Respiratory Flashcards
What should you do if a chest tube becomes dislodged?
apply pressure over the insertion site w/ a dressing that is tented on one side to allow escape of air
What should you do if a chest tube becomes disconnected from the drainage system?
cut the contaminated tip off of the tubing using a sterile scissors and immerse the end of the chest tube in 2 cm sterile water until system can be re-established
Where are chest tubes placed on a patient and why are they used?
they’re placed in the pleural space to drain air and/or lymphatic fluid and/or blood so that the lung can re-expand (the drainage system consists of 1 or more chest tubes)
Where do you place the collection container for a PT w/ a chest tube? What is it for?
place it below the PT’s chest and a water seal is used to keep air from entering the chest (this is where the drainage drains to)
nursing responsibilities r/t chest tube PTs
- Look out for for constant bubbling in the water-seal chamber (if continuous, indicates an air leak in the drainage system or in the PT. INTERMITTENT BUBBLING IS GOOD/MATCHES PT’S BREATHING). No bubbling is also bad.
- Monitor that the tubing doesn’t become dislodged or disconnected.
- Monitor amt of water in chamber (should always be at least 2 cm)
- Monitor drainage chamber (if “only” pneumothorax, you may not see any drainage)
- Monitor skin around site
what is the suction usually set at for adults on a chest tube
20 cm
what is the suction usually set at for children on a chest tube
15 cm
how does tube “milking” work
squeeze release move, squeeze release move. Always go proximal to distal. DO NOT STRIP
In what position should you place a postop PT after a new tracheostomy is placed?
Semi-Fowlers. Turn the PT’s head to one side until consciousness is regained.
This position facilitates respiration, promotes drainage, prevents edema, and prevents strain on the suture line.
how often should tracheostomy care be completed?
every 8 hrs or as needed
what is an indication for needing to perform tracheostomy care?
-secretions (excessive or tried)
which PTs are at risk for hospital-acquired pneumonia?
- depressed immune function
- chronic health problems
- risk for aspiration (e.g. NG tube)
- defense mechanisms
- poor oral care, mechanical ventilation
what is pneumothorax
lung collapse caused by accumulation of air in the pleural cavity; indications include pleuritic pain, tachypnea, diminished breath sounds; treatment includes chest tubes
what are early symptoms of oxygen toxicity in a PT receiving O2 per face mask
nonproductive cough, nasal congestion, sore throat, substernal discomfort or pain, GI upset, dyspnea
what are late symptoms of oxygen toxicity in a PT receiving O2 per face mask
decreased vital capacity, incr dyspnea, crackles, hypoxemia; atelectasis or structural damage to the lungs, along w/ pulmonary edema and hemorrhage and stiffness of lung tissue can occur (known as adult respiratory distress syndrome (ARDS)
Isoniazid (brand name: Nydrazid) is used for
treating or preventing TB. If using to treat TB, should always be used w/ another med.
Isoniazid is an antibacterial–it works by killing TB organisms
possible side effects of Isoniazid (brand name: Nydrazid)
severe and sometimes fatal liver problems (e.g. hepatitis)
-peripheral neuritis, rash, fever, blood dyscrasias, GI upset, local irritation at injection site
Nursing considerations for isoniazid
give in combo w/ other anti-TB agents when treating active TB, administer vitamin B6 to prevent peripheral neuritis, monitor for resolution of TB symptoms, check liver function tests; client education: signs of hepatitis, take before meals on empty stomach
what is the main purpose of a tracheostomy
to provide and maintain an airway (it permits removal of tracheobronchial secretions when the PT is unable to cough productively. Also permits positive pressure for ventilation, and prevents aspiration of secretions in the unconscious or paralyzed PT)
what is a risk for a PT receiving Assist-control ventilation (AC)
hyperventilation and respiratory alkalosis
how should oxygen be administered to COPD/emphysema patients
via venturi mask (provides O2 at specified percentages)
brand name for albuterol
Proventil
universal sign of choking
hands crossed at neck
wheezing can be described as
high-pitched musical-like squeaky sounds (often heard with asthma)
how to educate a chronic bronchitis PT about proper coughing technique?
sit w/ feet on the floor, lean slightly forward, take several slow deep breaths through the nose; exhale slowly and through pursed lips; during exhalation of the last breath the client should cough SEVERAL TIMES
what is rhinoplasty
nasal reconstruction to improve upper airway function or for cosmetic reasons; often includes packing to prevent bleeding; packing is removed day after surgery
what is aminophyline
a xanthine derivative that acts as a bronchodilator (relaxes smooth bronchial muscle, potentiates diaphragm contraction, and increases mucus movement in airways
common side effects of aminophyline (a bronchodilator)
tachycardia, nervousness, restlessness, and nausea (use w/ caution for cardiac PTs)
tuberculosis is caused by
BACTERIUM (Mycobacterium tuberculosis)
describe the CABG procedure
coronary artery bypass graft (CABG): in a bypass procedure, a graft is placed and anastomosed distally and proximally to bypass the obstruction
For a COPD PT receiving nutritional education, what nutrient should s/he avoid consuming in high amounts?
Carbs – bc excess amts can lead to increased CO2 production since carbs are broken down into glucose, CO2, and water when metabolized
function of an expectorant
loosen bronchial secretions so that PT is able to cough up the secretions
what is a croupette
a humidified oxygen tent
controlled ventilation (CV) is used for which PTs
PTs who are unable to initiate a breath, such as PTs with polio or Guilliain Barre
what is the preferred lubricant catheter used to suction a PT’s tracheostomy
sterile water (bc it won’t irritate the tissues; can also use sterile saline)
what is the preferred way for a PT to hold a metered-dose inhalers?
1-2 inches from mouth
what types of food might present problems for a PT with respiratory problems
DAIRY
bc milk and dairy products are mucus producing
what is an essential piece of equipment that needs to be available to a PT receiving mechanical ventilation
resuscitation bag
