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MEDSURG > PULMO > Flashcards

PULMO Flashcards

1
Q

Number of respiration per minute

A

RATE

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2
Q

12-21 bpm

A

Normal Rate

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3
Q

<12 bpm

A

Bradypnea

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4
Q

> 21 bpm

A

Tachypnea

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5
Q

Give medication (MAMCHOB) at what rate

A

> 16 bpm

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6
Q

DO NOT give medication at what rate

A

< 16 bpm

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7
Q

To promote maximal lung expansion

A

BODY POSTURE

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8
Q

Normal for Body Posture

A

High fowlers/Sitting position

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9
Q

For COPD

A

Tripod/Orthopneic position

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10
Q

For Seizure

A

Side-Lying Position

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11
Q

Objective sign for Seizure

A

Frothy secretions

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12
Q

For Unconscious

A

Side-Lying Position

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13
Q

1 cause of airway obstruction

A

Tongue

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14
Q

Strongest Substance in the body

A

Enamel

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15
Q

Strongest bone(s)

A

Tibia and Femur

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16
Q

Strongest muscle that can carry without any leverage

A

Tongue

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17
Q

Medications that can decrease RR or known as downers

A 
MAMCHOB
Morphine
Alcohol
Meperidine
Codeine
Heroin
Opiates
Barbituates/Benzodiazepine
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18
Q

Nursing Diagnosis for < 8 RR

A

Ineffective Breathing Pattern

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19
Q

Nursing Diagnosis for with Phlegm

A

Ineffective Airway Clearance

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20
Q

Nursing Diagnosis for O2 sat <45%

A

Ineffective Gas Exchange

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21
Q

Regularity of respiration

A

RHYTHM

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22
Q

Normal Rhythm

A

Eupnea

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23
Q

Short period of apnea

A

Cheyne-stokes Respiration

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24
Q

Seen in patients with head injuries, cerebral hemorrhage, when crying (for normal individuals)

A

Cheyne-stokes Respiration

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25
Q

Involves crescendo-decrescendo pattern of respiration

A

Cheyne-stokes Respiration

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26
Q

Hyperventilation due to metabolic acidosis

A

Kausmaul’s Respiration

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27
Q

Clustered severe depressed breathing

A

Biot’s Respiration

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28
Q

Long period of apnea (greater than 30 seconds of apnea)

A

Biot’s Respiration

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29
Q

Worst prognosis and can be seen in dying patients or overdose of narcotics

A

Biot’s Respiration

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30
Q

Sound and effort of breathing

A

QUALITY

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31
Q

Normal quality

A

Soundless and effortless

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32
Q

Vase of the lungs; loudest due to decrease airway size

A

Vesicular

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33
Q

In the Bronchus; in between, there can be loud/soft sound

A

Bronchovesicular

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34
Q

In the Trachea; soft (mahina) due to increase airway size

A

Tubular

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35
Q

Soft whistling (sounds musical)

A

Wheezes

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36
Q

Wheezes can be heard through?

A

Heard during Exhalation and through clinical ears

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37
Q

Cause of Wheezes

A

Due to bronchoconstriction which is common in asthma patients

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38
Q

Harsh, loud sound

A

Stridor

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39
Q

Functions of the respiratory system

A
  1. Provides oxygen for metabolism

2. Maintains acid-base balance

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40
Q

Stridor can be heard through?

A

Heard during Inhalation and through clinical ears

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41
Q

Cause of Stridor

A

Happens due to airway edema

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42
Q

Airway is still open

A

Longer stridor

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43
Q

Airway closed

A

Absence of stridor

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44
Q

If airway is closed, what should be done?

A

Tracheostomy is needed ASAP to open airway

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45
Q

Popping sound

A

Crackles

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46
Q

Crackles can be heard through?

A

Heard ONLY through auscultation

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47
Q

Cause of Crackles

A

Due to fluid-filled lungs/alveoli which is common in patient with pulmonary edema and left-sided heart failure

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48
Q

Grating sound of 2 inflamed pleura

A

Pleural Friction Rub

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49
Q

Pleural Friction Rub can be heard through?

A

Heard through auscultation

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50
Q

Cause of Pleural Friction Rub

A

Due to pleurisy which is common with a patient with pneumonia or water in lungs

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51
Q

Loud, phlegmatic sound

A

Ronchi

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52
Q

Ronchi can be heard through?

A

Either through inhalation/exhalation and through clinical ears/auscultation

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53
Q

Cause of Ronchi

A

Due to excessive secretion; sputum in airway which are common in patients with COPD or smokers

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54
Q

The respiratory system only expels excess CO2 upon exhalation, and not the entire CO2. Why?

A

We still need a little bit of CO2 in our lungs because it is the drive for breathing.

