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Study > Respiratory > Flashcards

Respiratory Flashcards

1
Q

paradoxical breathing

A

flail chest

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2
Q

what test for finger clubing

A

schamroth’s window test
-Lovibond’s angle

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3
Q

assessment for respiratory and position

A

inspection, palpation, percussion auscultation. upright, posterior first, apex to base, side to side assessment, “zigzag”

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4
Q

if the elderly can tolerate sitting up, what is the position and where to start to auscultate

A

upright, posterior, base first

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5
Q

if the elderly unable to tolerate upright, what is the position and where to start to auscultate?

A

semifowlers, anterior- posterior

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6
Q

normal breathing

A

eupnea

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7
Q

deep and slow breathing, after exercise with high altitude

A

Hypernea

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8
Q

deep and fast breathing

A

Kussmaul’s - “air hunger”/ “sawtooth”

-metabolic acidosis, DKA

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9
Q

absent breathing-

A

apnea

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10
Q

“waiting warning” (+) apnea >20sec, nearly dying pts
characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea.

A

cheyne strokes
-CHF, Acute Increased ICP, Brain stem damage

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11
Q

chaotic respiratory pattern characterized by irregular periods of deep, shallow, fast, and slow breathing.

A

BIOTS/ ataxic Cluster breathing
d/t opoid overdose

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12
Q

BQ: what is the respiratory pattern of px with morphine toxicity

A

BIOTS
-meningitis, chronic increased ICP, severe brain stem damage

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13
Q

what is the ratio of shoulder to shoulder

A

N- 1:2

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14
Q

what is the ratio of barrel chest

A

equal 2:2 or 1:1
-common in COPD and chronic asthma

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15
Q

what is the ratio of pigeon chest

A

2:1
anterior is longer
-common in px with marfan’s syndrom & kyphoscoliosis

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16
Q

pectus excavatus ratio

A

1:5
-Marfan’s syndrome

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17
Q

where does the nurse stand when palpating the the lung chest pt

A

at the back posterior
-thumbs at the T9-T10
-normal should be equal moving of the thumb
-abnormal- unequal thumb moving

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18
Q

what part of the hand are you going to use during assessing Tactile Fermitus

A

use both palms of the hands and let the pt say “ninety-nine”, “1-2-3” “eee-eee”

increased TF- consolidation (mucus, secretion, inflammation, tumors)
decreased TF- Air trapping such as
COPD- emphysema/ barrel chest.
Pneumothorax- pleural space

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19
Q

normal lung sound

A

resonance- soft low sound

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20
Q

what type of lung sound that is extreme dullness/ flat

A

Flat
-percussing the muscle and bones

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21
Q

mudlike sound, condolidation (lot of fluids inside the lungs)

A

Dull
-percussing the liver, heart and urinary bladdder

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22
Q

type of lung sound that is booming= air tapping

A

hyper resonance
-copd px/ pneumothorax

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23
Q

drum like sound, loud high pitch, excessive passive force

A

tympany
-stomach, colon

24
Q

sound in the anterior high pitch sound

A

Bronchial/ tracheal sound
-found in the trachea

25
Q

anterior & posterior-medium speech

A

bronchovesicular- found in the bronchi
anterior 1-2 ICS
posterior- between scapular region

26
Q

found in the anterior & posterior- low pitch “sighing”

A

vesicular- lung fields
only normal lung sound

27
Q

Sound does not match in the location

A

adventitious

28
Q

BQ: pneumonia px has expected adventitious sound

A

Bronchovesicular-bronchial

29
Q

popping, gurgling, crackling. heard with mucus, secretions, fluids (asthma), Both heard at inspi and expi

A

crackles or Rales
-more prominent in inspi

  1. coarse crackles- bronchial secretions early inspi (chronic bronchitis)
  2. fine- alveolar (late inspi)
30
Q

is it musical sound during expi. asthma, allegries, anaphylaxis. bronchoconstriction

A

wheezing
1. sonorous/ rhonchi- low pitch (snoring)
2. sibilant (high) more severe

31
Q

rough, grating, leather rubbing. both inspi and expi

A

Friction rub
- inflammation in pleuritis, pleurisy, pericarditis

32
Q

harsh, violent, high pitch, hoarse, whistling sound, air obstruction such as choking, epiglottitis, laryngospasm

A

stridor

33
Q

silent chest

A

status asmaticus

34
Q

silent chest lung

A

tension pneumothorax and respi failure

35
Q

silent lung

A

atelectasis

36
Q

BQ:what is the most common affects pulse ox?

