Respiratory Flashcards

1
Q

reflex, irritation in URT - removing irritant

A

sneezing

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2
Q

severe SOB & coughing attacks at night

A

paroxysmal nocturnal dyspnea

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3
Q

PFT & spirometry

measures…

A

pulmonary function test

pulmonary volumes & airflow times

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4
Q

FEV

measures…

A

forced expiratory volume

how much air a person can forcibly exhale

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5
Q

FEV1

A

amt of air exhaled in first second

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6
Q

FVC

measures…

A

forced vital capacity

amt of air exhaled during FEV test

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7
Q

TLC

measures…

A

total lung capacity

amt of air in lungs at max inspiration

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8
Q

exercise tolerance test measures…

A

ability of lungs & heart to supply O2 & remove CO2 before, during, after exercise

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9
Q

peak flow meter measures…

A

how well air moves out of lung

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10
Q

smooth & even respirations

E > I

A

eupnea

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11
Q

rapid superficial breathing

regular or irregular

A

tachypnea

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12
Q

slow, deep RR

regular rhythm

A

bradypnea

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13
Q

cessation of breathing

A

apnea

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14
Q

increased depth of breathing

regular rate & rhythm

A

hyperpnea

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15
Q

periods of apnea alternating with climbing & falling respiratory cycles

A

Cheyne-Stokes respirations

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16
Q

periods of apnea alternating with shallow breaths of equal depth

A

ataxic breathing

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17
Q

deep, regular sighing respirations

high RR

A

Kussmaul respirations

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18
Q

long, gasping inspiration

short, inadequate expiration

A

apneusis

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19
Q

long, ineffective expiration

shallow

increased RR

A

obstructed breathing

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20
Q

brief & inadequate respiratons

labored gasping or snorting

during or following cardiac arrest, CVA

A

agonal

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21
Q

high pitched continuous musical sound

I and/or E

narrowed airway

A

wheezes

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22
Q

“sonorous wheeze”

deep, low rumbling

respiratory secretions

A

rhonchi

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23
Q

high pitched, discontinuous, intermittent popping sounds

heard during early inspiration

air forced through passage/alveoli narrowed by pus, mucus, fluid

A

crackles/rales

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24
Q

fine crackles heard during…

A

late inspiration

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25
Q

coarse crackles heard during…

A

early inspiration

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26
Q

high pitched monophonic inspiratory wheezing

loudest over anterior neck

partially obstructed URT

A

stridor

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27
Q

low pitched grating noise

I and E

rough, inflamed or scarred pleura rub against one another

A

pleural friction rub

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28
Q

Passage of foreign material into trachea & lungs

A

aspiration

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29
Q

aspiration of gastric acid

A

chemical pneumonitis

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30
Q

aspiration of oral/pharyngeal bacteria

A

aspiration pneumonia

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31
Q

exogenous lipid pneumonia

A

aspiration of oil

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32
Q

aspiration of an object

A

foreign body aspiration

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33
Q

3 populations most affected by aspiration

A

premature babies

college age people who binge drink

dysphagia pts

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34
Q

s/s of aspiration (11)

A

coughing; fever

wheezing

stridor

hoarseness

nasal flaring

chest retraction

chest discomfort

cyanosis

pulmonary edema

resp distress syndrome

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35
Q

excess fluid in pleura

increased pressure on lungs

A

pleural effusion

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36
Q

etiology of pleural effusion (2)

A

↑ fluid production

↓ fluid absorption

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37
Q

r/f for pleural effusion (5)

A

CHF

kidney failure

PE

trauma

infection

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38
Q

s/s of pleural effusion

A

dyspnea

chest pain

tachypnea

tachycardia

percussed dullness

absence of breath sounds over area

tracheal deviation

hypotension

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39
Q

collapsed lung

alveoli deflated

little/no gas exchange

A

atelectasis

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40
Q

atelectasis uni/bilateral

A

unilateral (usually)

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41
Q

etiology of atelectasis (3)

A

airway blockage

pressure on lung

↓ surfactant

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42
Q

r/f for atelectasis (5)

