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Adult 2 RNUR 238 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Acidosis Manifestations

A

Alterations in cardiac contractions, decreased vascular response to catecholamines, decreased response to certain medications, decreased LOC

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2
Q

Alkalosis Manifestations

A

Impaired neuro and muscular function, muscle twitches, tingling sensations, nervousness

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3
Q

PaO2 measures

A

the pressure of O2 dissolved in the blood and how O2 moves from airspace of lungs into the blood

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4
Q

PaCO2 measures

A

the pressure of CO2 dissolved in the blood and how it is able to move out of the body

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5
Q

pH measures

A

hydrogen ions in the blood

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6
Q

HCO3 (bicarb) measures

A

the bicarbonate buffer that keeps pH from becoming too acidic/basic

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7
Q

HCO3 (bicarb) measures

A

the bicarbonate buffer that keeps pH from becoming too acidic/basic

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8
Q

pH normal range

A

7.35-7.45

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9
Q

PaCO2 range

A

35-45

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10
Q

HCO3 normal range

A

22-26

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11
Q

Common ABG draw sites

A

Radial, brachial, femoral

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12
Q

pH abnormal values

A

<7.35 is acidosis, >7.45 is alkalosis

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13
Q

CO2 abnormal values

A

<35 is alkalosis, >45 is acidosis

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14
Q

HCO3 abnormal values

A

<22 is acidosis, 26 is alkalosis

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15
Q

PaCO2 indicates the _____ of the ____

A

efficiency; lungs

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16
Q

HCO3 is an indicator of the _____ component of the _____

A

metabolic; kidneys

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17
Q

ROME acronym

A

Respiratory opposite, metabolic equal

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18
Q

Metabolic acidosis s/s

A

confusion, drowsiness, N/V, low BP, clammy skin, headache, Kussmaul’s breathing, coma

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19
Q

Kussmaul’s respirations

A

result of metabolic acidosis; deep, rapid, labored breathing

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20
Q

metabolic acidosis values (pH and CO3)

A

pH <7.35, HCO3 <22

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21
Q

metabolic acidosis treatment

A

administer bicarb IV, dialysis if R/T kidney failure

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22
Q

Respiratory acidosis values

A

pH <7.35, PCO2 >45

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23
Q

Respiratory acidosis causes

A

Inadequate ventilation, airway obstruction, pulmonary edema, chest trauma, drug OD

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24
Q

Respiratory acidosis S/S

A

increased pulse and BP, mental cloudiness

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25
Q

Respiratory acidosis treatment

A

Improve ventilation; bronchodilators, suctioning, adequate hydration

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26
Q

Metabolic alkalosis values

A

pH >7.45, HCO3 >26

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27
Q

Metabolic alkalosis causes

A

Loss of gastric juices per vomiting or NG suction, overuse of antacids

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28
Q

metabolic alkalosis s/s

A

tingling in fingers and toes, dizziness, lethargy, weakness, muscle twitching, cramps, tetany, decreased BP and gastric motility

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29
Q

metabolic alkalosis treatment

A

restore fluid volume with NaCl containing fluids (kidneys absorb NaCl allowing excretion of bicarb)

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30
Q

respiratory alkalosis values

A

pH >7.45, PCO2 <35

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31
Q

Respiratory alkalosis causes

A

hyperventilation, anxiety, high altitudes

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32
Q

respiratory alkalosis s/s

A

light headedness, numbness and tingling, tinnitus, restlessness, n/v, dysrhythmias

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33
Q

respiratory alkalosis treatment

A

breathe into a paper bag; retention of CO2

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34
Q

acidosis pathophysiology

A

increase in plasma H+ concentration resulting in depression of the nervous system

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35
Q

alkalosis pathophysiology

A

decrease in plasma H+ concentration resulting in over excitability of the nervous system

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36
Q

Pneumonia definition

A

inflammation of the lung parenchyma

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37
Q

Types of pneumonia

A

CAP (community), HAP (hospital), VAP (ventilator), aspiration

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38
Q

CAP pneumonia

A

within the first 48 hours of hospitalization, most common in patients under 60

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39
Q

leading bacteria causing CAP

A

H. influenzae

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40
Q

Pneumonia HAP

A

onset of symptoms occurs more than 48 hours after admission

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41
Q

HAP pneumonia bacteria

A

E. coli, Klebsiella, MRSA

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42
Q

Aspiration pneumonia

A

pulmonary consequences of entry of substances into lower airway

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43
Q

Aspiration pneumonia causes

A

normal bacteria from upper airway, gastric contents, chemicals, gases, foods

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44
Q

Pneumonia clinical manifestations (age dependent consideration)

