module 10: respiration

Question 1

pulse oximetry

Answer 1

measures SpO2 (peripheral arterial oxyhemoglobin saturation)

Question 2

this affects accuracy of reading

Answer 2

low hemoglobin; if SpO2 < 80%

Question 3

ideal oxygen saturation

Answer 3

98-100%

Question 4

normal oxygen saturation

Answer 4

95-100%

Question 5

giving O2 in an emergency:

Answer 5

can administer when there is a clear clinical indication and then get order later; up to 2L nasal cannula or venturi mask

Question 6

start O2 therapy is SpO2 is below

Answer 6

92%

Question 7

humidified oxygen

Answer 7

used for high-flow O2 rates (>6L/min); uses distilled or sterile water to liquify secretions and hydrate mucous

Question 8

venturi mask

Answer 8

delivers the most precise concentration of O2

Question 9

oxygen delivery for very sick patients

Answer 9

non-rebreather and high-flow nasal cannula

Question 10

nebulizer

Answer 10

disperses fine particles of liquid medication into respiratory tract; delver inhaled medications; continue until all of medication has been aerosolized

Question 11

metered dose inhalers

Answer 11

deliver a controlled dose of medication with each compression; bronchodilators, mucolytic agents, corticosteroids

Question 12

dry powder inhalers

Answer 12

small capsule or disk is inserted into dry powder inhaler and made into a powder; flow of med is activated by patient breath (powerful inspiration)

Question 13

deep breathing

Answer 13

in through nose and out through mouth; used to overcome hyperventilation; exhale longer than inhale

Question 14

pursed lip breathing

Answer 14

prolong exhalation by creating a smaller opening for air movement; can help feelings of dyspnea or panic

Question 15

diaphragmatic breathing

Answer 15

breathe in letting abdomen protrude; breathe out through pursed lips while contracting abdomen muscles; reduces RR, increases alveolar ventilation, promotes effective expiration; kids are normally abdomen breathers; singers and sports; can help COPD

Question 16

incentive spirometry

Answer 16

provides visual reinforcement for deep breathing; promotes optimal gas exchange and secretion expectoration; measures max inhalation in mL; inhale as much as possible, hold for 3 secs, exhale as much as possible

Question 17

splinting

Answer 17

placing a pillow on abdomen over sutures during deep breathing or productive coughing post surgery

Question 18

chest physiotherapy (CPT)

Answer 18

mobilizes/loosens secretions to increase mucus clearance; includes percussion, vibration, and postural drainage; not recommended for pneumonia, COPT or post-op

Question 19

sputum culture

Answer 19

can be suctioned or coughed up

Question 20

ventilation

Answer 20

moving air in/out of lungs

Question 21

respiration

Answer 21

gas exchange between atmospheric air and alveoli

Question 22

normal respiratory system requires:

Answer 22

integrity of airway system, functioning alveolar system, functioning cardiovascular system for perfusion

Question 23

upper respiratory tract

Answer 23

nasal cavity, pharynx, larynx

Question 24

lower respiratory tract

Answer 24

trachea, bronchi, lungs

Question 25

active phase of ventillation

Answer 25

inspiration; requires muscles to bring air into lungs

Question 26

passive phase of ventillation

Answer 26

expiration

Question 27

cigarette smoking impacts:

Answer 27

internal cilia of lungs

Question 28

anteroposterior diameter

Answer 28

diameter from posterior to anterior

Question 29

older adults have higher risk for pneumonia due to:

Answer 29

less effective airway clearance, hold onto secretions; less gas exchange due to dec. lung elasticity

Question 30

wheeze caused by

Answer 30

restricted airways; typically on expiration

Question 31

clear sputum

Answer 31

allergies

Question 32

green/yellow sputum

Answer 32

infection

Question 33

bloody sputum

Answer 33

lung cancer

Question 34

normal anteroposterior to transverse diameter

Answer 34

1:2

Question 35

barrel chest AP:transverse ratio

Answer 35

1:1, normal in infants

Question 36

pectus excavatum

Answer 36

congenital indent in chest

Question 37

pectus carinatum

Answer 37

congenital protruding of chest

Question 38

cheyne-stokes respirations

Answer 38

alternating periods of deep, rapid breathing followed by periods of apnea; regular right before death

Question 39

biot's respirations

Answer 39

varying depth and rate of breathing followed by periods of apnea; irregular

Question 40

kussmaul's respirations

Answer 40

hyperventilation caused by ketoacidosis; could be diabetes or for dying pt.

Question 41

point of maximal impulse (PMI)

Answer 41

location where the cardiac impulse can be best palpated on the chest; often the left 5th intercostal space at the midclavicular line

Question 42

adventitious

Answer 42

unexpected/abnormal

Question 43

bronchial breath sound

Answer 43

high pitched; inspiration shorter than expiration; heard over trachea

Question 44

bronchovesicular breath sound

Answer 44

medium pitch; inspiration same length as expiration; heard over main bronchi

Question 45

vesicular breath sound

Answer 45

low pitched inspiration longer than expiration; heard over peripheral lung fields

Question 46

often first respiratory sign of disease

Answer 46

decrease in rate and depth of breathing

Question 47

vesicular breath sounds become bronchial when:

Answer 47

there is fluid/mucus in areas that normally have vesicular sounds

Question 48

crackles

Answer 48

high pitched, discontinuous popping sound; fluid in the lungs; usually during inspiration; usually does not clear with coughing; associated w/ pneumonia and congestive HF; can be fine or coarse

Question 49

fine crackles

Answer 49

brief sounds, like hair rubbing together between fingers

Question 50

course crackles

Answer 50

louder, moist bubbling sounds

Question 51

crackle intervention

Answer 51

fluid restriction, diuretics; get extra fluid out of lungs

Question 52

wheeze

Answer 52

high pitched, continuous on inspiration or expiration, ex is more typical; musical/squeaking; caused by swelling of airway; heard in lower lungs; associated w/ asthma

Question 53

wheeze cause

Answer 53

air passing through narrow airways constricted by swelling, narrowing, secretions, or tumors

Question 54

sonorous wheeze

Answer 54

course wheeze that may clear with coughing

Question 55

wheeze intervention

Answer 55

bronchodilators, hydration, coughing

Question 56

stridor

Answer 56

high pitched, crowing sound typically on inspiration; associated with upper airway obstruction; associated with croup

Question 57

rhonchi

Answer 57

low pitched, continuous snoring or rumbling; usually inspiration and expiration; may clear with coughing; caused by secretions in the large bronchial airways

Question 58

rhonchi interventions

Answer 58

cough and deep breathing, hydration, humidified air, mobilization