Medsurg hesi 2 respiratory Flashcards

1
Q

asthma: the volume of air blown out as hard and fast as possible during the first second of the most forceful exhalation after the greatest full inhalation.

A

Forced expiratory volume in the first second (FEV1)

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2
Q

asthma: the fastest airflow rate reached during exhalation

A

Peak expiratory flow

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3
Q

asthma: beta2 agonists, such as albuterol (Proventil, Ventolin), provide rapid relief of acute symptoms and

A

prevent exercise-induced asthma

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4
Q

asthma: Anticholinergic medications, such as ipratropium are ___ acting and

A

long-acting and used to prevent bronchospasms

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5
Q

asthma: Methylxanthines, use only when

A

other medications aren’t working

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6
Q

asthma: salmeterol

A

Long-acting beta2 agonist, primarily used for attack prevention.

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7
Q

Salmeterol – Advise client to use to

A

prevent an asthma attack and not at the onset of an attack.

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8
Q

Encourage the client to take prednisone with

A

food

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9
Q

bronchodilator and anti-inflammatory combination: If prescribed for inhalation administration at the same time, administer the

A

bronchodilator first in order to increase the absorption of the anti-inflammatory agent.

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10
Q

This is a life-threatening episode of airway obstruction that is often unresponsive to common treatment

A

Status asthmaticus

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11
Q

Emphysema is characterized by

A

the loss of lung elasticity and hyperinflation of lung tissue

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12
Q

characterized by the loss of lung elasticity and hyperinflation of lung tissue

A

Emphysema

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13
Q

Chronic bronchitis is an

A

inflammation of the bronchi and bronchioles due to chronic exposure to irritants.

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14
Q

Chronic bronchitis is an inflammation of the bronchi and bronchioles due to

A

chronic exposure to irritants

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15
Q

Alpha1-antitrypsin (AAT) deficiency is a risk factor for

A

COPD

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16
Q

COPD includes 2 main things

A

emphysema and chronic bronchitis

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17
Q

Barrel chest or increased chest diameter with

A

emphysema

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18
Q

COPD: you may have Dependent edema secondary to

A

right-sided heart failure

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19
Q

COPD findings of extremities

A

arms and legs thing, clubbing of fingers and toes

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20
Q

In clients who have dark-colored skin or in older adults, oxygen saturation levels

A

can be slightly lower

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21
Q

COPD findings of hematocrit

A

An increased hematocrit level is due to low oxygenation levels.

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22
Q

Comparisons of __ to ___ are used to classify COPD as mild to very severe.

A

forced expiratory volume (FEV) to forced vital capacity (FVC)

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23
Q

Chest x-ray and COPD

A

not often used to dx early stages, more for the advanced disease

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24
Q

a special enzyme produced by the liver that helps regulate other enzymes (that help breakdown pollutants) from attacking lung tissue.

A

AAT

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25
Q

COPD: Increased work of breathing increases

A

caloric demands

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26
Q

COPD: Dyspnea decreases energy available for eating, so

A

soft, high-calorie foods should be encouraged

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27
Q

For pursed lip breathing, instruct the client not to:

A

puff the cheeks

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28
Q

Incentive spirometry: Instruct the client to keep a tight mouth seal around mouthpiece and to inhale and

A

hold breath for 3 to 5 seconds

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29
Q

It is important to recognize in COPD that low arterial levels

A

of oxygen serve as the primary drive for breathing

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30
Q

Omalizumab (Xolair) can cause

A

anaphylaxis

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31
Q

COPD: Encourage the client to eat __ ___ foods to promote energy

A

high-calorie

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32
Q

cor pulmonale

A

Right-sided heart failure

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33
Q

Air trapping, airway collapse, and stiff alveoli lead to increased

A

pulmonary pressures (and eventually cor pulmonale, which is right side failure)

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34
Q

COPD: Blood flow through the lung tissue is difficult. This increased workload leads to

A

enlargement and thickening of the right atrium and ventricle. (and eventually cor pulmonale, which is right side failure)

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35
Q

Right-sided heart failure (cor pulmonale): finding of palpation

A

liver enlarged

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36
Q

TB: The risk of transmission decreases after _____ of antituberculin therapy.

A

2 to 3 weeks

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37
Q

TB: A client will have a positive intradermal TB test within _____ of exposure to the infection

A

2 to 10 weeks

38
Q

TB: Mantoux test should be read in

A

48 to 72 hr

39
Q

TB: Skin test: An induration of _ mm is considered a positive test for immunocompromised clients.

A

5

40
Q

TB: Streptomycin sulfate should only be used

A

for pts with multi resistance

41
Q

TB: Streptomycin sulfate can cause

A

ototoxicity

42
Q

TB: Inform the client that sputum samples are needed every _____ to monitor therapy effectiveness

A

2 to 4 weeks

43
Q

TB: The organism invades the bloodstream and can spread to multiple body organs

A

Miliary TB

44
Q

PE: in the beginning, PaCO2 levels are

A

low (because the person is hyperventilating)

45
Q

These tests provide initial identification of a PE

A

x ray and CT scan (x ray can only show a large PE)

46
Q

dx test where a catheter is inserted into the vena cava to visually see a PE.