A

Fever, pain, cough with blood or thick sputum, tachypnea, orthopnea, cyanosis

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45
Q

Pneumonia breath sounds

A

diminished, absent, adventitious

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46
Q

Adventitious sounds

A

crackles (rales), wheezes, gurgles (rhonci), friction rub

47
Q

Pneumonia geri considerations

A

May be primary problem or complication of chronic illness (ex: COPD), classic s/s may be mission, general deterioration, abdominal symptoms, confusion, weakness, much higher rate of mortality

48
Q

Pneumonia medical management

A

Antibiotic (culture dependent), oxygen, antipyretics, antitussives, antihistamines, hydration, respiratory therapy, rest

49
Q

COPD types

A

Chronic bronchitis and emphysema

50
Q

Bronchitis (acute) definition

A

inflammation of the bronchial tree often following an URTI

51
Q

Bronchitis (acute) S/S

A

mucous in sputum, noisy inspirations, sternal soreness from coughing, fever, general malaise

52
Q

Bronchitis (acute) treatment

A

(symptomatic treatment) cool steam inhalation, increased fluid intake (2-3L/24 hours), bedrest, antibiotics after sputum culture

53
Q

Bronchitis (chronic) s/s

A

productive cough lasting minimum of three months a year for two or more consecutive years, hx of frequent respiratory infections, common cigarette smoke or pollution exposure

54
Q

Bronchitis (chronic) diagnosis mechanisms

A

ABGs, x-ray, pulmonary functions testing (shows a decrease in vital capacity and forced expiratory volume)

55
Q

Bronchitis (chronic) treatment

A

bronchodilators, postural drainage, increase fluids 2-3L/24 hours, rest, corticosteroids if client fails to respond

56
Q

Emphysema (definition/explanation)

A

Alveolar walls are destroyed, leading to permanent distention of airspaces, increased WOB because there is decreased functional tissue

57
Q

Emphysema S/S

A

Progressive dyspnea on exertion, thin client, tachypnea with prolonged expiration, anterior/posterior chest diameter enlarged (Barrel chest), accessory muscle use

58
Q

Emphysema Treatment

A

bronchodilators and steroids, oxygen (1-3L – be careful not to use too much because it can obliterate respiratory drive), moist mucous membranes, cluster NSG care, pursed lip breathing

59
Q

Asthma pathophysiology

A

chronic inflammatory process and disorder of the bronchial airways characterized by episodes of bronchospasm and narrowing of airways

60
Q

Asthma S/S

A

Dyspnea, cough, chest tightness, nasal flaring, pursed lip breathing, expiratory wheeze, anxiety

61
Q

Status asthmatics duration

A

over 24 hours

62
Q

status asthmatics definition

A

acute episode of asthma, life threatening complication with severe bronchospasms, paradoxical pulse, hypoxemia, acidosis, and can cause cardiac arrest

63
Q

Asthma treatment: SABA (strong acting beta agonists)

A

Albuterol, Xopenex, Maxair

64
Q

Asthma treatment: anticholinergics

A

Atrovent

65
Q

Asthma treatment: Anti-inflammatory

A

Corticosteroid (ex: prednisone)

66
Q

Asthma treatment: Bronchodilators

A

Long acting beta agonists (Advair), theophylline

67
Q

Asthma treatment: Leukotriene modifiers

A

Singular

68
Q

Asthma treatment (non pharm)

A

Low dose O2, hydration, energy conservation, maintain patent airway, maintain effective gas exchange

69
Q

Asthma treatment for ineffective bronchodilators

A

Nebulizer of atropine sulfate or epinephrine, Theophylline IV or steroids IV

70
Q

TB test results are read within ____ Hours

A

48-72

71
Q

What can cause a false positive in a TB test?

A

BCG vaccination

72
Q

Tuberculosis is cause by

A

mycobacterium tuberculosis

73
Q

TB affects the

A

lung parenchyma

74
Q

Risk factors for TB

A

poverty, malnutrition, living in close quarters, inadequate healthcare

75
Q

Tuberculosis pathophysiology

A

First time infection is “primary” and then cells undergo the process of necrotic degeneration

76
Q

What happens to the lung tissue when TB has invaded?

