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aa Orgo > Medsurg hesi 1 respiratory > Flashcards

Medsurg hesi 1 respiratory Flashcards

1
Q

___ measure lung volumes and capacities, diffusion capacity, gas exchange, flow rates, airway
resistance along with distribution of ventilation

A

PFTs (pulmonary function tests)

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2
Q

Dx test Commonly performed for clients who have dyspnea

A

PFTs (pulmonary function tests)

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3
Q

PFTs: instruct client not to ___6 to 8 hr prior to testing.

A

smoke

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4
Q

PFTs: withhold___ for 4 to 6 hr prior to testing

A

inhalers

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5
Q

ABG: PaO2 range

A

80 to 100 mm Hg

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6
Q

ABG: PaCO2 range

A

35 to 45 mm Hg

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7
Q

Arterial Puncture (for ABG): Obtain a ___ syringe for the sample collection

A

heparinized

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8
Q

Arterial Puncture (for ABG): perform a ___ test prior to the stick

A

Allen’s

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9
Q

Arterial Puncture (for ABG): Place the collected and capped specimen into a basin of ___ and ___ to preserve it

A

ice and water

also should be transported to the lab immediately

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10
Q

Arterial Puncture (for ABG): Accessing the radial artery for sampling may be more difficult with ___ clients because of impaired peripheral vasculature

A

older

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11
Q

Immediately after an arterial puncture,

A

hold direct pressure over the site for at least 5 min.

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12
Q

Immediately after an arterial puncture, hold direct pressure over the site for at least 5 min.
Pressure must be maintained for at least 20 min if the client is

A

receiving anticoagulant

therapy

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13
Q

Arterial puncture is frequently done by a ___ therapist in hospital settings.

A

respiratory

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14
Q

Arterial Puncture (for ABG): Collect waste and specimen. Place ___ on ice for transport to the laboratory immediately.

A

both

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15
Q

Arterial Puncture (for ABG): Assess the arterial ___ upon completion

A

waveform

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16
Q

A _____ is when blood accumulates under the skin at the IV site.

A

hematoma

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17
Q

Arterial Puncture (for ABG): Complication: if a hematoma develops

A

Apply pressure to the hematoma site.

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18
Q

Air embolism: positioning of the client

A

left side, trendelenburg

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19
Q

Monitor the client for a sudden onset of shortness of breath, decrease in SaO2 levels, chest
pain, anxiety, and air hunger.
These indicate

A

air embolism

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20
Q

Bronchoscopy can be performed on clients who are receiving mechanical ventilation by

A

inserting the scope through the client’s ET tube

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21
Q

Bronchoscopy: before the procedure assess for routine use of

A

anticoagulants (risk for bleeding with this procedure)

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22
Q

Bronchoscopy position

A

sitting

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23
Q

Common types of meds for bronchoscopy (beside the anesthesia)

A

sedatives, antianxiety agents, and/or atropine

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24
Q

Bronchoscopy: atropine is used to reduce

A

oral secretions

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25
Q

after Bronchoscopy, assess the client’s level of consciousness, presence of gag reflex, and ability to swallow prior to resuming oral intake (usually takes about __ hours).

A

2

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26
Q

Bronchoscopy: Once the cough reflex returns, the nurse may offer

A

ice chips to the client and eventually fluids

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27
Q

Bronchoscopy: a small amount of ___ ___ ___ is expected afterwards

A

blood tinged sputum

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28
Q

Bronchoscopy: Instruct clients that gargling with __ ___ or using throat lozenges may provide comfort for
soreness of the throat

A

salt water

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29
Q

Administer oxygen therapy to the client as prescribed. _____ can decrease the likelihood of laryngeal edema

A

Humidification

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30
Q

Pneumothorax can occur following a ____ bronchoscopy.

A

rigid

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31
Q

Thoracentesis: Use of an ___ for guidance decreases the risk of complications

A

ultrasound

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32
Q

the collection of pus in a cavity in the body, especially in the pleural cavity.

A

Empyema

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33
Q

Thoracentesis: Percussion, auscultation, ____, or ____ is used to locate the effusion and needle
insertion site

A

radiography, or sonography

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34
Q

Thoracentesis: Changes in ___ ____ in many older adult clients may make it difficult for the provider to
identify the landmarks for insertion of the thoracentesis needle

A

fat deposition

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35
Q

Thoracentesis: The amount of fluid removed is limited to __ L at a time to prevent cardiovascular collapse.

