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Med Sur 4 > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

PaO2

A

80-100

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2
Q

PaCO2

A

Alkalineacidic

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3
Q

HCO3

A

Acidicalkaline

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4
Q

SaO2

A

> 95%

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5
Q

Gas exchange

A

O2 in and CO2 out
Happens in the alveoli
Gases diffuse across the membrane

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6
Q

Ventilation-perfusion mismatch

A

Breathing in and diffusion not equal

Results in hypoxemia

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7
Q

Causes of respiratory failure

A

Ventilation-perfusion mismatch
Impaired gas diffusion
Hypo ventilation

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8
Q

Impaired gas diffusion

A

How CO2 and O2 move across membrane into blood

Causes hypoxemia and hypercapnia

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9
Q

Hypoventilation

A

Not enough breathing

Hypoxemia and hypercapnia

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10
Q

Hypoxemia

A

Low levels of O2 in the blood

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11
Q

Hypercapnia

A

Increased CO2

If too much CO2 brain stops telling you to breathe

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12
Q

Manifestations of hypoxemia

A 
Hypertension 1st, then hypotension
tachypnea
Poor tissue perfusion
Cyanosis
Anxious
Dyspnea
Change in LOC
Diaphoresis
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13
Q

Manifestations of hypercapnia

A 
Dyspnea
pH > 7.45
Diminished lung sounds
Dizzy, drowsy
Tachy
Change in LOC
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14
Q

Diagnostic assessment of gas exchange

A 
VS
O2 use
CXR
VQ scan
CBC
ABGs 
Sputum
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15
Q

Lactic acidosis

A 
Too much lactic acid
Higher the level the longer the problem
Anaerobic
Cells don't have enough O2
Causes tissue death
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16
Q

Modified aliens test

A

Put pressure on bilateral sides

See if you can draw blood and they will still have flow

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17
Q

Why intubate a pt

A

Inability to oxygenated
Inability to ventilate
Mental status

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18
Q

Ventilation allows

A

Increased lung volume
Fluid redistribution in alveoli
Decreased O2 demand
Positive pressure airway

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19
Q

Nurses responsibility during intubation

A

Document
Monitor
Supplies
Advocate

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20
Q

Rapid sequence for intubation

A

Analgesic
Sedative
Paralytic

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21
Q

Sedatives

A

Benzo
Propofol
Dexmedetomidine
Etomidate

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22
Q

Analgesic

A

Fentanyl

Hydromorphone

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23
Q

Paralytic S

A

Vecuronium
Cisatracurium
Complete control
Must be sedated

24
Q

How to check tube placement

A

Chest x-Ray
CO2 detector
Listen for bilateral lung sounds

25
Q

Nursing responsibilities post intubation

A

NG or Og

Restrain pt

26
Q

Effectiveness of the intubation

A 
O2 sats stable
Lung sounds
Vent compliance
ABGs
Mental status
27
Q

SAT

A

Spontaneous awakening trial
Determines how much sedation
Shut off sedation and see if they are breathing

28
Q

SBT

A

Done after SAT

29
Q

RASS scale

A 
Sedation level
Allows titration of sedation
\+ is crazy
- is sedated
0 is normal
30
Q

Cardio impact of intubation

A

Tachy

Change in BP

31
Q

Respiratory impact

A

Improve gas exchange

Get rid of liquid

32
Q

Complications of ventilation

A

Infection
Barotrauma
Ulcer
Imbalanced nutrition

33
Q

Care of intubated pt

A 
Oral care 
Reposition Q2hrs
DVT, PUD
Glucose control
HOB 30 degrees
Nutrition
Communication
Assess readiness for SAT and SBT
Mobility
Assess and treat delirium
34
Q

FiO2

A

21-100%

Direct impact on gas exchange

35
Q

Rate

A

Number of breaths given by the vent/min

36
Q

Tidal volume

A

Amount of air given in each breath

Help with oxygenation

37
Q

Pressure support

A

Weaning mode

38
Q

Positive end expiration you pressure(PEEP)

A

Positive pressure at the end of expiration
Keeps alveoli open
Critical in oxygenation

39
Q

Assist control mode

A

Preset number of breaths

And preset VT on the vent regardless of ventilator or patient initiated breaths

40
Q

SIMV

A

Preset number of breaths delivered at VT set on the vent

Patient controls VT of any other breaths

41
Q

BiPAP

A 
Non-invasive ventilation
2 pressure
Inspiratory and expiration
Monitor for anxiety
FiO2
42
Q

Pneumothorax

A

Air in pleural cavity
Absent lung sound where deflated
Tachypnea
Accessory muscles

43
Q

Hemothorax

A

Blood in pleural space
Diminished breaths sounds in lower lobe
Hemoglobin

44
Q

Flail chest

A

2 or more consecutive ribs broken
See-saw resp.
Painful resp.

45
Q

Pulmonary contusion

A

Bruising to lung, alveoli rupture
12-24hrs
Severe dyspnea
Blood tinged sputum

46
Q

Nursing assessment of chest trauma

A

Lung sounds
Mental status
Chest X-ray
VS

47
Q

Chest drainage system

A

Position below waist
Reestablish negative pressure
Advocate for pain meds

48
Q

Chest system water level

A

Bubbling could indicate a leak, check tubing and site

Tidaling is movement of water with breathing

49
Q

COPD

A

Chronic airflow obstruction
Exacerbations
Smoking

50
Q

Chronic bronchitis

A 
Thick excessive secretions
Recurrent infections
Expiration is difficult
Then inspiration
Blu bloaters
51
Q

Emphysema

A

Progressive destruction of alveoli
Decreased ability to oxygenate blood
Cough, barrel chest, sit forward
Pink puffers

52
Q

COPD nursing interventions

A 
Wear O2
Bi-pap, c-pap
Lung assessment
Nutrition
Cyanosis
Smoking cessation
53
Q

Bronchodilators

A

Albuterol-short acting

Aminophyline-long acting

54
Q

Anticholinergic

A

Tiotropium

Daily use

55
Q

Steroid

A

Fluticasone

56
Q

Normal pH

A

Acidic alkaline

Med Sur 4 (2 decks)

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