lecture 2 - pulmonary Flashcards
what causes shunting?
compromised intraventricular septum (impaired gas exchange)
what are the clinical manifestations of acidosis?
- CNS depression
- hyperkalemia
- hyperventilation
what are the clinical manifestations of alkalosis?
- CNS excitement
- hypokalemia
- hypoventilation
suctioning is only PRN for patients on ventilation
true
what is the most important thing to look out for in mech vent patients?
infection–they are at a higher risk for VAP
measures for preventing VAP
- oral care q12h
- oral swabs q2-4h
what does excessive suctioning lead to?
tissue damage
what causes positive expiratory pressure?
high peak settings of the ventilator
ventilators can exert a lot of pressure on the thoracic blood vessels
true
manifestations of occluded thoracic blood vessels
- decreased cardiac output
- hypotension
unplanned extubation is a medical emergency and needs to be prevented
true
what are the nursing priorities for planned extubations?
- secure the airway
- assess for stridor (high pitched lung sound)
what does stridor indicate for planned extubations?
- intolerance to procedure
- need for a secure airway
how is lung hygiene managed?
- incentive spirometer
- TCDB
- thin secretions w/ fluids
- ambulation
ventilated patients are at risk for which conditions?
- gastric ulcers
- VTE
- acute kidney injury
VAP is considered a never event
true
what are the breath sounds for a patient with pneumothorax?
diminished
why are neurovascular assessments critical to respiratory assessments?
indicates status of perfusion
what are the manifestations for pneumothorax?
- SOB
- CP
- hypoxia
- diminished breath sounds
what are the types of pneumothorax?
- tension
- open
- spontaneous
why does tension pneumothorax occur subsequent to spontaneous pneumothorax?
built up air pressure in the pleural space can cause a tracheal shift
tracheal shift is an emergency
true
what makes open pneumothorax different from others?
there is no built-up air, the lung is punctured all the way through–air exits the body
what is the intervention for open pneumothorax?
use a dressing taped on 3 sides
what does the dressing for an open pneumothorax do?
lets air out without letting it back in
what is the average tidal volume of the lung?
7-9mL / kg
which conditions can cause respiratory acidosis?
- respiratory depression
- spinal cord injuries
- pulmonary edema
- pneumonia
what are some causes of metabolic acidosis?
- renal failure
- excessive diarrhea
- DKA
what can cause respiratory alkalosis?
- hyperventilation
- high fever
- thyroid toxicity
- psychogenic responses
which events can cause metabolic alkalosis?
- vomiting
- excessive gastric suctioning
- excessive antacids
respiratory compensation
full, partial, uncompensated
what are the nursing actions after a planned extubation?
- warm, humidified O2 via facemask
- oral care
- NPO for extended period
- high fowler’s position
which conditions is the patient at risk for after a planned extubation?
- atelectasis
- pneumonia
what is the nursing action for stridor?
reintubation
need to secure airway due to present adventitious sounds (stridor)
