gas exchange Flashcards
1
Q
coughing up blood
A
hemoptysis
2
Q
shortness of breath when lying down
A
orthopnea
3
Q
slow, shallow breaths
A
hypoventilation
4
Q
retain to much co2
A
hypercapnia
5
Q
not enough co2
A
hypocapnia
6
Q
breathing to rapid
A
hyperventilation
7
Q
abnormally low oxygen concentration in the blood
A
hypoexemia
8
Q
tissue not getting enough oxygen
A
hypoxia
9
Q
anything that is not supposed to go into the lungs
A
aspiration
10
Q
collapse of the lung
A
atelectasis
11
Q
early signs of hypoxia
A
restlessness
hypertension
tachycardia
tachypnea
dyspnea
increase agitation
retraction
altered loc
fatigue
12
Q
late sign of hypoxia
A
cyanosis
hypotension
increase restlessness
stupor
dyspnea
decrease respiration
bradycardia
arrythmia
13
Q
chronic sign of hypoxia
A
clubbing
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
15
Q
signs of chronic bronchitis
A
cyanosis
pedal edema
increase hemoglobin
weight gain
gray, white, yellow sputum
jugular vein distention
16
Q
risk factors of chronic bronchitis
A
smoking
irritants
dust
noxious gases
respiratory tract infection
17
Q
how is emphysema diagnosed?
A
spirometry
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
19
Q
can emphysema be reversed?
A
no
20
Q
what are the risk factors of emphysema?
A
cigarrete smoking
occupational chemical and dust
air pollution
infection
heredity
aging
21
Q
how do you get tuberculosis?
A
droplet
close contact
22
Q
what bacteria is tuberculosis?
A
mycobacterium tuberculosis
23
Q
how long does it take for mycobacterium to show up on culture?
A
6-8 weeks
slow growing bacteria
24
Q
how is tuberculosis diagnosed?
A
sputum culture
25
what are the signs and symptoms of tuberculosis
fatigue
weakness
weight loss
night sweats
low grade fever
malaise
crackles
diminished lung sounds
hemoptysis
productive cough
anorexia
26
what are the risk factors of tuberculosis?
homeless
residents of inner cities neighborhood
foreign born person
drug users
living in working institutions
poverty
immunocompromised
asian decent
27
what is the ppd looking for to be positive?
induration
28
>5mm for tuberculosis
HIV positive
recent contact with an active TB patient
nodular or fibrotic changes on chest x ray
organ transplant
29
>10mm for tuberculosis
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..
30
>15mm for tuberculosis
person with no known risk for TB
31
what to teach patient taking antibiotics for TB
take treatment for 6-9 months
all medication affects the liver
2-3 weeks considered noncontagious
32
what precaution is a patient with tuberculosis considered in hospital settings?
airborne
negative pressure
surgical mask when going into patient room
and patient must wear mask when leaving room
33
air in pleural space
pneumothorax
34
blood in the pleural space
hemothorax
35
how to confirm location of chest drain?
xray
36
what should you never do when patient has a chest drain system
milk or strip
37
where should chest drain be located
below chest level
keep it from kinks
38
is chest cavity negative or positive pressure?
negative
39
what are the nursing managements when having a chest drain?
vital signs
lung sounds
pain
rr
i&o (leveling) drainage amount
40
when to notify physician about output of chest drainage?
100cc in an hour
infection
if serous sangreous changes to bright red
41
what do you do if the chest drainage system breaks?
put tube in 1" of sterile water to remain negative pressure
42
what do you do if chest drain is ripped out?
place a sterile dressing and do a 3 sided tape and notify MD
43
does a trach treat lung diseases?
no
44
why is trach placed in a pt?
ventilation, airway obstruction, airway protection, or secretions
45
how is trach performed?
planned
emergency
general anesthesia
bedside
46
what are the risks of performing a tracheostomy?
thyroid gland damage
erosion of trachea caused by the cuff
collapse of lung
scar tissue in trachea
47
what should you always have at the bedside when patient has a tracheostomy?
size smaller trach and obutrator
48
are trach's permanent?
no, not always
49
infection that inflames lungs air sacs
pneumonia
50
what are signs and symptoms of pneumonia
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
what are the risk factors of pneumonia?
chronic illness
cancer
abd or thoracic surgery
atelectasis
cold/viral
respiratory infections
influenza
smoking
aspiration
52
how is pneumonia diagnosed?
chest xray
53
whats important to get before starting and antibiotic?
culture and sensitivity
54
whats a late sign of TB
hemoptysis
dyspnea
55
when do you repeat chest xray after having getting antibiotics for pneumonia
6-8 weeks
56
what is aspiration pneumonia?
inhale something that is not supposed in the lungs, then the lungs get inflamed in 48-72 hours
57
what are the risk factors of aspirations pneumonia?
