Brainscape's Knowledge GenomeTM

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


See full index

CardioPulm > Pulmonary Exam 2 > Flashcards

Pulmonary Exam 2 Flashcards

1
Q

active cycle of breathing

A 
quiet breathing 2-3 cycles
3-4 thoracic expansions, hold 3 sec then sigh out
quiet breathing 2-3 cycles
repeat several times
follow with forced expiratory technique
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

forced expiratory technique

A

1-2 huffs followed by relaxed controlled diaphragmatic breathing

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

autogenic drainage

A

can’t usually teach to children
often used in chronic bronchitis and CF
three levels: unsticking (from ERV to 1/2 ERV), collecting (VT+1/2ERV), evacuating (from 1/2 ERV to insp. capacity)

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

positive expiratory pressure

A

exhale through resistance, keeps airways open and helps air get behind mucus
after 10 PEP exhalations, perform several huffs, followed by several coughs
repeat 4-6 times for 10-20 min total

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

Acapella and flutter

A

PEP + high frequency oscillations
works sort of like internal percussion
acapella can be done in any position
flutter valve frequency changes at different angles

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

assist control ventilation

A

no spontaneous breaths occur
predetermined number of machine breaths
pt can initiate additional breath at set tidal volume and flow rate

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

intermittent mandatory ventilation (IMV, SIMV)

A

provides predetermined breaths, but pt can initiate additional spontaneous (non mechanical) breaths, more as they get better
minute ventilation = spontaneous + mechanical breaths

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

control ventilation

A

machine totally controls ventilation

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

assist ventilation

A

patient initiates, but breath is mechanical

resp rate is determined by patient

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

PEEP

A

positive end expiratory pressure
lungs remain partially distended to prevent airway collapse and facilitate collateral ventilation
given with mechanical breath

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

CPAP

A

continuous positive airway pressure

like PEEP but with spontaneous breath

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

pressure support

A

used when weaning from ventilator
ventilator delivers set pressure when patient triggers it
not forcing any air in, just giving pressure to help with flow rate

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

dyspnea definition

A

subjective!

sensation of difficulty breathing

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

chronic bronchitis lung changes

A

mucus clogging airways

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

emphysema lung changes

A

destruction of alveolar walls or overly dilated alveoli leading to poor gas exchange

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

cor pulmonale

A

right heart failure due to pulmonary pathology

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

training in COPD

A

train diaphragm for strength - endurance is fine

train peripheral muscles for endurance, they have more atrophy than you would expect from just being sedentary

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

exercise with COPD

A

quicker to produce lactic acid
increased CO2
central chemoreceptors increase activity
hyper-respirate to blow off CO2

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

intrinsic asthma

A 
affects adults > kids
not allergic reaction
no family history
attacks don't respond to treatment
history of sinus infections
poor prognosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

extrinsic asthma

A

affects kids>adults, often grow out of it
usually family history
attacks related to antigen

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

bronchiectasis

A

permanent abnormal dilation and distortion of medium sized bronchi and bronchioles due to destruction of elastic and muscular components of bronchial walls
associated with cystic fibrosis and infections

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

BODE index

A 
predicts mortality in COPD
BMI
degree of obstruction (FEV1)
Dyspnea
Exercise capacity (6 min walk test)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

cystic fibrosis

A

disorder of exocrine glands
abnormal secretions in resp tract, sweat glands, small intestine, pancreas, bile ducts
leads to frequent resp. infections and COPD

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

treatment for cystic fibrosis

A 
*bronchial hygiene*
exercise
meds
nutrition
lung or heart/lung transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

pulmonary fibrosis

A

inflammatory process in alveolar wall
scarring or fibrotic process leading to “honeycomb lung”
restrictive lung disease - lungs don’t expand well
presents similar to emphysema
will eventually need lung transplant

26
Q

pneumonia sounds

A

decreased breath sounds, dull percussion, possible increased fremitis, end inspiratory crackles

27
Q

bacterial vs viral pneumonia

A

bacterial get chills, high fever, productive cough, pleural pain
viral get only mod fever, non productive cough, muscle pain

28
Q

pneumonia treatment

A

airway clearance techniques
antibiotics if bacterial
hydration
isolation

29
Q

pleural effusion

A

accumulation of fluid in pleural space

transudate: low protein count
exudate: high protein count
treatment: treat underlying cause, chest tube to drain, pleurodesis (irritation to pleura to get it to attach to what it should and should stop fluid buildup)

