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resp Flashcards

1
Q

resp distress intervention

A 
raise them up
suction
o2 adm
assess lung sounds
notfy hcp
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2
Q

what is cystic fibrosis

A

deficiency of protein that is responsible of transportion sodium and chloride causing the secretions to be thicke and stickier

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3
Q

CF complications

A

pnuemothorax

infection

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4
Q

pnuemothorax signs

A

dyspnea
tacypnea
tacycardia
DROP IN O2- EARLIEST CLUE

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5
Q

CF normal

A

chronic cough
inabiltity to clear secretions
blood streaked sputum
decreased pulse o2 but 90 or less is urgent untervention
-hard to gain weight bc of malasoprtion of carbs, fats , and portein
-fecal retention and impaction due to decreased water and sodium secretion into the intestines
-short lifepsna up to 30s

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6
Q

carbon manoxiete vs o2

A

Carbon manoxide has a stronger bond to hgb than O2 causing o2 to be dispalced from hgb causing hypoxia that is NOT REFLEXTED BY PULSE O2

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7
Q

carbon manoxide poisiong intervnetion

A

100% O2 using nonretbreather at 15/min

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8
Q

why is pulse o2 reading no accurate in CO posiioning

A

dont ever look at pulse ox to determine pt o2 because pulse ox cannot differentiate CO from o2

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9
Q

dignosis of CO poisioning

A

co-oximtry of a blood gas sample

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10
Q

COPD leads to

A

chronic air trapping

-reduced gas excange by decreased ventilation

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11
Q

Copd clients are at increasd risk for

A

resp infections which can trigger exacerbations

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12
Q

COPD education

A

get pnumonccal cavvine

-seek help for increased sputum, worsening sob, lack or relive from mesd

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13
Q

COPD expected

A

polycetmehmia so iron isnt needed and can cause harm

-ANEMIA IS NOTTTT a problem so dont give IRONNNN

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14
Q

normal o2 levels

A

95-99

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15
Q

what provides o2, ventilation in a client with resp failure

A

ABG

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16
Q

when do you clamp chest tube

A

few hours prior to remove it to check for air leak

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17
Q

how often do you check the chest tube chamber

A

every hour for the first 8 hours after surgery, then every 8 hours until removed

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18
Q

what is epected after surgery

A

low o2

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19
Q

pleural effusion

A

abnormal collection of fluid >15 ml in the pleural space that prevevnts lungs from expanding fully, decreasing lung volume, ineffective gas exchange, atelecatasis

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20
Q

plural effusion disgnosed by

A

chest xray or CT scan

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21
Q

plueral effusion pt report waht signs

A

dyspnea with NON productive cough

  • chest pain with respiration
  • diminished breath sounds
  • dullness to percussion
  • decreased tacile fremitus
  • WHEEZING NOT A SIGNNNNN
  • decreasd mov over the affected lung
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22
Q

wheezing is seen in

A

obstructive process such as COPD

AND ASTHMA not pleural effusion

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23
Q

perussion in pnuemothorax

A

hypoerresoonse

in pleural effusion it is DULL

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24
Q

earliest sign of hypoxemia

A

restleness

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25
Q

whatt should not be used in pt with COPD

A

benzodiapines and morphine bc they depress the resp system

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26
Q

rib fractures intevention

A

if there are no singigicat injuries then do PAIN MANGEMENT

AND PUL HYGEINE

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27
Q

expected finding of rib fractures

A

shallow breathing
pain on inspiration
dont need HCP if they are complianing of these things

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28
Q

bronchitis

A

inflammation of the upper airways by viral infection

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29
Q

rhonchi souund

A

continous, low pitched adventious sound

-sounds like moaning or snoring and hear mainly on expiration but inspiration as well sometims

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30
Q

rhonchi sounds occur when

A

thick secretions or forgin bodies like tumor obstruct the airflow in the upperairways

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31
Q

rhonchi sounds are manily heard in

A

bronchitis
Cystic F
pneumonia

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32
Q

asthma signs

A

high pitched, muscual wheezes

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33
Q

croup sound

A

manifests with strifor

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34
Q

plurisy

A

pleural friction rub, loud, rough rubbing
on inspiration and exp
-caused by pleural surfaces rubbing together
-similar to crackles