A

It grows tubercules that liquify masses of dead WBC and the invading bacteria. (those then heal over time after being coughed up but leave scar tissue)

77
Q

Reasons for TB reinfection

A

Advanced age, HIV, malnutrition, alcoholism, institutionalized, severe disease states (immunosuppression)

78
Q

Only definitive diagnostic TB test

A

sputum

79
Q

Medications for TB

A

isoniazid, rifampin, streptomycin, pyrazinamide

80
Q

TB treatment includes ___ antibiotics

A

multiple (R/T killing any resistant organism)

81
Q

Patient is non-infectious after TB after ___ weeks of starting medication

A

2-3

82
Q

Lung Abscess causes

A

aspiration, mechanical or functional obstruction, infections that result in necrosis

83
Q

Lung abscess S/S

A

Fever, chills, pleuritic pain, cough, copious sputum (foul or bloody), decreased breath sounds, dullness to percussion, friction rub over affected area, crackles as abscess drains

84
Q

Lung Abscess diagnosis

A

CXR, CT scan, sputum, bronc

85
Q

Lung Abscess treatment

A

antibiotics, therapeutic bronc, postural drainage, frequent mouth care, high calorie and high protein diet, lobectomy

86
Q

Pleural Effusion causes

A

CHF (usually w/o pleuritic pain), Liver/renal failure, infections, TB, lupus, arthritis, cancer, trauma, lymphatic obstruction

87
Q

Pleurisy is inflammation of the

A

pleurae (parietal and visceral layers of the lungs)

88
Q

____ pleura has nerve endings

A

parietal

89
Q

_____ pleura does not have nerve endings

A

visceral

90
Q

Pleurisy s/s

A

pleuritic pain, sharp, severe, knifelike on one side and felt suddenly with deep inspiration, sneezing, and coughing

91
Q

Pleurisy medical management

A

Treat the pain and find underlying cause

92
Q

Pleural effusion primary diagnostic test

A

Thoracentesis to remove excess fluid, obtain specimen and relieve dyspnea

93
Q

Pleural effusion is a _____ of _____ in the _____ space

A

collection, fluid, pleural

94
Q

Pleural effusion s/s

A

SOB, lies/sites in position of comfort, decreased chest wall excursion, dry and non-productive cough, pleurisy (pain), dull percussion

95
Q

Respiratory medications (list of types)

A

Bronchodilators, antihistamines, expectorants, cough suppressants

96
Q

List of bronchodilators

A

Albuterol, ipratropium, metaproteranol, aminophylline, theophylline

97
Q

List of antihistamines

A

vistaril, atropine, Benadryl, phenergan, epinephrine

98
Q

list of expectorants

A

Robitussin (guiafenesin), mucinex

99
Q

List of cough suppressants

A

codeine, dextromethorphan

100
Q

List of antifungals

A

Diflucan, amphotericin B

101
Q

List of corticosteroids

A

Hydrocortisone (IV) prednisone (PO) dexamethasone (inhaler)

102
Q

Nursing precautions for corticosteroids

A

take PO steroids with food, don’t skip or alter doses, don’t stop taking suddenly

103
Q

Potential long term problems with corticosteroids

A

cataracts, osteoporosis, ulcers

104
Q

Fremitus definition

A

vibrations felt with speech

105
Q

bronchophony definition

A

voice sounds over a consolidated lung

106
Q

ego phony definition

A

change in the sound of “e” as in bee to “a” as in say when auscultated

107
Q

Resonance lung sound

A

heard over normal lungs, usually low pitched

108
Q

hyper resonance lung sounds

A

low pitched but lower than normal, heard over hyper-inflated lungs

109
Q

Flat Percussion sound

A

High pitched with soft quality, heard over dense tissue where there is no air

110
Q

Dull percussion sound

A

medium pitch, heard where there is a combination of solid and fluid-filled area

111
Q

tympany percussion sound

A

drum-like and heard from a gas filled area as well as a pneumothorax

112
Q

Best time of the day to get a sputum sample is the

A

morning

113
Q

optimal pH range for most life

A

6.2-8.5

Adult 2 RNUR 238 (1 decks)

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