Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURS124 > Resp disorders > Flashcards

Resp disorders Flashcards

1
Q

what is pleural effusion

A

fluid in pleural space caused by transudative or exudative effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

transudative vs. exudative effusion

A

transudative: increased hydrostatic pressure or low oncotic pressure from HF, cirrhosis
exudative: increase in capillary permeability from inflammation - infection, tumors, hemothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why are the elderly at risk for pleural effusion

A
  • decreased elasticity of the lungs -> enlarged air spaces
  • increased anteroposterior diameter, shortened thorax
  • altered mobility
  • decreased vital capacity (max air inhaled)
  • decreased chest wall compliance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

classic pleural effusion s/s

A
  • dyspnea
  • pleuritic chest pain (esp. on inspiration) referred to shoulder or abdomen
  • cough: nonproductive
  • decreased breath sounds, pleural friction rub
  • dullness/hyperresonance when percussed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how to diagnose pleural effusion

A
  • CXR: blunting of costophrenic angle (typically used to diagnose)
  • CT scan
  • thoracentesis
  • ultrasound to ensure needle placement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can rapid removal of fluids via thoracentesis cause

A

hypotension, hypoxemia, or reexpansion pulmonary edema
so remove 1,000 - 1,200 mLs at a time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does diff pleural fluid mean:
- bloody
- milky
- purulent
- viscous
- clear straw colored

A
  • bloody: trauma
  • milky: effusion there a long time
  • purulent: infection
  • viscous: mesothelioma
  • clear straw colored: normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is pneumothorax

A

trapped air in pleural space and pressure is exerted in nearby structures such as trachea and heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

closed vs. open vs. tension pneumothorax

A

closed: air entering remains the same
open: air circulates freely
tension: air accumulates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

causes for pneumothorax

A
  • primary: without underlying lung disease
  • secondary: with lung disease
  • trauma, scuba diving
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what procedures puts pt at risk for pneumothroax

A
  • central line placement
  • mechanical ventilation
  • tracheostomy
  • bronchoscopy
  • intercostal nerve blocks
  • pacemaker placement
  • CPR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

classic signs of pneumothorax

A
  • tracheal deviation, mediastinum shift
  • JVD
  • sharp pleuritic pain radiating
  • hypotension, tachycardia, dyspnea
  • cardiac arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how to diagnose pneumothorax

A
  • ultrasound -> CXR -> CT
  • EKG, cardiac enzymes
  • ABG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treatment of pneumothorax

A
  • needle decompression slow
  • chest tube placement
  • pain meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PaO2 normal level

A

80-100 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fully compensated vs. partially compensated vs. uncompensated ABG

A

fully compensated: pH normal
partially compensated: all values abnormal
uncompensated: PaCO2 or HCO3 is one normal one abnormal, pH out of range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what to prepare for chest tube placement

A
  • informed consent obtained
  • sterile environment
  • pt sitting up leaning across table
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is flail chest

A

trauma where 3+ ribs broken in at least 2 places
the chest moves independently from chest wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

s/s of flail chest

A
  • paradoxical chest movement
  • pain & splinting
  • dyspnea, tachypnea
  • bruising, bleeding, edema in injured area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

severity of flail chest depend on which 3 factors

A
  1. pleural pressure
  2. extent of the flail
  3. movement of intercostal muscles during inspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does flail segment of the chest lead to in terms of damage

A

hypoventilation w/ atelectasis + pulmonary contusion (bruising), which leads to edema and hemorrhage
in turn, reduces lung space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

diagnosis for flail chest

A

CT> CXR
- ABG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

treatment for flail chest

A

probably mechanical ventilation, but try hiflow O2, CPAP/BiPAP first
endotracheal tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are long-terms effects of flail chest

