Respiratory Flashcards
ARDS, COPD, Pneumonia, Pneumothorax, PE, chest tubes
S+S of ARDs
SOB
Refractory hypoxemia
Compensatory tachypnea
Intercostal retractions, accessory muscle use
Anxiety
Tachycardia
Fever
Crackles on auscultation (pulmonary edema)
Nursing interventions of ARDS
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
For ARDS, once intubated, what interventions?
Prevent DVT w/ anticoagulants and SCDs
Anticipate that severe hypoxemia may require high PEEP and prone positioning
S+S of pneumonia
Difficulty breathing
Productive cough w/ purulent sputum
Increased RR
Chest pain on deep breathing (pleurisy)
Fever, chills, malaise
Tachycardia
Crackles
Nursing interventions of pneumonia
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
Pneumothorax (open)
Air enters through hole in chest wall
Gunshot wound
Pneumothorax (closed)
Air enters through hole in lung tissue
After lung surgery
Pneumothorax (tension)
Closed pneumothorax but air cannot escape
Lungs collapse
Trachea shifts to unaffected side
Hypotension
S+S of pneumothorax
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
Nursing interventions of pneumothorax
Place 3 way occlusive dressing over chest wound
Fowler position
Insertion of chest tube
Water seal chamber
Tidaling is expected
Bubbling = air leak
Suction chamber
Gentle, continuous bubbling = expected
Notify HCP about chest tube system if
Drainage exceeds 100 mL/hr
Sudden, bright red or free-flowing drainage
Pulmonary embolism risk factors
Thromboembolism (Virchow’s triad)
Recent surgery
Inactivity/immobility
Pregnancy
C-section
Hx of DVT
Malignancy
Obesity
Oral contraceptives and hormone therapy
Smoking
S+S of PE
Dyspnea
Pleuritic chest pain
Hypoxemia
Tachypnea
Cough
Hemoptysis
Nursing interventions of PE
High Fowler
Administer: anticoagulants (heparin), analgesics, oxygen
Anticipate fibrinolytics or embolectomy w/ large PE
Long-term oral anticoagulation
COPD S+S
Dyspnea
Wheezing
Chronic cough
Barrel chest
Fatigue
Extremity clubbing
Interventions of COPD
Collect sputum sample
Request prescription for inhaled short-acting beta-adrenergic agonist
Monitor for changes in LOC
Crackles vs. wheezing tx
Crackles: diuretics
Wheezing: albuterol
CO poisoning tx
100% oxygen using nonrebreather mask w/ flow rate of 15 L/min
Cystic fibrosis def and S+S
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
COPD exacerbation
Wheezing
Worsening dyspnea
Altered mental status
Increased cough frequency
Increased sputum production
Decreased exercise tolerance and fatigue
COPD exacerbation risk for what?
Air trapping for developing hypercapnic respiratory failure
Huff coughing
Sit upright and inhale deeply
Perform quick, forceful exhalation (“huff”)
Tracheostomy open-suction technique
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
Interventions for pt who has tracheostomy and mechanical ventilation
Perform oropharyngeal suctioning
Administer anxiolytic to pt
Ensure 2 fingers fit under tracheostomy ties
DO NOT DEFLATE TRACHEOSTOMY CUFF