A

Pulmonary Angiography

47
Q

to prevent hypotension give streptokinase

A

slowly

48
Q

PE patient Care After Discharge: If the client is homebound, set up home care services to

A

perform weekly blood draws

49
Q

prevention of a PE: Encourage the client to wear

A

compression stockings to promote circulation

50
Q

Advise the client to monitor intake of foods high in _______ if taking warfarin

A

vitamin K (green, leafy vegetables)

51
Q

Vitamin K can reduce the anticoagulant effects of

A

warfarin

52
Q

Patient has PE, what might you hear on auscultation of their heart

A

S3 and S4

53
Q

Decreased cardiac output: Administer inotropic agents (milrinone, dobutamine), to

A

increase myocardial contractility.

54
Q

Decreased cardiac output: ___ may be needed if pulmonary artery pressure is high enough that it interferes with cardiac contractility

A

Vasodilators

55
Q

Decreased cardiac output: Vasodilators may be needed if

A

pulmonary artery pressure is high enough that it interferes with cardiac contractility

56
Q

A tension pneumothorax occurs when air

A

enters the pleural space during inspiration through a one-way valve and is not able to exit upon expiration

57
Q

occurs when air enters the pleural space during inspiration through a one-way valve and is not able to exit upon expiration

A

tension pneumothorax

58
Q

the most important complication of tension pneumothorax

A

the increase in pressure compresses blood vessels and limits venous return, leading to a decrease in cardiac output.

59
Q

As a result of a tension pneumothorax, air and pressure continue to rise in the pleural cavity, which causes a ___ ___

A

mediastinal shift

60
Q

A flail chest occurs when

A

several ribs, usually on one side of the chest, sustain multiple fractures

61
Q

Tracheal deviation to the unaffected side suggests

A

tension pneumothorax

62
Q

How will a thoracentesis feel to the client

A

When the needle is inserted into the lung, some pressure may be felt, but no pain.

63
Q

When the amount of blood pumped by the heart decreases as intrathoracic pressure rises, _____ develops.

A

Hypotension

64
Q

the inability of the injured side of the chest to expand adequately upon inhalation and contract upon exhalation.

A

Flail chest

65
Q

Flail chest caused by rib fractures is often related to

A

car crash or CPR

66
Q

Acute respiratory failure (ARF) is caused by failure to adequately

A

ventilate and/or oxygenate.

67
Q

Acute respiratory failure (ARF): PaO2 less than __ mm Hg

A

60

68
Q

Acute respiratory failure (ARF): SaO2 less than

A

90%

69
Q

___ is the result of a viral infection from a mutated strain of the coronaviruses, a group of viruses that also cause the common cold.

A

SARS

70
Q

SARS is the result of a viral infection from a mutated strain of the

A

coronaviruses, a group of viruses that also cause the common cold.

71
Q

Severe acute respiratory syndrome (SARS): The virus does not spread to the

A

bloodstream because it flourishes at temperatures slightly below normal core body temperature.

72
Q

Orthopnea

A

difficulty breathing lying flat

73
Q

Chest x ray showing Diffuse infiltrates and white-out or ground-glass appearance

A

ARDS

74
Q

Chest x ray showing cardiomegaly

A

ARF

75
Q

Chest x ray showing infiltrates

A

SARS

76
Q

Pulmonary capillary wedge pressure with ARDS is usually

A

low or within the expected reference range

77
Q

often is used to prevent alveolar collapse during expiration.

A

PEEP

78
Q

Medication: Reduces WBC migration, decreases inflammation, and helps stabilize the alveolar-capillary membrane during ARDS

A

prednisone

79
Q

Corticosteroids: administer with an __ __ medications

A

anti-ulcer

80
Q

PEEP is added to the ventilator setting to

A

increase oxygenation and improve lung expansion

81
Q

special kinetic bed

A

rotates laterally alters client positioning to reduce atelectasis and improve ventilation.

82
Q

Blocked endotracheal tube is indicated by ___-pressure alarm on ventilator

A

high

83
Q

a neuromuscular blocking agent given to facilitate

ventilation and decrease oxygen consumption.

A

Vecuronium

84
Q

A client who experienced a near-drowning incident is at risk for developing ___ due to trauma to the lungs and cerebral edema

A

ARDS

85
Q

A client following coronary artery bypass graft surgery is at risk for developing ___ due to trauma to the chest.

A

ARDS

86
Q

A client who experienced a drug overdose is at risk for developing ARDS due to

A

damage to the central nervous system

87
Q

Administration of _____ should be included in the plan of care for SARS. They are used to vasodilate the client’s airway

A

bronchodilators

88
Q

an ultrasound of the heart

A

echocardiogram

89
Q

echocardiogram is used to diagnose

A

valve disorders and cardiomyopathy.

90
Q

echocardiogram: Instruct the client to lie on

A

left side and remain still.