A

artifacts/ motion such as Parkinson dse

37
Q

maximum of how many x-ray in a year?

A

2 or q6 months

38
Q

what is the Gold standard of the CTPA

A

for pulmonary embolism
-inject through femoral (contrast dye)
Iodine= ask for allergies and ask about metformin (need to hold for 48hrs)

39
Q

what is the Gold standard of sputum culture for TB

A

DSSM- direct sputum smear microscopy
3 consecutive days at least 2(+)= +TB
take it AM before breakfast
-no brushing and mouthwash
- gargle with water only
-deep breathing 3x and cough forcefully

C/I superficial saliva
>5ml sputum in a sterile container

40
Q

in getting the stool sample and urine sample =, which container must the nurse use, the sterile container or clean container?

A

clean container only

41
Q

what are the 3 non invasive Dx test for respiratory

A

x-ray, ct scan, MRI

42
Q

tuberculin skin test AKA? what is the route and Gauge

A

Mantoux test
Purified Protein Derivative (PPD)-inject in
ID route (5-15)
tuberculin syringe (0.1ml)
27 G
- has a wheal/ bleb= check after 48- 72 use ruler to measure
-healthy >15mm- filipino
- at risk <10mm- foreign
-immunocompromised >5mm

43
Q

in antibiotic skin test after how many mins you recheck the bleb?

A

30mins

44
Q

what are the s/sx of TB

A

fever, cough, night sweats
-bloody mucopurulent sputum (green-yellowish sputum)

45
Q

rusty sputum/ brownie sputum

A

pneumococcal pneumonia

46
Q

what is the position during bronchoscopy

A

supine with neck extended*
or upright with neck extended
-NPO for 6-8hrs
- if emergency bronchoscopy “lavage”
and atropine sulfate
S/e blurred vision, dry mouth, uo retention and constipation

47
Q

what are the expected and unexpected of post bronchoscopy

A

Expected- absent gag reflex for 2 hrs, decreased RR & O2 sat, blood tingled saliva sputum

Unexpected- gagreflex >2hrs
RR<8
O2 <92%
-coughing out of blood/ Hemoptysis & frequent swallowing

48
Q

it is a rough, crunchy feling

A

crepitus/ subcutaneous emphysema

49
Q

complications after surgery of bronchoscopy

A
  1. perforation- risk for shock, can cause pneumothorax.
    WOF: subcutaneous emphysema= +crepitus
  2. risk for infection- Normal to have fever after 24hrs of surgery but the succeeding hrs not
  3. risk for bronchospasm and laryngo spasm
50
Q

only confirmatory test of respiratory failure* only ventilation can support it

A

ABG ANALYSIS

51
Q

in Respiratory acid base that is underventilation, hypo, absent, CO2 trapping

A

respiratory acidosis

52
Q

in Respiratory acid based that is overventilation, hyper, CO2 elimination

A

respiratory alkalosis

53
Q

in Metabolic acid base that is vomiting, gastric suctioning and antacid, HCL loss

A

metabolic alkalosis

54
Q

in Metabolic acid base that is everything else=gavage

A

metabolic acidosis

55
Q

cause by toxic gas, burns. that is colorless, odorless, tasteless, Hgb ha 200x affinity to CO than O2

A

carbon monoxide poisoning

56
Q

confirmatory test for CO

A

carboxyhemoglobin test
N=0-10%
Px will turn “cherry red’ appearance

57
Q

mgt for carbon monoxide poisoning

A

pure 02 100%. highest is non rebreather mask (10-15 Lpm)
Nc: reservoir bag must be inflated at all times, this is for severe hypoxia. the bag must be inflated for 2/3

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