Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 205 > Management of Respiratory Problems > Flashcards

Management of Respiratory Problems Flashcards

1
Q

What is an infection?

A

Invasion of the body by a pathogen & resulting signs & symptoms that develop in response to the invasion

May be localized or systemic

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

What’s the most common cause of infection?

A
  • Bacteria
  • Viruses
  • Fungi
  • Protozoa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are bacteria?

A

One-celled micro-organisms

Many considered normal flora

Cause disease when they:

  • enter body & grow inside cells (ex: TB)
  • secrete toxins that damage cells (ex: tetanus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are viruses?

A

Not cells like bacteria

Consist of RNA or DNA & a protein envelope

Can only reproduce in the cells of a living organism (ex: HIV, COVID-19)

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

At least 30% of HAIs can be prevented by following infection prevention strategies

A

Resistance: Occurs when pathological organisms change in ways that decrease the ability of a drug to treat disease

Methicillin-resistant Staphylococcus aureus (MRSA)

Vancomycin-resistant enterococci (VRE)

Carbapenemase-producing organism (CPO)

Penicillin-resistant Streptococcus pneumoniae

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

What are Healthcare-Associated Infections (HAIs)?

A

Infections acquired in healthcare settings.

At least 30% of HAIs can be prevented by following infection prevention strategies

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

True or false: An estimated 8000 Canadians die in hospitals each year due to HAIs

A

True

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

When are routine practices initiated?

A

For care of ALL clients in hospitals and health care settings regardless of diagnosis or presumed infection status

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

When are additional precautions implemented? What are the different types?

A

For clients suspected of being infected with epidemiologically important pathogens that can be transmitted by:

  • Air (TB)
  • Droplet (COVID)
  • Contact (direct or indirect; ex: C. diff & MRSA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What PPE is required for contact precautions? (2)

A
  • Gown

- Gloves

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

What PPE is required for droplet precautions? (2)

A
  • Mask

- Goggles/face shield

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

What PPE is required for droplet precautions? (1)

A
  • N95 mask
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Atelectasis?

A

Condition in which all or part of a lung becomes airless and collapses

Alveoli become deflated

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

What are the causes of Atelectasis?

A

Alveolar collapse may be the result of

  • Retained secretions in airway
  • Suppression of deep breathing & coughing (opioids, sedatives, general anesthesia, pain)
  • Compression
  • Adhesive Atelectasis
  • Most common cause of postoperative hypoxemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risk factors of Atelectasis? (6)

A
  • Smoking
  • Immobility
  • Obesity
  • History of lung disorders (COPD, cystic fibrosis, asthma)
  • Chest or abdominal surgery
  • Chest or abdominal pain from other causes (trauma, pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the possible complications of Atelectasis?

A

Hypoxemia

Lung scarring

Pneumonia

Respiratory failure

  • A small area of atelectasis, especially in an adult is usually is treatable
  • But for a large area, particularly in an infant or in someone with lung disease, can be life-threatening.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are you assessing during the nursing assessment?

A

Past health history

Medications

Surgery

Symptoms:

  • SOB/dyspnea/rapid shallow breathing
  • Coughing/chest pain
  • Low-grade fever
  • Fatigue/N&V
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What physical exam findings do you expect to observe in a pt w/ Atelectasis?

A

Inspection

  • Tachypnea
  • Tracheal shift

Percussion
- Dullness

Palpation
- Decreased chest movement

Auscultation
- Decreased breath sounds

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

How is Atelectasis diagnosed?

A
  • History and physical
  • Chest x-ray
  • Mild leukocytosis
  • Hypoxemia (low blood oxygen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the treatment for Atelectasis?

A

Continuous Positive Airway Pressure

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

What is Leukocytosis?

A

Is a condition characterized by an elevated number of white cells in the blood (WBC)

The increased number of leukocytes can occur abnormally as a result of inflammation or infection

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

What is the normal range for leukocyte counts?

A

Normal leukocyte (WBC) counts are 5-10x109/L or 5000-10,0000/mm3 (microlitres)

23
Q

What is the difference b/w Hypoxemia and Hypoxia?

A

Hypoxemia: low oxygen levels in the blood

Hypoxia: low oxygen levels in the body (tissues)

They may or may not occur together

Generally hypoxemia suggests hypoxia

Hypoxemia is the most common cause of hypoxia

24
Q

How does an oximeter work?

A

A source of light originates from the probe at two wavelengths.

The light is partly absorbed by hemoglobin, by amounts which differ depending on whether it is saturated or desaturated with oxygen.

By calculating the absorption at the two wavelengths the processor can compute the proportion of hemoglobin which is oxygenated

25
Q

What are the ways you can optimize oxygenation and ventilation? (7)

A
  • Positioning
  • Early ambulation
  • Deep breathing & coughing exercises
  • Pain management
  • Energy management
  • Adequate hydration
  • Supplemental oxygen
26
Q

How does positioning help in optimizing oxygenation and ventilation?

A

Patient should be repositioned frequently to promote secretion removal

Should have the affected lung dependent as little as possible

Good lung should be on downward position (optimizes ventilation perfusion) -> gravity is in use so pt can breathe properly

27
Q

How does early mobilization help in optimizing oxygenation and ventilation?

A

Sitting at the bedside/chair/walking is essential for restoring lung function

Keeping the thorax in a straight alignment while they breathe deeply accommodates diaphragmatic descent & intercostal muscle action

Movement helps restore lung function

28
Q

How does deep breathing & coughing exercises help in optimizing oxygenation and ventilation?

A

Deep breath & held for 3 seconds or longer

At least 10 deep, effective breaths per hour [while awake]

These activities help open your lungs & make you cough

29
Q

What kind of pain management may help in optimizing oxygenation and ventilation?

A

Pharmacologic

  • Epidural
  • IV
  • PO

Pre-emptive analgesia

Non-pharmacological

  • Splinting the incision with a pillow or blanket
  • Distraction techniques
30
Q

How does energy management help in optimizing oxygenation and ventilation?

A

Schedule treatment/procedures at times other than feeding to conserve energy for breathing

Plan activities for periods when patient has the most energy

Alternate rest & activity periods to provide activity based on patient’s response & promote increased feeling of accomplishment

31
Q

How does adequate hydration help in optimizing oxygenation and ventilation?

A

The most effective way to thin secretions is through systemic hydration

Drinking or IV fluids
- 2-3 L/day

32
Q

How does supplemental oxygen help in optimizing oxygenation and ventilation?

A

Maintain adequate oxygen saturation, usually 92% or greater

May be lower for patients with COPD e.g. 88%

33
Q

What are the different types of supplemental oxygen?

A

Nasal prongs: flow rate of 1-5/6L delivers O2 concentration of about 28% (i.e. Fi02=28%)

Simple face mask: flow rates of 6-12L can deliver O2 concentrations of 35%-50%

Non-rebreather mask: flow rate minimum of 10L delivers O2 concentrations of 60-90%

Venturi mask: delivers precise high-flow rates, adaptors can be changed to deliver 24%, 28%, 31%, 35%, 40% & 50%

34
Q

What are some complications of oxygen therapy?

A

Combustion

  • Supports combustion & increases rate of burning
  • Display ‘No smoking’ signs in patient’s home

CO2 narcosis

  • Normally CO2 accumulation is major stimulant to breathe
  • Some COPD patients develop a tolerance for high CO2 levels
  • Most COPD patients can tolerate 2L/min via Nasal Prongs
  • Higher flow rates require careful monitoring

O2 toxicity
- Results from prolonged exposure to high levels of O2

Early manifestations: cough, substernal chest pain, nausea, vomiting, sore throat, nasal stuffiness

Later stages: fluid in alveoli, copious sputum

Potential consequences:

  • CNS: seizures
  • Lungs: atelectasis
  • Eyes: visual changes, retinal detachment
35
Q

What is an Incentive Spirometry (IS)? What does it do?

A

Mechanical device

Developed to imitate the natural sigh or yawn & to encourage patient to sustain inspiration for a prolonged time with slow inspiratory flow & deep breaths

It increases abdominal movement

It improves diaphragmatic movement & thus increases lung volume

Causes patient to cough up secretions

36
Q

What is pneumonia?

A

Acute inflammation & infection of lower airway

Incidence decreased since discovery of sulpha drugs & penicillin

Still a significant cause
of hospital admission & death from infectious
disease in Canada

37
Q

What is the etiology of pneumonia?

