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Med Surg > Respiratory > Flashcards

Respiratory Flashcards

1
Q

3 systems involved in oxygenation

A

respiratory, hematologic, cardiovascular

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2
Q

oxygen-carrying mechanism in RBCS

A

hemoglobin

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3
Q

_________ system is responsible for the perfusion of the tissues

A

cardiovascular

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4
Q

the amount if oxygen entering the lungs

A

ventilation

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5
Q

the blood flow to lungs and tissues

A

perfusion

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6
Q

rate of oxygen exchange

A

dissusion

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7
Q

3 things that influence oxygen-carrying capacity

A
  • the amount of oxygen dissolved in the plasma
  • amount of hemoglobin
  • tendency of hemoglobin to bind with oxygen
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8
Q

2 things that increase when the body’s need for oxygen increase

A

HR and RR

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9
Q

process of adding moisture or medications to inspired air by mixing particles with the air

A

nebulization

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10
Q

a group of therapies used in combination to mobilize pulmonary secretions

A

chest physiotherapy

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11
Q

oxygen in the air is __%

A

21

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12
Q

low levels of oxygen in the blood

A

hypoxemia

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13
Q

low levels of oxygen in the tissues

A

hypoxia

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14
Q

5 non-respiratory indications of oxygen use

A
  • heart failure
  • fever
  • sepsis
  • poisons
  • decreased hemoglobin or poor hemoglobin quality
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15
Q

someone who is hypoxic has high ____ levels in the blood

A

CO2

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16
Q

best method to determine oxygenation needs

A

ABG

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17
Q

central chemoreceptors are in the ______

A

medulla

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18
Q

peripheral chemoreceptors are in the _____ _____ and ______ ____

A

aortic arch and carotid arteries

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19
Q

primary role in stimulation in change of respiration

A

CO2

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20
Q

3 causes of hypoxia

A
  • respiratory problems
  • reduced hemoglobin
  • reduced blood flow
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21
Q

_________ hypoxia is caused by inadequate levels of oxygen in the air or respiratory problems that don’t allow oxygen to get to the lungs

A

hypoxemic

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22
Q

______ hypoxia is caused by a condition that reduces the amount of hemoglobin in the blood

A

anemic

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23
Q

______ hypoxia is caused by reduction of blood flow to the capillaries

A

circulatory

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24
Q

3 causes of circulatory hypoxia

A
  • vascular occlusion
  • heart failure
  • high altitude
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25
Q

______ hypoxia is caused by cells being unable to use oxygen due to poisoning

A

histotoxic

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26
Q

3 causes of histotoxic hypoxia

A
  • cyanide
  • carbon monoxide
  • sodium nitrate
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27
Q

carbon monoxide poisoning causes a combination of ______ and ______ hypoxia

A

histotoxic and anemic

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28
Q

hypoxia stimulates kidneys to produce ___________

A

erythropoetin

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29
Q

______ ____ uses the erythropoetin made by the kidenys to produce RBC

A

bone marrow

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30
Q

______ and _____ are responsible for storing RBCs for release as needed

A

spleen and liver

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31
Q

hypoxia is O2 sat less than ___%

A

94

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32
Q

hypoxemia is O2 sat less than ____%

A

90

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33
Q

less than ___% O2 sat is extreme hypoxemia

A

80

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34
Q

less than ____% O2 sat is critical hypoxemia

A

60

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35
Q

oxygen dissociation occurs faster when the tension level is greater than ___ mmHg

A

26

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36
Q

oxygen dissociation occurs slower when the tension level is less than ___ mmHg

A

26

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37
Q

O2 sat of 75% is a PaO2 of ___ mmHg

A

40

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38
Q

normal PaO2

A

70 mmHg

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39
Q

relativley safe range of PaO2 levels

A

45-70

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40
Q

dangerous level of PaO2

A

below 40 mmHg

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41
Q

1 L/min on nasal cannula is __% oxygen

A

24

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42
Q

6 L/min on nasal cannula is ___% oxygen

A

44

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43
Q

simple facemask delivers oxygen concentrations of ____ to ____% and a minimum flow rate of ___ L/minute

A

40-60%
5 L/min

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44
Q

simple face masks are used for short term in ________

A

emergencies

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45
Q

partial rebreather masks delivery oxygen at a concentration of ____ to ____% and ____ to ____ L per minute

A

60-75%
6-11 l/min

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46
Q

________ mask delivers the highest levels of oxygen in low flow systems

A

non-rebreather

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47
Q

non-rebreather masks can deliver up to ____% oxygen and a flow rate of ____ to ___ L/min

A

90
10-15 L/min

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48
Q

oxygen therapy can be given through a _____ ____

A

trach collar

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49
Q

high flow systems can deliver oxygen range from ____ to ___% at ____ to ___ L/minute

A

24-100
8-15 L/min

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50
Q

high flow nasal cannula can give up to ____ L/min

A

60

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51
Q

high flow nasal cannula are mostly used for ______, but can also be used for critically ill patients

A

neonates

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52
Q

a ____ _____ delivers the MOST accurate oxygen concentration without intubation

A

venturi mask

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53
Q

______ is not needed with the venti mask

A

humidity

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54
Q

a face tent is used for patients who cannot handle a _____ fitting mask

A

tight

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55
Q

noninvasive pressure ventilation uses _______ pressure to keep alveoli open and improve gas exchange

A

positive

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56
Q

_____ delivers a set of psoitive airway pressure throughout inspiration and expiration to open collapsed alveoli

A

CPAP

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57
Q

______ cycles different pressures at inspiration and expiration to improve tidal volume, reduce RR< and relieve dyspnea

A

BiPAP

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58
Q

home oxygen can be administered to patients of a PaO2 less than ____ mmHg or O2 sat less than ____%

A

55 mmHg
88%

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59
Q

initial signs of oxygen toxicity

A
  • nonproductive cough
  • chest pain
  • GI upset
  • dyspnea
  • crackles
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60
Q

prolonged signs of oxygen toxicity

A
  • pulmonary edema
  • hemmorrhage
  • atelectasis
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61
Q

______ ______ _____ is for wound care of non-healing wounds

A

hyperbaric oxygen therapy

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62
Q

in hyperbaric oxygen therapy the oxygen is _____%

A

100

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63
Q

2 things to never use with a patient on oxygen because they are flammable

A

petroleum jelly and aerosol sprays

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64
Q

oxygen stats may drop when the client is _________

A

sleeping

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65
Q

the diaphragm is controlled by the ______ nerve

A

phrenic

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66
Q

oxygen and carbon dioxide move across the alveolar-capillary membrane by ______ diffusion from high to low concentration

A

passive

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67
Q

a structural unit consisting of a respiratory bronchiole, alveolar duct, and alveolar sac

A

acinus

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68
Q

the ______ is where gs exchange occurs

A

acinus

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69
Q

cells in the alveoli walls that secrete surfactant

A

type II pneumocytes

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70
Q

a fatty protein that reduces surface tension in the alveoli

A

surfactant

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71
Q

without surfactant _______ occurs ,reducing gas exchange

A

surfactant

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72
Q

when the need for oxygen in the tissues is greater the oxygen-hemoglobin curve shifts to the ______ and oxygen dissociates faster

A

right

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73
Q

3 things that cause the oxygen-hemoglobin curve to shift to the right

A
  • increase in CO2
  • increase in temp
  • increase in Hydrogen (decreased pH)
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74
Q

when the need for oxygen is less because the tissues are already saturated the oxygen-hemoglobin curve shifts to the ______

A

left

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75
Q

4 things that can cause the oxygen-hemoglobin curve to shift to the left

A
  • decreased hydrogen (increased pH)
  • decreased products of glucose breakdown
  • decreased temp
  • decreased CO2
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76
Q

aging causes decreased ______ _____ in the lungs

A

elasticity recoil

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77
Q

aging can cause _____ of the alveoli

A

fibrosis

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78
Q

single most cause of respiratory disease

A

smoking

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79
Q

percentage of people wwho get lung cancer because of second hand smoking

A

20-30%

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80
Q

percentage of people exposed to 2nd hand smoke who get asthma

A

40-60%

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81
Q

percentage of people exposed to 2nd hand smoke that will get a stroke

A

80%

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82
Q

percentage of people exposed to 2nd hand smoke that will cause heart disease

A

25-35%

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83
Q

normal AP diameter

A

1:1.5

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84
Q

air trapping under the skin also known as subcutaneous emphysema

A

crepitus

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85
Q

vibration felt when patient speaks

A

tactile fremitus

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86
Q

while listening to lungs have the patient breath out their _____

A

mouth

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87
Q

if someone gets nose bleeds easily then they will have a low _____ count

A

platelet

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88
Q

the radiologic study used to detect pulmonary embolism in patients unable to complete a CT angiogram

A

V/Q scan

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89
Q

most common upper respiratory infection

A

rhinitis

90
Q

inflammation of the nasal cavity and nasopharyngeal cavities

A

rhinitis

91
Q

4 different kinds of rhinitis

A

nonallergenic
allergenic
viral
bacterial

92
Q

only type of chronic rhinitis

A

allergenic

93
Q

________ rhinitis are acute episodes that may occur as a rebound effects from overuse of nasal decongestant or chronic inhalation of cocaine

A

nonallergenic

94
Q

________ rhinitis is episodic reaction to an allergen

A

allergenic

95
Q

_______ rhinitis is the common cold that is highly contagious

A

viral

96
Q

viral rhinitis is ______ precaution

A

droplet

97
Q

viral rhinitis is most contagious ___ to ____ days after symptoms start

A

2-3

98
Q

______ rhinitis may occur due to increased susceptibility of the mucous membranes caused by other types of rhinitis

A

bacterial

99
Q

months that the seasonal cold follows

A

January
April
September

100
Q

medication that dries up respiratory secretions via an anticholinergic effect

A

antihistamines

101
Q

5 contraindications of antihistamines

A
  • COPD
  • glaucoma
  • obstructive urinary problems
  • decreased GI motility
  • cardiovascular disease
102
Q

do not mix antihistamines with ________

A

alcohol

103
Q

4 things to immediately notify the doctor of with antihistamines

A

chest tightness
wheezing
confusion
bleeding

104
Q

medication that will aid in the relief of nasal obstructions due to edema, itching, and inflammation via vasoconstriction

A

decongestants

105
Q

decongestants stimulate the _________ nervous system

A

sympathetic

106
Q

3 things decongestants are contraindicated in

A

heart disease
hypertension
glaucoma

107
Q

2 common side effects of decongestants

A

nervousness
difficulty sleeping

108
Q

patients should limit the use of nasal decongestants to less than ___ days

A

3

109
Q

mild decongestant intranasal spray that liquefies mucous

A

saline

110
Q

antihistamine intranasal spray that dries up secretions

A

cromolyn (Nasocrom)

111
Q

anticholinergic intranasal spray that inhibits secretions from nasal glands to reliever rhinorrhea

A

ipratropium (atrovent)

112
Q

intranasal spray that reduces severe congestion and inhibits inflammatory response

A

corticosteroids

113
Q

inflammation of one or more mucous membranes of the sinuses, often associated with Rhinitis

A

rhinosinusitis

114
Q

sinuses mostly involved in rhinosinusitis

A

maxillary and frontal

115
Q

rhinosinusitis most commonly follows an _______ _______ infection

A

upper respiratory

116
Q

most rhinosinusitis are ______ in origin, but they can be _______

A

viral, bacterial

117
Q

3 life-threatening potential complications associated with rhinosinusitis

A

abscess
meningitis
cellulitis

118
Q

_______ rhinosinusitis has a rapid onset with purulent drianage

A

acute

119
Q

______ rhinosinusitis is less than 3 months with persistent purulent drainage despite treatment

A

subacute

120
Q

______ rhinosinusitis is persistent secondary infection lasting longer than 3 months

A

chronic

121
Q

3 common infectious organisms that cause rhinosinusitis

A

streptococcus
Haemophiles Influenzae
staphylococcus

122
Q

5 things to seek immediate medical attention with in rhinosinusitis

A

periorbital edema
severe pain on palpation
fever
severe headache
nuchal rigidity

123
Q

3 diagnostic criteria of aspirin NSAID idiosyncrasy

A

total obstruction
nasal polyps
loss of smell

124
Q

_________ are used for prolonged symptoms of rhinosinusitis

A

antibiotics

125
Q

1st line antibiotics for rhinosinusitis

A

amoxicillin
ampicillin
trimethoprim/sulfamethoxazole
erythromycin

126
Q

2nds line antibiotics for rhinosinusitis

A

cephalosporins
macrolides
quinolones

127
Q

medication for nasal polyps

A

low dose corticosteroids or intranasal corticosteroids

128
Q

point the nasal inhaler towards the _____ of the nasal wall

A

back

129
Q

acute inflammation of the pharynx aka sore throat often associated with rhinitis and sinusitis

A

pharyngitis

130
Q

pharyngitis is generally _______

A

viral

131
Q

4 viruses that cause pharyngitis

A

adenovirus
influenza virus
epstein-barr virus
herpes simplex virus

132
Q

bacteria that causes pahryngitis

A

group A beta-hemolytic streptococcus

133
Q

examples of group A beta-hemolytic streptococcus

A

neisseria gonorrhea
H. influenza type B
mycoplasm

134
Q

________ may occur 7-10 days after acute pharyngitis

A

glomerulonephritis

135
Q

_____ _____ can occur 3-5 weeks after pharyngitis

A

rheumatic fever

136
Q

a critical complication of pharyngitis

A

epiglottitis

137
Q

odynophagia

A

pain with swallowing

138
Q

3 things associated with bacterial pharyngitis

A

drainage
exudate
petechia

139
Q

3 antibiotics used to treat streptococcal pharyngitis

A

penicillin OR cephalosporins
macrolides

140
Q

2 tests to diagnose Group-A beta hemolytic streptococcal pharyngitis

A

gen-probe
optical immunoassay

141
Q

acute inflammation and infection of the palatine tonsils and lymphatic system on each side of the throat

A

tonsilitis

142
Q

tonsillitis is contagious through ________ transmission

A

airborne

143
Q

tonsillitis can be bacterial or viral but most commonly ________

A

bacterial

144
Q

bacteria that causes bacterial tonsilitis

A

streptococcus

145
Q

for tonsillitis take a ________ for 7-10 days

A

non-penicillin

146
Q

tonsillectomy may be necessary for ____ or more streptococcal infections a year

A

4

147
Q

3 other indications of tonsillectomy

A

sleep apnea
tonsillar malignancies
chronic mouth breathing

148
Q

a complication of tonsilitis infection that spreads to the surrounding tissue - mostly on the superior aspect

A

peritonsillar abscess

149
Q

peritonsillar abscesses are caused by ___________ bacteria

A

streptococcus

150
Q

peritonsillar abscesses begins as acute exudate tonsillitis and then progresses to _______ of the tonsil surface obstructing tonsil drainage

A

cellulitis

151
Q

the peritonsillar abscess forms as a result of tissue ______ and ____ formation

A

necrosis, pus

152
Q

with the peritonsillar abscess the uvula will be deviated to the ______ side

A

unaffected

153
Q

trismus

A

contraction of chewing muscles

154
Q

cervical lymphadenopathy

A

swollen neck glands

155
Q

2 things that can happen secondary to peritonsillar abscess rupture

A

development of lung abscess
aspiration pneumonitis

156
Q

laryngitis is inflammation most commonly occurs after a ______ upper respiratory infection

A

viral

157
Q

5 causes of chronic laryngitis

A

vocal nodules/polyps
voice overuse
GERD
air irritants
infection

158
Q

laryngitis can cause _____ _____ edema

A

vocal cord

159
Q

2 things to avoid with laryngitis

A

spicy foods
caffeine

160
Q

_______ technique is a method to treat voice impairment by practicing proper posture and breathing techniques

A

Alexander

161
Q

with the flu, you are contagious ____ hours prior to symptom manifestation and up to ____ days afterward

A

24, 5

162
Q

additional symptoms that only B flu has

A

N/V and diarrhea

163
Q

2 medications that shorten the duration of influenza A and B

A

zanamir (relenza)
oseltamivir (tamiflu)

164
Q

3 patients to use zanamivir cautiously in

A

elderly
COPD
asthma

165
Q

antivirals taken for influenza A

A

amantadine (symmetrel)
rimantadine (flumadine)

166
Q

antiviral taken for influenza B

A

Ribavirin (virazole)

167
Q

_______ influenza is when viruses among animals and bords mature and become highly infectious to humans

A

pandemic

168
Q

from the point of suspected pandemic influenza, isolate the patient in a ______ _____ with ______ isolation precautions

A

negative pressure, aiborne

169
Q

H1N1 strain of pandemic influenza

A

swine flu

170
Q

H5N1 strain of pandemic influenza

A

bird or avian flu

171
Q

pandemic influenza can cause bleeding from the ______ and _____

A

gums and nose

172
Q

vaccination available for pandemic flus but not given unless suspected exposure in an area

A

Vepacel

173
Q

2 medications given to lessen severity and mortality rate of pandemic flu

A

zanamivir (relenza)
oseltamivir (tamiflu)

