Nursing Science T1Yr2 Flashcards
1
Q
What controls the respiratory system?
Two items
A
Chemoreceptors and Mechanical Receptors
2
Q
What is the function of the respiratory system?
function & involves?
A
Brings oxygen into the lungs and removes carbon dioxide. Involves inhalation and exhalation.
3
Q
What is the role of Chemoreceptors in the respiratory sytem?
A
Respond to gas exchange and central nervous system.
4
Q
What do Mechanical Receptors control in the respiratory system?
3 items.
A
Control muscles, size of the lungs, strength of muscles.
Including diaphragm.
5
Q
What does the mucociliary clearance system contain?
A
Cough and bronchoconstrictions.
6
Q
What does the upper respiratory tract include?
A
Nose, pharynx, larynx and sinuses.
7
Q
What are the 3 types of respiratory conditions?
A
Upper Respiratory Diseases, Lower Respiratory Diseases, Obstructive Pulmonary Diseases.
8
Q
What are impacts of upper respiratory tract diseases?
A
Affects sleep, nutrition, ventilation, O2 supply, smell and taste.
9
Q
What is a deviated septum?
A
Misalignment of the septum.
10
Q
What are the causes of a deviated septum?
A
Trauma, normal childhood growth, congenital defect.
11
Q
What are the affects of a deviated septum?
A
Difficulty breathing, dryness of nasal mucosa (crusting + bleeding), nasal edema.
12
Q
Cause of a nasal fracture…
Most often
A
Caused by trauma to the middle of the face.
Most often
13
Q
What are complications of a nasal fracture?
4 items.
A
airway obstruction, epistaxis, meningeal tears, cosmetic deformity.
14
Q
What are the classifications of a nasal fracture?
3 of them
A
Unilateral, bilateral and complex.
15
Q
What is a Rhinoplasty?
A
Surgery on the nose to remodel or reconstruct the external nose.
16
Q
What is a Septoplasty?
Addition to…
A
Addition to rhinoplasty to reconstruct and remodel the nasal septum.
17
Q
What is an Epistaxis?
A
Nose bleed.
18
Q
What are causes of epistaxis?
8 items
A
Trauma, foreign bodies, dry air, nasal spray misuse, alcohol and drug misuse, anatomical malformation, allergic rhinitis, tumors.
19
Q
Is anterior bleeding with epistaxis the most common type of bleeding?
Does bleeding usually stop?
A
Yes.
20
Q
Posterior bleeding with epistaxis is most common with…?
secondary too?
A
Older persons secondary to other health conditions.
21
Q
What is Allergic Rhinitis?
A
Inflammation of the nasal mucosa.
22
Q
Symptoms of Allergic Rhinitis
Resembles common cold.
A
Sneezing, itchy eyes, altered sense of smell, watery nasal discharge.
23
Q
How is Acute Viral Rhinitis spread?
A
Airborne droplets or direct hand contact.
24
Q
What is a nursing management for someone who has Acute Viral Rhinitis?
A
Supportive therapy including fluids and rest.
25
What are typical symptoms of Influenza?
Cough, fever, myalgia.
26
What are symptoms that are signs of pulmonary complications in an Influenza patient?
Dyspnea, diffuse crackles in the lungs.
27
What is myalgia?
Muscle pains and aches.
28
What is dyspnea?
Difficulty breathing.
29
What is Sinusitis?
Inflammation of the mucosa blocking the openings in the sinuses.
30
What can cause infection (sinusitis)?
Secretions accumulating behind the obstruction.
31
What is nursing managements for individuals with Sinusitis?
Antibiotics, rest and fluid.
32
What are Nasal Polyps?
| & forms in response too?
Benign mucous membrane masses that form in response to repeated inflammation
33
What can patients experience with Nasal Polyps?
| 2 items.
Discharge and speech distortion.
34
What is Acute Pharyngitis?
Acute inflammation of the pharyngeal walls.
35
What are nursingmanagements for patients with Acute Pharyngitis?
Antibiotics, rest, fluid.
36
What is required to fix Peritonsillar Abscesses?
IV antibiotics, needle to aspirate to drain the abscess, remove tonsils.
37
What is a complete airway obstruction identified as?
| (type)
Medical emergency.
38
What is cough variant asthma?
When patients only present with cough as a symptom.
39
What are symptoms of an Airway Obstruction?
Stridor, accessory muscle use, suprasternal and intercostal retractions, wheezing, restlessness, tachycardia and cyanosis.
40
What is a tracheotomy?
| why get this?
Surgical incision into the trachea to get an airway.
41
What is a tracheostomy?
The opening that results from tracheotomy.
42
Indications to get a tracheotomy are...
Obstruction, remove secretions, long-term ventilation.
43
Where can Laryngeal Polyps develop?
| from?
Vocal cords from abuse or irritation.
44
Can you block a Lary Tube after a Laryngectomy?
No.
45
What is Asthma?
Chronic inflammatory disorder of the airways.
46
What are key characteristics of Asthma?
Cough, wheezes, chest tightness, dyspnea.
47
What is Early-Phase Asthma Response triggered by?
Allergens or irritants attach to immunoglobulin E receptors on mast cells.
48
What are clinical effects of Early-Phase Response in Asthma?
Bronchospasm, increased mucus and sputum, edema.
49
When does Late-Phase Response to Asthma peak?
5-12 hours after exposure.
50
What are triggers of Asthma attacks?
| 7 items.
Allergens, tobacco smoke, respiratory infections, sinusitis, exercise, cold/dry air, stress.
51
What is the Asthma triad?
Nasal polyps, asthma and sensitivity to asprin and NSAIDs.
52
What are clinical manifestations of Asthma?
| 11 items.
Wheezing, breathlessness, chest tightness, coughing, hypoxemia, increased pulse and BP, increased resp rate, accessory muscle use, difficulty speaking in sentences, 2-5 word dyspnea.
53
What is Optimal Asthma Control?
Absence of asthma symptoms, the need for rescue bronchodilator, normal pulmonary function.
54
What is Status Asthmaticus?
| Type of medical emergency? Form?
Most extreme form of acute asthma attack and a life-threatening medical emergency.
55
How is Status Asthmaticus characterized?
Hypoxia, hypercapnia, acute respiratory failure.
56
What is hypoxia?
Low oxygen level in the tissues.
57
What are the 2 diagnostic measures considered for Asthma?
Symptoms and variable airflow obstruction.
58
What are the 2 categories for medical therapy for Asthma?
Relievers and controllers.
59
What are relievers in medical therapy for Asthma?
| Why? Given?
Rescue medications to ease symptoms, given intermittently.
60
What are controllers in medical therapy for Asthma?
| For? Given?
Maintenance therapy, typically used BID for long-term suppression of inflammation.
61
What are are salbutamol and ipratropium?
| Classification, medical therapy?
Bronchodilator and reliever.
62
What are INH flucticasone and oral prednisone?
| Classification, medical therapy?
Corticosteroids and controllers.
63
What is IgE (Immunoglobulin E)?
Antibody that helps the body fight off foreign bodies like bacteria or viruses.
64
What do antiluekotriences do?
They block actions of leukotrienes which are potent bronchodilators.
65
What are the purpose of corticosteroids?
They reduce bronchial hyper-responsiveness by blocking late-phase responses and inhibit inflammatory cells.
66
What is COPD?
An enhanced chronic inflammatory response in the airways and lungs.
67
What are symptoms of COPD?
| 4 items.
1. Dyspnea
2. Difficulty breathing
3. SOB
4. Limitations in activity.
68
In advanced COPD, what can be affected?
Skeletal muscles, right sided heart failure, secondary polycythemia, depression, altered nutrition.
69
What are the defining features of COPD?
| 3 items.
1. Airflow limitations during forced exhalation
2. Airflow obstruction
3. Air trapping
70
Diagnosis of COPD should be considered when...?
| Shows symptoms of...
Cough, sputum production, dyspnea, hx of smoking or exposure to risk factors.
71
What is AECOPD?
Acute exacerbations of chronic obstructive pulmonary disease.
72
Mild AECOPD is determined by...?
Worsening or new respiratory symptoms whichout a change in prescribed medications.
73
What is needed for moderate AECOPD?
Prescribe antibiotic and/or corticosteroid.
74
What is needed for severe AECOPD?
Hospital admission or emergency department visit.
75
What is lung volume reduction surgery?
| Allows for?
Reduces lung size. Room for remaining alveoli to function is increased.
76
What is a Bullectomy?
Surgical removal of bulla intended to decompress adjacent lung parenchyma.
77
What is Cystic Fibrosis?
Multisystem disease characterized by altered function of the lungs, pancreas, and sweat glands.
78
How is CF characterized?
Chronic airway infection.
79
What are 3 critical life-threatening complications of CF?
1. Pneumothorax
2. Massive hemoptysis
3. Respiratory failure
80
What is a flutter mucus clearance device?
Causes airway fibration which loosens mucus from walls intermittently increasing endobronchial pressure.
81
What is Acute Bronchitis?
| also caused by...? Viral or not?
* Inflammation of the bronchi in the lower respiratory tract
* Caused by infection
* Viral
82
What are the types of pneumonia?
| 5 items.
1. Community-acquired pneumonia (CAP)
2. Hospital-acquired pneumonia (HAP)
3. Fungal
4. Aspiration
5. Opportunistic
83
What is Tuberculosis (TB)? How is it spread?
* Infectious disease caused by myobacterium tuberculosis.
* Airborne.
84
What are clinical manifestations of TB?
| 6 items.
* Fatigue
* Malaise
* Anorexia
* Weight loss
* Low fevers
* Night sweats
85
What is Bronchiectasis?
Permanent, abnormal dilation of 1 or more large bronchi.
86
What are clinical manifesations of bronchiectasis?
Persistent recurrent cough with production >20mL of purulent sputum her day.
87
What is a lung abscess?
A pus-containing lesion of lung parenchyma that gives rise to a cavity formed by necrosis of lung tissue.
88
Clinical Manifestations of a lung abscess...?
| Onset?
* Cough producing purulent sputum, fever, chills, dyspnea, weight loss.
* Onset is insidious.
89
What is a Nursing Management for a lung abscess?
Abx given for prolonged period.
90
What is Pneumoconiosis?
Environmental or occupational lung diseases result from inhaled dust or chemicals.
91
What is the leading cause of cancer related death in Canada?
| Type?
Lung cancer.
92
What is the most significant and first reported symptom of lung cancer?
Persistent cough, may be productive.
93
What are diagnostic studies for lung cancer?
* Chest radiography
* CT scan
* PET scan
* MRI
* Staging
* Screening
94
What is Blunt Trauma?
| What is it and type of injury?
* Body struck by blunt object
* External injury
95
# Related to blunt trauma.
What is contrecoup trauma?
| Example?
An injury as a result of the main injury. Injury on the opposite side of the affected area.
| Ruptured spleen.
96
What is a penetrating trauma?
Foreign body that impales or passes through the body tissues.
97
What is a pneumothorax?
The presence of air in the pleural space.
98
What are 5 types of pneumothorax?
1. Closed
2. Open
3. Tension
4. Hemothorax
5. Chylothorax
99
What are clinical manifestations of a small pneumothorax?
* Mild tachycardia
* Dyspnea
100
What are the clinical manifestations for a large pneumothorax?
* Respiratory distress
* Dyspnea
* Air hunger
* Decreased O2 saturation
## Footnote
Respiratory distress would include shallow, rapid respirations.
101
What is the most common type of chest injury from trauma?
Fractured ribs.
102
What is flail chest?
A result of multiple rib fractures, causing instability of the chest wall.
103
How will flail chest present?
Affected area will move paradoxically to the intact portion of the chest during respirations.
During inspiration, the affected portion is sucked in.
During expiration, the affeceted portion bulges out.
104
What is the purpose of a chest tube?
To remove air and fluid from the pleural space and restore normal intrapleural pressure so lungs can re-expand.
105
Which pneumothorax has no associated external wound?
Closed.
106
What is a closed pneumothorax?
| Can it reoccur?
* Accumulation of air in the pleural space without an apparent preceded event
* It can reoccur
107
What is an open pneumothorax?
When air enters the pleural space through an opening in the chest wall.
108
What kind of dressing should be covering an open pneumothorax?
Vented dressing.
109
What is a tension pneumothorax?
| Can result in...? Can cause...?
* Rapid accumulation of air in the pleural space
* Can result in open or closed pneumothorax
* Can cause severely high intrapleural pressures affecting the heart and great vessels.
110
Is a tension pneumothorax a medical emergency?
Yes.
111
What is a hemothorax?
| Frequently found with...?
* An accumulation of blood in the intrapleural space
* Frequently found with open pneumothorax
112
What is a chylothorax?
Accumulation of lymphatic fluid in the pleural space due to leak in thoracic duct.
113
What can cause a hemothorax?
* Chest trauma
* Lung malignancy
* Complication of anticoagulant
* Pulmonary embolus
* Tearing of pleural adhesions
114
What can cause a chylothorax?
* Trauma
* Surgical procedure
* Malignancy
115
What are 3 basic compartments of pleural drainage?
1. Collection chamber
2. Water-seal chamber
3. Suction control chamber
116
# Related to pleural drainage.
What is the purpose of a collection chamber?
Receives fluid and air from the chest cavity.
117
# Related to pleural drainage
What is the purpose of a water-seal chamber?
* Acts as a 1 way valve.
* Incoming air enters from the collection chamber and bubbles up through the water.
118
# Related to pleural drainage
What is the purpose of the suction control chamber?
Applies controlled suction to the chest drainage system.
119
# Related to pleural drainage
What is the normal suction pressure that is ordered?
20cmH20
120
# Related to pleural drainage.
Should bubbling in the water-seal chamber be constant?
No.
121
What is a complication involving chest tubes that arises from not taking deep breaths or from splinting?
Pneumonia.
122
# Related to surgical therapy.
What is a thoracotomy?
* A surgical opening into the thoracic cavity.
123
# Related to thoracotomy
What are 2 types of thoracic incisions?
* Sternotomy
* Lateral thoracotomy
124
# Related to surgical therapy
What is VATS
| Why use this?
* Video-assisted thoracoscopic surgery.
* Improves visualization of thoracic cavity.
125
# Related to surgical therapy
What is a lobectomy?
Removal of one lobe of the lung.
| Most common lung surgery.
## Footnote
Indicated for TB, and fungal infections.
126
# Related to surgical therapy
What is a pneumonectomy?
| Why do this?
* Removal of the entire lung.
* Only done when a lobectomy or segmental resection will not remove all diseased tissue.
127
# Related to surgical therapy
What is segmental resection?
| Why do this?
* Removal of one or more lung segments.
* Done to remove segments, insert chest tube, expansion of remaining lung tissue to fill space.
128
# Related to surgical therapy
What is a wedge resection?
| Why do this?
* Removal of small localized lesion that occupies only part of a segment.
* Used for lung biopsy, removing small nodules.
129
# Related to surgical therapy
What is decortication?
| Indicated by...?
* Removal of thick fibrous membrane from visceral pleura.
* Empyema.
130
# Related to surgical therapy
What is exploratory thoracotomy?
| Used for...?
* Incision into thorax to look for injured or bleeding tissues.
* Used for chest trauma.
131
# Related to surgical therapy
What is a thoracotomy not involving the lungs?
Incision into the thorax for surgery on other organs.
## Footnote
Example: hernia repair, open-heart surgery, esophageal surgery, aortic aneurysm repair.
132
What are restrictive respiratory disorders characterised by?
| caused by?
restriction in lung volume caused by decreased compliance of the lungs or chest wall.
132
What is extrapulmonary in relation to restrictive respiratory disorders?
Causes of restrictive lung disease include disorders involving the CNS, neuromuscular, and chest wall.
132
What are the 2 categories of restrictive respiratory disorders?
* extrapulmonary
* intrapulmonary
133
What is intrapulmonary disorders in relation to restrictive respiratory disorders?
causes of restrictive lung disease involving the pleura or the lung tissue.
134
what is a pleural effusion?
the collection of fluidin the pleural space.
135
Where does the pleural space lie?
between the lung and chest wall
136
What is a transudative pleural effusion?
* an accumulation of protein and cell-poor fluid.
* primarily in non-inflammatory conditions.
137
What is exudative pleural effusions?
accumulation of fluid and cells in an area of inflammation.
138
What is transudative pleural effusion caused by?
* increased hydrostatic pressure found in heart failure.
* decrease oncotic pressure from hypoalbuminemia found in chronic liver or renal disease.
139
What does exudative pleural effusion result from?
increased capillary permeability characteristics of the inflammatory reaction.
140
What is empyema?
Pleural effusion that contains pus.
140
What are the symptoms of empyema?
* Fever
* Night sweats
* Cough
* Weight loss
141
What is tx for empyema?
Abx
142
What is trapped lung?
Visceral pleura becomes encased in fibrous peel or rind due to effusion or empyema.
143
What are interstitial lung disease?
acute or chronic disorders with variable degrees of pulmonary inflammation and fibrosis.
144
What is idiopathic pulmonary fibrosis characterized by?
scar tissue in the connective tissue of the lungs as a sequel to inflammation or irritation.
145
What are clinical manifestations of idiopathic pulmonary fibrosis?
* exrtional dyspnea
* nonproductive cough
* inspirational crackles w/ or w/o clubbing
146
What is sarcoidosis?
chronic, multisystem granulomatous disease with an unknown cause that primarily affects the lungs.
147
What is tx for sarcoidosis?
* corticosteroids
* NSAIDs help symptoms but not progression
148
what is pulmonary edema?
abnormal, life-threatening accumulation of fluid in the alveoli & interstitial spaces of the lungs.
149
What medication do you give a patient for chest pain?
Nitroglycerin.
150
what is the most common cause of pulmonary edema?
Left-sided heart failure.
151
what is a pulmonary embolism?
the blockage of pulmonary arteries by a thrombus, fat or air embolus, or tumor tissue.
152
what are clinical manifestations of a PE?
dyspnea, chest pain, and hemoptysis
## Footnote
hymoptysis only occurs in 20% of patients.
symptoms can begin slowly or suddenly.
153
What is a complication of a PE?
pulmonary infarction (death of lung tissue)
## Footnote
This is insufficient collateral blood flow from the bronchial circulation.
154
what is pulmonary hypertension?
elevated pulmonary pressure resulting from an increase in pulmonary vascular resistance to blood flow through small arteries and arterioles.
155
what is PPH (primary pulmonary hypertension)
| characterized by...?
* rare, severe, progressive disease.
* characterized by mean pulmonary arterial pressure >25mmHg at rest and >30mmHg w/ exercise in absense of noticable cause.
156
What are symptoms of PPH?
* dyspnea on exertion
* fatigue
* exertional syncope
* chest pain
* dizziness
157
What is secondary pulmonary hypertension (SPH)?
occurs when a primary disease causes a chronic increase in pulmonary artery pressures.
158
What is tx for SPH?
managing the primary disease and medication tx similar to PPH.
159
what are indications for a lung transplant
* bronchiectasis
* CF
* emphysema
* idiopathic pulmonary fibrosis
* sarcoidosis
* pulmonary hypertension
160
what is emphysema?
lung condition that causes SOB.
161
# Pediatrics Respiratory
What is nasopharyngitis?
A cold.
## Footnote
It is the most common infection of the respiratory tract
162