A

obesity

general anesthesia

OSA

lung disorders

resp distress syndrome

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43
Q

s/s of atelectasis (5)

A

dyspnea; cough

tachycardia

chest pain

cyanosis

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44
Q

collapsed lung

may be open, closed, tension

A

pneumothorax

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45
Q

etiology of closed pneumothorax (3)

A

spontaneous

idiopathic

ruptured emphysematous bleb

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46
Q

etiology of open, tension pneumothorax

A

puncture wound

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47
Q

s/s of pneumothorax

s/s of 3 types

A

increased, labored respirations; dyspnea; tachycardia; pleural pain; asymmetrical chest movement

  • Closed - absent breath sounds; hypoxemia
  • Open- “sucking” noise; tracheal swing; ↓ BP; moderate hypoxemia
  • Tension - absent breath sounds; tracheal deviation to unaffected side
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48
Q

tx for open pneumothorax

A

protect wound

as wound starts to heal, cover with 3-sided bandage so air can move out, but not into lung

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49
Q

tx for tension pneumothorax

A

needle decompression

chest tube to keep pressure from returning

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50
Q

Portion of ribcage removed from part of chest wall

A

flail chest

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51
Q

complications of flail chest (6)

A

hypoxia

pneumothorax

hemothorax

pulmonary contusion

pneumonia

atelectasis

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52
Q

URI most likely type of pathogen

A

virus

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53
Q

r/f for URI (6)

A

smoking

young age

chronic disease

altered immune system

stress

crowding

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54
Q

s/s of URI (9)

A

cough

congestion

runny nose

sinus pressure

excessive mucus

sore throat

mild fever

body aches

itchy eyes

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55
Q

influenza season

A

Oct - March

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56
Q

inflammation/swelling of epiglottis

A

epiglottitis

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57
Q

epiglottitis mostly caused by…

A

Haemophilus influenzae bacteria

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58
Q

r/f for epiglottitis (3)

A

male

unvaccinated

immunocompromised

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59
Q

s/s of epiglottitis

A

fever

sore throat

stridor

painful swallowing

drooling

anxiety

leaning forward (instinctively protecting airway from saliva)

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60
Q

interventions for epiglottitis

A

do NOT look in pt’s mouth or ask pt to open their mouth

keep them leaning forward

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61
Q

complications of epiglottitis (4)

A

meningitis

abscess

pneumonia

death with airway obstruction

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62
Q

immunization for epiglottitis

A

Hib vaccine series for babies

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63
Q

Bronchioles infection only in children

A

bronchiolitis

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64
Q

most likely pathogen causing bronchiolitis

A

viral

Human metapneumovirus (HMPV)

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65
Q

r/f for bronchiolitis (7)

A

child

heart or lung condition

2nd hand smoke

never been breastfed

crowding

siblings

daycare

66
Q

s/s of bronchiolitis (5)

A

cough; fever

rhinitis

stuffy nose/congestion

wheezing

67
Q

complications of bronchiolitis (4)

A

dehydration

hypoxia

apnea

cyanosis

68
Q

infection of alveoli

A

pneumonia

69
Q

r/f for pneumonia (5)

A

older age; smoking

recent hospitalization

chronic illness

immunosuppressed

70
Q

s/s of pneumonia (7)

A

fever; fatigue; cough; dyspnea

chest pain

nausea

confusion in older pts

71
Q

immunizations for pneumonia

which populations are they for

A
  • PCV13 - <2yo
  • PCV23 - >65yo OR smokers >19yo
72
Q

Infection by Histoplasma capsulatum fungus found in bird & bat feces in humid areas

A

histoplasmosis

73
Q

histoplasmosis mode of transmission

A

inhaling fungal spores

74
Q

3 forms of histoplasmosis

A
  • Acute primary
  • Chronic cavitary
  • Progressive dissemination
75
Q

r/f for histoplasmosis

A

age <2 or >55

weak immune system

being around caves, barns

76
Q

s/s of histoplasmosis (10)

A

fever

myalgia

chest pain

malaise

pneumonia

pulmonary lesions

worsening cough and dyspnea

hepatomegaly

lymphadenopathy

wt loss

77
Q

complications of histoplasmosis (2)

A

meningitis

Addison’s disease

78
Q

encapsulated TB on chest x-ray

A

latent TB

79
Q

latent TB may become active if…

A

immune system is weakened/compromised

80
Q

r/f for TB (6)

A

close contact c infected

immunocompromised

homelessness

close quarters (prison, shelters etc)

drug/alcohol abuse

occupation

81
Q

s/s of TB (7)

A

fever; fatigue; cough

wt loss

hemoptysis

night sweats

chills

82
Q

immunization for TB

A

BCG vaccine

not used in USA

83
Q

difficulty exhaling

A

obstructive disorders

84
Q

difficulty inhaling

A

restrictive disorders

85
Q

etiology of OSA in adults & children

A
  • Adults - tongue and throat relax, soft tissue at back of throat blocks airway
  • Children - large tonsils/adenoids in upper airway
86
Q

r/f for OSA (7)

A

obesity; DM; smoking; family hx

male

asthma

narrow airway

87
Q

s/s of OSA (7)

A

snoring

noisy breathing

tiredness after sleeping

morning h/a

dry mouth

waking gasping for air

observed apneic spell

88
Q

A gene changes in a protein regulating salt movement

causes a thick, sticky mucus in resp, GI, reproductive systems

A

cystic fibrosis

89
Q

best for these patients not to gather together

because…

A

CF

can pass resistant forms of bacteria to one another - less capable of getting rid of them

90
Q

s/s of CF (9)

A

persistent cough

wheezing

chronic/resistant infection

exercise intolerance

steatorrhea (fat in stool)

poor wt gain

intenstinal blockage

constipation

salty sweat

91
Q

steatorrhea indicates…

A

CF

92
Q

genetic condition that increaes risk for contracting a resistant infection

A

CF

93
Q

tx for CF

A

percussion to help clear airways

94
Q

avg CF lifespan

A

37 years

95
Q

Chronic, intermittent

overresponse of immune system to an allergen

inflames & narrows airways in lungs

excessive production of mucus

remodelling of airways

A

asthma

96
Q

r/f of asthma (6)

A

family hx; obesity

male

African American

exposure to toxins

poverty (exposed to more triggers)

97
Q

which populations is asthma more common in?

A

males

African Americans

in poverty

98
Q

s/s of asthma (7)

A

cough; dyspnea

chest tightness

nighttime coughing

wheezing

use of accessory muscles

↓ O2 sat

99
Q

common asthma triggers

A

danders; cockroach droppings; viral illness; smoking; pollutants; physical activity

100
Q

2 diseases included in COPD

A

emphysema

chronic bronchitis

101
Q

“pink puffer”

A

emphysema

102
Q

“blue bloater”

A

chronic bronchitis

103
Q

overinflation of alveoli

A

emphysema

104
Q

chronically inflamed bronchi produce excessive mucus

A

chronic bronchitis

105
Q

etiology of emphysema

A

irreversible breakdown of alveolar walls

permanent holes in lower lung tissue

106
Q

etiology of chronic bronchitis

A

repeated irritation/damage to airways

107
Q

major risk factor/cause of emphysema

A

smoking

108
Q

other r/f for COPD besides smoking

A

exposure to toxins

109
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

rhonchi & wheezing

A

CB

110
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

diminished lung sounds

A

emphysema

111
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

excessive sputum

A

both

112
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

hypercapnia

A

both

113
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

pursed lip breathing

A

emphysema

114
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

cyanosis

A

CB

115
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

hyperresonance

A

emphysema

116
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

orthopnea

A

emphysema

117
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

thin with barrel chest

A

emphysema

118
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

overweight

A

CB

119
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

prolonged expiratory time

A

emphysema

120
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

tachypnea

A

both

121
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

anxiety, fatigue, short sentences

A

emphysema

122
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

use of accessory muscles to breath

A

both

123
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

hypoxia, cyanosis, clubbing

A

CB

124
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

recurrent productive cough (daily for more than 3 months)

