Respi Flashcards

1
Q

What are the early signs of hypoxia in bronchial asthma and what are the late signs as well

A

Altered level of consciousness

cyanotic clubbing of fingers

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2
Q

What will be the position if a patient with asthma has wheezing

A

Orthopneic position

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3
Q

What will be the sign that a patient with asthma is worsening

A

diminished breath sounds

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4
Q

ASTHMA Air trapping
prolonged inhalation or exhalation?

A

Exhalation

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5
Q

First sign of hypoxia what will be the ABG

A

respiratory alkalosis

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6
Q

What will be the ABG if w status asthmaticus or in ET intubation

A

Respiratory acidosis

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7
Q

Peak expiratory flow rate
green means
yellow means
red means

A

Green means go under control,

yellow means mellow rescue drug every four hours for one to two days.

Red means alert.

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8
Q

Is there a need to avoid strenuous exercise or activity in asthma?

A

No need you just have to take the meds before the exercise.

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9
Q

drugs to avoid in asthma

A

NSAIDs beta blockers

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10
Q

Example of NSAIDs

A

naproxen, aspirin, ibuprofen, indomethacin ketorolac

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11
Q

Pharmacology for asthma

A

bam and slam
Beta2 agonist (terol),
anti-cholinergics (tropium), methylxantines (phylline),

steroids,
leukotriene inhibitors (lukast),
mast cell stabilizers (cromolyn)

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12
Q

Cholinergic

constriction or dilation
parasympathetic or sympathetic nerve system

A

Constriction parasympathetic

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13
Q

2 orders of medicine bronchodilator and anti-inflammatory how will you give it?

A

Wait for five minutes interval give the bronchodilator first but if same med you just have to wait for 1 to 2 minutes

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14
Q

Medicine for brutal asthma attacks

A

albuterol

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15
Q

Anticholinergics makes your body?

A

Dry

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16
Q

Theophylline symptom of toxicity and therapeutic range

A

Very fast heart rate , 10 to 20

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17
Q

Three S side effects of steroids

A

Sores or oral thrush, sepsis and sickness, sugar increased

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18
Q

Metered dose inhaler instruction

A

hold your breath for 10 seconds after inhaling. You can use spacer to increase the delivery of meds.

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19
Q

Metered dose inhaler instruction

A

hold your breath for 10 seconds after inhaling. You can use spacer to increase the delivery of meds.

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20
Q

Two memory trick of COPD

A

chronic air trapping
carbon dioxide HIGH

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21
Q

Signs and symptoms of emphysema

A

PINKO

Pink skin, pursed lip reading

Inc prolonged expiratory/barrel chest/ accessory muscles

no chronic cough

keep tripoding

overdistended alveoli

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22
Q

Bronchitis signs and symptoms

A

BLUE

Blue skim/Cyanosis

long-term cough and sputum

unusual lung sounds (crackles and wheezes)

edema/ ascites

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23
Q

How many months or years bronchitis will be considered as chronic

A

last three months in each two consecutive years

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24
Q

COPD can be caused by genetics what deficiency

A

alpha one antitrypsin deficiency

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25
Q

BLOOD COUNT IN COPD

A

POLYCYTHEMIA

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26
Q

WHAT IS THE ABG IN COPD

A

RESPIRATORY ACIDOSIS

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27
Q

NUMBER ONE COMPLICATION OF COPD?

A

RESPIRATORY -BIPAP

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28
Q

Second complication of COPD?

A

Cor pulmonale

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29
Q

Explain hypoxic drive

A

Decreased oxygen brain will detect positive breathing, if increase oxygen no breathing, then apnea

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30
Q

Type of mask for COPD

A

Venturi mask

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31
Q

Position for COPD

A

orthopneic position

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32
Q

drugs should be restricted in COPD

A

opioids and benzos

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33
Q

Diet of COPD,

A

soft diet
high calories,
high protein,
low carbohydrates,
low fiber

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34
Q

Vaccine prevention in COPD?

A

Flu vaccine every year and pneumococcal vaccine every five years

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35
Q

Mobilize secretions you may give?

A

Guaifenesin or cool mist humidifier

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36
Q

How to do a pursed lipreading?

A

Inhale 2 seconds in nose and exhale 4 seconds with pursed lips

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37
Q

COPD HUFF coughing technique

A

hold his breath and forcefully exhale.

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38
Q

type of COPD when there is damaged Goblet cells or increased mucus production?

A

Chronic bronchitis.

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39
Q

type of cough chronic bronchitis have? Productive cough

A

Productive cough

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40
Q

type of COPD that have pulmonary hypertension and bloatedness or ascites?

A

Chronic bronchitis.

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41
Q

How many 02 percent Venturi mask give?

How about nasal cannula?

A

Lowest possible 33%
lowest possible 45%

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42
Q

pulmonary toileting

A

Deep breathing exercises, coughing, pursed lip reading.