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35
Q

crackles are only heard on

A

inspiration

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36
Q

CF tratment

A
  • chest physio
  • aerobic acervise- promote removal of airway secretions, improve muscle strength
  • finicial needs
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37
Q

diet of CF

A

high in fat and calories

fluids are recommneded

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38
Q

to open up an occuluded airway

A

head tilt and chin lift

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39
Q

airway obstruction signs

A

cynosis
snoring
acessory muscles
dec o2 sat

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40
Q

post op client after gernal anesgthia requires mointoring for

A

hypoxia

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41
Q

gardening doesnt cause

A

pnuemonia

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42
Q

oenmuonia risk factors

A 
advanced age >65
young age <2
CNS depression
decrease LOC
chronic disease (cv)
immunsupression
inadq nutrition
proglonged imm
smoking, air pollution
URTI
tracheal intubation
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43
Q

claming the CT during transport

A

contrindicated bc air willa ccumate in the plural caivty causeing tension pnuemthroax

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44
Q

tension pnuemothriax results in

A

compression of the unaffected lung and pressure on the heart and great vesels

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45
Q

chest tube should be hung

A

below the chest to promote draniage and reentry of fluids

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46
Q

nasopharyngeal airway (NPA)

A

tube like device used to maintain upper airway patency

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47
Q

nasopharyngeal airway (NPA frequently used in

A

alert or semiconscious or oral trauma or maxillofacial surgery clients that are at less liekly to cause gagging

NEVER USED IN HEAD TRAUMA

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48
Q

nasopharyngeal airway (NPA should nevere be used in

A

head trauma clients (fical or basiallar)

-use ct scan to rule out fracture

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49
Q

verify placmeent nasopharyngeal airway (NPA

A

asuculating the lungs

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50
Q

inappropriate nasopharyngeal airway (NPA) sizr

A

risk of airway obstruction
sinus blockage
infection

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51
Q

nasopharyngeal airway (NPA) meaasuring size

A

tip of nose to earr lope and selectes diamter smaller than the naris

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52
Q

contrinidations to nasopharyngeal airway (NPA

A

head trumaa
bleeding disorders
use of anticog or anntiplaet

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53
Q

tach tube pirooty goal

A

checking to see if tube i s placed securely
by CHCKECING THE TIGHTNESS AND ALLOWING FOR ONEEE finger to fit under these ties
yes mouth care to prevent infection is priority but not as important as checing tightness

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54
Q

changing inner cannalu and trach ties

A

not done until 24 hours after insertion bc of the dislogement with immature tract

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55
Q

dressing of trach

A

can be change if it becomes wet or solied

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56
Q

cuff of trach

A

are not regulary delfated or re inflated and the RT therpost does this

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57
Q

common asthma triggers

A

cigar smoke and nsaids

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58
Q

clients with asthma and are atlhestes should take

A

inhaled bronchodilator 20 mins before before activity

59
Q

abdominal breathing with huff

A

forced expiraory cough tech and good in mobilizing secretions

60
Q

purses lips and secretions

A

not good to get secretions out and prolongs exhalation

61
Q

pneumonia signs

A 
crackles
PLEURTIC CPP
fever chills
prpductive cough
increasedd vocal .tactile fremitus
-bronchial breath sounds in peripheral lung fields
-unequal chest expanision
-dullness
62
Q

how to perform huff coughing

A

sit upright

  • perform slow deep inhaltion
  • hold breath for 2-3 seconds
  • then perfrom q aquick forceful exhaltion creating an audible huff
  • repear the hugg once or twice more
  • rest for 5-10 regular breaths and repeat as necessary
63
Q

huff coughing can be beneifical in

A

COPD

pnuemonia

64
Q

PE signs

A

pleuuritc chest pain (sharp pain when inhaling)
-dyspnea
hypoxemia
-tacypnea
-cough (dry or productive with bloody sputum)
-tacycardia
-umilaterla swelling, erthyema and tenderness

65
Q

pleurisy pain

A

stabbing chest pain that increases on inspiration or with cough

66
Q

palpitation virbation

A

fremitus

expected finding in pnuemonia

67
Q

complication of pbeumonia

A

pleurisy

68
Q

acute respiraotry failure signs

A

PaO2 ≤60 mm Hg
PaCO2 ≥50 mm Hg
pH ≤7.30.