A
  • permanent chest wall deformity
  • exercise intolerance
  • stiffened thoracic cavity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what can flail chest lead to
- resp failure - pneumothorax, hemothorax - pulmonary contusion - atelectasis -> hypoventilation
26
what are some unexpected findings in flail chest
- tachycardia, hypotension - hypoxia, respiratory distress - ALOC - increased pain - abnormal ABG or cardiac enzymes
27
what is saddle embolism
a large clot that blocks the bifurcation of the main pulmonary artery
28
how does embolism affect BP
clot blocks blood supply -> increased pulmonary arterial pressure -> harder to pump -> dead space -> high V/Q
29
how does pulmonary embolism affect V/Q mismatch
high V/Q >0.8 dead space created from lack of blood flow while ventilation remains the same serotonin released -> vessels contract -> reduced bloodflow to lungs
30
what ABG would you expect from pulmonary embolism
- hyperventilation attempts to compensate, leading to hypocapnia - respiratory alkalosis
31
how does pulmonary embolism affect the heart
increased vascular resistance increases right ventricular afterload and causes dilation & R ventricular failure
32
normal V/Q value
4/5 = 0.8
33
shunt vs. dead space
shunt: NO ventilation, has perfusion dead space: has ventilation, NO perfusion
34
how does pulmonary embolism affect ABGs
hyperventilation & inflammation leads to: - hypoxemia - hypocapnia - respiratory alkalosis
35
what is included in Virchow's triad
1. hypercoagulability 2. vessel wall injury 3. venous stasis
36
what defines venous thromboembolism (VTE)
when pt has both pulmonary embolism & DVT
37
list some risk factors for pulmonary embolism
- male, black americans - HF, A.fib, A. flutter - indwelling venous catheter - air pollution - trauma, lower limb fracture -> immobilization
38
what are the typical s/s for pulmonary embolism
- dyspnea, cough - chest pain - syncope - JVD If more severe: - arrhythmia, right ventricle failure - hemodynamic collapse, shock
39
diagnostic tests for pulmonary embolism
- troponin (0 - 0.04) & BNP (<100) - d-dimer for clot (<0.5 normal) - EKG, CXR, ultrasound - lung scintigraphy (V/Q scan) - ABG
40
what are the anticoagulants used for pulmonary embolism
- LMWH, fondaparinux (Atrixtra) - dalteparin (Fragmin) - alteplase (Activase)
41
what is fondaprinux contraindicated in
renal issues
42
what should pts taking fondaprinux avoid
NSAIDS
43
what are the adverse effects of alteplase
- hives - difficulty breathing - swelling of face
44
what are the 2 classifications of resp failure
hypoxemic or hypercapnic
45
define hypoxemic vs. hypercapnic resp failure
- hypoxemic: PaO2 <60mmHg caused by lung failure (Q) - think lung dxs, PE, COPD, asthma - hypercapnic: PaCO2 >50mmHg caused by ventilation failure (V) - think MS, sedatives, flail chest, spinal cord injuries
46
what classification of resp failure is more common
hypoxemic is more common than hypercapnic
47
what are the 2 causes of resp failure
1. V/Q mismatch - low from hypoxemia or hypercapnia 2. shunt - hypoxemia even with 100% O2 inhaled from poor ventilation
48
acute vs. chronic resp failure
acute: developed in mins to hours chronic: developed over several days or longer
49
diagnostic tests for resp failure
- thyroid function tests - pulmonary function tests spirometry FEV1/FVC (80-100%) - electrolytes - CXR - CBC - EKG
50
what is FEV1/FVC test
forced expiratory volume in 1 second after full inspiration / forced vital capacity (max exp)
51
signs of hypoxemic resp failure
- dyspnea - confusion - increased HR, RR - arrhythmia - cyanosis, somnolence
52
signs of hypercapnic resp failure
- headache - asterixis (hand flap tremor) - warm extremities - papilledema (optic disc swelling) -> change in vision - coma
53
when should a pt w/ resp failure be put on mechanical ventilation
- RR>30 - SpO2 <90% doesn't respond to O2 - shock symptoms - extreme ABGs
54
what defines ARDS
- within 7 days after trauma - fibrotic tissue makes lungs stiff -> increased pulmonary arterial pressure, decreased pulmonary compliance from stiffness - inflammation increased permeability -> alveoli edema - deadspace -> hypercapnia - shunt -> hypoxemia key: doesn't respond to O2
55
what position to place a pt with ARDS
prone position (lying down) so affected lung can expand
56
common causes of ARDS
- sepsis most common - pneumonia - aspiration - in ICU
57
impact of ARDS long-term
cognitive change from prolonged hypoxia muscle wasting, wt loss, tracheostomy - MV
58
what is included in the Berlin criteria for ARDS
- onset within 7 days - noncardiac origin - bilateral lung infiltrates in imaging - abnormal O2 - PaO2/FiO ratio less than 300mmHg
59
s/s of ARDS
- dyspnea worsening - increased HR, RR - crackles, rales lung sounds - low O2 saturation
60
CXR tube placement should show how far down the tube is placed
20-22cm for females 22-24cm for males
61
what s/s could indicate inappropriate endotracheal tube placement
- asymmetrical lung sounds - no rise of chest wall - lung sounds in abdomen
62
ventilator abbreviations: AC
assisted control takes over if RR falls below settings
63
ventilator abbreviations: HME
heat & moisture exchanger
64
ventilator abbreviations: PEEP
positive end-expiratory pressure pressure left in lungs after expiration
65
ventilator abbreviations: PIP
peak inspiratory pressure
66
ventilator abbreviations: PSV
pressure support ventilation
67
ventilator abbreviations: SIMV
synchronized intermittent mandatory ventilation ventilation + pt's own efforts not all breaths helped
68
ventilator abbreviations: TV
tidal volume air in n out
69
richmond agitation & sedation scale (RASS) tells you what
+4 combative ---- 0 alert&calm ----- -5 unarousable while on MV
70
purpose of ECMO
artificial circulation where blood is pumped out to oxygenate and remove CO2 and return to the body venoarterial or venovenous
71
pathophys of emphysema
alveoli damaged and eventually rupture diffusion issue

NURS124 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions