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Foundations of Nursing > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

The higher the altitude, the [higher/lower] the oxygen pressure

A

lower

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2
Q

At high altitudes, respirations will be [↑/↓], heart rate will [↑/↓], and red blood cell production will [↑/↓]

A

all ↑

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3
Q

Alcohol, barbituates, benzodiazepines [↑/↓] the central nervous system

A

↓ depress

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4
Q

alveoli collapse from lungs not being able to expand fully

A

atelectasis

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5
Q

t/f: a cough is always infectious

A

false. Determine how long it’s been present, how frequent, what helps, and what makes it worse.

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6
Q

a “productive” cough indicates the presence of:

A

sputum

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7
Q

dyspnea

A

shortness of breath

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8
Q

t/f: chest pain can be based on respiratory conditions

A

true. Chest pain in peds is typically respiratory and in adults is typically cardiac. But both can happen to either group.

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9
Q

What level of dyspnea do we worry about in the clinical setting?

A

III or higher: short of breath while talking or performing ADLs

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10
Q

What does the curve of normal respiratory rates look like as age increases?

A

A lopsided smile! Higher in infants, decreasing through adulthood, increases again in older adults

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11
Q

elevated CO2 in the blood

A

hypercapnia

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12
Q

low O2 in the blood

A

hypoxemia

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13
Q

Using abdomen, shoulder, and neck muscles when breathing

A

use of accessory muscles

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14
Q

clubbing related to respiratory is a sign of

A

long term hypoxia

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15
Q

normal ratio for antierior-posterior chest diameter

A

1:2

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16
Q

COPD patients have what ratio of anterior-posterior chest diameter (compared to lateral)

A

closer to 1:1

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17
Q

tactile fremitus means ____, increases with ____, and decreases with

A

feeling of vibration on someone’s back when they talk
increases with consolidation: fluid or other substance has taken the place of air in the lung
decreases with pleural effusion

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18
Q

fluid in the lung gives a [dull/sharp/resonant] sound on percussion

A

dull

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19
Q

fine crackles late in inspiration

A

pneumonia, congestive heart failure

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20
Q

O2 goal for COPD patients

A

88-92% (outside of crisis)

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21
Q

In COPD patients, the drive to breathe is [hypercapnia/hypoxia], whereas in others the drive to breathe is [hypercapnia/hypoxia]

A

COPD: hypoxia
Normal: hypercapnia

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22
Q

End-tidal carbon dioxide monitoring is attached to ___ and indicates ___

A

attached to nasal cannula and indicates immediate breathing status

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23
Q

sites for pulse oximetry

A

fingers, toes, earlobe, forehead

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24
Q

when to use end-tidal CO2 monitoring

A

any medications that cause respiratory depression or any condition that messes with breathing rate.

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25
Q

diagnostic test to

diagnose lung conditions and determine placement of medical devices

A

x ray

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26
Q

diagnostic test to

visualise trachea and bronchi, remove foreign objects or mucus, obtain sputum sample

A

bronchoscopy

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27
Q

diagnostic test to

check exposure to tuberculosis or assess allergies

A

skin test

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28
Q

pulmonary function test

volume of air inhaled and exhaled in a normal breath

A

tidal volume

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29
Q

volume of air exhaled after taking the deepest possible breath

A

vital capacity

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30
Q

pulmonary function test

volume of air forcibly exhaled in 1 second after taking the deepest possible breath

A

forced expiratory volume in 1 second

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31
Q

Pulmonary function test or diagnostic:

Diagnostic test: chronic situation to assess interventions

A

pulmonary function test

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32
Q

Pulmonary function test or diagnostic:

