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Exam 3, Mods 5,6 &7 > Resp. Assess, Asthma > Flashcards

Resp. Assess, Asthma Flashcards

0
Q

What do pulmonary function tests measure?

A

Lung volumes and the flow rate.

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1
Q

What is ALTE?

A

Apparent life threatening Event -clinical presentation of apnea of infancy, including some combination of changes in color,muscle tone, and choking and gagging.

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2
Q

What are the purposes of pulmonary function tests?

A

Dx pulmonary dz and set a baseline
Monitor dz progression
Evaluate how much disability they have
How well are meds and tx working

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3
Q

FEV1

A

The amount of air that is expired in the first second of exhalation

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4
Q

Peak expirtatory flow rate

A

At what rate is air moving out. Rate will change with diameter of large air ways. How much air is being expired

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5
Q

What test provides gas exchange information?

A

ABG’s and SPO2 need numbers

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6
Q

What are the nursing considerations for thoracocentesis?

A

Pre- informed consent
Sit upright or bent over table
Get baselines RR, O2, HR, BP, effort
During- quiet, no movement
Watch patient carefully for distress, VS
Post- Verify breath sounds bilaterally,
Look at excursion-expansion is even
VS
Look for drainage at the site

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7
Q

What complications can happen from a thoracocentesis ?

A

Pneumo

Hypotension if take off too much fluid

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8
Q

What are retractions?

A

An inspiration due to upper airway obstruction or conditions causing decreased pulmonary compliance.

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9
Q

What are four clinical signs of respiratory assessment?

A

LOC
RR
Respiratory effort and mechanics
Skin and mucous membrane color

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10
Q

What are signs and symptoms of respiratory distress in regard to cardiac signs?

A

Tachycardia
Dysrhythmias-low O2in muscles
Cyanosis of fingers and toes, cold (sympathetic nervous system keeps the O2close to the heart and brain

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11
Q

What are signs of respiratory distress in the central nervous system?

A

Change in LOC
Anxiety
Lethargy, sommelance -increases CO2 in brain

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12
Q

What are the clinical symptoms of asthma?

A

Chest tightness- change in pressure, pulling air in is easier than blowing it out.
Dyspnea
Cough
Wheezing

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13
Q

What is the treatment for asthma?

A 
O2 if needed 
HOB up
PLB
Medications with order
Self monitoring of symptoms and daily use of PEFR measurements
Avoidance of triggers
Daily medication plan
Treat underlying conditions
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14
Q

What is the difference between ventilation and oxygenation?

A

Ventilation is the movement of air into and out of the lungs.
Oxygenation is the ability to move O2 into blood.

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15
Q

What does SaO2 measure

A

The amount of oxygen bound to hemoglobin in comparison to the amount of O2 the hemoglobin can carry.= if SaO2 = 90% then 90% of the hemoglobin attachments for oxygen have oxygen bound to them.

16
Q

What do normal lungs sounds on an infant or child sound like?

A

Soft, tubular breath sounds on inspiration and minimal to no lung sounds on expiration.

17
Q

What does Stridor sound like?

A

High pitched sounds secondary to obstruction between the supraglottic space and the lower trachea.

18
Q

What does wheezing sound like?

A

Prolonged expiration indicates obstruction of the intra thoracic airway, e.g

19
Q

What are signs of mild respiratory distress in a child with chronic lung dz?

A

Increased respiratory rate
Retractions- intercostal and subcostal
Interactive with environment

20
Q

Where do you auscultate lung sounds on a pediatric patient and why?

A

Over peripheral lung fields, chest is so small breath sounds are readily transmitted from one side to the other. Listen at midaxillary toward the back

21
Q

What is grunting?

A

Premature closure of the glottis during active expiration in an attempt to increase end expiratory pressure.

22
Q

What asthma meds are short acting beta adrenergic agonists?

A

Albuterol ( Proventil)

23
Q

What asthma meds are fast acting bronchodilators?

A

Albuterol

Ipratropium (atrovent)

24
Q

What medications will decrease swelling in mucous membranes with asthma?

A

Fluticasone (flo-vent)
Montelukast (singular)
Prednisone
Salmeterol/fluticasone (advair)

25
Q

What meds can be combined in an MDI? In a nebulizer?For asthma

A

Albuterol and ipratropium (duoneb)= nebulizer

(Combivent)=MDI

26
Q

What is involved with a focused respiratory assessment?

A

Inspects for nasal flaring

  • asses for expiratory grunting,coughing, and drooling
  • inspects, palpate and auscultates chest
  • pal pages CRT, skin temp, diaphoresis, color, and peripheral pulses.
27
Q

What are common indications for ET intubation?

A

Upper airway obstruction

  1. Apnea
  2. High risk aspiration
  3. Ineffective clearance of secretions
  4. Respiratory distress
28
Q

How does the RN know that correct ET tube placement is being maintained?

A

Symmetric chest wall expansion

Auscultate to confirm bilateral breath sounds

29
Q

What are indications for suctioning tracheostomy tube?

A

Clear secretions if pt is unable to
Noisy wet respirations-course crackles or rhonchi over large airways
Decreases SpO2 or PaO2, restless and agitated
Increased peak inspiratory pressure on mechanical vent

30
Q

What should be done pre procedure when suctioning a trach tube?

A

Per oxygenation for 3-4 breaths with 100% O2

31
Q

How much suction or negative pressure should be used when suctioning trach tubes for adults? Children?

A

120-150mmHg-adults

60-100mmHg -children

32
Q

What is the length of time with each suction?

A

10-15 seconds

33
Q

What is the length of time between sections?

A

1 min

34
Q

What is the safe number of suctioning passes in one session?

A

3

35
Q

What are indications for discontinuing suction?

A

HR-drops more than 20 beats/min
HR -increases more than 40 beats / min
Dysrhythmias
SpO2 drops to <90%

36
Q

What is done post trach suction?

A

Rinse catheter and suction the oral pharynx or use mouth suction
Listen to breath sounds
Document-time, amount,character of secretions and response to suction

37
Q

How do you perform tracheostomy care?

A

Sterile technique
Get a water proof container
Clean the inner cannula, stoma and faceplate:
-unlock and remove inner cannula
- put it in 3% hydrogen peroxide! clean inside and out with a tube brush or a pipe cleaner
-drain H2O2, rinse with sterile H2O

Exam 3, Mods 5,6 &7 (2 decks)

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