Respiratory Flashcards
3 systems involved in oxygenation
respiratory, hematologic, cardiovascular
oxygen-carrying mechanism in RBCS
hemoglobin
_________ system is responsible for the perfusion of the tissues
cardiovascular
the amount if oxygen entering the lungs
ventilation
the blood flow to lungs and tissues
perfusion
rate of oxygen exchange
dissusion
3 things that influence oxygen-carrying capacity
- the amount of oxygen dissolved in the plasma
- amount of hemoglobin
- tendency of hemoglobin to bind with oxygen
2 things that increase when the body’s need for oxygen increase
HR and RR
process of adding moisture or medications to inspired air by mixing particles with the air
nebulization
a group of therapies used in combination to mobilize pulmonary secretions
chest physiotherapy
oxygen in the air is __%
21
low levels of oxygen in the blood
hypoxemia
low levels of oxygen in the tissues
hypoxia
5 non-respiratory indications of oxygen use
- heart failure
- fever
- sepsis
- poisons
- decreased hemoglobin or poor hemoglobin quality
someone who is hypoxic has high ____ levels in the blood
CO2
best method to determine oxygenation needs
ABG
central chemoreceptors are in the ______
medulla
peripheral chemoreceptors are in the _____ _____ and ______ ____
aortic arch and carotid arteries
primary role in stimulation in change of respiration
CO2
3 causes of hypoxia
- respiratory problems
- reduced hemoglobin
- reduced blood flow
_________ hypoxia is caused by inadequate levels of oxygen in the air or respiratory problems that don’t allow oxygen to get to the lungs
hypoxemic
______ hypoxia is caused by a condition that reduces the amount of hemoglobin in the blood
anemic
______ hypoxia is caused by reduction of blood flow to the capillaries
circulatory
3 causes of circulatory hypoxia
- vascular occlusion
- heart failure
- high altitude
______ hypoxia is caused by cells being unable to use oxygen due to poisoning
histotoxic
3 causes of histotoxic hypoxia
- cyanide
- carbon monoxide
- sodium nitrate
carbon monoxide poisoning causes a combination of ______ and ______ hypoxia
histotoxic and anemic
hypoxia stimulates kidneys to produce ___________
erythropoetin
______ ____ uses the erythropoetin made by the kidenys to produce RBC
bone marrow
______ and _____ are responsible for storing RBCs for release as needed
spleen and liver
hypoxia is O2 sat less than ___%
94
hypoxemia is O2 sat less than ____%
90
less than ___% O2 sat is extreme hypoxemia
80
less than ____% O2 sat is critical hypoxemia
60
oxygen dissociation occurs faster when the tension level is greater than ___ mmHg
26
oxygen dissociation occurs slower when the tension level is less than ___ mmHg
26
O2 sat of 75% is a PaO2 of ___ mmHg
40
normal PaO2
70 mmHg
relativley safe range of PaO2 levels
45-70
dangerous level of PaO2
below 40 mmHg
1 L/min on nasal cannula is __% oxygen
24
6 L/min on nasal cannula is ___% oxygen
44
simple facemask delivers oxygen concentrations of ____ to ____% and a minimum flow rate of ___ L/minute
40-60%
5 L/min
simple face masks are used for short term in ________
emergencies
partial rebreather masks delivery oxygen at a concentration of ____ to ____% and ____ to ____ L per minute
60-75%
6-11 l/min
________ mask delivers the highest levels of oxygen in low flow systems
non-rebreather
non-rebreather masks can deliver up to ____% oxygen and a flow rate of ____ to ___ L/min
90
10-15 L/min
oxygen therapy can be given through a _____ ____
trach collar
high flow systems can deliver oxygen range from ____ to ___% at ____ to ___ L/minute
24-100
8-15 L/min
high flow nasal cannula can give up to ____ L/min
60
high flow nasal cannula are mostly used for ______, but can also be used for critically ill patients
neonates
a ____ _____ delivers the MOST accurate oxygen concentration without intubation
venturi mask
______ is not needed with the venti mask
humidity
a face tent is used for patients who cannot handle a _____ fitting mask
tight
noninvasive pressure ventilation uses _______ pressure to keep alveoli open and improve gas exchange
positive
_____ delivers a set of psoitive airway pressure throughout inspiration and expiration to open collapsed alveoli
CPAP
______ cycles different pressures at inspiration and expiration to improve tidal volume, reduce RR< and relieve dyspnea
BiPAP
home oxygen can be administered to patients of a PaO2 less than ____ mmHg or O2 sat less than ____%
55 mmHg
88%
initial signs of oxygen toxicity
- nonproductive cough
- chest pain
- GI upset
- dyspnea
- crackles
prolonged signs of oxygen toxicity
- pulmonary edema
- hemmorrhage
- atelectasis
______ ______ _____ is for wound care of non-healing wounds
hyperbaric oxygen therapy
in hyperbaric oxygen therapy the oxygen is _____%
100
2 things to never use with a patient on oxygen because they are flammable
petroleum jelly and aerosol sprays
oxygen stats may drop when the client is _________
sleeping
the diaphragm is controlled by the ______ nerve
phrenic
oxygen and carbon dioxide move across the alveolar-capillary membrane by ______ diffusion from high to low concentration
passive
a structural unit consisting of a respiratory bronchiole, alveolar duct, and alveolar sac
acinus
the ______ is where gs exchange occurs
acinus
cells in the alveoli walls that secrete surfactant
type II pneumocytes
a fatty protein that reduces surface tension in the alveoli
surfactant
without surfactant _______ occurs ,reducing gas exchange
surfactant
when the need for oxygen in the tissues is greater the oxygen-hemoglobin curve shifts to the ______ and oxygen dissociates faster
right
3 things that cause the oxygen-hemoglobin curve to shift to the right
- increase in CO2
- increase in temp
- increase in Hydrogen (decreased pH)
when the need for oxygen is less because the tissues are already saturated the oxygen-hemoglobin curve shifts to the ______
left
4 things that can cause the oxygen-hemoglobin curve to shift to the left
- decreased hydrogen (increased pH)
- decreased products of glucose breakdown
- decreased temp
- decreased CO2
aging causes decreased ______ _____ in the lungs
elasticity recoil
aging can cause _____ of the alveoli
fibrosis
single most cause of respiratory disease
smoking
percentage of people wwho get lung cancer because of second hand smoking
20-30%
percentage of people exposed to 2nd hand smoke who get asthma
40-60%
percentage of people exposed to 2nd hand smoke that will get a stroke
80%
percentage of people exposed to 2nd hand smoke that will cause heart disease
25-35%
normal AP diameter
1:1.5
air trapping under the skin also known as subcutaneous emphysema
crepitus
vibration felt when patient speaks
tactile fremitus
while listening to lungs have the patient breath out their _____
mouth
if someone gets nose bleeds easily then they will have a low _____ count
platelet
the radiologic study used to detect pulmonary embolism in patients unable to complete a CT angiogram
V/Q scan
most common upper respiratory infection
rhinitis
inflammation of the nasal cavity and nasopharyngeal cavities
rhinitis
4 different kinds of rhinitis
nonallergenic
allergenic
viral
bacterial
only type of chronic rhinitis
allergenic
________ rhinitis are acute episodes that may occur as a rebound effects from overuse of nasal decongestant or chronic inhalation of cocaine
nonallergenic
________ rhinitis is episodic reaction to an allergen
allergenic
_______ rhinitis is the common cold that is highly contagious
viral
viral rhinitis is ______ precaution
droplet
viral rhinitis is most contagious ___ to ____ days after symptoms start
2-3
______ rhinitis may occur due to increased susceptibility of the mucous membranes caused by other types of rhinitis
bacterial
months that the seasonal cold follows
January
April
September
medication that dries up respiratory secretions via an anticholinergic effect
antihistamines
5 contraindications of antihistamines
- COPD
- glaucoma
- obstructive urinary problems
- decreased GI motility
- cardiovascular disease
do not mix antihistamines with ________
alcohol
4 things to immediately notify the doctor of with antihistamines
chest tightness
wheezing
confusion
bleeding
medication that will aid in the relief of nasal obstructions due to edema, itching, and inflammation via vasoconstriction
decongestants
decongestants stimulate the _________ nervous system
sympathetic
3 things decongestants are contraindicated in
heart disease
hypertension
glaucoma
2 common side effects of decongestants
nervousness
difficulty sleeping
patients should limit the use of nasal decongestants to less than ___ days
3
mild decongestant intranasal spray that liquefies mucous
saline
antihistamine intranasal spray that dries up secretions
cromolyn (Nasocrom)
anticholinergic intranasal spray that inhibits secretions from nasal glands to reliever rhinorrhea