acute situation to understand pathology

A

diagnostic

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33
Q

t/f: pulse oximeter should be removed while ambulating

A

false, can be useful

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34
Q

hyperventilation: [↑/↓] CO2

A

decreased

35
Q

hypoventilation: [↑/↓] CO2

A

increased

36
Q

ABG measures

A

oxygen, carbon dioxide, bicarbonate, pH

37
Q

mild hypoxemia

A

60-80 mmHg

normal: 80-100
mild: 60-80
moderate: 40-60
severe: <40

38
Q

normal oxygen PaO2

A

80-100 mmHg

normal: 80-100
mild: 60-80
moderate: 40-60
severe: <40

39
Q

% oxygen in environment

A

21%

40
Q

moderate hypoxemia PaO2

A

40-60 mmHg

normal: 80-100
mild: 60-80
moderate: 40-60
severe: <40

41
Q

severe hypoxemia PaO2

A

<40 mmHg

normal: 80-100
mild: 60-80
moderate: 40-60
severe: <40

42
Q

Positioning: bad lung goes up or down

A

up, so it can expand more easily without weight

43
Q

t/f: movement and repositioning is advised

A

true - breaks up mucus

44
Q

ABG

normal pH

A

7.35-7.45

45
Q

ABG

normal PaCO2

A

35-45 mmHg

46
Q

ABG

normal bicarb

A

22-26 mEq/L

47
Q

normal SpO2

A

95-100%

48
Q

normal FiO2

A

21%

fraction of inspired oxygen – oxygen in room air

49
Q

normal EtCO2

A

35-45 mmHg

50
Q

with respiratory issues, raise or lower head of the bed

A

raise

51
Q

ambulation helps reduce risk of these two respiratory conditions

A

pneumonia and atelectasis

52
Q

inhale or exhale with incentive spirometer

A

inhale

53
Q

incentive spirometer helps reduce risk of…

A

atelectasis and pneumonia

54
Q

**Interventions that reduce risk of atelectasis and pneumonia

A

ambulation, incentive spirometer, deep breathing, coughing

55
Q

What to do if a patient is immobilized and experiences pain when trying to cough

A

splinting incision (pillow over wound), stacked coughing (multiple coughs in short period), low flow cough (say “huff huff huff” on exhale), quad cough (push in and up on lower ribs on exhale)

56
Q

coarse crackles

A

low pitched, from pneumonia, pulmonary fibrosis, pulmonary edema

57
Q

fine crackles early in inspiration

A

COPD or asthma

58
Q

sonorous wheeze indicates

A

single-brochus obstruction

59
Q

sibilant wheeze indicates

A

acute asthma or chronic emphysema

60
Q

pleural friction rub indicates

A

pleuritis (sounds like a superficial crackle, during inspiration and expiration)

61
Q

four options for chest physical therapy

A

percussion (through bed control or vest)
vibration
oscillatory positive expiratory pressure therapy
postural drainage

62
Q

immobilized pt with mucus should receive [mucolytic or percussive therapy] to mobilize secretions

A

percussive therapy

63
Q

goals of oxygen therapy

A
  • improve tissue oxygenation
  • decreased respiratory work in pts with dyspnea
  • decreased cardiac work in pts with cardiac disease
    (it’s a medication and requires an order/prescription!)
64
Q

Nasal cannula percentage o2

A

24-44%

65
Q

Nasal cannula formula

A

1L=24%. Add 4% for every additional liter.

4L+24

66
Q

venturi mask percent o2

A

24-50

67
Q

simple mask percent o2

A

40-60%

68
Q

reservoir mask percent o2

A

90% or more

69
Q

oral airway device can also be used to

A

block bite

70
Q

artificial airway devices

A

oral airway, nasal trumpet, endotracheal tube, tracheostomy

71
Q

yankauer device is used for [oral/deeper] suctioning

A

oral

72
Q

with nasopharyngeal suctioning, patients should be [hyperoxemic, hypercapnic]

A

hyperoxemic

73
Q

inspiratory stridor

A

high pitched: near-total airway obstruction

74
Q

most common cause of airway obstruction

A

tongue

75
Q

how to manage tongue blocking airway

A

reposition – turn pt on side. (if unconscious, oral airway device)

76
Q

education points for home oxygen

A
  • infection risk: clean and know signs
  • fire risk
  • energy conservation
77
Q

Can you give too much supplemental oxygen

A

Yes! oxygen toxicity, or COPD issues

78
Q

CNS and vision problems related to oxygen toxicity are [acute/chronic]

A

acute

79
Q

alveolar problems related to oxygen toxicity are [acute/chronic]

A

chronic

80
Q

Oxygen should be titrated to the lowest level needed for adequate oxygenation. Which value is most accurate for assessing oxygen?

A

PaO2, but SpO2 is used because it’s not invasive.

81
Q

O2 sats are low: top things to check

A

positioning, if they’re on ordered oxygen

elevating head of bed is quicker and better

82
Q

position to use if pt needs to lay flat due to cardiac cath but has trouble breathing

A

reverse trendelenburg

83
Q

go-to interventions for nursing students when pts are in respiratory distress

A

reposition, ambulation

Foundations of Nursing (22 decks)

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