A

1

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36
Q

Chest tubes are removed when

A

the lungs have reexpanded and/or there is no more fluid drainage

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37
Q

Chest Tube 3 chamber Systems: First chamber is for

A

drainage collection

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38
Q

Chest Tube 3 chamber Systems: second chamber is for

A

water seal

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39
Q

Chest Tube 3 chamber Systems: 3rd chamber is for

A

suction control

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40
Q

Chest Tube: The water seal allows air to exit from the pleural space on exhalation and

A

stops air from entering with inhalation

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41
Q

Chest Tube: The height of the sterile fluid in the suction control chamber determines

A

the amount of suction transmitted to the pleural space

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42
Q

Chest Tube: A suction pressure of ___ H2O is common

A

-20 cm

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43
Q

Chest Tube: The application of suction results in continuous

A

bubbling in the suction chamber

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44
Q

Chest Tube: the movement of the fluid level with respiration

A

Tidaling

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45
Q

Chest Tube: Cessation of tidaling in the water seal chamber signals

A

lung reexpansion or an obstruction within the system

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46
Q

prior to the chest tube insertion, fill the

A

water seal chamber

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47
Q

Chest Tube insertion: Prep the insertion site with

A

povidone-iodine

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48
Q

For a pneumothorax, the chest tube tip is positioned

A

up toward the shoulder

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49
Q

For a hemothorax or pleural effusion, the chest tube tip is positioned

A

down

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50
Q

Chest tube insertion: The chest tube is ___ to the chest wall

A

sutured

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51
Q

Chest Tube: Report excessive drainage (greater than __ mL/hr)

A

70

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52
Q

Chest Tube: Report drainage that is

A

cloudy

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53
Q

Chest Tube: Check for expected findings of tidaling in the water seal chamber and continuous bubbling only in the

A

suction chamber

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54
Q

Chest Tube: verify the chest tube’s placement with an

A

x ray

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55
Q

Chest Tube: Keep two enclosed ___ at the bedside

A

hemostats (those scissor/forceps like things)

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56
Q

Chest Tube: Do not strip or ___ tubing; only perform this action when prescribed by the provider

A

milk

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57
Q

Chest Tube: Monitor the water seal chamber for continuous bubbling; this indicates

A

an air leak

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58
Q

Chest Tube: If the tubing separates, the client is instructed to

A

exhale as much as possible and to cough to remove as much air as possible from the pleural space

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59
Q

Chest Tube: If the chest tube drainage system is compromised, the nurse

A

immerses the end of the tube in sterile water to restore the water seal.

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60
Q

Chest Tube: If a chest tube is accidentally removed,

A

an occlusive dressing taped on only three sides of the site

61
Q

Sucking chest wounds, prolonged clamping of the tubing, kinks in the tubing, or obstruction may cause a ___ ____

A

tension pneumothorax

62
Q

Chest Tube removal: one option is to Instruct the client to take a deep breath, exhale, and

A

bear down

63
Q

Chest Tube removal: one option is to Instruct the client to

A

take a deep breath and hold it during chest tube removal.

64
Q

Chest Tube: after removal of the tube, Apply airtight sterile ___ jelly gauze dressing

A

petroleum

65
Q

Liters of O2 for a nasal cannula

A

1 to 6

66
Q

Nasal cannula: Provide humidification for flow rates of __ L/min and above

A

4

67
Q

Disadvantage of a simple face mask: Flow rates of 5 L/min or lower can result in

A

rebreathing of CO2

68
Q

Disadvantage of a simple face mask: Device is poorly tolerated by clients who have

A

anxiety or claustrophobia

69
Q

simple face mask: Use caution with clients who have a high risk of

A

aspiration or airway obstruction

70
Q

Liters of O2 delivered with Partial rebreather mask

A

6 to 11

71
Q

Disadvantage of Partial rebreather mask: Complete deflation of the reservoir bag during inspiration causes

A

CO2 buildup

72
Q

Partial rebreather mask: Keep the reservoir bag from deflating by

A

adjusting the oxygen flow rate

73
Q

Liters of O2 delivered with Nonrebreather mask

A

10 to 15 (highest amount possible except for intubation)

74
Q

Which mask is this: A one-way valve situated between the mask and reservoir allows the client to inhale maximum O2 from the reservoir bag

A

Nonrebreather mask

75
Q

Nonrebreather mask: A ___ ___ ___ situated between the mask and reservoir allows the client to inhale maximum O2 from the reservoir bag

A

one-way valve

76
Q

Which mask is this: The two exhalation ports have flaps covering them that prevent room air from entering the mask.

A

Nonrebreather mask

77
Q

advantage of Venturi mask: delivers

A

the most precise oxygen concentration.

78
Q

advantage of Venturi mask: ___ is not required.

A

Humidification

79
Q

Venturi mask is best suited for clients with

A

chronic lung disease

80
Q

Disadvantages of Venturi mask

A

expensive.

81
Q

Good for clients who do not tolerate masks well

A

Aerosol mask, face tent (fits loosely around the face and neck), and tracheostomy collar

82
Q

Nursing action for Aerosol mask, face tent (fits loosely around the face and neck), and tracheostomy collar: Empty ___ from the tubing often.

A

condensation

83
Q

Nursing action for Aerosol mask, face tent (fits loosely around the face and neck), and tracheostomy collar: Ensure that ___ ___ leaves from the vents during inspiration and expiration.

A

aerosol mist

84
Q

T-piece: This device can be used for clients who have tracheostomies, laryngectomies, or

A

endotracheal tubes (ET)

85
Q

T-piece: Ensure that the exhalation port is ___ and ____

A

open and uncovered

86
Q

3 Signs and symptoms of hypercarbia

A

restlessness, hypertension, and headache

87
Q

Use an oxygen mask with continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), or positive end expiratory pressure (PEEP) as prescribed while the client is on a mechanical ventilator to help decrease the amount of needed

A

oxygen

88
Q

Clients who have COPD rely on ___ ___ of ___ ___ as their primary drive for breathing

A

low levels of arterial oxygen

89
Q

Who is this: Providing supplemental oxygen at high levels can decrease or eliminate their respiratory drive.

A

COPD patients

90
Q

A tube is inserted through the client’s nose or mouth into the trachea. This allows for emergency airway management of the client.

A

ET tube

91
Q

Nasal intubation: This route is not used if the client has a ___ problem.

A

clotting

92
Q

Mechanical ventilation provides __% humidified oxygen

A

100

93
Q

Positive-pressure ventilators deliver air to the lungs under pressure throughout inspiration and/or expiration to

A

keep the alveoli open during inspiration and to prevent alveolar collapse during expiration

94
Q

Mode of ventilation: Client initiates breath and ventilator takes over

A

Assist-control (AC)

95
Q

Mode of ventilation: Client initiates breath and tidal volume will depend upon client’s effort

A

Synchronized intermittent mandatory ventilation (SIMV)

96
Q

Mode of ventilation: Works to keep the alveoli from collapsing during expiration.

A

Positive end expiratory pressure (PEEP)

97
Q

Positive end expiratory pressure (PEEP) allows for ___ levels of oxygen to be used

A

lower

98
Q

Mode of ventilation: Positive pressure supplied during spontaneous breathing. No ventilator breaths delivered unless in conjunction with SIMV.

A

CPAP

99
Q

Mode of ventilation: Often used for obstructive sleep apnea

A

CPAP

100
Q

Mode of ventilation: Positive pressure delivered during spontaneous breaths. Different pressures delivered for inspiration and expiration

A

BiPAP

101
Q

BiPAP: No

A

No spontaneous breaths delivered.

102
Q

Mode of ventilation: Often used to wean client from ventilator

A

BiPAP

103
Q

ventilation: Apply protective barriers (___ ___ ___) according to hospital protocol to prevent self-extubation.

A

soft wrist restraints

104
Q

ventilator alarms: Volume (low pressure) alarms indicate a low exhaled volume due to a ___ or ___ ___

A

disconnection or cuff leak

105
Q

ventilator alarms: Pressure (high pressure) alarms indicate

A

excess secretions, kinks, client coughing, pulmonary edema, bronchospasm, and/or pneumothorax.

106
Q

ventilator alarms: Apnea alarms indicate that the ventilator does not detect

A

spontaneous respiration in a preset time period

107
Q

ventilator: Maintain the cuff pressure below __ mm Hg to reduce the risk of tracheal necrosis.

