Respiratory Flashcards
The normal AP to Lateral ratio is 2:1. If a patient has a ratio of 1:1, what could this indicate? (4)
- barrel chest
- air trapping
- COPD
- chronic asthma
__________ is the aspiration of pleural fluid or air from pleural space.
Thoracentesis
After a thoracentesis a _______ ________ is always performed in order to rule out a pneumothroax.
Chest x-ray
Major complication of a thoracentesis is a tension pneumothorax. What are the signs and symptoms of tension pneumothorax? (5)
- SOB (air hunger)
- decreased O2 sats (in the 80%); cyanosis
- unilateral expansion
- tracheal deviation to unaffected side (very pronounced)
- cough (lung trying to inflate)
*sudden increase in HR indicates the lungs are not perfusing!
During a post-up nursing assessment of a patient that just underwent a lung biopsy, what are the big issues you should be concerned about? (2)
- hemoptysis (coughing up blood)
- monitor for signs of pneumothorax
*report reduced or absent breath sounds immediately
What are the two major components of asthma?
- Inflammation (constricted airways, increase mucous)
- Bronchospasm (impaired gas perfusion- can cause chronic cough)
**asthma cough is usually “barky”, “seal-like” and non-productive
What are some risk factors for asthma? (4)
- allergies
- smoking
- pollution
- family history (genetically linked)
Assessment Findings of Asthma (5)
- SOB
- EXPIRATORY wheeze (caused by obstruction in the lungs)
- use of accessory muscles
- decreased O2 sats (cyanotic, especially around lips)
- increased respirations
Peak Flow Meter
- what is it
- readings
- when is baseline obtained
- tube that is blown into to see how well the lungs are working
- best of 3 readings
- done when not having any symptoms to obtain a baseline
Important teaching topics for asthmatic patients (5)
- no smoking
- avoid triggers
- continue exercise as tolerated
- stay on medications
- monitor peak flow
What are the components of COPD?
- Emphysema (alveoli die off due to chronic exposure to pollutants)- lungs hyper inflated; lost of elasticity
- Chronic bronchitis (inflammation of bronchioles with increased mucous production)
Assessment Findings of COPD (8)
- barrel chest
- SOB
- tripod position
- acidotic (O2 levels are high)
- decrease in O2 sats
- diaphoresis
- ashy-type skin complexion (pale)
- clubbing (due to chronic decreased oxygen)
What are diagnostic tests used for patients with COPD? (4)
- ABG’s
- chest x-ray
- pulse oximetry
- blood: Hgb & Hct is increased due to erythropoietin because of chronic low oxygen levels
What is the preferred position for maximum breathing?
Up-right or in High Fowler’s position
*Orthopnea- sleeping in a upright position
Important teachings for patients with COPD (3)
- stop smoking
- important to get pneumonia & flu vaccine
- teach “pursed lip” breathing
Risks Factors of Pneumonia (4)
- age
- smoking
- chronic lung disease
- dysphasia
Assessment Findings of Pneumonia (5)
- fever (usually very high) causing the pt to be red & diaphoretic
- increase respirations & HR (due to anxiety)
- chest pain
- decreased O2 sats (~85%)
- cough->yellow mucous
When osculating a patient with pneumonia, what are the 3 different sounds that may be heard?
- Rhonchi- due to mucous and inflammation
- Crackles-due to inflammation and fluid
- Tactile fremitus-louder over areas of consolidation
Nursing Interventions Appropriate for Patients with Pneumonia (5)
- turn, cough, & deep breath
- nutrition is a huge issue!!! (pt has high fever increasing metabolism)
- increase fluids to at least 2L/day (to thin mucous)
- rest
- may get an order for O2 (want sats at or above 95%)
Important Teachings for Patients with Pneumonia (3)
- get up and move around
- finish antibiotics
- monitor body temperature
