Respi () Flashcards
Hollow areas between the bones in your head that help regulate the temperature and humidity of the air being inhaled.
sinuses
Tubes at the bottom of the windpipe that connect into each lung.
Brochial tubes
what are the bones and muscles of in the respiratory?
Diaphram - muscles that help the lungs pull air and push it out
Ribs - bones that protect heart and ribs
oxygen diffuses from the
capillary wall to the interstial fluid
air flow from a region of higher pressure to a region of lower pressure
air pressure variance
is determined cheifly by the radius or size of the airway through which air is flowing
air resistance
required to achiece normal levels of ventilation
increase resistance, greater than the normal respiratory effort
refers to which the lungs expland and indicates the relationship between the volume and the pressure of the lungs
Compliance
Regulation of acid base balance when inssuficient ventilation causes?
Hypercarbia
Respiratory acidemia causes
retention of excessive amount of CO2
hyper and hypocarpnia difference?
Hypercapnia, respiratory acidemia ; retention of exccessive amount of CO2
Hypocapnia, respiratory Alkalemia; Low amount of CO2 in the blood
the effectiveness of ventilation is best measured by the?
PCO2 in the ABG
explain respiratory process
- The diaphragm descends into the abdominal cavity during inspiration causing (-) pressure in the lungs.
- The (-) pressure draws the air from the area of greater pressure (THE ATMOSPHERE) into an area of lesser pressure (THE LUNGS)
- In the lungs, air passes thru the terminal bronchioles into the alveoli to oxygenate the body tissues
- At the end of inspiration, the diaphragm & intercostal muscles relax & the lungs recoil
- As the lungs recoil, pressure within the lungs becomes greater than atmospheric pressure, causing the air which now contains the cellular waste products of CO2 & H2O to move from the alveoli in the lungs to the atmosphere
- Expiration is a passive process
expiration lasts long than insipiration
Bronchial
best heard over trachea
bronchial
loud and high pitched w/ hollow quality
bronchial
ü Best heard posteriorly between scapula & anteriorly over bronchioles lateral to sternum at first & second intercostal spaces.
bronchovesicular
Inspiration = Expiration
Bronchovesicular
ü Blowing sounds that are moderate in pitch and intensity. Inspiration is equal to expiration.
Bronchovesicular
ü Created by air moving to large airways
bronchovesicular
ü Soft, low-pitched sounds that can be heard throughout the lungs, primarily when a person breathes in.
Vesivular
ü A loud, high-pitched crowing sound that is heard, usually w/o a stethoscope, during inspiration.
Stridor
caused by an obstruction in the upper airway requires immediate attention.
Stridor
usually changee or disappear w/ coughing
Rhonchi
ü Sounds occur as a result of air passing through fluid-filled, narrow passages, diseases where there is increased mucus production such as pneumonia, bronchitis, or bronchiectasis.
Rhonchi
ü Soft, high pitched discontinuous popping sounds that occur during inspiration
Crackles
ü Can be produced by rubbing a lock of hair between the thumb and finger close to the
ear.
Crackles
ü Obstructive disease in early inspiration, Bronchitis and pneumonia, CHF
crackles
ü Deep, low-pitched sounds heard during exhalation
wheezes
ü Due to narrowed tracheobronchial passages from secretions
wheezes
ü Continuous, musical, high-pitched, whistle - like sounds heard during inspiration and exhalation
wheeze
ü Narrow bronchioles, associated with
bronchospasm, asthma and buildup of secretions
ü Like 2 pieces of rubber rubbed together, inspiration and exhalation
friction rub
ü Inflammation and loss of fluid in the pleural space
Friction rub
friction rub is ü Associated with
pleurisy, pneumonia, or pleural infarct.
Information on the anatomic location & appearance
chest xray
it is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures.
chest xray
what is the pre procedure of chest xray
- remove jewelries other metal object
- assess for pregnancy
- inhale and hold breath
Suctioning rpocedure in obtaining sputum specimen
- Aseptic technique
- Hyper-oxygenate before and after
- Lubricate catheter with sterile water
- Tracheal suctioning: 4 inches
- Nasotracheal suctioning: insert to induce cough
- Suction intermittently for 10 to 15 sec
- Rotate and withdraw
It is a procedure to look directly at the airways in the lungs using a thin, lighted tube
Bronchoscopy
d/o that can’t use bronchoscopy
Pulmonary Arterial Hypertension (PAH)
Tracheal or Bronchial Stenosis
pre procedure of bronchoscopy
- Informed consent
- NPO prior
- Coagulation studies
- Remove dentures or eyeglasses
- Prepare suction
- Sedatives
- Resuscitation equipment available
post provedure of bronchoscopy
- V/S
- High Fowler’s
- Check gag reflex
- NPO
- Monitor for bloody sputum
- Monitor respiration
- Monitor for complications
- Notify the MD if complications occur
● Hole in the airway
Bronchial perforation
● Irritation of the airways
Bronchospasm
● Air in the space between the lung covering ________ that causes the lung to collapse ___.
● Air in the space between the lung covering Pleural space that causes the lung to collapse (pneumothorax)
Pulmonary angiography insertion
insertion of a fluoroscopy via the antecubital or femoral vein into the pulmonary artery
does Pulmonary angiography include iodine and radioplaque?
yes true chru
pre procedure of pulmonary angiography
Assess for allergy to seafood
POST-PROCEDURE NURSING CARE pulmonary angiograpy
- No bp for 24 hrs in the affected site
- Flat bed for 1-2 hrs
- monitor neurovascular status
- Monitor dye reation
a procedure to remove fluid or air from around the lungs
thoracentesis
prior to procedure of thorcentesis
. CXR or U/S prior to the procedure
what need to avoid during thoracentesis
Do not cough, breathe deeply, or move during the procedure
Common reasons to have thoracentesis done include:
- Infection. If your healthcare provider thinks you have an infectious disease (like a bacterial infection) that’s causing pleural effusion, they’ll remove some fluid for testing. Tests on your pleural fluid can help find the cause of infection.
- Cancer. If cancer may be causing pleural effusion, your provider can test your pleural fluid for cancer cells.
- Symptom relief. If pleural effusion is making it hard to breathe, your provider can remove some of the fluid to make you more comfortable.
a procedure in which samples of lung tissue are removed (with a special biopsy needle or during surgery) to determine if a lung disease or a cancer is present
Lung biopsy
Pre procedure of lung biopsy?
local anethesia
determines the patency of the pulmonary airways
VENTILATION PERFUSION LUNG SCAN
looks at how air moves in and out of your lungs
Ventilation scan
looks at how blood is flowing within your lungs
Perfusion
post procedure of lung biopsy
Handle secretions carefully for 24 hours
➥ is a way to help get rid of extra mucus in the lungs.
CHEST PHYSIOTHERAPY (CPT)
time of chest physiotherapy
1hr before meals or 2-3 hrs after meal
is the positioning of a patient with an involved lung segment such that gravity has a maximal effect of facilitating the drainage of broncho-pulmonary secretions from the tracheobronchial tree.
Postural drainage
It is a positioning technique to mobilize bronchial secretions.
Postural drainage
how long the position in postural drainage?
5-20 mins
➥ is designed to mimic natural sighing by encouraging patients to take slow, deep breaths
Incentive spirometry
Nasal cannula also called nasal prongs
Nasal cannula
It delivers a relatively low concentration of oxygen which is 24% to 44% at flow rates of 1 to 6 liters per minute.
Nasal canula
FI02 DELIVERED VIA NASAL CANNULA
24% - 1 lpm 36% - 4 lpm
28% - 2 lpm 40% - 5 lpm
32% - 3 lpm 44% - 6lpm
used for the client who has thick secretions
Aerosol mask
For high humidity & the desired O2 to the client with a endotracheal or tracheostomy
TRACHEOSTOMY COLLAR OR T-PIECE
is a tube that is placed between the vocal cords through the trachea.
endotracheal tube
it serves to provide oxygen and inhaled gases to the lungs and protects the lungs from contamination, such as gastric contents or blood
Endotracheal Tube
is a hole (stoma) that surgeons make through the front of the neck and into the windpipe (trachea).
Tracheostomy
most common cause of respiratoryillness and affect most people on occasion.