30
Q

pulmonary embolism high risk groups

A

post op orthopedic surgery
anyone on prolonged bedrest
cancer

31
Q

symptoms of small PE

A

tachycardia, breathlessness

32
Q

atelectasis causes

A

lack of upright position and movement
breathing at low lung volumes
most pts post op will have some degree - so good to encourage deep breathing

33
Q

central mechanism of atelectasis

A

dec volume
dec CNS drive
poor inspiratory pressure and volume

34
Q

external mechanisms of atelectasis

A

kyphoscoliosis, respiratory muscle weakness, phrenic nerve problem, pleural effusion

35
Q

bronchial wall mechanism of atelectasis

A

hypertrophy of smooth muscle and mucous glands

36
Q

internal mechanism of atelectasis

A

excess mucous in airway

37
Q

intervention for atelectasis

A 
prevention by deep breathing, coughing, segmental breathing
mobilization: move out of supine!
breathing control
coughing
airway clearance
38
Q

respiratory distress syndrome cause

A 
inadequate surfactant production when born premie
increased work of breathing
V/Q mismatch
collapsed alveoli 
will have dec pH
39
Q

signs and symptoms of respiratory distress

A 
expiratory grunting
crackles
dec breath sounds
bradycardia
hemorrhage in lung, brain, ventricles
rapid and labored breathing
nasal flaring
cyanotic
dec volume and strength of crying
40
Q

treatment for respiratory distress

A

surfactant replacement

41
Q

hypoxemic respiratory failure

A

most common

PaO2

42
Q

hypercapnic respiratory failure

A 
PaCO2 >50mmHg
hypoxemia common on room air
pH depends on duration (bicarb level)
common with asthma, COPD
can be acute or chronic, how fast it develops
43
Q

end inspiratory crackles suggest

A

restrictive disease

44
Q

how does restrictive disease lead to fast breathing?

A 
inc anerobic enzymes
you burn carbs rather than fat
increase lactic acid
dec pH
inc CO2
inc firing of central chemoreceptors
inc breathing
45
Q

flail chest

A

at least 2 ribs broken in 2 places each

46
Q

pneumothorax

A

air in pleural space, lung collapse

47
Q

tension pneumothorax

A

can get air in through chest wall, but then a flap closes and the air can’t get back out - really bad

48
Q

most common pulmonary meds

A

anticholinergic agents
beta agonists
glucocorticoids

49
Q

bronchodilators

A

excite cAMP pathway: beta adrenergics, anticholinergics

inhibit cAMP: methyxanthines

50
Q

anti-inflammatory agents

A

mast cell stabilizers - blocks antigens
corticosteroids
phophodiesterase-4 inhibitors

51
Q

anticholinergic effect

A

inhibit cGMP to decrease bronchoconstriction
superior to beta agonist for COPD
also decreases secretions, but thicker

52
Q

rescue inhaler contents

A

short acting beta2 agonist = brochodilation

albuterol, bitolterol

53
Q

prophylactic bronchodilation

A

long acting beta 2 agonist along with anti-inflammatory

54
Q

implications for PT after lung transplant

A

lack of cough reflex - remind them
decreased secretion clearance - airway clearance techniques important
V/Q imbalance
deep breathing important

55
Q

frequency of incentive spirometer use

A

5-6 times/hour awake

hold for a few seconds to encourage collateral ventilation

56
Q

precautions/contraindications for percussion

A

asthma, fracture, flail chest, low platelets, osteoporosis

57
Q

important training effect seen in 6 min walk test

A

25-35 m

58
Q

pulmonary rehab exercise prescription

A

dyspnea rating of 3~=50% VO2max

4-5 on Borg scale

59
Q

Borg scale of perceived breathlessness

A

0-10, limit exercise to 5

60
Q

Levels of dyspnea

A

0-4, judged by how many breaths needed to count to 15 (2=2 breaths needed), with 4 being unable to speak or count. Should not be >2 with exercise, not >1 with functional activities

61
Q

Dyspnea Scale for subjective rating

A

1-mild, not noticeable to observer
2-mild, noticeable to observer
3-moderate, but can continue
4-severe, cannot continue

62
Q

unique s/s of CO2 retention

A

flushed skin, diaphoresis

but hypoxemia more common, if pt is tachycardic and headache, probably hypoxic

CardioPulm (3 decks)

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