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module 3-gas exchange > gas exchange > Flashcards

gas exchange Flashcards

1
Q

coughing up blood

A

hemoptysis

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2
Q

shortness of breath when lying down

A

orthopnea

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3
Q

slow, shallow breaths

A

hypoventilation

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4
Q

retain to much co2

A

hypercapnia

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5
Q

not enough co2

A

hypocapnia

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6
Q

breathing to rapid

A

hyperventilation

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7
Q

abnormally low oxygen concentration in the blood

A

hypoexemia

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8
Q

tissue not getting enough oxygen

A

hypoxia

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9
Q

anything that is not supposed to go into the lungs

A

aspiration

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10
Q

collapse of the lung

A

atelectasis

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11
Q

early signs of hypoxia

A

restlessness
hypertension
tachycardia
tachypnea
dyspnea
increase agitation
retraction
altered loc
fatigue

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12
Q

late sign of hypoxia

A

cyanosis
hypotension
increase restlessness
stupor
dyspnea
decrease respiration
bradycardia
arrythmia

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13
Q

chronic sign of hypoxia

A

clubbing

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14
Q

how to diagnose chronic bronchitis

A

cough and sputum production on most days for 3 months of a year for 2 consecutive years

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15
Q

signs of chronic bronchitis

A

cyanosis
pedal edema
increase hemoglobin
weight gain
gray, white, yellow sputum
jugular vein distention

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16
Q

risk factors of chronic bronchitis

A

smoking
irritants
dust
noxious gases
respiratory tract infection

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17
Q

how is emphysema diagnosed?

A

spirometry

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18
Q

what are the signs and symptoms of emphysema?

A

diminished lung sounds
generally progressive
tripoding
tachypnea
barrel chest
loose elastic recoil of lungs
decrease lung sounds
flat diaphragm
clubbing
mental status change
wheezing

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19
Q

can emphysema be reversed?

A

no

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20
Q

what are the risk factors of emphysema?

A

cigarrete smoking
occupational chemical and dust
air pollution
infection
heredity
aging

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21
Q

how do you get tuberculosis?

A

droplet
close contact

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22
Q

what bacteria is tuberculosis?

A

mycobacterium tuberculosis

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23
Q

how long does it take for mycobacterium to show up on culture?

A

6-8 weeks
slow growing bacteria

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24
Q

how is tuberculosis diagnosed?

A

sputum culture

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25
Q

what are the signs and symptoms of tuberculosis

A

fatigue
weakness
weight loss
night sweats
low grade fever
malaise
crackles
diminished lung sounds
hemoptysis
productive cough
anorexia

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26
Q

what are the risk factors of tuberculosis?

A

homeless
residents of inner cities neighborhood
foreign born person
drug users
living in working institutions
poverty
immunocompromised
asian decent

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27
Q

what is the ppd looking for to be positive?

A

induration

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28
Q

> 5mm for tuberculosis

A

HIV positive
recent contact with an active TB patient
nodular or fibrotic changes on chest x ray
organ transplant

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29
Q

> 10mm for tuberculosis

A

recent arrivals (>5 yrs) from high prevalence countries
IV drug users
resident/employee of high-risk congregate setting
mycobacterology lab personnel
children <4 years old
infants, children, and adolecents exposed to high risk cate..

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30
Q

> 15mm for tuberculosis

A

person with no known risk for TB

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31
Q

what to teach patient taking antibiotics for TB

A

take treatment for 6-9 months
all medication affects the liver
2-3 weeks considered noncontagious

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32
Q

what precaution is a patient with tuberculosis considered in hospital settings?

A

airborne
negative pressure
surgical mask when going into patient room
and patient must wear mask when leaving room

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33
Q

air in pleural space

A

pneumothorax

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34
Q

blood in the pleural space

A

hemothorax

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35
Q

how to confirm location of chest drain?

A

xray

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36
Q

what should you never do when patient has a chest drain system

A

milk or strip

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37
Q

where should chest drain be located

A

below chest level
keep it from kinks

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38
Q

is chest cavity negative or positive pressure?

A

negative

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39
Q

what are the nursing managements when having a chest drain?

A

vital signs
lung sounds
pain
rr
i&o (leveling) drainage amount

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40
Q

when to notify physician about output of chest drainage?

A

100cc in an hour
infection
if serous sangreous changes to bright red

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41
Q

what do you do if the chest drainage system breaks?

A

put tube in 1” of sterile water to remain negative pressure

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42
Q

what do you do if chest drain is ripped out?

A

place a sterile dressing and do a 3 sided tape and notify MD

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43
Q

does a trach treat lung diseases?

A

no

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44
Q

why is trach placed in a pt?

A

ventilation, airway obstruction, airway protection, or secretions

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45
Q

how is trach performed?