ipratropium (atrovent)
intranasal spray that reduces severe congestion and inhibits inflammatory response
corticosteroids
inflammation of one or more mucous membranes of the sinuses, often associated with Rhinitis
rhinosinusitis
sinuses mostly involved in rhinosinusitis
maxillary and frontal
rhinosinusitis most commonly follows an _______ _______ infection
upper respiratory
most rhinosinusitis are ______ in origin, but they can be _______
viral, bacterial
3 life-threatening potential complications associated with rhinosinusitis
abscess
meningitis
cellulitis
_______ rhinosinusitis has a rapid onset with purulent drianage
acute
______ rhinosinusitis is less than 3 months with persistent purulent drainage despite treatment
subacute
______ rhinosinusitis is persistent secondary infection lasting longer than 3 months
chronic
3 common infectious organisms that cause rhinosinusitis
streptococcus
Haemophiles Influenzae
staphylococcus
5 things to seek immediate medical attention with in rhinosinusitis
periorbital edema
severe pain on palpation
fever
severe headache
nuchal rigidity
3 diagnostic criteria of aspirin NSAID idiosyncrasy
total obstruction
nasal polyps
loss of smell
_________ are used for prolonged symptoms of rhinosinusitis
antibiotics
1st line antibiotics for rhinosinusitis
amoxicillin
ampicillin
trimethoprim/sulfamethoxazole
erythromycin
2nds line antibiotics for rhinosinusitis
cephalosporins
macrolides
quinolones
medication for nasal polyps
low dose corticosteroids or intranasal corticosteroids
point the nasal inhaler towards the _____ of the nasal wall
back
acute inflammation of the pharynx aka sore throat often associated with rhinitis and sinusitis
pharyngitis
pharyngitis is generally _______
viral
4 viruses that cause pharyngitis
adenovirus
influenza virus
epstein-barr virus
herpes simplex virus
bacteria that causes pahryngitis
group A beta-hemolytic streptococcus
examples of group A beta-hemolytic streptococcus
neisseria gonorrhea
H. influenza type B
mycoplasm
________ may occur 7-10 days after acute pharyngitis
glomerulonephritis
_____ _____ can occur 3-5 weeks after pharyngitis
rheumatic fever
a critical complication of pharyngitis
epiglottitis
odynophagia
pain with swallowing
3 things associated with bacterial pharyngitis
drainage
exudate
petechia
3 antibiotics used to treat streptococcal pharyngitis
penicillin OR cephalosporins
macrolides
2 tests to diagnose Group-A beta hemolytic streptococcal pharyngitis
gen-probe
optical immunoassay
acute inflammation and infection of the palatine tonsils and lymphatic system on each side of the throat
tonsilitis
tonsillitis is contagious through ________ transmission
airborne
tonsillitis can be bacterial or viral but most commonly ________
bacterial
bacteria that causes bacterial tonsilitis
streptococcus
for tonsillitis take a ________ for 7-10 days
non-penicillin
tonsillectomy may be necessary for ____ or more streptococcal infections a year
4
3 other indications of tonsillectomy
sleep apnea
tonsillar malignancies
chronic mouth breathing
a complication of tonsilitis infection that spreads to the surrounding tissue - mostly on the superior aspect
peritonsillar abscess
peritonsillar abscesses are caused by ___________ bacteria
streptococcus
peritonsillar abscesses begins as acute exudate tonsillitis and then progresses to _______ of the tonsil surface obstructing tonsil drainage
cellulitis
the peritonsillar abscess forms as a result of tissue ______ and ____ formation
necrosis, pus
with the peritonsillar abscess the uvula will be deviated to the ______ side
unaffected
trismus
contraction of chewing muscles
cervical lymphadenopathy
swollen neck glands
2 things that can happen secondary to peritonsillar abscess rupture
development of lung abscess
aspiration pneumonitis
laryngitis is inflammation most commonly occurs after a ______ upper respiratory infection
viral
5 causes of chronic laryngitis
vocal nodules/polyps
voice overuse
GERD
air irritants
infection
laryngitis can cause _____ _____ edema
vocal cord
2 things to avoid with laryngitis
spicy foods
caffeine
_______ technique is a method to treat voice impairment by practicing proper posture and breathing techniques
Alexander
with the flu, you are contagious ____ hours prior to symptom manifestation and up to ____ days afterward
24, 5
additional symptoms that only B flu has
N/V and diarrhea
2 medications that shorten the duration of influenza A and B
zanamir (relenza)
oseltamivir (tamiflu)
3 patients to use zanamivir cautiously in
elderly
COPD
asthma
antivirals taken for influenza A
amantadine (symmetrel)
rimantadine (flumadine)
antiviral taken for influenza B
Ribavirin (virazole)
_______ influenza is when viruses among animals and bords mature and become highly infectious to humans
pandemic
from the point of suspected pandemic influenza, isolate the patient in a ______ _____ with ______ isolation precautions
negative pressure, aiborne
H1N1 strain of pandemic influenza
swine flu
H5N1 strain of pandemic influenza
bird or avian flu
pandemic influenza can cause bleeding from the ______ and _____
gums and nose
vaccination available for pandemic flus but not given unless suspected exposure in an area
Vepacel
2 medications given to lessen severity and mortality rate of pandemic flu
zanamivir (relenza)
oseltamivir (tamiflu)
obstructive sleep apnea is characterized by breathing disruption of at least ____ seconds occurring a minimum of ____ times an hour
10, 5
most common cause of obstructive sleep apnea
obstruction by tongue of soft palate
obstructive sleep apnea prevents ____ cycle of sleep
REM
a ______ splint can be used to treat mild obstructive sleep apnea
madibular
medication taken to improve daytime wakefulness in obstructive sleep apnea patients
modafinil
different between central sleep apnea and obstructive sleep apnea
central = cessation without respirator effort
for an anterior nosebleed, apply lateral pressure with cold packs for _____ minutes
10
______ _____ may help cauterize the blood vessel for a bloody nose
silver nitrate
3 topical vasoconstrictors used to stop nosebleeds
adrenaline
phenylephrine
thrombin
a ______ nose bleed is an emergencies because of the location of the blood vessels
posterior
short 6 inch tubes that have a balloon along the length of the rube used for posterior nose bleeds
epistaxis catheters
2 medications not to take if you suffer from nose bleeds
aspirin and NSAIDs
3 vaccines to check with on respiratory assessment
COVID
flu
pneumonia
regular breathing cycle where rate and depth increase and then decrease until apnea
Cheyne-stokes
periods of normal breathing followed by varying episodes of apnea
Biot’s breathing (atxic)
prolonged expiratory phase of expiration
Obstructive breathing pattern
breathing pattern seen in COPD and asthma
obstructive
what causes flatness in percussion
pleural effusion
what causes dullness percussion
pneumonia
what causes resonance percussion
bronchitis
what causes hyperresonance percussion
emphysema and pneumothorax
what causes tympany percussion
large pneumothorax
lung sound causes by constriction of bronchioles
wheeze
give _____ to correct wheezing
nebulizer
2 things to give to correct stridor
racemic epi
solumedrol
give _____ to correct crackles
lasix
flu is a _____ precuation
droplet
3 rare complications of the flu
pericarditis
sepsis
myositis
______ causes most flu deaths as the most common complication
pneumonia
tracheobronchitis is usually _______
viral
late manifestations of bronchitis include inspiratory ______ and expiratory ______
stridor, wheeze
most common bacterial cause of pneumonia
S. pneumonia
virus that causes pneumonia in older adults and those with comorbidities
H. influenzae
mortality rate of HAP
33%
VAP occurs in up to ____% of ventilated patients
27
VAP protocol is HOB at ___ to ___ degrees
30-40
VAP protocol is _____ and ____ prophylaxis
PUD and DVT
VAP protocol is daily oral care with _______
chlorohexidine
pneumonia cause _______-________ mismatch
ventilation-perfusion
pneumonia caused by viral infections causes ______
bradycardia
most common symptom elderly people have with pneumonia
confusion
pnuemonia may not show up on a chest x-ray of the patient is ______
dehydrated
_____ is given prior to endoscopy to dry up secretion and reduce the risk of aspiration
Robinol
_____ ____ lobe is most susceptible to aspiration
right lower
to prevent aspiration check NGT residual every ____ hours
4
5 things free radicals from oxygen can damage
lungs
heart
kidneys
brain
thryoid
3 medications that increase the risk of oxygen toxicity
dexamethasone
synthroid
acetazolamide (diamox)
3 things that cause atelectasis
hypoventilation
obstruction of airway
compression of lungs
3 types of macro-atelectasis
segemental
lobar
global
