NonInfectious Resp Flashcards
1
Q
Asthma Causes
A
- Inflammation & hyper responsiveness of airways to common stimuli
- Inflamm in mucous membrnes & hyper responsiveness constricts bronchial smooth muscle (bronchospasm)
- Intermittent if well controlled
2
Q
Asthma Triggers
A
- Allergens
- Cold air/poor air quality
- Exercise
- Resp illness/URI
- General irritants
- Microorganisms
- GERD
3
Q
Chest Tube Purpose
A
- Collects air, fluid, or blood from pleural spaces
- allows lung to re-expand
- Prevents air from re-entering the pleural space
4
Q
Chest Tube - 3 Chamber System
A
- Water seal chamber
- Drainage collection chamber
- Suction chamber
5
Q
Chest Tube - Priorities of Nursing Care
A
- Ensure integrity of system
- Promote comfort
- Ensure patency
- Prevent complications
6
Q
Chest Tubes
pt 1
A
- Ensure tht dressing on chest around tube is tight & intact
- Assess for SOA; auscultate lungs
- Check alignment of trachea
- Palpate are for puffiness or crackling tht may indicate subcut emphysema
- Observe for signs of infection at insertion site or excessive bleeding
- Check to see if tube “eyelets” are visible
- Assist pt to deep breath, cough, perform maxima; sustained inhalations
- Do not “strip” chest tube
- Keep drainage system lower than lvl of pt’s chest
7
Q
Chest Tubes
pt 2
A
- Keep chest tube as straight as possible, avoiding kinks & dependent loops
- Ensure all connections are securely taped
- Assess bubbling in water seal chamber (gentle bubbling on expiration)
- Assess for “tidaling”
- Check water lvl in water seal chamber
- CHeck water lvl in suction control chamber, & keep at lvl prescribed by surgeon
- Clamp chest tube only for brief periods to change drainage syste, or when checking for air leaks
- Check & document amnt, color, & characteristics of fluid
8
Q
Chest Tube Emergencies
A
- Tracheal deviation
- Sudden onset or incrd intensity of dyspnea
- Oxygen sat < 90%
- Drainage > 70 L/hr
- Visible eyelets on chest tube
- Chest tube falls out of pt’s chest
- Chest tube disconnect from drainage system
- Drainage in tube stops (in first 24hrs)
9
Q
Asthma Symptoms
A
- Dyspnea
- Chest tightness
- Coughing
- Hypoxemia/Cyanosis
- Tachypnea
- Use of accessory muscles
- Retractions
- Lungs wheezing throughout
- Long breathing cycle (prolonged exhalation)
- Barrel chest (w/ long standing, severe asthma)
10
Q
Asthma Treatment/Nursing Care
A
- Goal: control & prevent episodes improve airflow, relieve symptoms
- Avoidance of Triggers
> edu to avoid triggers, pre medicate prior to or medicate after exposure - Inhalers/Nebulizers
> teach proper use
> use of spacer for meter dose inhalers - Oxygen therapy
> if hypoxia is present
> for acute asthma attack
11
Q
Asthma Medications
A
-
Bronchodilators
> short & long acting beta2 agonists
> cholinergic antagonists
> methylxanthines
> short acting are “rescue drugs” -
Anti-Inflammatory Agents
> corticosteroids
> NSAIDs
> leukotriene antagonists
> immunomodulators
> inhaled corticosteroids are “preventative drugs”
12
Q
COPD Cause - Chronic Bronchitis
A
- chronic exposure to irritants, commonly smoking
- causes inflammation, congestion, mucosal edema & bronchospasm
- only affects are in airways, not alveoli
- production of large amnts of thick mucus
13
Q
COPD Cause - Emphysema
A
- Chronic exposure to irritants cause damage to alveoli & small airways
- Air trapping occurs as aveoli lose elasticity & are destroyed & small airways collapse
- Loss of surface area for gas exchange
- Loss of lung elasticity & hyperinflation of lung
- Abn excretion of proteases, an enzyme tht breaks down the elastin in alveoli
> can be caused by chronic smoking or other irritant to airways
> can be caused by an alpha anti-trypsin deficiency (genetics); blood test can be done to evaluate for this deificiency
14
Q
COPD Assessment/Symptoms
A
- Dyspnea
- Orthopnea
- Cough w/ sputum production
- Use of accessory muscles
- Hypoxemia
- Chronic acidosis
- Weight loss
- Fatigue
- Barrel chest
> caused by hyperinflation of lungs/flat disphragm - Cyanosis
- Clubbing of fingers
- ANXIETY
15
Q
COPD Treatment/Nursing Care
pt 1
A
- Goal: attain or maintain gas exchange w/in pt’s baseline & control symps
-
Oxygen therapy
> keep O2 sat 88-90%
> hypoxic vasoconstriction w/ emphysema -
Positioning
> elevate HOB; tripod positioning - Smoking cessation
- Energy conservation
-
Breathing exercises
> diaphragmatic breathing; purse lip breathing - Nutritional couseling
- Chest physiotherapy (CPT)
- Lung volume reduction surgery