A

planned
emergency
general anesthesia
bedside

46
Q

what are the risks of performing a tracheostomy?

A

thyroid gland damage
erosion of trachea caused by the cuff
collapse of lung
scar tissue in trachea

47
Q

what should you always have at the bedside when patient has a tracheostomy?

A

size smaller trach and obutrator

48
Q

are trach’s permanent?

A

no, not always

49
Q

infection that inflames lungs air sacs

A

pneumonia

50
Q

what are signs and symptoms of pneumonia

A

diminished crackles
muscle aches
dry cough
abd pain
cold in head or throat
fever with shivering
chest pain
n/v
pleural pain
productive cough or dry
tachycardia
tachypnea
dyspnea
malaise

51
Q

what are the risk factors of pneumonia?

A

chronic illness
cancer
abd or thoracic surgery
atelectasis
cold/viral
respiratory infections
influenza
smoking
aspiration

52
Q

how is pneumonia diagnosed?

A

chest xray

53
Q

whats important to get before starting and antibiotic?

A

culture and sensitivity

54
Q

whats a late sign of TB

A

hemoptysis
dyspnea

55
Q

when do you repeat chest xray after having getting antibiotics for pneumonia

A

6-8 weeks

56
Q

what is aspiration pneumonia?

A

inhale something that is not supposed in the lungs, then the lungs get inflamed in 48-72 hours

57
Q

what are the risk factors of aspirations pneumonia?

A

decrease LOC
difficulty swallowing
NG tube
alcohol intoxication
gingivitis
seizures

58
Q

what is community acquired pneumonia?

A

occurs in the community

59
Q

what is the organism that occurs in the community acquired pneumonia?

A

streptococcus pneumonia

60
Q

when does community acquired pneumonia occur most often

A

spring and winter

61
Q

what is hospital acquired pneumonia?

A

it occurs in the hospital 48 hours or more after administration

62
Q

what is palliative care for?

A

pain control
stages of life-limiting illness
whether acute
chronic
terminal

63
Q

what determines if the patient qualifies for hospice care?

A

physician feels patient has at least 6 months to death

64
Q

can patient withdraw from hospice care?

A

yes

65
Q

can patient receive curative treatment when admitting into hospice care?

A

no

66
Q

what are the hospice care settings?

A

home
inpatient settings
acute and long term care facilities
rehabilitation centers

67
Q

can hospice discharge a patient?

A

yes, if patient is not showing decline or if patient begins to show improvement

68
Q

all services provided in the home setting at no extra charge

A

routine home care

69
Q

inpatient stay at a facility provided on an occasional basis for the caregiver to have a break

A

inpatient respite care

70
Q

provided in the home for the management of medical crisis. reverts back to routine care when crisis is resolved

A

continuous care

71
Q

inpatient stay for symptom management that cannot be provided in the home. this is not subject to guidelines for a standard hospital inpatient stay

A

general inpatient care

72
Q

the patient is unaware of his or her terminal state, whereas others are aware

A

closed awareness

73
Q

the patient suspects what others know and attempt to find out details about his or her condition

A

suspected awareness

74
Q

the patient, the family, and the health care professionals are aware that the patient is dying, but all pretend otehrwise

A

mutual pretense awareness

75
Q

the patient, the family. and the health care professionals are aware that the patient is dying and openly acknowledge that reality

A

open awareness

76
Q

general term to describe documents that give instructions about future medical care

A

advanced directives

77
Q

the deliberate act of hastening death. the ana statement on this prohibits the nurse to participated in active euthanasia because it in direct violation of the code for nurses, ethical traditions and goals of the profession, and its covenant with society

A

euthanasia

78
Q

when to call a medical examiner?

A

death upon arrival to the hospital
death occurs within 24 hours of admission to hospital
result of homicide or unnatural means
absence of witness
suicide or circumstances that lead to suspect suicide
dies without having been seen by a licensed provider
child younger than 6 years and death is not expected

79
Q

avoidance, confusion, elation, shock, fear

A

denial

80
Q

frustration
irritation
anxiety

A

anger

81
Q

overwhelmed
helplessness
hostility
flight

A

bargaining

82
Q

struggling to find meaning
reaching out to others
telling one’s story

A

depression

83
Q

exploring options
new plans
moving on

A

acceptance

84
Q

what are the 5 stages of grief?

A

denial
anger
bargaining
depression
acceptance

85
Q

what is the nursing process?

A

assessment
priority/diagnosis
outcome/planning
implementation
evaluation

86
Q

what is tanner’s clinical judgment model

A

noticing
interpreting
responding
reflecting

87
Q

what are the nursing clinical judgement measurement model

A

recognize cues
analyze cues
prioritize hypotheses
generate solutions
take action
evaluate outcomes

88
Q

what are the ABC

A

airway
breathing
circulation

89
Q

how do you use an inhaler?