decrease LOC
difficulty swallowing
NG tube
alcohol intoxication
gingivitis
seizures
58
what is community acquired pneumonia?
occurs in the community
59
what is the organism that occurs in the community acquired pneumonia?
streptococcus pneumonia
60
when does community acquired pneumonia occur most often
spring and winter
61
what is hospital acquired pneumonia?
it occurs in the hospital 48 hours or more after administration
62
what is palliative care for?
pain control
stages of life-limiting illness
whether acute
chronic
terminal
63
what determines if the patient qualifies for hospice care?
physician feels patient has at least 6 months to death
64
can patient withdraw from hospice care?
yes
65
can patient receive curative treatment when admitting into hospice care?
no
66
what are the hospice care settings?
home
inpatient settings
acute and long term care facilities
rehabilitation centers
67
can hospice discharge a patient?
yes, if patient is not showing decline or if patient begins to show improvement
68
all services provided in the home setting at no extra charge
routine home care
69
inpatient stay at a facility provided on an occasional basis for the caregiver to have a break
inpatient respite care
70
provided in the home for the management of medical crisis. reverts back to routine care when crisis is resolved
continuous care
71
inpatient stay for symptom management that cannot be provided in the home. this is not subject to guidelines for a standard hospital inpatient stay
general inpatient care
72
the patient is unaware of his or her terminal state, whereas others are aware
closed awareness
73
the patient suspects what others know and attempt to find out details about his or her condition
suspected awareness
74
the patient, the family, and the health care professionals are aware that the patient is dying, but all pretend otehrwise
mutual pretense awareness
75
the patient, the family. and the health care professionals are aware that the patient is dying and openly acknowledge that reality
open awareness
76
general term to describe documents that give instructions about future medical care
advanced directives
77
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
euthanasia
78
when to call a medical examiner?
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
avoidance, confusion, elation, shock, fear
denial
80
frustration
irritation
anxiety
anger
81
overwhelmed
helplessness
hostility
flight
bargaining
82
struggling to find meaning
reaching out to others
telling one's story
depression
83
exploring options
new plans
moving on
acceptance
84
what are the 5 stages of grief?
denial
anger
bargaining
depression
acceptance
85
what is the nursing process?
assessment
priority/diagnosis
outcome/planning
implementation
evaluation
86
what is tanner's clinical judgment model
noticing
interpreting
responding
reflecting
87
what are the nursing clinical judgement measurement model
recognize cues
analyze cues
prioritize hypotheses
generate solutions
take action
evaluate outcomes
88
what are the ABC
airway
breathing
circulation
89
how do you use an inhaler?
shake inhaler
let all air out
push inhaler
hold for 3 seconds
if needed wait 1 minute then repeat
90
long acting bronchodilator
2x a day
2 inhalations q 6 hours
-abnormal taste
-may cause dizziness, blurred vision
anticholinergic
91
-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
methylxanthine
92
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
glucocorticoids
93
solu-medrol, deltasone
-anti-inflammatory
-immunosuppressant
-take food to avoid gi upset
- avoid large crowds
- should NEVER stop taking abruptly
prednisone
94
mucomuyst
mucolystic- agent
lowers mucus viscocity
acetylcysteine
95
-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
isoniazid inh
96
-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
rifampin
97
-when combined with rifampin increase chance of liver toxicity
-can cause gout and to be cautious about sensitivity
-n/v
- anemia
pyrazinamide
98
-instruct patients to report visual changes and neuropathy to hcp
-generally well tolerated
-optic neuritis
ethambutol
99
bacillus of calmette and guerin
-nausea
-increase frequency of urination
-can lead to false ppd
bcg vaccine
100
-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
beta-lactam
101
what is chemically similar to PNC
cephalosporin
102
-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
cephalosporins
103
saved as last resort
- meropenem, imipenem, eratapenem
-iv or im
carbapenems
104
mycin drug
-Azithromycin, clarithromycin, erythromycin, fidaxomicin , telithromycin
- best taken on empty stomach
- avoid grapejuice
- may increase blood level of digoxin. warfin, theophylline
-ototoxicity
macrolides
105
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
-
quinolones
106
Guaifenesin, mucinex, robitussin chest congestion
- take with a full glass of water
-avoid taking while taking MAOI's inhibitors
expectorant
107
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
antitissive
108
Promethazine with codeine
life threatening respiratory depression
antitussive with codeine
109
-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
decongestants afrin nasal spary
110
- do no take longer than 7 days with out consult hcp
-avoid taking at bedtime to prevent insomnia
decongestant pseudoephedrine
111
advise patient to report angioedema or s/s of thromocytipenia
- myalgia
asthenia
headache
fatigue
pneumococcal vaccine
112
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
influenza vaccine
