Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A-Med Surg 1 > respiratory > Flashcards

respiratory Flashcards

1
Q

what are oxygen administration devices?

A
  • nasal cannula
  • simple face mask
  • venturi mask
  • partial re-breather
  • non re-breather
  • ambu bag
  • tracheostomy collar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how do you care for a patient with a tracheostomy?

A
  • determine if it is temporary or permanent
  • assess breath sounds
  • suction
  • provide tracheostomy care
  • assess skin integrity
  • stabilization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the primary goal with tracheostomy

A

maintain patent airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are potential complications of trachs

A
  • risk for infection
  • risk for tissue damage
    • stabilization
    • cuff inflation
    • suction only when needed
    • importance of humidity, fluid balance, and nutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are some communication issues

A
  • patients can not talk if they have a tracheostomy
  • patient and family experience frustration
  • use white boards, ipads, paper/pen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the purpose of chest tubes

A
  1. removing air and fluid
  2. preventing drained air/fluid from returning to the pleural space
  3. restoring negative pressure within the pleural space to re-expand the lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are parts of the chest tube drainage systems

A
  • water seal chamber
    • fluctuates as pressure changes with inspiration and expiration; has a 1 way-valve for air out but not in
  • collection chamber
    • reservoir for draining fluid
  • suction control chamber
    • usually at -20 cm H2O adding more fluid increases suction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are nursing cares of patient with chest tubes

A
  • meticulous respiratory assessment
  • assess position of trachea
  • assess for pain control
  • monitor for signs of cardiac shift/compression
  • observe for signs of infection
  • prevent atelectasis
  • assess drainage output
  • monitor for crepitus
  • assess chest tube dressing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

things to keep in mind with chest tubes

A
  • verify connections
  • keep drainage system below level of chest
  • avoid kinks in chest tube
  • secure chest tube
  • monitor water level and water seal
  • maintain suction as presecribed
  • recognize when emergency assistance is needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do you manage someone with obstructive sleep apnea

A
  • weight loss
  • avoid alcohol consumption
  • CPAP
  • BiPAP
  • surgical repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the most common type of larynx cancer

A

squamous cell cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are clinical manifestions and diagnostics of larynx cancer

A
  • often no early sign
  • hoarseness
  • voice changes
  • persistent cough
  • unilateral throat pain or ear pain
  • sensation of foreign body in throat
  • neck masses
  • late signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

diagnostics of larynx cancer include

A
  • history and physical
  • laryngoscopy
  • biopsy
  • barium swallow
  • CT/MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

medical management for patients with laryngeal cancer

A
  • treatment depends on type of tumor
  • staged using TNM classification
  • radiation therapy
  • chemotherapy or targeted therapy as an adjunct with radiation and surgery
  • surgical treatment
    • laser surgery
    • partial laryngectomy
    • total laryngectomy with or without radical neck dissection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

surgical treatment for partial laryngectomy

A
  • airway remains intact
  • temporary tracheostomy
  • may have altered voice
  • assess swallowing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

surgical treatment for total laryngectomy

A
  • permanent loss of voice
  • permanent tracheostomy
  • risk of aspiration
  • potential for stricture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

nursing care of patient with a laryngectomy… preoperative care

A
  • respiratory assessment
  • nutritional assessment
  • expectations for voice after surgery
  • planning for addressing alcoholism, nicotine withdrawal
  • financial and work concern
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

nursing care of patient with a laryngectomy… postoperative care

A
  • decrease risk for aspiration
  • maintain patent airway
  • prevent infective airway clearance
  • assess for impaired gas exchange
  • provide nutritional therapy
  • decrease infection
  • promote communication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

discharge education: teaching self care

A
  • tracheostomy care at home
  • humidification
  • stoma bib for warmth and protection
  • bathing practice and water sports
  • medical alert bracelet
  • emergency resuscitation
  • stop smoking
  • psychosocial support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is atelectasis

A
  • collapse of alveoli
  • acute or chronic
  • can be segmental, lobar or whole lung
  • prevention is key
21
Q

preventive measures for atelectasis

A
  • TCDB
  • early mobilization
  • incentive spirometry
  • CPT
  • pain management
  • monitor opioid use
22
Q

what is pneumonia

A
  • inflammation of the lungs
  • can be bacterial, viral, or fungal
23
Q

types of pneumonia

A
  • community acquired
    • develops within first 48 hours of admission
  • healthcare associated
    • multi-drug resistance, immunocompromised, aspiration
  • hospital acquired
  • ventilator acquired
    • occurs >48 hours after intubation
  • prevention is key
24
Q

pneumococcal pneumonia

A
  • approx. 18,000 older adults die each year from pneumococcal disease in the usa
  • the vaccine should be administered routinely
    • adults 65 and older
    • anyone 2 years or older with certain chronic illnesses
25
Q

aspiration pneumonia-which lung is more likely to be affected and why

A

right lung because right lower lung lobe is the most common site of infiltrate formation due to the larger caliber and more vertical orientation of the right mainstem bronchus.

26
Q

collaborative care for patients with pneumonia-testing/diagnosis

A
  • history and physical
  • high priority-sputum and blood cultures
    • obtain prior to antibiotic therapy
  • chest x-ray
  • CBC
  • ABG
  • bronchoscopy
27
Q

management of pneumonia

A
  • specific antibiotic therapy
  • oxygenation
  • nutritional support
    • small, frequent meals
    • nutritional supplements
  • hydration-IV or PO
    • fluid and electrolyte balances
  • PPD to rule out TB
  • analgesics
  • antipyretics
  • rest
  • other respiratory support
    • suctioning
    • chest PT
    • bronchodilators
28
Q

health promotion of pneumonia

A
  • patient education
    • stop smoking
    • hand washing
    • identify patients at increased risk
  • prevent pneumonia in hospitalized patient
    • turn every 2 hours, HOB elevated, bundles for VAP, oral care
    • sterile technique when suctioning
    • administer antibiotics on time
    • vaccinations
29
Q

TB-mode of transmission and type of onset

A
  • airborne
  • gradual, very slow onset
30
Q

TB symptoms

A
  • weight loss
  • persistent cough
  • fever
  • chills
  • night sweats
  • anorexia
  • hemoptysis
  • fatigue
31
Q

who is at risk for tb

A
  • immunosuppressed
  • aging adults
  • living in a crowded environment
  • abuse of drugs and/or alcohol
  • immigrants
  • health care workers
32
Q

testing/diagnosis for tb

A
  • mantoux method
    • skin test injection of purified protein derivative
  • bacille calmette-guerin (BCG) injection
    • will cause a positive skin test
  • if have a positive TB skin test, repeated ones will also have positive though the person may not have current disease
  • interferon gamma release assay (IGRA)
    • blood test looking for an immune response
    • quantiFERON-tb gold in tube test (QFT-GIT) and T SPOT -TB test
33
Q

more types of testing for tb

A
  • sputum culture (AFB smear and culture)
    • confirms active tb
    • need to collect 3 different sputum samples
    • final culture results may take 4-6 weeks
    • culture should include multi-resistant organisms
  • can have false positive and false negative results
  • determine latent tb from active tb
34
Q

latent tb

A
  • exposed to tb bacteria but not sick
  • may never develop the disease
  • no transmission
  • positive PPD indicating exposure to tb
  • normal CXR and negative sputum
  • treat for latent tb and prevent active tb disease
35
Q

medication for treatment of active tb

A
  • initial phase or induction 1st 8 weeks
    • isoniazid (INH)
    • rifampin
    • pyrazinamide and ethambutol
    • combination meds may be prescribed
    • treatment last form 6-12 months
    • adherence with treatment is a major issue
    • patient education
36
Q

monitoring and follow up with tb

A
  • must be reported to the dept. of health
  • patient education
  • monitor for side effects
  • monitor/counsel on nutrition
  • increase activity and muscle strength
  • identifying community resources
  • prophylactic therapy for person at risk for significant disease
37
Q

what is COPD

A
  • chronic obstructive pulmonary disease
    • chronic bronchitis
      • airway problem
    • pulmonary emphysema
      • alveolar problem
    • other diseases
38
Q

etiology and risk factors

A
  • smoking causes
    • stimulates excess mucus production
    • coughing
    • destroys ciliary function
    • inflammation damages bronchiolar and alveolar walls
  • other risk factors include
    • second hand smoke
    • air pollution
    • genetics a1 antitrypsin deficiency
      • leads to early onset emphysema
    • aging
39
Q

chronic obstructive bronchitis

A
  • chronic coughing
  • increased mucus production-increase in number of goblet cells
  • scarring of bronchial lining-impairs ciliary function
  • symptoms continue for 3 months at a time in consecutive 2 years
40
Q

emphysema

A
  • alveolar walls destroyed
  • difficulty with expiration due to damaged alveolar
  • damages causes
    • blebs-pockets of air in alveolar spaces
    • bullae-pockets of air in lung parenchyma
    • ventilation dead space
41
Q

COPD physical assessment findings

A
  • increase AP diameter
  • barrel chest
  • decreased muscle mass in extremities
  • increased muscle mass in neck
  • poor hygiene, fatigue, weight loss
  • wheezes
  • retraction
  • decreased breath sounds
    • hyperinflation, trapped air
  • clubbing
  • color changes
  • sputum production
  • cor pulmonale
42
Q

complications with COPD

A
  • respiratory tract infections
    • lead to hospitalization
    • respiratory failure
  • spontaneous pneumothorax
  • dyspnea at night
  • hypoventilation and V/Q mismatch leads to chronic hypoxia
43
Q

goals and outcomes for copd

A
  • improve ventilation
  • facilitate removal of secretions
  • treat infection
  • reduce complications
  • slow progression of symptoms
  • promote health maintenance and client management of disease
44
Q

management of copd multidisciplinary approach

A
  • # 1 stop smoking - improves survival
  • breathing techniques
  • upright position/tripod positioning
  • effective coughing
  • airway clearance (CPT)
  • nutritional support
  • pulmonary rehab-with goal to improve QOL, improve physical and emotional health
45
Q

improve ventilation

A
  • bronchodilators
    • beta 2 adrenergic agonist
    • anticholinergic agents
    • combination agents
    • inhaled corticosteroids
    • inhaled corticosteroids with beta 2 adrenergic agonist
46
Q

oxygen therapy

A
  • oxygen therapy sufficient to produce a resting PaO2 of at least 60 or SaO2 90
  • oxygen administration-start low and go slow
  • teach safety
    • no smoking
    • safe storage
47
Q

airway clearance

A
  • bronchodilators
  • pulmonary hygiene
    • huff cough
  • chest PT with postural drainage
48
Q

reduce complications

A
  • monitor for signs of acute respiratory failure, and/or pneumothorax
  • DVT prophylaxis for clients who are immobile, polycythemic or dehydrated
  • vaccinations
    • influenza and pneumococcal
49
Q

promote activity tolerance

A
  • strengthen respiratory muscles

A-Med Surg 1 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions