Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 240 > NUR 240 ch 19 lower resp > Flashcards

NUR 240 ch 19 lower resp Flashcards

1
Q

Atelectasis

A

closure of collapse of alveoli
described in relation to chest x ray findings and signs and symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

microatelectasis vs macroatelectasis (AKA acute atelectasis

A

micro- not detectable on a chest X-ray
macro- loss of segmental, lobar, and overall lung volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

acute atelectasis occurs often in the ____

A

postoperative setting following thoracic and upper abdominal procedure, ppl who are immobilized, and have shallow monotonous breathing pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Obstructive atelectasis

A

results from a BLOCKAGE that impedes the passage of air to and from the alveoli, reducing alveolar ventilation
most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Obstructive atelectasis results from

A

reabsorption of gas (trapped alveolar air is absorbed into the blood stream)
no additional air can enter alveoli due to the blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of Atelectasis

A

foreign body,
tumor or growth in an airway,
altered breathing patterns,
retained secretions,
pain,
alterations in small airway function,
prolonged supine positioning,
increased abdominal pressure,
reduced lung volumes due to musculoskeletal or neurologic disorders,
restrictive defects,
specific surgical procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of atelectasis

A

“I’m having a hard time breathing” - increased work of breathing
low oxygen levels- hypoxia

tachycardia, tachypnea, pleural pain and central cyanosis (later stage of hypoxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

(atelectasis) What will you hear over after area?

A

decreased breath sounds and crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

diagnostic test for atelectasis

A

chest x ray
pulse oximetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

prevention of atelectasis

A

*frequent turning - SITTING UP RIGHT
*early mobilization
*incentive spirometer
*voluntary deep breathing and coughing
secretion management
pressurized meter dose inhaler

ICOUGH

Incentive spirometry
Coughing and deep breathing
Oral care (brushing teeth)
Understanding (patient and staff education)
Get out of bed at least 3 times a day
Head of bed elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

nebulizer

A

aerosolizes the medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chest physiotherapy

A

movement of secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

chest postural drainage

A

drainage of lung secretions using gravity
trendelenburg, hold meal for one hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

positive end-expiratory pressure (PEEP)

A

simple mask and one way valve system that provides varying amounts of expiratory resistance (10-15 cm H2O)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

With a large pleural effusion that is compressing lung tissue and causing alveolar collapse, treatment may include thoracentesis (removal of the fluid by needle aspiration) or insertion of a chest tube

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bronchoscopy (in atelectasis)

A

used to open an airway obstructed by lung cancer or a nonmalignant lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

if the cause of atelectasis is compression, the goal is to

A

decrease the compression

possibly from a pleural effusion –> thoracentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acute tracheobronchitis

A

inflammation of the mucous membranes of the trachea usually after a viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In acute tracheobronchitis, the inflamed mucosa of the bronchi produces

A

mucopurulent sputum

*** very important to get a sputum culture to identify the specific causative organism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

presentation of acute Tracheobronchitis

A

first- dry, irritating cough, small amount of mucoid sputum
As progresses, dyspnea, stridor, wheezes,
purulent sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

management of acute Tracheobronchitis

A

antibiotics
analgesics
increased fluid intake
cool vapor or steam inhalation
suctioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

nursing management of acute tracheobronchitis

A

bronchial hygiene- increased fluids, coughing
rest
complete full course of antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pneumonia

A

inflammation of the lung parenchyma (portion of the lung involved in gas exchange) caused by bacteria, myobacteria, fungi, and viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

classifications of pneumonia (RELATED TO TIME)

A

o Community-acquired (CAP)
o Health care–associated (HCAP)
o Hospital-acquired (HAP)
o Ventilator-associated (VAP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Community acquired pneumonia

A

acquired from the community or if diagnosed in the first 48 hours of hospital admission
rate of infection increases with age
S. Pneumoniae is the most common cause
among adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

health care associated pneumonia

A

often caused by multidrug-resistant organisms
early diagnosis and treatment is critical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

hospital acquired pneumonia

A

develops after 48 hours of more I hospital
high mortality rate
colonization of multiple organisms due to overuse of antimicrobial agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

signs and symptoms of hospital acquired pneumonia

A

pleural effusion, high fever, tachycardia, increased respiratory rate

most common in debilitated, dehydrated patients with minimal sputum production (older adults)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ventilator associated pneumonia

