd, edema, ards, chf
186
dyspnea on what/might do what full get what Assessment For Acute Respiratory Failure
Dyspnea on mild exertion- might lean forward to breathe better Full respiratory assessment Pulse oximetry
187
ABGs- if hypoventilation- what's retained ph causing Assessment For Acute Respiratory Failure
co2 is retained- low ph causing resp acidosis
188
ETCO2 increased when decreased when Assessment For Acute Respiratory Failure
-increased when vent is low decreased when pulmonary perfusion is impaired
189
therapy/goal treat bed conserve releif breath pressure Interventions Acute Respiratory Failure
Oxygen therapy-may need ventilation or intubation- goal is greater then 90% Treat underlying cause HOB Energy conservation Anxiety relief Cough and deep breathing Pressure-CPAP keeps lung open
190
ARDS persistent decreased pnea bilateral dense
Persistent hypoxemia- Decreased pulmonary compliance Dyspnea bilateral pulmonary edema Dense pulmonary infiltrates
191
ARDS devleops as a leads to leads to
a complication of tissue hypoxia -leads to metabolic acidosis and sepsis- leads to multiorgan failure and death
192
Common Causes of ARDS s t injuries p s near bypass c
Shock Trauma Nervous system injuries Pancreatitis Sepsis Near drowning Cardiopulmaory bypass Covid 19
193
Manifestations of ARDS d a use of changes s/r
Dyspnea Anxiety Intercoastal/accessory muscles Mental status changes Stridor and retractions
194
Manifestations of ARDS pnea what hypoxemia what lung sounds what color
Tachypnea Refractory hypoxemia- does not improve with 02 Crackles/bronchi in lungs Cyanosis
195
Diagnostic testing Medical Care of Client With ARDS
chest x ray and abg
196
Medications- Medical Care of Client With ARDS
antibiotics and steroids
197
Medical Care of Client With ARDS careful use of nutrition correct
Careful fluid replacement- Use of Swan Ganz catheter Nutrition- tpn Correct underlying condition
198
main medical care with ARDS
Mechanical ventilation with PEEP
199
what position what does ARDS
Prone position open airways and lungs by pushing dirapagm
200
Nursing Interventions ARDS position n o a care t
Positioning-PRONING Nutrition Oxygenation Assessment Skin care Teaching and emotional support
201
Intubation and Ventilation 1-h 2-progressive_ w/ 3- to
Hypoxemia Progressive hypoventilation with respiratory acidosis To conserve energy
202
Oral endotracheal tube- secure no most Intubation Types
difficult to secure, no communication -most common inital
203
tracheostomy no what tube can emergency when what in place keep what at bedside
No natural warming and humidification, tube can become dislodged- emergency especially in first 72 hours, sutured in place, keep obturator and trach kit at bedside
204
trach care what for cleaning what for stoma
½ H2O2 and sterile water or NS for cleaning the plastic , only NS for stoma
205
Preparing- Intubation creating giving
creating pt airway giving oxygen
206
Tube placement- Intubation do what right away measure listen
- document right away measuring form teeth- listen to lung sounds bil to see correct spot
207
Stabilizing- where Intubation
securing to mouth nose or neck
208
Keep the trach midline- no on one side Intubation
no pressure- pressure on one side can cause narrowing
209
Mechanical pressure injury- if when Intubation
if too much air is pushed in at one time
210
Assessment intubation p need for __assessment adequate sounds
Placement Need for suctioning Chest assessment Adequate sedation Lung sounds
211
Mechanical Ventilation goals is not
Goals- have for for shortest period or time Is not a cure
212
long term mechanical ventilation short term mechanical ventilation
Long term-MD, SCI, ALS Short term- any resp issue/ post mi or cpr, ards, pe brain surgery
213
Synchronized Intermittent Mandatory Ventilation- Ventilator Modes
patient breathes spontaneously between vent breaths
214
Assisted control used triggered by if Ventilator Modes
most often used- triggered by inspiratory effort , if effort is low, the vent kicks in
215
CPAP- all maintain Ventilator Modes
all breathing triggered by patient, maintains the airway
216
Ventilator Controls and Settings tidal volume rate fraction
Tidal volume- 500-750ml Rate-12-15/min for adults Fraction of inspired O2 (FIO2)- adjusted per the ABGs
217
If vent is alarming figure out why ventilatior tube occluded tachypenic bradypenic
TO-suction needed T--need sedation or slow breathing B--requires different vent setting
218
a u dry pneumonia-> s e p ulcer tubes Potential Complications of ventilator
Anxiety Uncomfortable Dry mucous membranes Pneumonia-frequent oral hygiene- hob raised- every 2 hours- early weening, standard precautions Subcutaneous emphysema Pneumothorax Stress ulcers Og/ng tube
219
Nursing Management-Ventilators Assess client’s response- Assess anxiety suction
Assess client’s response- vs, breath sounds, abg Assess anxiety- are they tachypnea Suction- clear airway –unable to swallow
220
nursing Management-Ventilator education communication always do what
Education-why they are restrained and cant speak Communication- cant speak with tube- might be restrained//if no restraint white board Always treat client first-
221
Nursing’s role in Weaning From Ventilator
-monitors for patients readiness to start weaning
222
if Concern for pneumonia, who does extruding Weaning From Ventilator
get them off of the vent ASAP keep on trialing them MD, and RT
223
Prevent Infection/pnemonia h care bed food s Weaning From Ventilator
HH, trach care , HOB up, NPO, suction
224
Pediatric Concerns kids airway grows higher risk for
kids airway grows until 12 higher risk for obstruction dt small short airway
225
SIDS s/s arrest mouth diagnosed how
cardiopulomary arrest frothy blood secretions from mouth diagnosed on autopsy if no outwards cause
226
SIDS risk factors what race what gender what age what wt what season/why p c what bedding what sleeping second
black males 2-3 month low birth weight winter-blanket positioning cosleepig soft bedding prone or side sleeping second hand smoke
227
Parent teaching for all newborns SIDS what position what at bedtime
Supine, pacifier at bedtime,
228
Laryngotracheobronchitis known as affects caused by
Croup Affects larynx, trachea and bronchi Can be caused by bacteria or virus but usually a virus
229
croup s/s s b sometimes
Stridor, barking cough, sometimes a fever
230
treatment croup expose e c a
expose child to cool air-(freezer, outside) epinephrin corticosteroids albuterol

D-Third semester (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions