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Fundamentals > Respiratory > Flashcards

Respiratory Flashcards

1
Q

alveoli

A

gas exchange by diffusion

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2
Q

diffusion in the alveoli

A

CO2 into alveoli, O2 from alveoli into capillaries

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3
Q

10y-adult RR norms

A

12-20

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4
Q

older adult (60y+) RR

A

16-25

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5
Q

bradypnea

A

<12

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6
Q

tachypnea

A

> 20

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7
Q

factors affecting respiratory function -6

A

body position, environment, lifestyle habits, increased work of breathing, rotund abdomen (obesity, pregnant), large chest (fat, muscle)

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8
Q

causes of increased work of breathing

A
  • airway obstruction-reduced diameter, increased airway resistance, more work
  • restricted lung movement: more work, more oxygen
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9
Q

exhalation vs inhalation time and types of processes

A

2x longer than inspiration; passive vs active

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10
Q

reasons for restricted lung movement-4

A

smoking, pneumonia, rib injury, scoliosis

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11
Q

reasons for airway obstruction

A

cystic fibrosis, bronchitis, asthma –anything that inflames

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12
Q

atelectasis

A

alveolar collapse, poor gas exchange; sometimes in combo with pneumonia

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13
Q

Causes of altered respiratory function -5

A

cough, sputum production, shortness of breath, chest pain, emotions

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14
Q

dyspnea

A

trouble breathing, there are levels of this

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15
Q

Respiratory history should focus on four major areas

A
  • risk factors for lung disease
  • signs and symptoms of respiratory dysfunction
  • impact of respiratory status of ADLs
  • adaptive measures for respiratory dysfunction
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16
Q

risk factors for lung disease

A

smoking, occupational exposure to pollutants

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17
Q

S&S of Respiratory dysfunction (3)

A

cough, sputum production, dyspnea

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18
Q

for smoking you need to look at

A

duration and extend, packs X year

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19
Q

potential problems that interfere with respiratory

A

obesity –> snore, O2 stat down during night

CHF

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20
Q

inspection with respiratory

A

observe rate, pattern and breathing effort

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21
Q

Biot breathing pattern

A

fast shallow breathing then stops with apnea in between

Think shallow bitch, can talk fast

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22
Q

what conditions could cause Biot breathing (6)

A

meningitis, encephalitis, head trauma, brain, abscess, heatstroke
Think B for brain

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23
Q

Cheyne Stokes

A

periods of respirations of increased rate and depth alternating with periods of apnea

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24
Q

reasons for Cheyne stokes (4)

A

CHF, drug overdose, increased intracranial pressure, impending death

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25
Q

kussmaul

A

increased rate and depth of respirations; look like been exercising

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26
Q

conditions where we would see kussmaul

A

metabolic acidosis, diabetic ketoacidosis, renal failure

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27
Q

clubbing

A

related to chronic cyanosis and chronic hypoxia

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28
Q

look at breathing effort

A

are they using accessory muscles?

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29
Q

mucus secretions- clear vs yellow

A

normal; infection

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30
Q

hemoptysis

A

blood in secretions

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31
Q

inspect color

A

around lips, hands, nails, capillaries-should be pink not blue

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32
Q

palpation (5)

A
  • check extent and pattern of thoracic expansion and trachea position
  • check fremitus for characteristics
  • temperature, tenderness, lesions
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33
Q

barrel chest is due to

A

chronic use of accessory muscles

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34
Q

percussion

A

detect fluid filled or consolidated portions of the lungs

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35
Q

consolidation

A

air is replaced with something else either fluid or solid within lungs, does not move with change of position

36
Q

normal lung tissue sound

A

resonance

37
Q

auscultation start in

A

front diaphragm, supraclavicular (apex of lungs) and compare each side

38
Q

qualities to look for with auscultation

A

intensity, pitch, duration and quality

39
Q

with auscultation wait for

A

full inhalation and exhalation

40
Q

discontinuous sounds and example

A

hear on inspiration or exhalation; crackles (rales)

41
Q

continuous sounds

A

hear on both insp and exhalation; rhonchi, wheezes, stridor, pleural friction rub

42
Q

normal sounds

A

trachea: bronchiole breath sounds
bronchioles: bronchiovesicular
parenchyma (lung tissue): vesicular