A

received mechanical ventilation for at least 48 hours
prevention is key

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

pneumonia in immunocomprimised individuals

A

can occur with the use of corticosteroids, chemotherapy, nutrition depletion, use of broad spec antibiotics, AIDS, genetic disorders and long term advanced life support (mechanical ventilation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pneumonia carries a higher morbidity and mortality rate in patients who are ______ than in those who are ______

A

immunocompromised, immunocompetent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Aspiration pneumonia

A

entry of endogenous or exogenous substances into the lower airway.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

some COPD patients only show these symptoms of pneumonia

A

purulent sputum, or slight changes in respiratory symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

diagnosis of pneumonia

A

history (antibiotics in the last 3 months?)
physical exam
chest x ray
blood culture
sputum examination
bronchoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pneumonia prevention

A

pneumococcal vaccination (two types)
1. PCV-13 - covers 13 strains (rec. for 65+, HIV, immunosuppressive, organ transplant, leukemia, asplenia, CKD)
2. one year and one day later PPSV-23

36
Q

Older adults usually have ___ symptoms of pneumonia

A

vague

37
Q

COVID-19 related Pneumonia signs and symptoms

A

fatigue, myalgia, congestion, sore throat, diarrhea

38
Q

COVID-19 related Pneumonia increases risk for

A

thromboembolism which can lead to shock and respiratory failure

39
Q

complications of patients with bacterial pneumonia

A

sepsis, respiratory failure, atelectasis, pleural effusion, delirium

40
Q

pneumonia nursing diagnosis

A

decreased activity intolerance
ineffective airway clearance
impaired gas exchange
ineffective health management

41
Q

fraction of inspired oxygen [FiO2]

A

more aggressive respiratory support measure, administration of high concentrations of oxygen

42
Q

aspiration

A

inhalation of foreign material into the lungs leads to inflammatory reaction, hypoventilation, and ventilation-perfusion mismatch

43
Q

aspiration can cause

A

broncho or lobar pneumonia

44
Q

aspiration prevention

A

swallowing screen
HOB elevated (intubated- endotracheal cuff elevated)
avoid stimulation of gag reflex with suctioning
check placement of tube feeding
soft diet, small bites, no straws

45
Q

pulmonary tuberculosis s/s

A

low-grade fever
cough, nonproductive or mucopurulent, hemoptysis, NIGHT SWEATS , fatigue, weight loss

46
Q

pulmonary tuberculosis tranmission

A

Spreads by airborne transmission through droplets then
moves to other parts of the body such as the kidneys,
bones, and cerebral cortex.

47
Q

TB diagnostic tests

A

history and physical
TB skin test: Mantoux method
TB blood test
sputum culture
sputum testing

48
Q

TB test and what are they looking for

A

Mantoux method (positive= palpable, a bump)

49
Q

primary concern for medical management tof tuberculosis

A

drug resistance

50
Q

treatment of TB and drugs to treat it

A

anti-TB agents for 6-12 month
Isoniazid

51
Q

treatment of TB and drugs to treat it

A

anti-TB agents for 6-12 month
Isoniazid
Rifampin
rifapentine
pyrazinamide
ethambutol
isoniazid + rifampin

52
Q

nursing management of TB

A

promoting airway clearance (copious secretion interfere with gas exchange)
promoting adherence to treatment regimen
promote activity and adequate nutrition
prevent transmission of TB (N95)

53
Q

lung abscess

A

localized collection of pus caused by microbial infection

54
Q

lung abscess is generally caused by

A

aspiration of anaerobic bacteria

55
Q

lung abscess physical exam

A

dullness on percussion
decreased or absent breath sounds with an intermittent pleural friction rub on auscultation

56
Q

pleural friction rub

A

grating or cracking sound

57
Q

lung abscess can lead to

A

empyema (pocket of pus) and bronchopleural fistula (with collection of fluid in the pleura)

58
Q

lung abscess s/s

A

mild productive cough to acute illness, FOUL-SMELLING SPUTUM, leukocytosis, pleurisy, dyspnea, weakness, anorexia, an d weight loss

59
Q

management tof lung abscess

A

chest physiotherapy to drain excess fluid

60
Q

sarcoidosis

A

type of interstitial lung disease that is also an inflammatory, multi-system, granulomatous disease of unknown eitology

61
Q

walking pneumonia

A

mycoplasma pneumoniae

62
Q

correct use of incentive spirometer

A

the patient inhales slowly from the device until no longer able and then holds breath for 6 seconds and exhales

63
Q

vancomycin can cause

A

ototoxicity

64
Q

pluerisy

A

Inflammation of both layers of pleurae
Key characteristic of pleuritic pain is its relationship to respiratory movement

65
Q

plueral effusion

A

fluid collection in pleural space usually secondary to heart failure, TB, Pneumonia, pulmonary infections

66
Q

empyema

A

accumulation of thick purulent fluid in pleural space often with fibrin development, patient will be acutely ill
sings and symptoms similar those of acute pneumonia

67
Q

pulmonary edema

A
68
Q

pleural effusion s/s

A

fever, chills, pleuritic pain, dyspnea
decreased or absent breath sounds, decreased fremits and dull/flat sound on percussion

69
Q

empyema is a complication of

A

bacterial pneumonia or a lung abscess

70
Q

acute respiratory failure

A

deterioration of the gas exchange of the lungs and indicates their failure to provide adequate oxygenation of ventilation for the blood

71
Q

visceral pleura

A

membranes covering the lungs

72
Q

parietal pleura

A

membranes covering the chest wall

73
Q

Acute respiratory failure causes

A

hypoxemia (decrease in arterial oxygen)
hypercapnia (increase in arterial CO2)
respiratory acidosis
impaired ventilation and perfusion mechanisms

74
Q

early and late signs of acute respiratory failure

A

early: restlessness, tachycardia, hypertension, fatigue, headache
late: confusion, lethargy, central cyanosis, diaphoresis, respiratory arrest

75
Q

clinical manifestations of acute respiratory failure

A

accessory muscles, decreased breath sounds

76
Q

medical and nursing management of ARF

A

intubation, mechanical ventilation (depending on severity)
enteral feedings
reduce anxiety

77
Q

endotracheal intubation (why do we use the oral route?)

A

involves passing an endotracheal intubation tube through the nose or mouth into the trachea

oral intubation is preferred because its less risk for infection and trauma, and can accommodate a larger diameter

78
Q

Intubation provides…

A

a patent airway when the patient is in respiratory distress and cannot maintain an adequate airway on their own

79
Q

endotracheal intubation can be left in for

A

14-21 days.
after that, a tracheostomy is required

80
Q

tracheotomy

A

is a surgical procedure in which an opening is made into the trachea

81
Q

immediately after intubation the nurse should

A

check symmetry of chest expansion
auscultate breath sounds anterior and lateral
obtain chest x-ray and capnography

82
Q

ARF is defined as a decrease in arterial oxygen tension (PaO2) to less than 60 mm Hg (hypoxemia) and an increase in arterial carbon dioxide tension (PaCO2) to >50 mm Hg (hypercapnia), with an arterial pH less than 7.35.

A

decreased PaO2 less than 60mmHg (hypoxemia)
increased PaCO2 over 50mmHg (hypercapnia)
decreased pH less than 7.35

83
Q

5mm induration

A

positive for those at risk.
people with HIV, those who have been around someone with HIV,

84
Q

10 mm induration or greater

A

considered significant in people who have normal or mildly impaired immunity.

85
Q

A significant (positive) reaction does not necessarily mean that active disease is present in the body. More than 90% of people who are tuberculin-significant reactors do not develop clinical TB

A
86
Q

sputum specimen for TB

A

if positive for AFB, MAY indicate disease but does not confirm diagnosis

87
Q

key characteristic of pleurisy

A

its relationship to respiratory movement.
Taking a deep breath, coughing, or sneezing worsens the pain

NUR 240 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions