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concept 4 > med surg resp > Flashcards

med surg resp Flashcards

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1
Q

what procedure should be performed for a patient with a pneumothorax secondary to blunt chest trauma?

A

chest tube insertion connected to a water seal drainage

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2
Q

what procedure should be performed for a pt with pneumothorax secondary to cancer, pleurisy, or tuberculosis

A

thoracentesis

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3
Q

how does a thoracentesis provide relief for a pt

A

removes air or fluid from lungs

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4
Q

measure of air lungs can hold after maximum inhalation

A

total lung capacity

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5
Q

measure of amount of air pt can exhale after maximum inhalation

A

vital lung capacity

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6
Q

measure of amount of air in lungs after normal expiration

A

functional residual capacity

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7
Q

measure of air in lungs after forced expiration

A

residual volume

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8
Q

will tracheostomy with inflated cuff allow pt to speak

A

no

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9
Q

how often should a nurse assess tracheostomy pt for suctioning

A

every 2 hrs

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10
Q

after the pt coughs suctionin for a tracheostomy pt should only be performed if the nurse asses what

A

pt is unable to exporate secretions

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11
Q

where will trachea be deviated in a pt with a tension pneumothorax?

A

unaffected side

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12
Q

what breath sounds will u auscultate on afftected side of a tension pneumothorax

A

none they will be absent

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13
Q

how will neck veins be in a pt with tension pneumothorax

A

distended

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14
Q

breathing rhythm of pt with tension pneumothorax

A

tachypnea

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15
Q

can a pt wear dentures, glasses or contacts during a bronchoscopy

A

no

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16
Q

can a tissue sample be obtained during an endoscopy?

A

yes

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17
Q

what does a friction rub during lung auscultation indicate?

A

pleurisy

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18
Q

what do crackles/rales indicate during lung auscultation

A

pneumonia

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19
Q

increased tactile fremitus is an indication of what

A

pneumonia

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20
Q

how many meals should emphysema pt eat daily

A

4-6 small meals

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21
Q

why should emphysema pts eat 4-6 small meals daily

A

to prevent exhaustion and SOB from big meals

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22
Q

how long will a pt who undergoes a total laryngectomy need a tracheostomy?

A

forever

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23
Q

will a pt who had a total laryngectomy be able to cough and breath deeply after surgery

A

yes and should to clear secretions

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24
Q

can total laryngectomy pts eat immediately surgery

A

no will receive enteral feedings for 7-10 days after surgery

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25
Q

will a pt s/p laryngectomy be able to speak with their normal voice?

A

no they will have no natural voice

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26
Q

what should u do if pt s/p rhinoplasty has edema of nose, eyes and face

A

nothing its an expected finding

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27
Q

how should pts s/p rhinoplasty breath

A

through their mouth

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28
Q

what should u do if pt s/p rhinoplasty has frequent swallowing

A

notify surgeon

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29
Q

why should u notify surgeon of frequent swallowing in pt s/p rhinoplasty

A

could be posterior nasal bleeding/hemorrhage

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30
Q

what is transillumination used for

A

to diagnose occluded sinuses by seeing if light is able to be passed through tissues

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31
Q

can symptoms be used to diagnose lung cancer in its early stages

A

no because cancer is metastasized by time pt shows sxs

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32
Q

what does inspiratory stridor indicate?

A

airway obstruction

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33
Q

what should be done if pt has inspiratory stridor

A

notify rapid response team
give humidified oxygen

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34
Q

how will pts neck be during bronchoscopy

A

hyperextended to align pharynx w trachea so no trauma occurs w scope insertion

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35
Q

signs of inhalation injury

A

-singed hair on face, neck or torso
-trouble talking
-soot in nose/mouth
-confusion/anxiety

