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Med surg Exam 3 > Respiratory 1 > Flashcards

Respiratory 1 Flashcards

1
Q

What is asthma

A

intermittent and reversible airway obstruction releated to inflammation and airway hyperresponsiveness -

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2
Q

what age does asthma occur

A

can occur at any age

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3
Q

what are the manifestations of asthma

A

hypertrophy, edema, thick mucus, bronchoconstriction

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4
Q

what is athma health promotion

A

stop smoking, decrease exposure to irritants, get vaccines, avoid triggers, teach how to use meds, regular exercise, hot water to wash sheets

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5
Q

what do ABGs look like for someone with asthma

A

hypoxemia = less then 80
early in attack = hypocarbia = PaCO2 less then 35, Late in attack = hypercarbia= PaO2 over 45, increased ETCO2

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6
Q

how to confirm asthma with pulmonary function test

A

if measurements increase by 12% after treatment with bronchodilator, pts usually have 15-20% decrease in one of FVC, FEV, PEA, airway responisveness

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7
Q

Asthma risk factors

A

family history, smoking (2nd hand too), environmental allergies, chemical irritants, GERD, older adult

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8
Q

Respiratory changes in older adults

A

decrease pulmonary reserve, more susceptible to infection, decrease sensitivity to beta receptors causes an increased risk for bronchospasms

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9
Q

diagnostic imaging for asthma

A

chest X-ray, immunoglobulin

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10
Q

SS of asthma

A

wheezing on exhale, cough, mucus production, increased respirations, accessory muscle use, barrel chest, cyanosis, decreased SP O2, hypoxemia increased heart rate

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11
Q

what changes are seen in eosinophils with asthma

A

increased with allergies too

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12
Q

what will you find in a sputum culture for asthma

A

curshman spirals

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13
Q

what is the treatment goal for asthma

A

to control asthma, guided self-care patient active and managing their care

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14
Q

what is an individual asthma action plan

A

developed by patient and PCP, tailored to meet personal triggers, asthma symptoms, and drug response

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15
Q

what is intermittent asthma classification

A

signs and symptoms less than two days a week

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16
Q

what is mild persistent asthma classification

A

signs and symptoms over two days a week

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17
Q

what is persistent asthma classification

A

signs and symptoms daily

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18
Q

what is severe asthma classification

A

signs and symptoms continuous

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19
Q

what is the nursing care for asthma

A

position for maximum ventilation, give O2, monitor heart, initiate IV, provide rest, teach infection prevention, encourage vaccinations

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20
Q

what are asthma symptoms of determining control

A

daytime wheezing, dyspnea, coughing more than two times per week, waking from sleep with wheezing/dyspnea/coughing, rescue drug used over two times per week, activity limited or stopped by symptoms over two times weekly

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21
Q

what are some complications that can occur from asthma

A

respiratory failure caused by persistent hypoxemia related to asthma

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22
Q

what is the hospital admin criteria for an acute asthma attack

A

FEV1 = less than 30% of predicted no improvement in one hour

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23
Q

what is the SS for an acute asthma attack

A

respiratory distress at rest, difficulty speaking, diaphoresis, accessory muscle use, respirations over 30, heart rate over 120

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24
Q

what are the signs and symptoms of an emergency asthma attack

A

absent breath sounds, cyanosis, inability to lie down, abdominal breathing

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25
Q

what is status asthmaticus

A

severe life threatening emergency, acute episode of airway obstruction, intensifies once it begins, often does not respond to common treatments, patient can develop a new thorax or cardiac arrest

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26
Q

what are the interventions for an acute asthma attack

A

hydration, supplemental O2 or by mask or nasal cannula, high flow with severe bronchospasms

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27
Q

what is COPD

A

chronic inflammation of the Airways, lung parenchyna and blood and vessels irreversible changes may lead to respiratory failure

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28
Q

what is the health promotion for COPD

A

stop smoking, decrease exposure to irritants, get vaccines, avoid and recognize triggers, exercise regularly, infection prevention

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29
Q

what are the risk factors for COPD

A

old age because of decreased pulmonary reserve, smoking over 10 packs per year, air pollution, occupational exposure, genetics (ATT deficiency)

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30
Q

what are long changes caused by COPD

A

loss of elastic recoil, air flow obstruction, hyper exertion of mucus, edema, bronchospasms

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31
Q

what are the signs and symptoms of COPD

A

dyspnea on exertion, chest tightness, productive cough in the morning over three months, crackles, wheezing, rapid and shallow respirations, using accessory muscles, irregular breathing pattern, tripod, thin extremities, dependent edema

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32
Q

what are the late signs of COPD

A

clubbing of toes and fingers, palar, cyanosis

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33
Q

what does a chest X-ray show you for COPD

A

hyperinflation of alveoli, ID’s blebs or infection, not helpful in diagnosing early or moderate disease, flattened diaphragm and light disease because of emphysema

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34
Q

what are the long term medications used for COPD

A

arfermoterol, indacaterol, tiotropium, aclidinium, bromide, olodaterol

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35
Q

What is the gold classification for COPD

A

evidence based strategy for COPD diagnosis and management based on class signs and symptoms and history

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36
Q

what is mild gold classification for COPD

A

FEV over 80%

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37
Q

what is moderate gold classification for COPD

A

50-80%

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38
Q

what is severe gold classification for COPD

A

30-50%

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39
Q

what is very severe gold classification for COPD

A

below 30%

40
Q

what does pulse ox show you for COPD

A

hypoxia

41
Q

what does ET CO2 show you for COPD

A

hypercarbia

42
Q

what do ABG’s show you for COPD

A

hypoxemia – PAO2 less than 80 and hypercarbia over 45 because of increased etco 2

43
Q

what does the CBC show you for COPD

A

increase hematocrit, decreased O2

44
Q

what does a pulmonary function test show you for COPD

A

decreased fev and FVC not reserved with bronchodilator

45
Q

What is the client education for COPD

A

increase calorie, washed hands, rest periods, stop smoking, vaccines, use O2

46
Q

how does acidosis happen for COPD

A

because of obstructed airway leads to poor gas exchange resulting in respiratory acidosis

47
Q

what are the interventions for hypoxemia and tissue anoxia

A

encourage using O2, promote pulmonary toilet

48
Q

how does someone with COPD get respiratory infections

A

secondary to increased mucus production and poor oxygenation

49
Q

what are some cardiac complications that can occur because of COPD

A

failure especially in cor pulmonale (increased pulmonary pressure equals increased cardiac workload), dysrhythmias related to acidosis, fluid imbalances, poor oxygenation and increased cardiac workload

50
Q

what are the manifestations of cor pulmonale

A

decreased O2, circumoral cyanosis, enlarged and tender liver, JDV, dependent edema

51
Q

what should you monitor with someone with cor pulmonale

A

respiratory status, heart rate and rhythm, acid base balance

52
Q

what are the signs and symptoms of COPD exacerbation

A

increase dyspnea, increase sputum production and its purulent

53
Q

what is the treatment for COPD exacerbation

A

supplemental O2 limit is one to two liters or 24 to 28%, goal spo 2 is 90 to 92%, short acting beta 2 agonist, corticosteroids, methylxathines

54
Q

What are the signs of bronchitis in COPD

A

intermittent mild to moderate dyspnea, onset after 35 years old, increased hematocrit, hypercarbia and hypoxemia

55
Q

what happens in the lungs for bronchitis

A

inflation of bronchi and bronchioles, congestion, mucosal edema, bronchospasm, purulent and copious secretions

56
Q

what are the signs of emphysema

A

progressive constant dyspnea, onset after 50 years, normal hematocrit, thin waisted

57
Q

what happens in the lungs for emphysema

A

clear sputum, hyperinflation of lungs total lung capacity increased on pulmonary function test, air trapping causes diameter of chest to increased looks barrel chested, loss of lung elasticity

58
Q

what is a transmembrane conductance regulator for cystic fibrosis

A

mutation that results in excessive thick, tenacious mucus lined airway causing blocked chloride transport leading to thick mucus with decreased water content, decreased resistance to infection, air trapping related to mucus plugs obstructing airway

59
Q

what are the problems noticed with exocrine glands with cystic fibrosis

A

decreased pancreatic enzymes and hypersecretion of gastric acids

60
Q

what is noticed in exocrine glands in the late stage cystic fibrosis

A

insulin production in the islets of langerhans affected, electrolyte change and secretion of sweat glands

61
Q

what happens in the male exocrine glands for cystic fibrosis

A

reproductive issues plugging vans deferens related to thick seminal fluid

62
Q

what happens in the female exocrine glands for cystic fibrosis

A

thick vaginal secretions limit sperm motility

63
Q

what do you notice in a pulse ox for cystic fibrosis

A

02 saturation may be decreased especially during pulmonary exacerbation

64
Q

what is sweat sodium test and cystic fibrosis considered diagnostic

A

consider diagnostic if level over 90

65
Q

what is the chest radiography show you for cystic fibrosis

A

might reveal hyperinflation, bronchial wall thickening, atelectasis or infiltration

66
Q

GI enzyme tests show you for cystic fibrosis

A

evaluation shows pancreatic enzyme deficiency

67
Q

how do you diagnose cystic fibrosis

A

made by respiratory symptoms like coughing, wheezing, dyspnea, meconium ileus, failure to thrive

68
Q

what are the signs and symptoms of cystic fibrosis

A

salty tasting skin, chronic respiratory symptoms, frequent lung infections because of thickened mucus pools and bronchioles, poor growth, Constipation, greasy and bulky stools

69
Q

what does a sweat chloride test show you for cystic fibrosis

A

considered suspicious at the level of chloride in the collected sweat is over 50 and diagnostic if the level is over 60

70
Q

what would a pulmonary function test reveal for someone with cystic fibrosis

A

decreased in FVC and FEV with increased residual volume

71
Q

what are the common organisms found with cystic fibrosis

A

staph aureus, pseudomans, H. flu

72
Q

What is an airway clearance treatment for cystic fibrosis

A

percussion, vibration, huff coughing, PEP devices

73
Q

what is the education for cystic fibrosis

A

increase calorie increase protein, monitor weight, positive expiatory devices, exercise conditioning

74
Q

how long does a lung transplant extend your life

A

1-15 years

75
Q

What is pulmonary arterial hypertension

A

blood vessels constriction and increased vascular resistance in the lung deficiency of prostacyclin 1

76
Q

what are the risk factors for pulmonary arterial hypertension

A

exposure to drugs, more common in women ages 20 to 40, autosomal dominant, if left untreated patients die within two years of diagnosis

77
Q

what are the signs and symptoms of pulmonary arterial hypertension

A

dyspnea, fatigue and otherwise healthy adult, angina

78
Q

what meds are used for pulmonary arterial hypertension

A

warfarin - clot prevention related to vessel constriction and a calcium channel blocker to dilate blood vessels

79
Q

how do you diagnose pulmonary arterial hypertension

A

made an absence of other lung disorders common most often diagnosed late stage when damage is already done, pulmonary function test, right sided heart Cath showing increased pulmonary pressure

80
Q

what are occupational lung alterations

A

extent of damage secondary to toxicity, duration and amount of inhaled substances, fibrosis and inflammation

81
Q

what are the signs and symptoms of occupational lung alterations

A

10 to 15 years after exposure, dyspnea, coughing, wheezing, weight loss

82
Q

what is chemical pneumonitis

A

inhalation of chemical irritants acute is pulmonary edema chronic is inflammation and fibrosis

83
Q

what is pneumoconiosis

A

inhalation and retention of mineral or metal dust particles causes inflammation and fibrosis

84
Q

what is hypersensitivity pneumonitis

A

inhalation of fungus spores from moldy hair, bird droppings, or other organic dust causes inflamed air sacs, fibrosis scar tissue, abnormal breathing

85
Q

what are the complications of occupational long alterations

A

COPD, cancer, cor pulmonale

86
Q

what is laryngeal cancer

A

originates at mucosal surface squamous cell carcinoma

87
Q

how do you prevent laryngeal cancer

A

quit smoking, regular exams

88
Q

how do you diagnose laryngeal cancer

A

visualization with laryngeal mirror, laryngeal scope, MRI, CT, PET to assess lymph node involvement, ultrasound, biopsy

89
Q

what is the treatment for laryngeal cancer

A

depends on location and stage options are radiation therapy, chemo, minimally invasive laser, robotic surgery, surgical procedure to preserve laryngeal

90
Q

what are the nursing considerations for someone with laryngeal cancer

A

allow time for communication come and use normal tournaments voice, address changes in self-image, provide social contact, educate on trade care and oral feedings

91
Q

what are the risk factors for laryngeal cancer

A

smoking, secondhand smoke, some unknown

92
Q

what are the early signs and symptoms of laryngeal cancer

A

referred ear pain

93
Q

what are the late signs of laryngeal cancer

A

difficult or painful swallowing, dyspnea, noisy breathing, severe hoarseness, mass or growth on the neck

94
Q

what is total laryngectomy

A

for severe cases separates trachea and esophagus, permanent tracheostomy, voice prosthesis, electrolarynx

95
Q

what is the care for a total laryngectomy post-op

A

insure patent Airways, assess lung sounds, hourly respiratory assessment

96
Q

what are the complications of a laryngectomy

A

stomal stenosis, infection, hematoma, carotid damage

Med surg Exam 3 (6 decks)

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