A

20

108
Q

ventilator: Reposition the oral endotracheal tube every __ hr or according to protocol

A

24

109
Q

damage to the lungs by positive pressure

A

Barotramua

110
Q

damage to the lungs by volume delivered from one lung to the other

A

Volutrauma

111
Q

Oxygen toxicity can result from high concentrations of oxygen (typically above __%), long durations of oxygen therapy (typically more than _________)

A

above 50%

more than 24 to 48 hr

112
Q

Mechanical ventilation has a risk of increased thoracic pressure (positive pressure), which can result in ___ ___ ___

A

decreased venous return

113
Q

___ ulcers can be evident in clients receiving mechanical ventilation

A

Gastric ulcers

114
Q

Pneumonia is an inflammatory process in the lungs that __ ___ ___

A

produces excess fluid

115
Q

Pneumonia is triggered by

A

infectious organisms or by the aspiration of an irritant

116
Q

rhinorrhea

A

runny nose

117
Q

Rhinitis: Decongestants, such as _____, constrict blood vessels and decrease edema.

A

phenylephrine

118
Q

the most effective for prevention and treatment of seasonal and perennial rhinitis.

A

Intranasal glucocorticoid sprays (Flonase)

119
Q

rhinitis: Complementary therapies may be helpful such as e____, vitamin __, z___

A

echinacea, vitamin C, and zinc

120
Q

Facial pressure or pain (worse when head is tilted forward)

A

Sinusitis

121
Q

Endoscopic sinus cavity lavage or surgery to relieve the obstruction and promote drainage of secretions may be done as a diagnostic procedure.

A

Sinusitis

122
Q

Clients should be encouraged to begin over-the-counter ____ use at the first
manifestation of sinusitis

A

decongestant

123
Q

Sinusitis: Sinus ___ and ___ ___ sprays are an effective alternative to antibiotics for relieving nasal congestion

A

irrigation and saline nasal

124
Q

Sinusitis: ___ and ____ can occur if pathogens enter the bloodstream from the sinus cavity.

A

Meningitis and encephalitis

125
Q

influenza: Adults are contagious from __ __ before manifestations develop and up to 5 days after they begin

A

1 day

126
Q

Maintain ____ and ____ precautions for hospitalized clients with pandemic influenza.

A

airborne and contact

127
Q

Encourage clients to begin antiviral medications within ___ to ___ hr after the onset
of manifestations

A

24 to 48

128
Q

Influenza Vaccination is encouraged for everyone over

A

6 months of age

129
Q

Influenza Vaccination: pregnant women, and health care providers

A

are at higher risk and require vaccination

130
Q

pneumonia: Obtain specimen before starting

A

abx

131
Q

pneumonia finding: ABGs – Hypoxemia (decreased PaO2 less than __ mm Hg)

A

80

132
Q

albuterol provides

A

rapid relief

133
Q

Cholinergic antagonists (anticholinergic medications), such as ipratropium (Atrovent), block the parasympathetic nervous system, allowing for increased bronchodilation and

A

decreased pulmonary secretions

134
Q

Methylxanthines, such as theophylline (Theo-24), require

A

close monitoring of serum levels due to the narrow therapeutic range.

135
Q

Watch for ___ and ___ for clients taking albuterol.

A

tremors and tachycardia

136
Q

aphthous lesions

A

canker sores

137
Q

aphthous lesions (canker sores) can occur with what kind of med

A

steroid

138
Q

Encourage the client to take glucocorticosteroids with

A

food

139
Q

Hypoxemia that persists despite oxygen therapy is a sign of

A

Acute Respiratory Distress Syndrome (ARDS)

140
Q

Acute Respiratory Distress Syndrome (ARDS) signs include ____ pulmonary edema

A

bilateral

141
Q

A chest x-ray shows an area of density with a “ground glass” appearance

A

Acute Respiratory Distress Syndrome (ARDS)

142
Q

Acute Respiratory Distress Syndrome (ARDS): Blood gas findings demonstrate high levels of carbon dioxide (hypercarbia) even though

A

pulse oximetry shows decreased saturation (so despite what the POX says, they do in fact have high CO2)

143
Q

a chronic inflammatory disorder of the airways that results in intermittent and reversible airflow obstruction of the bronchioles.

A

Asthma

144
Q

Asthma: The obstruction occurs either by

A

inflammation or airway hyperresponsiveness.

145
Q

Manifestations of asthma: excessive ____ production

A

mucus

146
Q

early in an asthma attack, the CO2 level will be

A

low

147
Q

late in an asthma attack, the CO2 level will be

A

high

148
Q

the most accurate tests for diagnosing asthma and its severity.

A

PFTs (pulmonary function tests)

aa Orgo (196 decks)

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