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55
Q

What are the types of cells seen in alveoli?

A

Type 2 Alveolar Cells

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56
Q

What are the functions of Type 2 Alveolar cells

A

They secrete surfactants which reduces the surface tension of alveoli

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57
Q

What happens if there are is decreased surfactant secretion in the Type 2 alveolar cells?

A

No reduction of surface tension, which leads to alveolar collapse

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58
Q

Two Types of Breathing

A

Costal breathing

Diaphragmatic breathing

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59
Q

Type of breathing in adolescents of adults

A

Costal breathing

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60
Q

Type of breathing in babies; it is abdominal breathing

A

Diaphragmatic breathing

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61
Q

The 4 regulators of respiration

A
  1. Medulla Oblongata
  2. Pons
  3. Baroreceptors
  4. Proprioceptors
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62
Q

This is the primary regulator of respiration.

A

Medulla oblongata

63
Q

Responsible for initiation, proper rhythm, depth and rate of breathing.

A

Medulla Oblongata

64
Q

Two centers found/Two functions in the pons

A

Pneumotaxic center and apneustic center

65
Q

This center of the pons is responsible for the cessation of breathing

A

Pneumotaxic center

66
Q

This center of the pons is responsible for the detection of apnea, and stimulates deep long inspiration

A

Apneustic

67
Q

It detects pressure

A

Baroreceptors

68
Q

Hallmark of Pleural Friction Rub

A

Pleurisy; pain during inhalation

69
Q

3-way bottle system

A

CLOSED TUBE TRACHEOSTOMY (CTT)

70
Q

1st bottle

A

Drainage bottle

71
Q

2nd bottle

A

Daterseal bottle

72
Q

3rd bottle

A

Suction bottle

73
Q

Removal of fluid, pus, air or blood in the patient

A

CLOSED TUBE TRACHEOSTOMY (CTT)

74
Q

Transfer of fluid from one portion to the other

A

CLOSED TUBE TRACHEOSTOMY (CTT)

75
Q

Suction bottle

A

Continuous bubbling

76
Q

Drainage bottle

A

No bubbles/ bubbling, straight from the pleural cavity of the patient

77
Q

Waterseal bottle

A

Intermittent bubbling

78
Q

2 Conditions in waterseal bottle

A

Continuous bubbling & No bubbles

79
Q

Is continuous bubbling normal or abnormal?

A

Abnormal

80
Q

Cause of the continuous bubbling

A

leakage

81
Q

Effect of continuous bubbling

A

pneumothorax

82
Q

Bubbling

A

Suction bottle, Drainage bottle, and Waterseal bottle

83
Q

Oscillation

A

Rise (inhale) and fall (exhale) of H2O in the waterseal

84
Q

Oscillation

A

Best way to know that the 3-way bottle system is working

85
Q

Anatomical position, location and lung appearance

A

Chest X-ray

86
Q

To identify the organism in the sputum

A

Sputum Specimens

87
Q

approximate mL of sputum

A

15 mL

88
Q

Removal of fluid, pus, air or blood in the patient

A

CLOSED TUBE TRACHEOSTOMY (CTT)

89
Q

Aspiration/ removal of fluid, pus, air or blood from the pleural cavity

A

THORACENTESIS

90
Q

Actual direct visualization and examination of larynx, trachea, bronchi with fiberoptic bronchoscope

A

LARYNGOSCOPY & BRONCHOSCOPY

91
Q

What test should be done to patient with tracheal injury

A

LARYNGOSCOPY & BRONCHOSCOPY

92
Q 
Before thoracentesis:
Informed consent should be
obtained by \_\_
served by \_\_
given by \_\_
A

MD
nurse
patient

93
Q

If expectoration of blood:

Immediate action/ Primary RN: Notify the MD → due to __

A

Perforation of lungs (Pneumothorax)

94
Q

deadliest complication; absence of breath sounds

A

Pneumothorax

95
Q

Transfer of fluid from one portion to the other

A

CLOSED TUBE TRACHEOSTOMY (CTT)

96
Q

continuous bubbling

A

Suction bottle

97
Q

no bubbles/ bubbling

A

Drainage bottle

98
Q

Waterseal bottle

A

Intermittent bubbling

99
Q

2 conditions in waterseal bottle

A

Continuous bubbling in the water seal bottle;

No bubbles in the water seal bottle

100
Q

Rise (inhale) and fall (exhale) of H2O in the waterseal

A

Oscillation

101
Q

If the bottle is intact:

A

reconnect the tube

102
Q

If the bottle is broken:

A

Immerse in a new bottle

103
Q

Normal PaCO2

A

35-45 mmHg

104
Q

Determines patency of pulmonary airways and detects abnormal ventilation

A

VENTILATION/PERFUSION SCAN (V/Q)

105
Q

Evaluates blood flow (perfusion) in the lungs

A

VENTILATION/PERFUSION SCAN (V/Q)

106
Q

The test used to evaluate lung mechanism, gas exchange, acid base balance: thru spirometric measurements, lung volume, & ABG test

A

PULMONARY FUNCTION TEST

107
Q

Used to diagnose pulmonary embolism

A

SPIRAL (HELICAL) CT SCAN

108
Q

There is a scanner that rotates your body and gives you 3D picture of all the regions of your lungs

A

SPIRAL (HELICAL) CT SCAN

109
Q

What to use If the patient cannot be injected with dye?