43
Q

abnormal sounds are called

A

adventitious sounds

44
Q

two types of crackles

A

coarse and fine

45
Q

landmarks of anterior and posterior chest wall

A

anterior, posterior, left lateral, right lateral

46
Q

bronchial sounds description

A

blowing hollow sounds over trachea

Remember B for bronchial and blowing

47
Q

bronchial sound intensity

A

expiration longer and louder

48
Q

bronchovesicular description

A

intermediate sounds

49
Q

vesicular description

A

soft and breezy sounds all over lung except airways

50
Q

characteristics of fine crackles

A

high pitches, short POPPING sounds during inspiration, cannot be cleared

51
Q

conditions for fine crackles; and conditions for those that occur early in inspiration

A

pneumonia and CHF; early in inspiration: bronchitis, asthma and emphysema

52
Q

coarse crackles

A

low pitched bubbling, moist sounds

53
Q

conditions for coarse crackles

A

pneumonia, pulmonary edema/fibrosis

54
Q

rhonchi

A

-OR sonorous wheezes; low pitches snoring or moaning, primarily heard in expiration; may be cleared with coughing

55
Q

conditions for rhonchi

A

bronchitis or singular bronchus obstruction

THINK BRONCHI RHONCHI

56
Q

wheezes (sibilant)

A

high pitched musical sounds, primarily during expiration

57
Q

sibilant wheezes found in what conditions

A

acute asthma or chronic emphysema

58
Q

pleural friction rub description

A

low pitched dry grating sound, superficial, during both inspiration and expiration

59
Q

pleural friction rub due to

A

pleuritis

60
Q

mechanisms for testing for respiratory

A

pulse oximetry, sputum culture

61
Q

where do we hear fine crackles

A

alveoli

62
Q

where do we hear coarse crackles, rales

A

peripheral airways

63
Q

where do we hear rhonchi

A

large airways

64
Q

where do we hear sibilant wheezes

A

large or small airways

65
Q

where do we hear pleural friction rub

A

pleural surfaces

66
Q

if someone is SOB, and you reposition them, what are you looking for

A

look at breathing (RR, how hard working, O2 stat)

67
Q

what do we want O2 stat at

A

93

68
Q

oxygen is considered and possible toxicity

A

a med, can have toxicity

69
Q

NEWolder adults considerations (5)

A
  • not taking deep breaths: incr secretions
  • gas exchange impaired, incr chance for infection
  • thoracic wall is more rigid
  • normal PaO2 decreases
  • lung capacity not the same
70
Q

health promotion: prevent and monitor

A

prevent respiratory infections; monitor peak flow

71
Q

health promotions: provide and position

A

providing adequate hydration; positioning and ambulation

72
Q

health promotion: deep breathing, use of

A

incentive spirometer for deep breathing; inhalation, mL of air

73
Q

stacked cough

A

cough 3 times with same breath, hold glottis in b/w

74
Q

oxygen therapy goals (4)

A

reverse hypoxemia
improve tissue oxygenation
decrease work of breathing in patient with dyspnea
decrease work of heart in patients with cardiac disease

75
Q

when should supplemental oxygen start

A

O2 stat is below 93%

76
Q

nasal cannula

A

1-6L/min, low flow, 22-44% oxygen

can be drying, could be mouth breather

77
Q

venturi mask

A

more accurate -control over Oxygen

3-8L/min, 24-50% oxygen, (plastic piece tells %)

78
Q

face mask (5)

A

6-10L/min, 40-60%
more controlled, covers mouth breathers
humidifies
can cause aspiration

79
Q

secretion mobilization exercises

A

coughing and deep breathing

80
Q

Reservoir bag-non rebreather purpose

A

to prevent hypoxemia, urgent- last step before intubation

81
Q

reservoir bag: non-rebreather characteristics

A

10-15L/min, 90-100% O2
keep bag inflated !
2 holes on side: CO2 goes out and breath from reservoir bag; no mixing of CO2 and O2

82
Q

pillows for splinting

A

gives resistance and comfort, for abdominal and cardio thoracic patients

83
Q

oxygen safety concerns

A

combustible, no smoking or near something that sparks

84
Q

oxygen devices

A

home oxygen systems –unlimited, make continuously

85
Q

E cylinders

A

limited supply, below 500 PSI need to change or alert for new

Fundamentals (5 decks)

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