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respiratory chapter 12 > part 4 > Flashcards

part 4 Flashcards

1
Q

pt w/ sinus may complain of

A

headache

malasie

bad tase in the mouth

nasal congestion or obstruction

purulent drainage from thw nose

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2
Q

hoarseness and loss of voice (aphonia) are common symptom of

A

laryngitis

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3
Q

if hoarseness or a sore throat that last 2weeks should be what

A

should be noted because this may assist in the early detection of throat malignancy

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4
Q

when assessing an older adult pt it is important to obtain a

what percentage of throat cancer occurs in people who

A

history of alcohol intake throughout adulthood

approximately 90 of throat cancer occurs in people who both smoke and IMMODATERELY DRINK ALCOHOL

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5
Q

cough is moist and deep, often accompanied by rhonchi or wheezing and ends in production of sputum

A

productive cough

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6
Q

is dry and harsh, no sputum is produced

A

nonproductive

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7
Q

what are the early sign of inadequate O2 in the blood

and an assessment starts where

A

restlessness
agitation or
mental confusion
increase heart rate

head to toes

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8
Q

when you are listening to a pt lung sound what are you trying to listen to

A

abnormal sound like

  • adventitous
  • wheezes
  • crackle
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9
Q

what type of sounds are common in pt w/ asthma

A

wheezes

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10
Q

are a whistling, musical, high-pitched around produced by air being forced a narrowed airway

another type of coarse or sonorous wheezing is low-pitched rattling sounds are

A

wheezes

rhonchi

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11
Q

are produce by air passing through moisture in smaller airway

A

Crackles

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12
Q

are high in pitch and can be heard in pt wo have atelectasis, fibrosis, pneumonia or early congestive heart failure

A

fine crackles

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13
Q

fine crackle are heard in pt w/

A
  • atelectasis,
  • fibrosis,
  • pneumonia or
  • early congestive heart failure
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14
Q

are louder and low in pitch and are heard u=in pt w/ bronchitis, pulmonary edema and resolving pneumonia

A

coarse crackle

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15
Q

what do fine crackle sound similar to

A

rubbing hair

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16
Q

which is a grating or scratchy sound similar to creaking shoe leather or opening squeaky door

A

pleural friction rub

17
Q

occur when irritated visceral and parietal pleura rub against each other

what are some s/s

A

pleural friction rub

pain

18
Q

croaking sound can be heard w/out a stethoscope when there is partial obstruction of the upper air passage

A

stridor

19
Q

these sound are typically heard in children w/ croup but can be heard in adults w/ upper airway obstruction

its important to distinguish between airway swelling and foreign body obstruction

A

stridor

20
Q

the inflammation that is producing the obstruction often also affects what which produces

A

it affect the larynx producing hoarseness

21
Q

what the nursing goal for pts w/ a respiratory disorder are

A

Promote oxygenation.

Prevent infection.

Prevent further lung damage.

Promote rehabilitation.

22
Q

effectiveness of intervention for and treatment of pts w/ respiratory disorder is based on what ?

what should your breath sounds show?

what should your pulse oximeter show?

what should your arterial blood gas show ?

what should your lung sound show ?

should there be a decrease or increase in coughing ?

should there be decrease or increase in sputum production ?

would there be a decrease in wheezing ?

sign if infection should what ?

the pt should show report what and show are what and ability to show what ?

A

Improved breathing pattern,

an improvement on the pulse oximeter readings,

an improvement on arterial blood gas values,

an improvement lung sounds.

Decreases in coughing,

sputum production,

yes there should be a decrease in wheezing,

there should be a decrease in signs of infection

Lessened dyspnea and more energy and ability to perform more self-care

Reassessment is an ongoing nursing activity

23
Q

why should you encourage a pt to deep-breath and cough

A

because it helps removes sputum and decrease the like hood of complications like pneumonia

24
Q

agent used to inhibit the cough reflex in the cough center in the brain

A

antitissue

25
Q

what is the most effective method to liquefy secretion so they can be expectorated

A

adequate hydration

26
Q

what type of med can given to soothe the nerve ending in the upper respiratory mucosa ?

the dose of these med are given in what ?

and what should not be taken w it immediately after why ?

A

cough syrup

small amount

water because it rinses off the topical application of the med

27
Q

bacterial infection and chronic respiratory disease the sputum is usually

what should you offer ?
by doing this it helps remove what ?

A
  • foul smelling
  • leaves a bad taste in the mouth and bad breath

mouth care
remove pathogenic microorganism from the oral cavity that will diminished the possibility that they will be aspirated deep into the air passage

28
Q

when is mechanical suctioning is needed

and what type of technique should be used?

A

when the pt cannot clear the airway of excessive amount of secretion

ascetic technique

29
Q

O2 is administered to relieved what

coach the pt to do what

what position is best for a pt w/ dyspnea

A

relief dyspnea

to perform pursed-lip and diaphragmatic breathing

high fowler

30
Q

for serve dyspnea what position is the most effective
and why

whats a other way to allow maximum expansion

A

orthpnea
because the pt has some problem breathing when supine

pt sits upright and lean over the overbed table (which is padded w pillow) and elevated and round the shoulder to allow maximum expansion of the lung

31
Q

what are some risk factor for dyspnea

A

pressure from organ, fluid or tissue below or near the lung

full stomach

abdominal distention from edema

flatus(gas) fecal material

OBESITY

32
Q

the tissue is most sensitive to changes in what

and what does that indicate or what type of s/s is this

A

to changes in oxygen levels including the brain and heart

what indicate hypoxia which shows first in those organ

33
Q

alteration in the brain function included

what show up in the VS if hypoxia is not identified

A

restlessness
anxiety
confusion

the heart rate increases in an attempt to increase O2 delivery

34
Q

whats show the measurement and display pf CO2

A

Capnography

35
Q

is the result of excessive amount of CO2?
and how does it happen ?
what another name for it?

A
  • Hypercapnia
  • it happens by the result of hypoventilation during which the usual amount of CO2 is not eliminated by exhalation
  • hypercarbia
36
Q

is a deficit of CO2

how does it happen and it can result in what?

A

hypocapnia

-it occur from hyperventilation and can result in respiratory alkalosis

37
Q

condition associated w hypocapnia

  1. are those w/ increase what?
  2. those who are taking what ?
  3. and those who are using what ?
A
  1. those in which there is an increase metabolic rate such as thyrotoxicosis, persistent fever, and acute anxiety
  2. salicylate. overdose
  3. improper use of mechanical ventilation
38
Q

what are some (6)signs of respiratory alkalosis?

A 
hyperactive neuromuscular reflexes 
tetany
carpopedal spasm
vertigo
blurred vision
diaphoresis
39
Q

low blood O2 level

low level of tissue O2

A

hypoxemia

hypoxia

respiratory chapter 12 (5 decks)

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