A

V/Q SCAN

110
Q

Measures the dissolved O2 & CO2 in arterial blood indicating the acid-base state & how well O2 is being cared out all throughout the body

A

ARTERIAL BLOOD GAS (ABG)

111
Q

Device that measures O2 saturation levels before any s/sx of hypoxemia develops

A

PULSE OXIMETRY

112
Q

What to perform before procedure to assess ABG supply in hand (radial artery)

A

Allen’s Test

113
Q

Normal value: pH

A

7.35-7.45

114
Q

Normal value: HCO3

A

22-26 mg/dL

115
Q

Normal value: PaCO2

A

35-45 mmHg

116
Q

ROME:
pH: 7.30 ↓
pCO2: 61 ↑

A

Respiratory Acidosis

117
Q

ROME:
pH: 7.50 ↑
PaCO2: 18 ↓
HCO3: 22 = normal

A

Respiratory Alkalosis

118
Q

ROME:
pH: 7.25 ↓
HCO3: 18 ↓

A

Metabolic Acidosis

119
Q

Blood test to measure clot formation and lysis (result from fibrin degradation)

A

D-DIMER

120
Q

Most sensitive organ for hypoxia

A

Brain

121
Q

> 5 mins without circulation

A

Irreversible brain damage

122
Q

↓ RBC / ↓O2:

A

There’s anemia (pallor)

123
Q

(Color of O2 Tank)

red tank:

A

fire extinguisher

124
Q

(Color of O2 Tank)

black tank:

A

compressed air

125
Q

(Color of O2 Tank)

green tank:

A

oxygen

126
Q

2 types of pulse oximetry

A

Adhesive;

Clips

127
Q

Normal D-Dimer level:

A

≤ 250 ng/mL

128
Q

Normal fibrinogen:

A

200-400 mg/dL or 2-4 g/L

129
Q

Normal O2 Saturation:

A

95-100%

130
Q

Initial sign of hypoxia

A

restlessness

131
Q

To ↓ use of accessory muscles

A

BREATHING RETRAINING

132
Q

promotes CO2 elimination. (Exhalation>inhalation)

A

Pursed lip breathing

133
Q

How many deep breaths by pursed-lip breathing (lean forward + deep breaths)?

A

3-4 deep breaths

134
Q

How many times coughing during exhalation?

A

3-4 times

135
Q

Patient in sitting/upright position

A

Incentive Spirometry

136
Q

End of incentive spirometry is close to the ___

A

Mouth

137
Q

Advice to inhale slowly and maintain the flow rate indicator between ___

A

600-900 marks

138
Q

How many seconds should the px hold his/her breathing during incentive spirometry

A

5 seconds

139
Q

Best done during early morning upon rising before meals

A

CHEST PHYSIOTHERAPY

140
Q

Why is chest physiotherapy best done during early morning?

A

to remove all secretions and not food

141
Q

Postural drainage → Positioning

A

Place on unaffected side

142
Q

Right percussion = __

A

popping/ booming sound

143
Q

Receptor formed in the muscle and joints

A

Proprioceptors

144
Q

What to use during percussion in chest physiotherapy

A

Use cupped / scoping hand with forceful strikes on the skin with a good morning towel

145
Q

Rationale of using cupped / scoping hand with forceful strikes on the skin with a good morning towel

A

To prevent hurting the patient and irritation on the skin

146
Q

Waxing and waving respiration and short periods of apnea

A

Cheyne-Stokes Respiration

147
Q

Respiration with diabetic ketoacidosis

A

Kausmaul’s Respiration

148
Q

If the bottle is intact

A

reconnect the tube

149
Q

If the bottle is broken

A

Immerse in a new bottle

150
Q

Post-Thoracostomy earliest sign

A

↓ LOC (Loss of consciousness)

151
Q

Allergic reaction in the airways

A

Asthma

152
Q

The Causative agent of Asthma

A

Precipitant results to an immediate obstruction and/or late bronchial obstruction reaction

153
Q

Precipitants of Asthma

A

Allergens, Irritants, Sprays, Changes in temperature, Stress, Viral URTI, Medication, Occupational - toxic materials and Food additives

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