Respiratory 3

Question 1

describe epi

Answer 1

• bronchodilate, allow you take in more oxygen (relax smooth muscle)
• epi can be given IV or through ET tube
• lungs are very vascular and will pick up epi quickly
• epi is #1 beta 2 agonist

Question 2

describe albuterol

Answer 2

• inhaled, given with mask
• SE: HR increases, will feel shaky/dizzy, palpitations
• may be given in two doses
• SHORT ACTING beta 2 agonist

Question 3

describe Ipatropium

Answer 3

• anticholinergic given with albuterol
• help breathe faster to get stuff off, will also bronchodilate
• Short-acting relief of bronchospasm with chronic bronchitis and emphysema

Question 4

describe Tiotropium

Answer 4

• Long-acting relief of bronchospasm with COPD
• anticholinergic
• given as a powder
• bronchodilate to get more oxygen in them
• SE: cough

Question 5

how are systemic corticosteroids given

Answer 5

take it by mouth (PO), pill form

Question 6

what are the systemic corticosteroids

Answer 6

Dexamethasone, Solu-Medrol and Prednisone

Question 7

why are systemic corticosteroids given

Answer 7

Anti-inflammatory for Acute respiratory failure, ARDS and COPD , asthma

Question 8

SE of systemic corticosteroids

Answer 8

arrhythmia, edema, pancreatitis, PUD, insomnia, hyperglycemia, hypokalemia, adrenal insufficiency

Question 9

what are the inhaled corticosteroids

Answer 9

Beclomethasone (QVAR)

Pulmicort, Aerobid, Flonase, Azmacort

Question 10

why are the inhaled corticosteroids given

Answer 10

Long-term asthma control

Question 11

SE of inhaled corticosteroids

Answer 11

hoarseness, dry mouth, wheezing, bronchospasm, oral candidiasis and headache

Question 12

what is important to teach pt about inhaled steroids

Answer 12

can get thrush so make sure to rinse mouth out after use

Question 13

describe nasal cannulas

Answer 13

Low flow 1-6 L/min delivers 24-44% FiO2
(needs to be humidified)
only delivers up to 40% O2

Question 14

describe simple mask

Answer 14

6-10 L/min (40-60% FiO2)

Question 15

describe partial rebreather

Answer 15

6-10 L/min (35-60% FiO2)

has holes on the side (COPD): need to get a lot of oxygen but not a lot of CO2

Question 16

describe non rebreather

Answer 16

is similar to breathing in a bag (given to asthmatics): need to slow them down
6-10 L/min (60-100% FiO2)

Question 17

describe venturi mask

Answer 17

4-10 L/mIn (24-55% FiO2, more precise

will tell you how many L based on the %

Question 18

what are the Noninvasive positive pressure ventilation (NPPV)

Answer 18

CPAP and BiPAP

Both are used for acidosis, pulmonary edema and respiratory failure

Question 19

describe CPAP

Answer 19

• home treatment
• continuous positive airway pressure
• room air, not oxygen
• Constant low-flow pressure into the airways to help hold the airway open, mobilize secretions, treat atelectasis and ease the work of breathing

Question 20

describe BiPAP

Answer 20

• oxygen, positive push
• used for resp difficult pts
• Preset inspiratory positive airway pressure both inspiratory and expiratory, they can also have a backup respiratory rate

Question 21

how long should ET tubes stay in

Answer 21

• ET tubes should stay in 5-7 days, need to be trached after that
• breathe better with trach (shorter, works better)

Question 22

what are the nursing responsibilities during intubation

Answer 22

• Nurse numbs bronchial tubes and administer paralytic (stop them from breathing)
• *Ensure that dr is ready for paralytic so not done too soon
• once tube is in place, listen to ensure ventilation
• Suction and ensure tube is working correctly
• Also listen for alarms

Question 23

after intubation, what should the nurse do

Answer 23

always listen for bilateral breath sounds, inflate the tube and check the CO2 level

Question 24

if on ventilator, what is important to remember about the balloon

Answer 24

• Balloon around trach and ETT (always be INFLATED if on ventilator)
• Will not get air otherwise!!! Air will go back out mouth instead of staying in lungs

Question 25

how do you ensure proper ETT placement

Answer 25

Need CXR to determine proper placement, listening is only the temporary determiner

Question 26

before intubation what should the nurse

Answer 26

Always preoxygenate pt before intubation (21-23 marker if in correct position)

Question 27

paralyzing meds for intubation should be given when

Answer 27

should not be given until ready to intubate

Question 28

how long do you keep the pt sedated after intubation

Answer 28

After tube is in, pt will bite and attempt to pull tube out (keep them sedated until oxygen is under control)

Question 29

what does sedation cause

Answer 29

decreased respirations