Respiratory 3 Flashcards
describe epi
- 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
describe albuterol
- inhaled, given with mask
- SE: HR increases, will feel shaky/dizzy, palpitations
- may be given in two doses
- SHORT ACTING beta 2 agonist
describe Ipatropium
- anticholinergic given with albuterol
- help breathe faster to get stuff off, will also bronchodilate
- Short-acting relief of bronchospasm with chronic bronchitis and emphysema
describe Tiotropium
- Long-acting relief of bronchospasm with COPD
- anticholinergic
- given as a powder
- bronchodilate to get more oxygen in them
- SE: cough
how are systemic corticosteroids given
take it by mouth (PO), pill form
what are the systemic corticosteroids
Dexamethasone, Solu-Medrol and Prednisone
why are systemic corticosteroids given
Anti-inflammatory for Acute respiratory failure, ARDS and COPD , asthma
SE of systemic corticosteroids
arrhythmia, edema, pancreatitis, PUD, insomnia, hyperglycemia, hypokalemia, adrenal insufficiency
what are the inhaled corticosteroids
Beclomethasone (QVAR)
Pulmicort, Aerobid, Flonase, Azmacort
why are the inhaled corticosteroids given
Long-term asthma control
SE of inhaled corticosteroids
hoarseness, dry mouth, wheezing, bronchospasm, oral candidiasis and headache
what is important to teach pt about inhaled steroids
can get thrush so make sure to rinse mouth out after use
describe nasal cannulas
Low flow 1-6 L/min delivers 24-44% FiO2
(needs to be humidified)
only delivers up to 40% O2
describe simple mask
6-10 L/min (40-60% FiO2)
describe partial rebreather
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
describe non rebreather
is similar to breathing in a bag (given to asthmatics): need to slow them down
6-10 L/min (60-100% FiO2)
describe venturi mask
4-10 L/mIn (24-55% FiO2, more precise
will tell you how many L based on the %
what are the Noninvasive positive pressure ventilation (NPPV)
CPAP and BiPAP
Both are used for acidosis, pulmonary edema and respiratory failure
describe CPAP
- 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
describe BiPAP
- 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
how long should ET tubes stay in
- ET tubes should stay in 5-7 days, need to be trached after that
- breathe better with trach (shorter, works better)
what are the nursing responsibilities during intubation
- 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
after intubation, what should the nurse do
always listen for bilateral breath sounds, inflate the tube and check the CO2 level
if on ventilator, what is important to remember about the balloon
- 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
how do you ensure proper ETT placement
Need CXR to determine proper placement, listening is only the temporary determiner
before intubation what should the nurse
Always preoxygenate pt before intubation (21-23 marker if in correct position)
paralyzing meds for intubation should be given when
should not be given until ready to intubate
how long do you keep the pt sedated after intubation
After tube is in, pt will bite and attempt to pull tube out (keep them sedated until oxygen is under control)
what does sedation cause
decreased respirations