69
Q

peak flow meter helpful in clients with

A

moderate to severe asthma

70
Q

peak flow mete how to use

A

exhale as quicky and forcibly

  • move the scale to 0 or the lowest number on scale
  • personal best reading is the highest peak flow usually over 2 wk period
  • peak flow is used after short acting bronchodilator not after coricosteoid such as fluticonsone MDI
71
Q

atlextasis prevention in post op pt, penumonia, resp prob, trauma pt

A

incentive spiromter

72
Q

complication of doing thoracentesis

A 
pneumo
hemothorax
pulmoary edema
infection
diff breathingn
taycpnea
hypoxemia
hypotension
73
Q

throcentesis afvantages

A

diagnotistic- cause of pleural effusion (infection, malignacy, HF)
2) therputic - removal of excessive dluif (>1L)

74
Q

hallmark sign of acute resp distress syndrome (ARDS)

A

refractory hypoxemia

75
Q

refractory hypoxemia

A

inability to improve oxygenation with increases in o2 concerntration

76
Q

when chest drainage stops abruptyly

A

asuculate the breath sounds to see if lungs have rexpanded

  • cough and deep brathe
  • reposition client
77
Q

changing suction level

A

only performed after obtaning HCP prescirbtion

78
Q

resp acidiosis

A 
over seadtion
aleep apnea
anesthia
drug overdose
neurosmuclar disase
copd
79
Q

met aicdsosis

A

diahrea
keotafisosis
lactic acid
renal failure

80
Q

met alka

A

gi suction

vomintig

81
Q

resp alka

A

hypoxia
anxiety
pain

82
Q

preoxygentte

A

pro2 100%o2 before suctioning for 30 seconds

83
Q

if suctions are thick and diff to remove

A

dont suction

instead do hydration

84
Q

how to thin secretions

A

sterile normal saline

muclystics such as acetylcysteine (Mucomyst) administered by nebulizer BUT NOTTTT WATERRRR

85
Q

limit suctioning to

A

10-15 seconds

86
Q

if chest tube discconects from drainage tubing without containation

A

wipe the end of the chest tube with antisepctic and reconenct it

87
Q

to prevent discoonection of the chest tube from tubing

A

secure all conections with tape or bands

88
Q

if chest tube disconnected with contamination or it breaks , cracks

A

submerge the distal end of the chest tube 1-2 in below the surace of 250 ml bottle of sterile water or saline

89
Q

what should be kept bedsite for chest tube

A

2 chest tube clamps
250 ml bottle of sterile water or saline solution
antiseptic wipes

90
Q

nasal cannula

A

short term
inexpensive
allows pt to eat and drink
o2 up to 44 percent

91
Q

non rebreather

A

emergencies

high o2 conc (90-95 percent)

92
Q

simple face mask

A

40-60 percent

93
Q

venturi

A

for unstable chronic obstructive pul disease

94
Q

pneumonia discharge teaching

A

aviod using OTC cough supressant med

  • follow up with HCP for chest xray
  • cool mist humdifier
  • incecntive
95
Q

HAP

A

bacterial infection in health care faciiality tht was not present on admission

96
Q

treatment hap

A

antibiocis is first line and if abx is effective, improvement is seen in 3-4 days

97
Q

best indiicator of abx treatment effectivness

A

WBC

98
Q

dust mite allergy reduced

A

washing bed linens every 1-2 wk with hot water
High temperature (>140 F [60 C]) is needed to kill the dust mites; warm or cold water washing should not be recommended.
-allergy-proof mattress and pillow covers and vacuuming the mattress on a regular basis.

99
Q

crackles are not

A

cleared by coughing

100
Q

courase vs fifne crackles

A

loud, low pitched bubbling

fine- high pitched pooping (atlectaiss)

101
Q

emphysema clients should be taught

A

pursed lip breathing to prevent alveloar collapse

102
Q

tossillectomy bleeding signs

A

swallowing
cough
resltness

103
Q

discharge teaching for tosillectomy

A

avoid coughing, clearing throat, or blowing of the nose

  • limit physical act
  • milk products are discoruaged due to their coating effect which makes you want to clear your throat
  • oral mouth rinses, garling, and tooth brushing viprgiusly should be avoided
104
Q

common and expected findings on tosillectomy

A

ear pain, low grade fever ad mouth odor for the first 5-10 days

105
Q

pnemoccal vaccinate states that

A

all adults age ≥65 should receive 2 pneumococcal vaccinations

106
Q

sucking chest wound

A

traumatic or “open” penumothroax and is med emergency bc resp distress appens

107
Q

sucking wound treatment

A

sterile occlusive dressing (eg, petroleum gauze) taped on three sides.