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43
Q

How many times will you perform chest physiotherapy COPD?

A

3 to 4 times a day

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44
Q

Antitussives is given for what type of COPD?

How about expectorants?

A

Emphysema
chronic bronchitis

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45
Q

best activity for Olds?

A

Gardening

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46
Q

other complication of COPD?

A

heart failure and sepsis

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47
Q

Type of COPD when there is a alveoli problem or over distended alveoli?

A

Emphysema

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48
Q

RIB FRACTURE AND FLAIL CHEST
Which is which isang rib lang affected

A

RIB FRACTURE

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49
Q

FLAIL CHEST
tawag if both sides or ribs affected, if unilateral lang affected?

A

COMPLETE, INCOMPLETE

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50
Q

RIB FRACTURE classic sx

A

CHEST PAIN/ REFERRED PAIN + shallow breathing

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51
Q

FLAIL CHEST classic six

A

CHEST PAIN/ REFERRED PAIN + paradoxical breathing (inhale=inward chest) normal is inhale=outward chest

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52
Q

PNEUMOTHORAX
ano loob

A

AIR

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53
Q

PNEUMOTHORAX
Ano type if pumutok ung bleb
if inc pressure
if may opening sa pleural wall

A

SPONTANEOUS
TENSION
OPEN

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54
Q

PNEUMOTHORAX
Tension pneumothorax sx that may lead to HF

A

TRACHEAL DEVIATION

55
Q

PLEURAL EFFUSION
ano sa loob

A

WATER

56
Q

PLEURAL EFFUSION
secondary cause

A

PTB, PNEUMONIA, CA

57
Q

PLEURAL EFFUSION
3 types

A

HEMOTHORAX
PYOTHORAX/EMPYEMA
HYDROTHORAX/ PLEURAL EFFUSION

58
Q

PLEURAL EFFUSION
Sa lungs, san makikita ang air at fluid? Ano meron sa breath sounds

A

Air- apex
Fluid- base
Dec or absent breath sounds

59
Q

PLEURAL EFFUSION
Confirmatory test

A

CT SCAN

60
Q

PLEURAL EFFUSION
Aside CT scan ano pa dx

A

CXR + clinical sx
UTZ

61
Q

PLEURAL EFFUSION
Mngt

A

Thoracentesis
CTT: pneumothorax
Diuretics
Emergency H dialysis
Pigtail insertion

62
Q

UTZ 3 fxns

A

LOC VOL SEPTATION

63
Q

SEPTATION

A

windowing/ kalat- kalat ung butas sa lungs not conducive for thoracentesis

64
Q

CHEST TUBE
1st bottle:
2nd:
3rd:

A

DWS (Drainage bottle, Water Seal, Suction control)

65
Q

CTT DRAINAGE BOTTLE
Abn collection

A

> 100 cc/hr + bright red

66
Q

CTT DRAINAGE BOTTLE
<50cc/3h gagawin

A

assess breath sounds and notify

67
Q

CTT DRAINAGE BOTTLE
Nagpositive nung ni auscultate ni doc ano expect mo

A

CXR (reexpansion)

68
Q

CTT DRAINAGE BOTTLE
Expansion what to expect? If di nag expand?

A

Pain med 30 mins prior removal
Notify and assess

69
Q

CTT DRAINAGE BOTTLE
(-) breath sounds gagawin

A

Notify

70
Q

CTT WATER SEALED
normal?

A

Intermittent, no oscillation, no tidaling and no bubbling

71
Q

CTT WATER SEALED
continues?

A

Air leak

72
Q

CTT WATER SEALED
No DOB? with DOB?

A

Assess breath sounds
Notify

73
Q

CTT SUCTION CONTROL
normal and abn

A

Continuous gentle bubbling
Continuous vigorous

74
Q

CTT
Tatransfer pt sino hahawak

A

Nurse below the chest

75
Q

CTT
Natanggal/ dislodged gagawin

A

3 way method sterile dressing

76
Q

CTT
Disconnect ung tubes gagawin

A

Submerged tube 2-3 cm

77
Q

CTT
Bakit 3 way method pag magcover

A

if not kasi, tension pneumothorax

78
Q

CTT
Tube disconnection materials

A

gauze, clamp, 2 bottles isa pang replace & isa pang submerge

79
Q

RESPI ANATOMY
Lining of ciliated mucosa divided by septum and contains olfactory receptors

A

NOSE

80
Q

RESPI ANATOMY
contains FEMS (frontal, ethmoid, maxillary, sphenoid)

A

Sinuses

81
Q

Biggest sinus

A

Frontal

82
Q

Widest sinus

A

Maxillary

83
Q

Sinusitis mngt

A

OFI

84
Q

RESPI ANATOMY
contains muscles w mucous lining & lympathic system

A

Pharynx

85
Q

Pharynx 3 fxns

A

Passageway, Immunity, Protection

86
Q

3 parts of Pharynx (NaOL)

A

NASOPHARYNX
OROPHARYNX
LARYNGOPHARYNX

87
Q

oropharynx passageway of?

A

Air and food

88
Q

Nasopharynx & larynopharynx passageway of?

A

Air

89
Q

Laryngopharynx prob mngt

A

INTUBATION, BRONCHOSCOPY

90
Q

Laryngopharynx prob mngt

A

INTUBATION, BRONCHOSCOPY

91
Q
A

LARYNX

92
Q

Adam’s apple’s cartilage

A

THYROID CARTILAGE

93
Q

Signet Ring Cartilage?

A

CRICOID CARTILAGE

94
Q

Lid/flap that opens (air to lungs), closes (food to stomach)

A

EPIGLOTTIS

95
Q

EPIGLOTITTIS consideration

A

NO INSERT, NO EXAMINATION

96
Q

Produces voice through Vibrations + expiration

A

VOCAL CORDS

97
Q

aka WINDPIPE, c-shapes pero flat sa likod, 10-12 cm long, passageway of air to lungs

A

TRACHEA

98
Q

Branch the trachea to bronchioles

A

MAINSTEM BRONCHI

99
Q

Smaller branches of bronchi

A

BRONCHIOLES

100
Q

smaller branches of bronchioles? smallest?

A

primary
secondary

101
Q

Gate going to alveoli

A

ALVEOLAR DUCTS

102
Q

unit of gas exchange

A

ALVEOLI

103
Q

ACCESSORY MUSCLE
elevates first 2 ribs

A

SCALENE

104
Q

ACCESSORY MUSCLE
Raises sternum

A

STERNOCLEIDOMUSCLE

105
Q

ACCESSORY MUSCLES
shoulder movt

A

TRAPEZIUS & PECTORALS MAJOR

106
Q

ACCESSORY MUSCLE
entire muscles

A

External intercoastal

107
Q

resp center

A

MEDULLA β€œMIDDLE/CENTER”

108
Q

Resp regulator

A

BRAINSTEM

109
Q

Controls rate & rhythm

A

PONS

110
Q

BREATHSOUNDS
large airways (larynx, bronchi, trachea/LBT)

A

BRONCHIAL

111
Q

BREATHSOUNDS
loud harsh, high pitch

A

BRONCHIAL

112
Q

BREATHSOUNDS
Smaller airways (bronchioles, distal part ng bronchi)

A

BRONCHOVESICULAR

113
Q

BREATHSOUNDS
moderate breezy sound

A

BRONCHOVESICULAR

114
Q

BREATHSOUNDS
alveoli

A

VESICULAR

115
Q

BREATHSOUNDS
low pitch (bell)

A

VESICULAR

116
Q

BREATHSOUNDS
Fluid accumulation, hair strand like sound

A

FINE CRACKLES

117
Q

BREATHSOUNDS
short high pitch bubbling sound

A

FINE CRACKLES

118
Q

BREATHSOUNDS
short low pitch Mucus accumulation

A

COURSE CRACKLES

119
Q

BREATHSOUNDS
High pitch musical hissing/whistle

A

WHEEZING

120
Q

BREATHSOUNDS
grating, squeky, scratchy/ sand paper, crackling

A

PLEURAL FRICTION RUB

121
Q

3 I’s maririnig si pleural friction rub

A

INFECTION (PTB, Pneumonia)
INFLAMMATION (pleuritic)
INFILTRATION (tumor, air/fluid)

122
Q

DX
Looks for anatomical, appearance of lungs that uses low beam radiation

A

XRAY

123
Q

Kidney fxn test
Fastest:
Reliable:

A

CREATININE
CREATININE CLEARANCE & GFT

124
Q

Kidney fxn test
orient pt na?

A

METALLIC TASTE, WARM FLUTTERY FEELING

125
Q

Kidney fxn test
Withhold_ bc __

A

OHA, nephrotoxic for 3 days

126
Q

Kidney fxn test
3 Complications
HEMATOMA, HEMORRHAGE, CIRCULATORY IMPAIRMENT

A

HEMATOMA, HEMORRHAGE, CIRCULATORY IMPAIRMENT

127
Q

hematoma abn centimeters

A

> 4 cm (microvascular bleeding)

128
Q

Mngt for hemorrhage

A

Pressure dressing, sand bag

129
Q

To do if may circulatory impairment

A

check distal pulse (no contralateral)
Pulse grading and sx of hypoxia

130
Q

removal of pleural fluid
THORACENTESIS

A
131
Q

THORACENTESIS 3 POSITIONS

A
  1. chair straddling tas arms and shoulder rested (posterior back)- upong tambay
  2. Sit w arms and shoulders rested sa table/bedside
  3. Unaffected side 30-45 HOB
132
Q

THORACENTESIS why position Unaffected side 30-45 HOB before and after

A

reexpansion

133
Q

THORACENTESIS why maintain in 1 position

A

baka mag compli to tension pneumothorax