A

shake inhaler
let all air out
push inhaler
hold for 3 seconds
if needed wait 1 minute then repeat

90
Q

long acting bronchodilator
2x a day
2 inhalations q 6 hours
-abnormal taste
-may cause dizziness, blurred vision

A

anticholinergic

91
Q

-bronchodilator
-smooth muscle relaxer
-s/s theophylline toxicity
-vomiting, diarrhea, seizures
-insomina
-tremors
-restlessness
-usually saved till last when other treatments not working
-should not drink with caffeinated beverages

A

methylxanthine

92
Q

fluicasone, dulera, pulmicort
-anti-inflammatory
- rinse mouth with water after each use and spit water out to avoid fungal infections
-usually 1 or 2 inhalations a day 12 hrs apart
- diarrhea
- respiratory tract infection
-osteoporosis
- cataracts

A

glucocorticoids

93
Q

solu-medrol, deltasone
-anti-inflammatory
-immunosuppressant
-take food to avoid gi upset
- avoid large crowds
- should NEVER stop taking abruptly

A

prednisone

94
Q

mucomuyst
mucolystic- agent
lowers mucus viscocity

A

acetylcysteine

95
Q

-patients can try B6 for neuropathy
-most often given in combination with other medication to help prevent resistant strains of TB
-avoid anything that will further cause liver damage
- 6/9 months if treatmet
- neuropathy
- increase liver enzymes

A

isoniazid inh

96
Q

-not usually given for any other infections but mycobacterial infections
-warn patients that body fluids may turn reddish orange, will stain soft contact lens
-can interfere with birth control pill/implant
-sun sensitivity

A

rifampin

97
Q

-when combined with rifampin increase chance of liver toxicity
-can cause gout and to be cautious about sensitivity
-n/v
- anemia

A

pyrazinamide

98
Q

-instruct patients to report visual changes and neuropathy to hcp
-generally well tolerated
-optic neuritis

A

ethambutol

99
Q

bacillus of calmette and guerin
-nausea
-increase frequency of urination
-can lead to false ppd

A

bcg vaccine

100
Q

-pnc
-amoxicillin, ampicillin, augmentin
-can be given IM, IV, PO
-remind patient to alernative form of birth control if -they are on oral contraceptives
-observe patient for 30 minutes past injection for allergic reaction
-N/V/D
- c-dff report bloody diarrhea

A

beta-lactam

101
Q

what is chemically similar to PNC

A

cephalosporin

102
Q

-cephalexin, cefdinir, cefimixime, omnicef, rocephin
-if patient consumes alcohol can make them alcohol intolerant for up to 3 days past last dose
-deep IM
-watch for 30 minute after administration
- c-diff report watery bloody diarrhea
-anaphylaxis
-abd pain

A

cephalosporins

103
Q

saved as last resort
- meropenem, imipenem, eratapenem
-iv or im

A

carbapenems

104
Q

mycin drug
-Azithromycin, clarithromycin, erythromycin, fidaxomicin , telithromycin
- best taken on empty stomach
- avoid grapejuice
- may increase blood level of digoxin. warfin, theophylline
-ototoxicity

A

macrolides

105
Q

ciprofloxacin, norfloxacin, levofloxacin, moxifloxacin
- report tendon pain risk for rupture
-take on empty stomach-drink plenty of water
-avoid exposure to sun or artificial sun
-teach patient to cover skin and use sun screen
-

A

quinolones

106
Q

Guaifenesin, mucinex, robitussin chest congestion
- take with a full glass of water
-avoid taking while taking MAOI’s inhibitors

A

expectorant

107
Q

Dextromethorphan and codeine ie. Triaminic dm, delsym, elixsure cough, Theraflu, robitussin dm, Vicks formula 44
-do not use more than 7 days with out seeking medical treatment
-mental altertness

A

antitissive

108
Q

Promethazine with codeine
life threatening respiratory depression

A

antitussive with codeine

109
Q

-2-3 sprays in each nostril BID daily up to 3 days
-must teach patient not to use longer due to rebound congestion
-may affect bp

A

decongestants afrin nasal spary

110
Q
  • do no take longer than 7 days with out consult hcp
    -avoid taking at bedtime to prevent insomnia
A

decongestant pseudoephedrine

111
Q

advise patient to report angioedema or s/s of thromocytipenia
- myalgia
asthenia
headache
fatigue

A

pneumococcal vaccine

112
Q

Afluria, fluarix quadrivalent, fluvirin
- teach patient even after vaccine can still get the flu but should be less severe
-instruct patient to immediately report s/s of guillain-barre syndrome
-advise patient to report severe or unusual adverse reactions following vaccination

A

influenza vaccine

module 3-gas exchange (2 decks)

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