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NCLEX > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

capillaries are where

A

exchange of nutrients/oxygen and waste products occur

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2
Q

gas exchange happens in the

A

alveoli

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3
Q

ventilation is the

A

air movement in and out of the lungs

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4
Q

oxygenation is the

A

oxygen in the blood stream

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5
Q

perfusion is the

A

oxygen in the tissues

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6
Q

Airway = _________
Breathing = _________
Circulation = ____________

A

Ventilation
Oxygenation
Perfusion

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7
Q

Flow in respiratory support is

A

how many L/min of gas is flowing into the client; low flow or high flow

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8
Q

Fraction of Inspired Oxygen (FiO2) is

A

percent of the gas that is oxygen

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9
Q

Types of pressure respiratory support are

A

CPAP and BiPAP

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10
Q

CPAP stands for

A

continuous positive airway pressure

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11
Q

BiPAP stans for

A

Bilevel positive airway pressure

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12
Q

what does CPAP do

A

delivers air pressure at single set level that stays consistent during sleep; inhalation and exhalation is a constant set pressure

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13
Q

CPAP is not as good for ____________ and is usually used for

A

accommodating breathing changes; obstructive sleep apnea

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14
Q

what does BiPAP do

A

uses two two different pressure settings for inhale vs exhale and allows for lower pressure during exhalation; inhale is at a constant set pressure and exhale is set at a lower constant set pressure

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15
Q

BiPAP is used for

A

complex breathing problems such as central sleep apnea, and heart/lung/neurological disorders that require additional airway support during sleep (CHF, COPD, Parkinson’s, ALS)

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16
Q

High ventilator alarm means

A

pressure in circuit is too high

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17
Q

Causes of high ventilator alarms

A

coughing, gagging, bronchospasm, fighting the ventilator, ETT occlusion, kink in tubing, increased secretions, thick secretions, water in ventilator circuit

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18
Q

Low ventilator alarm means

A

pressure in the circuit is too low

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19
Q

Causes of low ventilator alarms

A

tubing is disconnected, loose connections, leak, extubation, cuffed ETT or trach is deflated, poorly fitting CPAP/BiPAP mask

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20
Q

ETT placement should be verified by a

A

CXR and assessment of equal breath sounds

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21
Q

An ETT can become displaced into the ________ main stem bronchus

A

right

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22
Q

tracheostomy infection risk is high because

A

natural defenses of the nose and mouth are bypasse

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23
Q

prevent trach infections by

A

daily trach care and which is a sterile procedure

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24
Q

positioning for trach pts should be

A

fowlers or semi-fowlers

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25
Q

how to suction a trach

A

only to pre measured depth
don’t suction for longer than 10 seconds
insert suction catheter and apply suction catheter on the way out
some clients may need to be pre-oxygenate with 100% FiO2

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26
Q

____ fingers should fit underneath a trach tie

A

1

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27
Q

at the bedside of a trach pt you need to have

A

two back up trachs: 1 of the same size and 1 half a size smaller

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28
Q

Indications for chest tube

A

Pneumothorax
Effusions (pleural)
Abscess
Cancer (lung)
Hemothorax

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29
Q

________ chamber is connected to suction on chest tube system

A

suction control chamber

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30
Q

in the suction control chamber there should be ___________ bubbling

A

gentle bubbling

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31
Q

in the water seal chamber there should be __________ bubbling

A

intermittent bubbling

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32
Q

the ___________ chamber is connected to the pt in a chest tube system

A

drainage collection chamber

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33
Q

the drainage collection chamber should have _________ bubbling

A

no bubbling

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34
Q

the drainage system for a chest tube should always be kept

A

below the level of the client’s chest

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35
Q

drainage from a chest tube should be no more than ___________ and should be checked _________-

A

100ml/hr; hourly

36
Q

drainage from a chest tube should be (characteristics)

A

color: serous - serosanguinous
Odor: none
Consistency: thin-thick

37
Q

If the chest tube comes out of the pt

A

cover site with sterile dressing and tape on 3 sides

38
Q

if the chest tube disconnects from the drainage system

A

place end of tube in bottle of sterile water

39
Q

bronchodilators

A

bind to beta2 adrenergic receptors in the airway leading to relaxation of the smooth muscles in the airways

40
Q

bronchodilators can cause

A

tachycardia

41
Q

use caution when administering bronchodilators to pts with

A

heart disease, diabetes, glaucoma, or seizures

42
Q

Bronchodilator examples

A

albuterol, terbutaline, ipratropium

43
Q

side effects of terbutaline includes

A

shakiness, dizziness, drowsiness, sleep disturbances, weakness, headache, n/v, tachycardia, htn, hyperglycemia, CNS overstimulation

44
Q

montelukast

A

leukotriene modifier: long term control medication, helps prevent/control flare ups of allergic rhinits, allergies, asthma

45
Q

guaifenesin

A

expectorant; loosens up mucus and stimulates cough to get mucus out of respiratory tract

46
Q

acetylcysteine

A

mucolytic; breaks up mucus to get rid of it

47
Q

pseudophedrine, phenylephrine

A

decongestant; work on CVS system; capillaries in nasal passages and cause vasoconstriction which reduces edema leading to decongestion

48
Q

antitussives

A

dextromethorphan, codeine; cough medications, suppress the cough reflex

49
Q

methylprenisolone

A

steroid to reduce inflammations and suppress normal immune response

50
Q

too much steroid can cause

A

cushing’s symptoms

51
Q

Side effects of steroids

A

immunosuppression, hyperglycemia, osteoporosis, delayed wound healing

52
Q

antihistamines 2 types

A

histamine 1 blocker and histamine 2 blocker

53
Q

histamine 1 blockers and example

A

block H1 receptors in CNS -> stop allergies; used in resp system as blocking the CNS receptors cause depression of symptoms
example) diphenhydramine

54
Q

histamine 2 blockers and example

A

blocks production of stomach acid
example) famotidine, ranitidine

55
Q

diphenhydramine has anticholinergic effects which include

A

drying the body up, urinary retention, constipation

56
Q

COPD

A

group of lung diseases that block airflow and make it difficult to breathe; includes emphysema, chronic bronchitis, asthma

57
Q

emphysema

A

destruction of the alveoli due to chronic inflammation; decreased surface area of alveoli for gas exchange

58
Q

chronic bronchitis

A

chronic inflammation with a productive cough and excessive sputuma

59
Q

asthma

A

respiratory condition marked by spasms in the bronchi of the lungs causing difficulty in breathing - chronic inflammation of the bronchi and bronchioles and excess mucus

60
Q

COPD assessment findings

A

barrel chest
accessory muscle use
congestion
lung sounds diminished, crackles, wheezes
acidotic, hypercarbic, hypoxic

61
Q

explanation of ABGs in COPD pt

A

CO2 increases because air is being retained = hypercarbic, CO2 is an acid so they become acidotic; poor gas exchange due to surface area of alveoli decreasing leads to hypoxia

62
Q

COPD treatment

A

oxygen (carefully), bronchodilator, chest physio, increase fluid intake, pursed lip breathing, small frequent meals

63
Q

in a normal pt ___________ stimulates the body to breathe, but in COPD pts __________ is the driving factor to breathe because

A

hypercarbia; hypoxia; because they have been hypercarbic for an extended period of time

64
Q

asthma has to have a

A

trigger

65
Q

acute asthma exacerbation treatment

A

open up airway (albuterol? intubation?), O2 admin followed by bronchodilator, anticholinergic, steroid, IV fluids

66
Q

status asthmaticus

A

asthma attack that is refractory to treatment and leads to severe respiratory failure; will intubate to keep airway open (may give magnesium sulfate to vasodilate and sedation to help relax muscles)

67
Q

pneumonia

A

inflammation of the lung affecting alveoli, they become filled with pus and liquid

68
Q

diagnosis of pneumonia

A

CXR (patchy infiltrates), sputum culture

69
Q

pneumonia S&S

A

high fever, cough, tachypnea, crackles, chest pain, increased work of breathing

70
Q

Acute respiratory distress syndrome

A

characterized by bilateral pulmonary infiltrates and severe hypoxemia in absence of any cardiac relation

71
Q

ABGs in a pt with ARDS will show

A

respiratory acidosis; due to impaired gas exchange

72
Q

damage to the lungs from ARDS is reversible or irreversible

A

irreversible

73
Q

ARDS causes an increase in capillary membrane permeability which means

A

the cells spread out causing fluid to leak into alveoli leading to poor gas exchange

74
Q

causes of ARDS

A

anything that causes an inflammatory reaction in the lungs (trauma, sepsis, burns, aspiration pneumonia, overdose, near drowning)

75
Q

Diagnosis of ARDS

A

CXR showing diffuse bilateral infiltrates, hypoxemia; pale, cool, mottles, low SpO2

76
Q

treatments for ARDS

A

treat underlying condition, intubation and mechanical ventilation, prone, prevent infection (VAP), prevent barotrauma (too much pressure to alveoli)

77
Q

spontaneous pneumothorax occur due to a

A

disease process

78
Q

Pneumothorax S&S

A

SOB, chest pain, desaturation, hypotension, tachycardia, tracheal deviation?

79
Q

tension pneumothorax

A

air goes into lungs and leaks into pleural space where it then accumulates, it pushes on the lungs, trachea, and heart causing the trachea to shift

80
Q

pulmonary embolism

A

blood clot in lungs, causing hypoxemia

81
Q

pulmonary embolism can lead to _______ sided HF if untreated

A

right

82
Q

Pulmonary embolism S&S

A

dyspnea, chest pain, anxiety, hypoxemia, rales, diaphoresis, hemoptysis

83
Q

treatment and interventions for pulmonary embolism

A

O2 admin, high fowlers, anticoagulants, thrombolytics

84
Q

positioning for air embolism

A

durants: maneuver, left lateral trendelenburg

85
Q

positioning for pulmonary embolism

A

high fowlers

86
Q
A

NCLEX (23 decks)

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