174
Q

obstructive sleep apnea is characterized by breathing disruption of at least ____ seconds occurring a minimum of ____ times an hour

A

10, 5

175
Q

most common cause of obstructive sleep apnea

A

obstruction by tongue of soft palate

176
Q

obstructive sleep apnea prevents ____ cycle of sleep

A

REM

177
Q

a ______ splint can be used to treat mild obstructive sleep apnea

A

madibular

178
Q

medication taken to improve daytime wakefulness in obstructive sleep apnea patients

A

modafinil

179
Q

different between central sleep apnea and obstructive sleep apnea

A

central = cessation without respirator effort

180
Q

for an anterior nosebleed, apply lateral pressure with cold packs for _____ minutes

A

10

181
Q

______ _____ may help cauterize the blood vessel for a bloody nose

A

silver nitrate

182
Q

3 topical vasoconstrictors used to stop nosebleeds

A

adrenaline
phenylephrine
thrombin

183
Q

a ______ nose bleed is an emergencies because of the location of the blood vessels

A

posterior

184
Q

short 6 inch tubes that have a balloon along the length of the rube used for posterior nose bleeds

A

epistaxis catheters

185
Q

2 medications not to take if you suffer from nose bleeds

A

aspirin and NSAIDs

186
Q

3 vaccines to check with on respiratory assessment

A

COVID
flu
pneumonia

187
Q

regular breathing cycle where rate and depth increase and then decrease until apnea

A

Cheyne-stokes

188
Q

periods of normal breathing followed by varying episodes of apnea

A

Biot’s breathing (atxic)

189
Q

prolonged expiratory phase of expiration

A

Obstructive breathing pattern

190
Q

breathing pattern seen in COPD and asthma

A

obstructive

191
Q

what causes flatness in percussion

A

pleural effusion

192
Q

what causes dullness percussion

A

pneumonia

193
Q

what causes resonance percussion

A

bronchitis

194
Q

what causes hyperresonance percussion

A

emphysema and pneumothorax

195
Q

what causes tympany percussion

A

large pneumothorax

196
Q

lung sound causes by constriction of bronchioles

A

wheeze

197
Q

give _____ to correct wheezing

A

nebulizer

198
Q

2 things to give to correct stridor

A

racemic epi
solumedrol

199
Q

give _____ to correct crackles

A

lasix

200
Q

flu is a _____ precuation

A

droplet

201
Q

3 rare complications of the flu

A

pericarditis
sepsis
myositis

202
Q

______ causes most flu deaths as the most common complication

A

pneumonia

203
Q

tracheobronchitis is usually _______

A

viral

204
Q

late manifestations of bronchitis include inspiratory ______ and expiratory ______

A

stridor, wheeze

205
Q

most common bacterial cause of pneumonia

A

S. pneumonia

206
Q

virus that causes pneumonia in older adults and those with comorbidities

A

H. influenzae

207
Q

mortality rate of HAP

A

33%

208
Q

VAP occurs in up to ____% of ventilated patients

A

27

209
Q

VAP protocol is HOB at ___ to ___ degrees

A

30-40

210
Q

VAP protocol is _____ and ____ prophylaxis

A

PUD and DVT

211
Q

VAP protocol is daily oral care with _______

A

chlorohexidine

212
Q

pneumonia cause _______-________ mismatch

A

ventilation-perfusion

213
Q

pneumonia caused by viral infections causes ______

A

bradycardia

214
Q

most common symptom elderly people have with pneumonia

A

confusion

215
Q

pnuemonia may not show up on a chest x-ray of the patient is ______

A

dehydrated

216
Q

_____ is given prior to endoscopy to dry up secretion and reduce the risk of aspiration

A

Robinol

217
Q

_____ ____ lobe is most susceptible to aspiration

A

right lower

218
Q

to prevent aspiration check NGT residual every ____ hours

A

4

219
Q

5 things free radicals from oxygen can damage

A

lungs
heart
kidneys
brain
thryoid

220
Q

3 medications that increase the risk of oxygen toxicity

A

dexamethasone
synthroid
acetazolamide (diamox)

221
Q

3 things that cause atelectasis

A

hypoventilation
obstruction of airway
compression of lungs

222
Q

3 types of macro-atelectasis

A

segemental
lobar
global

Med Surg (10 decks)

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