Upper respiratory tract infection
group of disorders characterized by inflammation and irritation of the mucus membranes of the nose
Rhinitis
different types of rhinitis
● Acute Rhinitis - associated with environmental allergies or respiratory viral infections
● Chronic Rhinitis - set of symptoms that persists for months or even years
● Nonallergic Rhinitis - involves chronic sneezing, drippy nose with no apparent cause.
● Allergic Rhinitis - caused by an allergen such as pollen, dust, dander or flakes of skin from certain animals, and molds.
excessive nasal drainage
Rhinorrhea
Clinical manefestation of rhinitis
Clinical Manifestations:
● Rhinorrhea – excessive nasal drainage
● Nasal congestion
● Purulent nasal discharge
● Sneezing
● Pruritus of the nose, roof of the mouth, throat, eyes, and ears
● Headache
acute inflammation of the mucous membranes of the nasal cavity characterized by nasal congestion, rhinorrhea, sneezing, sore throat, and general malaise
COMMON COLD
_____________ is due to viral infection and ___________ bacterial infection
80% is due to viral infection and 20% bacterial infection
a sudden painful inflammation of the pharynx
acute pharyngitis
pharyngitis clinical manesfestation
FLESHY TONES mnemonic:
Fiery-red pharyngeal membrane and tonsils
Lymphoid follicles swollen and flecked with white-purple exudate
Enlarged and tender cervical lymph nodes
Sore throat
Headache
Yucky (vomiting, nausea, anorexia)
Tenderness (malaise)
Overwhelming fever
Nausea
Exhaustion (myalgia)
what happen when pharyngitis inflammation without exudate
● A. Redness and vascularity of the pillars and uvula are mild to moderate.
● B. Redness is diffuse and intense
Nutrional theraphy of pharyngitis
● Pharmacologic Therapy – antivirals, antibiotics, analgesics
● Nutritional Therapy – liquid or soft diet, cool beverages, warm liquids, flavored frozen desserts
persistent inflammation of the pharynx or persistent sore throat
Chronic Pharyngitis
common in adults who work in dusty surroundings, use their voice to excess, suffer from chronic cough, or habitually use of alcohol and tobacco.
Chronic pharyngitis
clinical manesfestation of chronic pharyngitis
MUCUS HEAD mnemonic:
Mucus that collects in the throat and can be expelled by coughing
Upset throat (constant irritation or fullness)
Coughing to clear the mucus
Uncomfortable swallowing (difficulty swallowing)
Sore throat (or irritation in the throat)
Headache
Excessive tiredness (fatigue)
Annoying voice (tired voice)
Difficulty swallowing (again, emphasizing this symptom)
different medical management of rhinitis, common cold , pharyngitis chronic pharyngitis, tonsilitis ,laryngitis
rhitinis :
Medical Management:
● Pharmacologic Therapy – antihistamine and corticosteroid nasal spray
Pharyngitis
Medical Management
● Pharmacologic Therapy – antivirals, antibiotics, analgesics
● Nutritional Therapy – liquid or soft diet, cool beverages, warm liquids, flavored frozen desserts
Chronic pharyngitis
Medical Management:
● Nasal sprays
● Antihistamines
● Analgesics
Tonsilitis
Medical Management
● Antibiotic therapy
● Tonsillectomy
Laryngitis
Medical Management:
● Antibiotic therapy
● Corticosteroids
● Expectorant agents
clinical manefestation of tonsilitis
SORE THROAT mnemonic:
Sore throat
Obstructed swallowing (difficulty swallowing)
Respiratory noise (noisy respiration)
Ear ache
Temperature (fever)
Halitosis (foul-smelling breath)
Respiratory snoring (snoring)
Open mouth (mouth-breathing)
Altered voice (voice impairment)
Tired from discomfort (difficulty swallowing)
Swollen throat (pain and irritation)
clinical mnefestation of laryngitis
HAVE SIP mnemonic:
Hoarseness
Aphonia (loss of voice)
Voice changes (associated with laryngeal inflammation)
Severe cough
Inflamed uvula
Painful throat (sore throat)
Is the term used for preventable and treatable disorders with some significant extrapulmonary effect
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
characterized by airflow limitation which is usually progressive and associated with an abnormal inflammatory response
Chronic obstructive pulmonary disease
Risk factors for COPD include environmental exposures and host factors.
Risk factors for COPD include environmental exposures and host factors.
1. cigarette smoking
2. passive smoking (second-hand smoke)
3. prolonged and intense exposure to occupational dusts and chemicals
4. air pollution
5. Genetic abnormalities - deficiency of alpha1-antitrypsin (enzyme inhibitor that counteracts the destruction of lung tissue and protects the lung parenchyma from injury)
Enzyme inhibitor that counteracts the destruction of lung tissue and protects the lung parenchyma from injury)
Deficiency of alpha 1 antitrypsin
genetic disorder resulting from deficiency of alpha1 antitrypsin, a protective agent for the lung
ALPHA1-ANTITRYPSIN DEFICIENCY
a disease of the airways which is defined as the presence of cough and sputum production for at least 3 months in each of 2 consecutive years
Chronic Bronchitis
a disease of the airways which is defined as the presence of cough and sputum production for at least ?
3 months in each of 2 consecutive years
chronic bronchitis affects the?
lung parenchyma
the most common cause of chronic bronchitis is
smoking
they are the “blue bloaters”
Chronic Bronchitis
what are the s/sx of chronic bronchitis?
- accessory muscle use
- anxiety and depression
- Broncho spasm
- Broncho edema
- Chronic productive cough
- Hyponatremia and renail failure
- Cyanosis and dyspnea
- Decrease activity tolerance
- Lung hyper resonance, Decrease breath sounds, diffuses wheezes, rhonchi, crackles, prolonged exp
- impaired ventilation especially in inspiration
- impaired diffusion cor purmonale and pulmonary hypertension may develop
- RV failure
- SOB awake night and excercise
- fatigue
- Fluid retention causeing swelling in ankles
- Difficulty concentrating
- Dizziness
- Sudden weight gain
- Increase urge to urinate
mainstay theraphy of choric bronchitis
Inhaled Anticholinergic and beta 2 adrenergic agonist
chronic brochitis aminophylline is given thru
IV
it is pathologic term that describes abnormal distention of airspaces beyond the terminal bronchioles and destruction of the walls of the alveoli
Emphysema
it results from alpha1 -antitrypsin deficiency and is associated with smoking and air pollution
Emphysema
they are the “pink puffers”
Emphysema
2 types of emphysema and manefestation
- Panlobular (panacinar)
- Hyperinflated (hyper extended) chest
- marked dyspnea on excertion
-Weight loss typically occur - Centrilobular (centroacinar)
- chronic hypoxemia
- hypercapnia
- Polycthemia
- RV failure
- Cyanosis
- Respi Failure
- Peripheral edema
polycythemia contributes to the development of
cor pulmonale
3 impairement of emphysema
- impair ventilation
- Impair diffusion
- impair perfusion
pt. position in emohysema
orthop
(Under the new definition of COPD, it is considered a disease process separate from COPD)
BRONCHIECTASIS
a chronic, irreversible dilation of the bronchi which may lead to increase mucus production leading to respiratory acidosis
Bronchiectasis
- is a state in which there is usually a failure of ventilation and an accumulation of carbon dioxide
REspiratory acidosis
Paco2 and ph of bronchiectasis
PaCo2 increase PH decrease
bronchiectasis manifestation
- chronic cough
- Production of purulent sputum
- Hemoptysis
- Clubbing of fingers
treatment objectives of Bronciectasis
Bronchial draingae
a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.
Paroxymal Dyspnea
3 most common signs/symptoms
of asthma
- cough
- dyspnea
- wheezing
severe form of constriction & inflammation despite treatment; may lead to respiratory or cardiac failure
- status asthmaticus
Asthma’s best indication of an attack’s severity and may reveal hypoxemia during an acute attack
ABG analysis
a disease that causes thick, sticky mucus that build up in the lungs, digestive tract, and other areas of the body.
cystic fibrosis
it is one of the most common chronic lung diseases in children and young adults.
Cystic fibrosis
↑PaCO2 =
↓PaCO2 =
↑HCO3 =
↓HCO3 =
Acidosis
Alkalosis
Alkalosos
Acidosis