A

Likely to result when defense mechanisms become incompetent or overwhelmed

Decreased cough & epiglottal reflexes may allow aspiration

Inhaled: microbes present in the air

Mucociliary mechanism impaired

  • Pollution
  • Cigarette Smoking
  • Upper respiratory
  • Infection
  • Tracheal Intubation
  • Aging
38
Q

What are the types of pneumonia?

A

Community-acquired [CAP]

  • Lower respiratory infection of lung with onset in community or during first 2 days of hospitalization
  • Higher incidence in winter
  • Smoking is important risk factor

Hospital-acquired [HAP]
- Occurring 48 hours or longer after admission and not incubating at time of hospitalization

39
Q

What is the most common organism of CAP? Least common organism?

A

Most common causative organism: Streptococcus pneumoniae

Atypical organisms: Legionella, Mycoplasma, Chlamydia, viral

40
Q

What are the modifiable risk factors of CAP?

A

Modifying risk factors (increased risk of infection):

  • COPD
  • Recent antibiotic use
  • Risk of aspiration
41
Q

What are the classifications of CAP?

A

Classify patients to determine antibiotic therapy options:

  • Outpatients with no modifying factors
  • Outpatients with modifying factors
  • Nursing home residents
  • Clients hospitalized on medical wards
42
Q

What is the most common type of organism that causes HAP?

A

Bacteria responsible for majority of HAP infections

Many of the organisms causing HAP enter the lungs after aspiration of the particles from the patient’s own pharynx
- If patient has a feeding tube, make sure they are at 30 degrees or higher

43
Q

What are some pre-disposing factors to HAP?

A

Pre-disposing factor: immunosuppressive therapy, general debility, and endotracheal intubation

44
Q

Who are the ones at greatest risk of HAP?

A

Age 65 years and older

Have chronic illnesses, such as heart, lung, and kidney disease, diabetes, alcoholism, do not have a spleen, or whose spleens do not work well

Have HIV infection, or other conditions associated with an impaired immune system

Live in nursing homes or other chronic care facilities

Have cancer, being treated with chemo/radiation, those on corticosteroids

45
Q

True or false: Pneumococcal Pneumonia is becoming more difficult to treat because some strains of the responsible bacterium have become resistant to treatment with certain antibiotics

A

True

46
Q

True or false: Pneumococcal Pneumonia is a leading cause of death in older adults & people with chronic illnesses

A

True

47
Q

How effective is the Pneumococcal vaccine?

A

A vaccine has been developed to help prevent pneumococcal pneumonia

Can protect against strains of pneumococcus which cause 9 out of 10 cases of pneumococcal disease

Indicated primarily for persons at risk

48
Q

Is the Influenza vaccine recommended?

A

Mainstay of prevention

Recommended annually for high risk individuals (children, senior, healthcare professionals)

49
Q

What are some preventative nursing interventions in regards to pneumonia?

A
  • Encourage those at risk to obtain vaccinations
  • Reposition clients q2h
  • Assist clients at risk for aspiration with eating, drinking & taking meds
  • Follow strict asepsis
50
Q

What are clinical manifestations of pneumonia?

A

Common nonspecific symptoms: fatigue, headache, myalgia, and anorexia

Other symptoms:

  • Fever, sweats or chills
  • Dyspnea
  • Chest discomfort (pleuritic pain)
  • New cough with or without sputum production (or a change in the color of respiratory secretions, in patients with chronic cough)
51
Q

What physical exam findings do you expect to observe in a pt w/ pneumonia?

A

Inspection

  • Dyspnea
  • Tachycardia

Percussion
- Dullness

Palpation

  • Increased tactile fremitus
  • Decreased excursion

Auscultation

  • Bronchial breath sounds
  • Crackles
52
Q

How is pneumonia diagnosed?

A
  • History & physical exam
  • Chest x-ray
  • Sputum Culture & Sensitivity, & Gram’s stain
  • Leukocytosis
  • Hypoxemia
53
Q

What are some nursing interventions for pneumonia? (6)

A
  • Position to minimize respiratory effort
  • Titrate supplemental oxygen as prescribed
  • Administer antibiotics as ordered
  • Promote adequate hydration
  • Pain management & energy management
  • Monitor responses to treatment

NURS 205 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions