Repiratory 2 Flashcards
Accumulation of fluid and blood in the pleural space interferes with lung expansion, ventilation, and gas exchange.
Hemothorax
Air in the pleural space creates positive pressure, causing lung tissue to collapse.
Pneumothorax
albuterol
bronchodialator - beta adrenergic - metered dose inhaler -
anemia is ____ ____ ____ which _____ o2 carrying capacity
inadequate red blood cells (or heme)
reduces
steroid - inhaler - can cause yeast infection in mouth - rinse mouth -
beclomethasone
start small and then cough harder as you move along
cascade coughing
Causes of hypoxia
decreased hemoglobin or RBCs decreased O2 concentration (high altitude) inability of tissues to extract O2 (CO2 poisoning) decreased perfusion (pneumonia) poor tissue perfusion (shock) impaired ventilation (chest trauma) Decreased cardiac output Pneumothorax
Components of respiration assessment
Rate Rhythm Volume Character Breath sounds Lifespan considerations
Explain the difference between how wheezes and crackles sound.
Wheezes: musical noise during inspiration or expiration, usually louder during expiration
crackles: high pitched, heard during inspiration, not cleared by a cough
Factors affecting pulse
Pulse sites Pulse deficit Medications Telemetry Lifespan considerations
helps support breathing by the opening of the airways during exhalation and increasing excretion of volatile acids in the form of carbon dioxide preventing or relieving hypercapnia.
pursed ip breathing
How many liters of blood does the average male (160 lbs./5’10”) have?
5 liters
how often should a pt use an IS
optimally it would be 10 times an hour if you can get people to start with two an hour that’s great
Huff coughing
get encourage someone to lean forward an exhale sharply making the Huff sound it helps keep a central Airways open while moving the secretions out
Hypoxia is
inadequate o2 at tissue level
List three outcomes for a client who develops pneumonia after surgery.
Client will demonstrate correct use of incentive spirometer.
Client will list reasons for grandchildren not to visit.
Client will list three symptoms of possible reinfection.
Client will state amount of fluid to drink daily.
List three ways to mobilize secretions?
Hydrate – push fluids if not contraindicated
Humidification of air/O2 via humidifiers, vaporizer, etc.
Positioning
Ambulation
measures the carbon dioxide (CO2) in inhaled and exhaled air
Capnography
Normal range for arterial blood PH
7.35 - 7.45
pulmonary hygiene
keeping the lungs in as good a shape as possible
Signs and Symptoms of hypoxia
Difficulty breathing, apprehension, restlessness, inability to concentrate, dizziness, fatigue, increased pulse/respiration, increased BP, skin color changes
stacked coughing
where you take a deep breath and hold it making several small short cause instead of 1 long big one just a few times coughing is very energy depleting
What are the actions the nurse takes after a bronchoscopy?
NPO until gag reflex returns Assess vital signs per unit protocol (q2h) Monitor for recovery from sedation Assess O2 stats Assess pain Assess swallowing Monitor for hemorrhage and pneumothorax
What are the responsibilities of the nurse before and after a thoracentesis?
Done at the bedside Assess baseline vital signs Written consent Help keep client calm and still Analgesics as ordered Vital signs, respirations Assess coughing and sputum Ensure chest xray completed.
What are three precautions to teach clients about portable O2 administration?
Avoid open flames
Place No Smoking signs
Keep electrical equipment in good working order
Avoid wearing synthetic fabrics that build up static electricity
Avoid using oils in the area
What are two methods for ensuring an accurate blood pressure reading?
Right size cuff to talking no moving clothing not under cuff lessen stress
What are two of the muscles used in respiration?
Diaphram, intercostals, obliques
What are two symptoms of anemia (low level of red blood cells)?
SOB, change in stool color, fainting and fatigue, angina and heart attack
What does an echocardiogram evaluate?
Noninvasive ultrasound Evaluate abnormal heart sounds Size of heart Size and function of cardiac structures Direction and speed of blood flow Presence of abnormalities No prep or after care needed
What does the lung scan evaluate?
Two part nuclear medicine scan used to diagnose a pulmonary embolism
Ventilation scan V scan) – detects ventilation abnormalities, especially in clients with emphysema – done with radioactive tracer gas
Perfusion scan (Q scan) – measure integrity of pulmonary blood vessels and evaluate blood flow abnormalities – requires radioactive injection
Used together provides greater and more accurate diagnostic information
What effect do corticosteroids (prednisone, dexamethasone, triamcinolone, etc.) have on inflamed tissue?
What are the routes of administration?
What area common side effects?
Reduces inflammation
Routes: PO, IV, nebulizer, inhaler
Increased risk of infection, GI distress, insomnia
What is a common outcome for a client who does not receive adequate pulmonary hygiene after surgery?
pneumonia
What is diffusion
- movement of gas particles from areas of high concentration to areas of lower concentration
What is hematocrit
% of cells per volume in a blood sample
What is perfusion
blood flow to capillary bed to provide nutrients and oxygen
What is the difference between ventilation and respiration?
Ventilation – movement of air in and out of lungs through breathing
Respiration – Exchange of gases
What structure is considered the “pacemaker” of the heart?
SA Node - Sinoatrial Node
Which ventricle failure would initially cause lower extremity edema?
right ventricle
who can pursed ip breathing help
COPD patients