108
Q

trach tube dsilogment in a mature >7 days after insertion

A

attempt to open the airway by inserting a curved hemostat to maintain stoma patency and insert a new tracheostomy tube with an obturator

109
Q

if the trach tube cannot be resinserted

A

stoma is covered with a sterile, occlusive dressing.

110
Q

bronchscopy

A

precudre in which the bonrchi is cisualized with a flexible bronchscopoe that is passed down through the nose

111
Q

sedation for bonchscopt

A 
mild sedation (midazolam)
-topical ansestic (lodoscaine) to supress gag and cough reflexes
112
Q

bronscopy is done to

A 
diagnose,
obtain tissue sample
-lavage
-tissue sample
-recome objects
113
Q

what is noral in bronchscopy

A

blood tinged sputum

114
Q

what is not normal in bronconscpy

A

hemptsysis or bight red- hemm esp if bippsy done

115
Q

what is expected after a procedure

A

low o2 and low resp

116
Q

complications of broncschopscy

A

hemoptysis, hypoxemia, hypercarbia, hypotension, laryngospasm, bradycardia, pneumothorax, and adverse effects from medications used before and during the procedure.

117
Q

resp failure signs

A 
paco2 >50
pao2  <60
paradoxial breathing 
mental status changes
absence of wheezing or silent chest
single word dyspnea
118
Q

what is elevated in allergy

A

esopinopholl

119
Q

normal neutrophils

A

55-70

120
Q

reticulocytes

A

immature RBC

121
Q

normal reticuloytes

A

0.5%-2.0%. Levels are elevated in hemolytic anemia or hemorrhage when the marrow is attempting to compensate for lost blood.

122
Q

non rebreather mask consists of

A

o2 decie, face mask, and resvoir bag

123
Q

resvoir bag

A

the liter flow must be high enough (15L/MIN) to keep the reservious bag at least 2/3 inflated

  • INcrease the o2 amt if it is deflated
  • the ports should be occuleded when filling with o2
124
Q

green zone

A

PEF is 80-100
asthma under control
no worsening of cough, wheezing, or trouble breathing

125
Q

yellow zne

A

caution

even if it goes to green after taking meds, you need further med or chnage in treatment

126
Q

red zone

A

med alert, emergency

ermgency treatment if the level does not imm return to yellow after taking rescue meds

127
Q

colors in chest tube

A

sanguieous (bright red) for severeal hours, then change to serosangious (pink) and then serous (yellow)

128
Q

bright red chest drainage from CT

A

indicate active bleeding and imm concern

129
Q

preventing post op penumonai

A 
pain contol
0ambulate within 8 hours
-coughing
-deep breathing
-incetive
-flowers poistion (45-60)
swab mouth with chloehexidine swabs q 12 hours
130
Q

pneumatic compression

A

promotes venous return and helps prevnt venous thormbosis

DOES NOT PREENT PNEUMONIA

131
Q

to help remove secretions

A

hydration
huff ocughing
chest physiotherpy
FOWELER POUSTION NOTTTT SIDE LYING

132
Q

bipap for resp failure

A

will help expel co2 and provide postive pressure o2

133
Q

lethagy and cofusion in resp failure

A

later sign

134
Q

what is thre treatment to decrease co2 levels

A

bipap

135
Q

peritonsillar results from

A

tonsilltis or phargyngitis

136
Q

signs of peritonsillar

A

hot potato (muffled voice)
trimus (inability to open the mouth)
-pooling of the salivia (drooling)
-deviation of the uvula to onse side

-abscees

137
Q

complication of peritonsillar

A

the abseccess can progress to airway obstruction (dysphagia, stridor, restleness)

138
Q

nosebleeding that doesnt resolve with external pressure

A

hemostatic interventions such as caterization, nasal packing

139
Q

acute pancreatitis can develop

A

resp complications (plerual effisions, atelectasis, ARDS)

140
Q

dont give what for OSA

A

sedatives bc it can lead to airway obstruction by relaxing the muslces
-dont nap during the nap

141
Q

what is not assoicated with the dev of COPD

A

etoh use
poor nurtrition
overweight

142
Q

what can cause copf

A

tacbaoo smoke, occulpational exposre, air pollution, geqnetics

143
Q

VAP

A

HAI that occurs within ≥2-3 days after the initiation of mechanical ventilation.

144
Q

VAP signs

A

purulent secretions, positive sputum culture, leukocytosis, elevated temperature, and new or progressive pulmonary infiltrates on chest x-ray.

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