A

CB

125
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

cardiac enlargement

A

CB

126
Q

EMPHYSEMA OR CHRONIC BRONCHITIS

peripheral edema

A

CB

127
Q

2 restrictive lung disorders

A

chest wall abnormality

pulmonary fibrosis

128
Q

chest wall abnormality etiology examples

A

kyphosis; scoliosis; poliomyelitis; ALS; botulism; muscular dystrophy

129
Q

Chronic, progressive

alveoli become scarred & stiff

makes gas exchange difficult/impossible

A

pulmonary fibrosis

130
Q

s/s of pulmonary fibrosis (6)

A

dyspnea; cough

clubbing

wt loss

myalgia

rapid shallow breathing

131
Q

Fluid accumulates in tissue & alveoli of lungs, making gas exchange difficult

A

pulmonary edema

132
Q

etiology of pulmonary edema

A

left-sided HF

133
Q

r/f for pulmonary edema (7)

A

DM; obesity; HTN; HLD

HF

medications

IV fluids

134
Q

s/s of pulmonary edema (12)

A

dyspnea

coughing frothy pink sputum

feeling like suffocating (especially lying)

wheezing

orthopnea

cold clammy skin

tachycardia

irregular heartbeat

palpitations

anxiety

cyanosis

death

135
Q

blood clot blocks artery in lungs

A

pulmonary embolism

136
Q

r/f for PE (10)

A

smoking; HTN; obesity

clotting disorder

pregnancy/30-60 days postpartum

oral contraceptive

arrhythmia

surgery

injury

decreased mobility

137
Q

s/s of PE (6)

A

dyspnea; weakness

sudden onset

severe chest pain

hemoptysis - usually frank blood

syncope

dizziness

138
Q

vessels in lungs blocked or destroyed leading to increased BP

A

pulmonary HTN

139
Q

pulmonary HTN affects…

A

lungs

right side of heart

140
Q

etiology of pulmonary HTN (5)

A

vessel destruction

left side HF

lung disease

chronic PE

comorbidities

141
Q

r/f for pulmonary HTN (5)

A

family hx; obesity

medications

high altitudes

congenital CV diseases

142
Q

s/s of pulmonary HTN (10)

A

dyspnea; fatigue

dizziness

syncope

chest pain

edema

ascites

palpitations

tachycardia

cyanosis

143
Q

surfactant deficiency in neonates

A

infant respiratory distress syndrome

144
Q

first 30 days of life

A

neonate

145
Q

r/f for IRDS

A

prematurity

146
Q

s/s of IRDS

A

rapid labored breathing

grunting

visible ICS (suprasternal & substernal retractions)

flaring of nostrils

lethargy

cyanosis

irregular breathing

apnea

cardiac failure

147
Q

fluid builds up in alveoli from response of immune system

A

acute respiratory distress syndrome

148
Q

etiology of ARDS

A

damaged membrane between alveoli & blood vessels

149
Q

r/f for ARDS (6)

A

hospitalization

sepsis

smoke inhalation

pneumonia

injury

underlying disease

150
Q

tx for ARDS

A

ventilation

151
Q

most cancer deaths/year in US caused by…

A

lung cancer

152
Q

2 types of lung cancer

A

small cell

non small cell

153
Q

small cell lung cancer occurs in…

A

heavy smokers

154
Q

localized small cell prognosis

A

56%

155
Q

localized non small cell prognosis

A

16%

156
Q

metastasized lung cancer prognosis

A

16%

157
Q

pack life =

A

packs/day x years person has smoked

158
Q

screening for lung cancer

A

low-dose computed tomography (LDCT) for people 55-80yo with a 30-year hx and have smoked in the last 15 years

159
Q

after ___ years of not smoking, the risk for lung cancer is the same as someone who never smoked

A

15

160
Q

5 A’s of encountering a smoker patient

A
  • Ask pt if they use tobacco products
  • Advise pt that smoking is bad for them
  • Assess willingness to quit smoking
  • Assist pt in quitting
  • Arrange a follow up evaluation for pt
161
Q

abnormal heart sound associated with pulmonary HTN

A

split S2