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Med Surg > Resp Disorder > Flashcards

Resp Disorder Flashcards

1
Q

what is a normal pH level and what is acidosis and alkalosis

A

normal: 7.35-7.45
acidosis: <7.35
alkalosis: >7.45

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2
Q

what is normal partial pressure of Co2 in arterial blood

A

35-45 mmHg

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3
Q

what is normal partial pressure of O2 in arterial blood

A

80-100 mmHg

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4
Q

what is a normal bicarbonate concentration in plasma

A

22-26 mEglL

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5
Q

what is a normal base excess, measure of buffering capacity

A

-3 to +3

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6
Q

what is ABG interpretation

A

R-respiratory
O-opposite
M-metabolic
S-same

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7
Q

what are the s/s of metabolic acidosis

A

headache, decreased BP, hyperkalemia, muscle twitching, warm flushed skin, N/V, decreased muscle tone and reflexes, Kussmaul respiration

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8
Q

causes of metabolic acidosis

A
  • increased H production
  • decreased H elimination
  • decreased HCO3 production
  • increased HCO3 elimination
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9
Q

what common studies are done for resp. diseases diagnoses

A

sputum studies: culture and sensitivity

      - acid fast smear thoracentesis: palliative
      - position client like epidural
      - pulls fluid off of lungs
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10
Q

broadly describe Laryngeal cancer/tumor

A
  • can develop on any part of glottis
  • cancer is differentiated, slow growing
  • metastasis occurs late in illness
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11
Q

risk factors of laryngeal cancer/tumor

A
  • tobacco and alcohol
  • HPV
  • race, poor nutrition, asbestos
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12
Q

manifestations/ s/s of laryngeal cancer

A 
hoarseness (doesnt improve)
difficulty eating (lost wt d/t difficulty eating)
white growth inside mouth (friable)
change in voice quality
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13
Q

diagnosis of laryngeal cancer/tumor

A

visual inspection and biopsy

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14
Q

treatment of laryngeal cancer

A

radiation therapy (chemo cures 80% of the time)

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15
Q

goal of laryngeal cancer

A

preserve airway
remove malignancy
achieve optimal cosmetic appearance (surgery will permanently disfigure)

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16
Q

what psychological effects does laryngeal cancer have

A

suicide rate is high with head and neck cancers d/t disfigurement from surgery

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17
Q

when does hoarseness improve after surgery

A

4-6 wks after surgery

will initially worsen

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18
Q

what is important after surgery for laryngeal cancer

A

need to rest voice after surgery

gargle with saline and use ice

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19
Q

what does friable mean

A

bleeds easily

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20
Q

trachea and esophagus function

A

trachea: air
esophagus: food

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21
Q

what is xerostomia

A

when salivary glands are in the path of treatment (radiation)
causes permanent dry mouth

22
Q

what does xerostomia increase risk in pt for

A
  • dental cavities (saliva is a natural protectant)
  • oral infections
  • halitosis (bad breath)
  • change in taste buds-nutrition help
  • difficulty swallowing
23
Q

what helps with xerostomia

A

mouth swabs, sprays, artificial saliva

increase fluid intake

24
Q

radiation and chemo cause what is laryngeal cancer pt

A

mouth sores

25
Q

what is surgical management of laryngeal cancer determined by

A

size, location, and degree of cancer

26
Q

what are the types of surgery for laryngeal cancer

A

laser laryngoscopy
laryngectomy
radical neck dissection
neck dissection (removal of neck muscles/lymph nodes)

27
Q

what is the normal flow of air when we talk

A

trachea, larynx, mouth, formation of words

28
Q

what is a laryngectomy

A

complete removal of larynx

29
Q

how is the trachea adjusted in laryngectomy

A
  • rerouted through neck
  • no more connection to mouth, no words out of mouth
  • can still eat, esophagus not altered
30
Q

what is the biggest concern with laryngectomy

A

communication (need to re teach how to talk)

31
Q

what is nursing priority with laryngectomy pt

A

airway management

32
Q

why do laryngectomy pts have drain

A

to collect blood from site and ensure patent airway

33
Q

why can aspiration not occur in laryngectomy pt

A

trachea completely separated from esophagus (trach rerouted to neck)

34
Q

what type of management is necessary post laryngectomy

A
  • pain management (PCA)- very uncomfortable
  • before initiating eating, Barium swallow
  • speech rehabilitation
35
Q

describe the types of speech rehabilitation

A
  • electrolarynges-easiest to use (robot voice)
  • esophageal speech-burp air up to form words (air from esophagus)
  • tracheoesophageal puncture- one way valve to make sound (most normal voice) * not everyone is a candidate for this
36
Q

post op care of laryngectomy

A
  • trach care, sterile technique with suctioning
  • cough secretions up
  • do not suction unless sats drop
  • change inner cannula each shift
  • maintain fluid intake
  • may choke when swallow-relearn by head forward and food at back
37
Q

broadly describe what asthma is

A
  • immune response gone wrong (overboard reaction to normal response)
  • reversible airflow obstruction and wheezing
  • intermittent occcurence
38
Q

describe bronchiole during asthma attack

A

Normal bonchiole: wide open lumen (easy for air to pass through)
asthmatic bronchiole: very small lumen (difficult for air to pass through)

39
Q

patho of asthma attack

A

1) trigger (ie dust)
2) IgE pick up trigger and carry to mast cells
3) mast cell releases excessive histamine response

40
Q

what are the arterial CO2 levels early and late in asthma attack

A

early: decreased CO2
late: increased CO2

41
Q

how is asthma classified

A

based on response to asthma drugs

42
Q

s/s of asthma attack

A

cough, increased mucus, SOB, chest tightness, wheezing and prolonged expiration, retractions

43
Q

when is asthma attack an emergency

A

if symptoms do not respond to usual treatment in 30 min, seek medical attention

44
Q

what are indicators of hypoxemia

A

tachycardia, increased restlessness, tachypena

45
Q

potential triggers of asthma attack

A

hypersensitivity, URI, exercise, air pollutants

46
Q

how is asthma diagnosed

A

pulmonary function test and peak expiratory flow rates

47
Q

describe pulmonary function test (PFT)

A

looking for reversibility of airway obstruction

*hallmark of asthma

48
Q

describe peak expiratory flow rates

A

most valuable in determining severity and effectiveness of treatment
how well are they moving air in and out?

49
Q

what is a firm diagnosis of asthma

A

20% less than what is normal (PEFR)
OR
increased by greater than 12% after rescue drug

50
Q

what is the management of asthma

A

A-adrenergics (beta 2 agonists and Albuterol)
S-steroids (inhaled)
T-theophylline (when not responsive to meds)
H-hydration (IV with severe distress)
M-maintain patent O2 sat (>90)
A-anticholinergics

51
Q

what is important education for pt taking corticosteroids

A

rinse mouth out after inhaled corticosteroids to prevent thrush

Med Surg (23 decks)

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