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36
Q

why does CO (carbon monoxide) poisoning cause hypoxia

A

CO binds to Hgb faster than Oxygen

37
Q

cherry red skin is a sign of what kind of inhalation injury

A

carbon monoxide poisoning

38
Q

how to treat CO (carbon monoxide) poisoning

A

100% oxygen

39
Q

which side of the chest can u hear the upper lung lobes

A

anterior

40
Q

which side of the chest will u hear lower lung lobes the best

A

posterior

41
Q

what position should pt sit when auscultating lungs

A

semi fowlers

42
Q

what are the 3 normal lung sounds

A

-bronchial
-vesicular
-bronchovesicular

43
Q

how will brochial lung sounds sound

A

-high
-loud
-hollow

44
Q

where can u hear brochial lung sounds

A

over the trachea/larynx

45
Q

can u hear bronchial lung sounds posteriorly

A

no only anteriorly over trachea/larynx

46
Q

what part of breathing will bronchial sounds be longer

A

expiration

47
Q

what of breathing will vesicular sounds be longer

A

on inspiration

48
Q

when will brochovesicular sounds be longer

A

they will be equal on inspiration and expiration

49
Q

how will vesicular breath sounds sound

A

-soft
-low-pitched
-rushing sound

50
Q

where can vesicular sounds be heard

A

anteriorly and posteriorly

51
Q

how will bronchovesicular breath sounds sound

A

medium pitched
hollow

52
Q

adventitious lung sounds are

A

abnormal lung sounds

53
Q

what are the 2 categories of adeventitious lung sounds

A

-discontinuous lung sounds
-continuous lung sounds

54
Q

discrete crackling sounds in the lungs are what category of adventitious lung sounds

A

discontinuous

55
Q

what are the 3 types of discontinuous adventitious lung sounds

A

-fine crackles
-coarse crackles
-pleural friction rub

56
Q

high pitched crackling sounds are what type of discontinuous adventitious lung sounds

A

fine crackles

57
Q

low pitched wet bubbling sounds are what discontinuous adventitious lung sounds

A

coarse crackles

58
Q

low pitched harsh grating sounds are what discontinuous adventitious lung sounds

A

pleural friction rub

59
Q

connected musical sounds are what kind of adventitious lung sounds

A

continuous sounds

60
Q

what are the 2 types of continuous adventitious lung sounds

A

wheezes
stridor

61
Q

high pitched musical with polyphonic sound quality is what continous adventitious breath sound

A

wheezing

62
Q

high pitched whistling/gasping with harsh sound quality is what continuous adventitious lung sound

A

stridor

63
Q

what causes fine crackles

A

deflated airways popping back open (i.e pulmonary edema, asthma, COPD)

64
Q

what causes coarse crackles

A

inhaled air colliding with secretions [anything where fluid in lungs] (i.e pulmonary edema, pneumonia, depressed cough reflex)

65
Q

what causes pleural friction rub

A

surfaces rubbing together during respirations because of pleural inflamation (I.e pleuritis)

66
Q

what causes wheezing

A

air moving through narrow airway (I.e asthma, bronchitis, chronic emphysema)

67
Q

what causes stridor

A

disturbed air flow in larnx or trachea (I.e croup, epiglottitis, airway obstruction)

68
Q

how to diagnose COPD

A

-ABGs
-CXR
-pulmonary function test (spirometry)

69
Q

pt with COPD would have what ratio of FEV1/FVC

A

less than 70%

70
Q

what is FEV1

A

forced expiratory volume

71
Q

what is FVC

A

forced vital capacity

72
Q

what are the 2 types of COPD

A

emphysema
chronic bronchitis

73
Q

s/s of emphysema

A

-barrel chest (hyperinflation of the lungs)
-weight loss
-SOB
-dyspnea

74
Q

what causes barrel chest

A

hyperinflation of the lungs (puffed up lungs)

75
Q

s/s of chronic bronchitis

A

-overweight
-cyanotic
-peripheral edema
-rhonchi
-wheezing
-chronic cough

76
Q

diet education for COPD pt

A

-increase calories
-small frequent meals
-stay hydrated

77
Q

why should COPD increase calories

A

to replace burned calories from breathing

78
Q

why should COPD pts stay hydrated

A

to thin secretions

79
Q

how should COPD pts breath

A

pursed lips
using diaphragm

80
Q

why should COPD pts breath through pursed lips

A

to eliminate CO2 while keeping air passages open

81
Q

what vaccines should be suggested to COPD pts

A

-influenza
-pnemococcal vaccine

82
Q

meds for COPD

A

bronchodilators
corticosteroids

83
Q

how should u give meds for COPD

A

bronchodilator and then corticosteroids

84
Q

corticosteroid suffixes

A

-asone
-inide
-olone

85
Q

what kind of med ends in -asone

A

corticosteroid

86
Q

what kind of med ends in inide

A

corticosteroid

87
Q

what kind of med ends in olone

A

corticosteroid

88
Q

how to diagnose pneumonia

A

-cxr
-wbc
-sputum culture

concept 4 (12 decks)

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