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NURS122 > Pulmonary - Interactive Lecture > Flashcards

Pulmonary - Interactive Lecture Flashcards

1
Q

how does aging affect breathing

A
  • brain is less sensitive to changes in gases (hypoxia, hypocapnea)
  • higher residual volume which increases chances of pneumonia & bronchitis
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2
Q

bulging of intercostal spaces could indicate what

A

tumor, aneurysm, cardiac enlargement

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3
Q

define barrel chest

A

AP to transverse of 1:2 is normal
barrel chest is 1:1 ratio

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4
Q

normal RR for different ages

A
  • infant: 30-60
  • toddler: 25-40
  • preschooler: 20-35
  • school-age: 20-30
  • adolescent: 12-16
  • adult: 16-20
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5
Q

men vs. children vs. women breathes typically from where

A

men & kids: diaphragm breathing
women: thoracic breathing

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6
Q

describe pleural friction rub

A

loud, dry, crackling sound in anterior and lateral areas

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7
Q

5 main symptoms of respiration issues

A

Cardiac Beats With Strong Pulse

Cough
Breathlessness
Wheezes
Sputum
Pain

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8
Q

what does WBC & pathogen filling the alveoli lead to

A

thick, blood-tinged yellow-green sputum with pus

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9
Q

population that is at risk for pneumonia

A
  • weaker immune system
  • decreased cough & epiglottal reflexes
  • hospitalization or use of ventilators
  • weaker lungs (COPD, asthma, smokers)
  • work in an environment that has pollutants
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10
Q

CAP
MCAP: HAP, VAP, HCAP

A

CAP: community acquired pneumonia
MCAP: medical care associated pneumonia
HAP: hospital associated
VAP: ventilator associated
HCAP: health care associated

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11
Q

what part of the lungs does CAP affect

A

lower respiratory infection

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12
Q

signs and symptoms of pneumonia

A
  • acute fever/chills
  • cough
  • pleuritic chest pain
  • crackles, SOB, dyspnea
  • pulmonary consolidation (alveoli filled with fluids instead of air)
  • confusion in older adults
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13
Q

what does subcutaneous emphysema feel like

A

palpitation leads to crackling sound (crepitation)

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14
Q

Where are bronchial sounds heard

A

manubrium & sternum

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15
Q

what does bronchial sounds sound like

A

1:1.5 insp slightly shorter:exp
high pitched

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16
Q

what does tracheal sounds sound like

A

loud, high pitched

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17
Q

where are bronchiovascular sounds heard

A

1-2nd ICS anterior, scapula posterior

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18
Q

what does bronchiovascular sounds sound like

A

1:1 insp:exp
mid intensity & pitch

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19
Q

where are vesicular sounds heard

A

most lung fields

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20
Q

what do vesicular sounds sound like

A

2:1 insp:exp
soft, low pitch

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21
Q

how many times anterior and posterior we should auscultate to

A

12 anterior
14 posterior

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22
Q

what do crackles sound like;
where & when is it heard

A

bubbling, popping, clicking in the lower lung bases
mostly during inspiration

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23
Q

what are crackles associated with

A

fluid in alveoli
PE, early CHF, pneumonia

24
Q

what do wheezes sound like

A

high-pitched whistle heard in most lung fields
heard mostly during expiration but can happen during inspiration depending on severity

25
Q

what do wheezes indicate

A

constricted airways due to asthma, chronic bronchitis, COPD

26
Q

what does rhonchi sound like

A

low-pitched snoring, gurgling over the larger airways

27
Q

what does rhonchi indicate

A

blockage in larger airways
acute bronchitis

28
Q

what does stridor sound like

A

inspiratory musical wheeze during inspiration

29
Q

what does stridor indicate

A

obstructed trachea or larynx - emergency
turbulent flow through narrow upper airways

30
Q

which population should get pneumococcal vaccine

A
  • at risk: chronic heart/lung dx, diabetes
  • recovering from severe illness
  • older than 65yrs old
  • in a long-term care facility
31
Q

which abx to give for pneumonia

A

fluoroquinolones (“floxacin”), beta-lactams, macrolides (Azithromycin)

32
Q

what is commonly characterized by barrel chest, muscle wasting, weight loss, and air trapping

A

emphysema

33
Q

what is emphysema

A

alveoli damaged over time

34
Q

is acidosis or alkalosis easier for the body to balance

A

acid easier to deal with

35
Q

what part of the brain control breathing

A

medulla

36
Q

purpose of renal system in controlling acid/base balance

A

excretes free H+ with ammonia through urine
conserves bicarbonate

37
Q

where are ABG tests taken from and what does it tell you

A

ABG taken from arteries
pH, O2, CO2 monitored

38
Q

upper vs. lower airway issues

A
  • upper is less severe - cough, rhinitis, mild fever, sore throat
  • lower is worse - increased RR/HR, high fever (>38.5), O2 sat below 95%, retractions, cyanosis
39
Q

ROME mnemonic

A

Respiratory
Opposite
Metabolic
Equal

40
Q

normal pH range

A

7.35 - 7.45

41
Q

normal PaCO2 range

A

35 - 45

42
Q

normal HCO3 range

A

22 - 26

43
Q

causes of metabolic acidosis

A

ACIDOTIC mnemonic

Aspirin toxicity
Carbohydrates unmetabolized (malnutrition)
Insufficiency of kidneys
Diarrhea
Ostomy
fisTula
Intake of high fat
Carbonic anhydrase inhibitors

and DKA

44
Q

S/S of metabolic acidosis

A
  • Kussmauls breathing
  • weakness, confusion
  • hypotension
  • change in cardiac
  • N&V
45
Q

nursing interventions for metabolic acidosis

A
  • assess neuro/seizures
  • treat renal failure
  • monitor fluids/electrolytes
  • treat DKA, manage resp distress
46
Q

causes of metabolic alkalosis

A

ALKALI mnemonic

Aldosterone production excess (hyperaldosteronism)
Loop diuretics
alKali ingestion (antiacids)
Anticoagulant - citrates
Loss of fluids (vomiting, NG tube suctioning)
Increased sodium bicarb administration

47
Q

reasoning behind getting metabolic alkalosis

A

decrease in H+ which is required to transport HCO3 out of blood
so HCO3 will accumulate in blood

48
Q

S/S of metabolic alkalosis

A
  • bradypnea
  • hypokalemia
49
Q

nursing interventions for metabolic alkalosis

A
  • antiemetics
  • stop NG suction, diuretics
  • monitor Na & Cl
50
Q

causes of respiratory acidosis

A

DEPRESS mnemonic

Depressed breathing & NMS (neuroleptic malignant syndrome - rxn to anti-psychotic meds)
Edema
Pneumonia
Resp. center damage
Emboli
Spasms of bronchi (asthma)
Sac elasticity changes (COPD/emphysema)

chronic: severe obesity, neuromuscular d/o, scoliosis
acute: obstructed airways, sedative overdose, cardiac arrest

51
Q

S/S of resp acidosis

A
  • neuro changes
  • headache
  • decrease in BP/RR
52
Q

nursing interventions for resp acidosis

A
  • supply O2
  • DB&C
  • potassium monitoring, EKG
  • Abx
  • endotracheal intubation
53
Q

causes of resp alkalosis

A

TACHYPNEA mnemonic

Temp increase
Aspirin toxicity
Controlled mechanical ventilation
Hyperventilation
hYsteria
Pain, pregnancy, pneumonia
Neurological injuries
Embolism/Edema
Asthma

54
Q

S/S for resp alkalosis

A
  • tachypnea
  • change in LOC
  • tetany, chvostek sign from hypocalcemia
  • changes in EKG
  • muscle cramps
55
Q

nursing interventions for resp alkalosis

A
  • paper bag breathing
  • monitor K & Ca
  • monitor mechanically ventilated pts
56
Q

what is thoracentesis

A

needle in pleural space or lungs to drain fluids

57
Q

what is pneumothorax

A

air leakage from punctured pleural space leading to collapse of lungs

NURS122 (28 decks)

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