Respiratory Flashcards

ARDS, COPD, Pneumonia, Pneumothorax, PE, chest tubes

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1
Q

S+S of ARDs

A

SOB
Refractory hypoxemia
Compensatory tachypnea
Intercostal retractions, accessory muscle use
Anxiety
Tachycardia
Fever
Crackles on auscultation (pulmonary edema)

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2
Q

Nursing interventions of ARDS

A

Administer oxygen
Fowler’s position
Prepare for intubation and mechanical ventilation w/ PEEP
Restrict fluids
Provide and monitor sedation and paralytic support
Provide enteral nutritional support
Implement prone therapy

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3
Q

For ARDS, once intubated, what interventions?

A

Prevent DVT w/ anticoagulants and SCDs
Anticipate that severe hypoxemia may require high PEEP and prone positioning

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4
Q

S+S of pneumonia

A

Difficulty breathing
Productive cough w/ purulent sputum
Increased RR
Chest pain on deep breathing (pleurisy)
Fever, chills, malaise
Tachycardia
Crackles

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5
Q

Nursing interventions of pneumonia

A

Hydration to liquefy secretions
IS
Cough and deep breathe (every 2 hrs)
Collect sputum and blood cultures
Administer abx, antipyretics, IV fluids
Encourage vaxx
Proper position w/ affected lung up

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6
Q

Pneumothorax (open)

A

Air enters through hole in chest wall
Gunshot wound

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7
Q

Pneumothorax (closed)

A

Air enters through hole in lung tissue
After lung surgery

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8
Q

Pneumothorax (tension)

A

Closed pneumothorax but air cannot escape
Lungs collapse
Trachea shifts to unaffected side
Hypotension

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9
Q

S+S of pneumothorax

A

Progressive dyspnea
Restlessness, anxious
Progressive cyanosis
Chest pain
Hypotension and tachycardia
Low oxygen saturation
CXR in stable pts
Hyperresonance percussion
Diminished breath sounds
Decreased tactile vocal fremitus

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10
Q

Nursing interventions of pneumothorax

A

Place 3 way occlusive dressing over chest wound
Fowler position
Insertion of chest tube

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11
Q

Water seal chamber

A

Tidaling is expected
Bubbling = air leak

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12
Q

Suction chamber

A

Gentle, continuous bubbling = expected

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13
Q

Notify HCP about chest tube system if

A

Drainage exceeds 100 mL/hr
Sudden, bright red or free-flowing drainage

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14
Q

Pulmonary embolism risk factors

A

Thromboembolism (Virchow’s triad)
Recent surgery
Inactivity/immobility
Pregnancy
C-section
Hx of DVT
Malignancy
Obesity
Oral contraceptives and hormone therapy
Smoking

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15
Q

S+S of PE

A

Dyspnea
Pleuritic chest pain
Hypoxemia
Tachypnea
Cough
Hemoptysis

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16
Q

Nursing interventions of PE

A

High Fowler
Administer: anticoagulants (heparin), analgesics, oxygen
Anticipate fibrinolytics or embolectomy w/ large PE
Long-term oral anticoagulation

17
Q

COPD S+S

A

Dyspnea
Wheezing
Chronic cough
Barrel chest
Fatigue
Extremity clubbing

18
Q

Interventions of COPD

A

Collect sputum sample
Request prescription for inhaled short-acting beta-adrenergic agonist
Monitor for changes in LOC

19
Q

Crackles vs. wheezing tx

A

Crackles: diuretics
Wheezing: albuterol

20
Q

CO poisoning tx

A

100% oxygen using nonrebreather mask w/ flow rate of 15 L/min

21
Q

Cystic fibrosis def and S+S

A

Genetic disorder which causes glands to produce thick and sticky secretions that plug small airways and GI tract
S+S: ineffective airway clearance, risk of infx, chronic lung dz, low baseline oxygen saturation

22
Q

COPD exacerbation

A

Wheezing
Worsening dyspnea
Altered mental status
Increased cough frequency
Increased sputum production
Decreased exercise tolerance and fatigue

23
Q

COPD exacerbation risk for what?

A

Air trapping for developing hypercapnic respiratory failure

24
Q

Huff coughing

A

Sit upright and inhale deeply
Perform quick, forceful exhalation (“huff”)

25
Q

Tracheostomy open-suction technique

A

Place in semi-Fowler position
Hyperoxygenate
Insert suction cath w/o applying suction
Apply intermittent suction while withdrawing cath, limit suction to 10-15 secs
Flush suction cath w/ NS after

26
Q

Interventions for pt who has tracheostomy and mechanical ventilation

A

Perform oropharyngeal suctioning
Administer anxiolytic to pt
Ensure 2 fingers fit under tracheostomy ties
DO NOT DEFLATE TRACHEOSTOMY CUFF