Respiratory Flashcards
normal ABG values:
pH: 7.35-7.45
pCO2: 35-45 mmHg
HCO3: 22-26 mEq/L
pO2: 80-100 mmHg
lab changes for allergic asthma
elevated serum eosiniphil
elevated IgE
pulmonary function tests for asthma (3)
- forced vital capacity (FVC)
- forced expiratory volume in first second (FEV1)
- peak expiratory flow rate (PEFR) - green, red, yellow light
preventative therapy drugs for asthma (3)
- inhaled corticosteroids - fluticasone
- long-acting beta-2 agonists (LABA) - salmetrol
- leukotriene receptor antagonists (LTRA) - Singulair pill
rescue drugs for asthma (2)
- short-acting beta-2 agonists (SABA) - albuterol, salbutamol
- anticholinergics - Atrovent
what is the cornerstone of drug therapy for moderate persistent asthma?
inhaled corticosteroids
treatment for status asthmaticus (5)
- emergency! go to ER
- IV fluids
- IV steroids
- potent systemic bronchodilator
- epinephrine
- O2 therapy
risks for COPD
- cigarette smoking
- alpha-1 antitrypsin (AAT) deficiency - emphysema
- air pollution (occupation, etc.)
complications of COPD
- hypoxemia, acidosis
- respiratory infections
- cardiac dysrhythmias, cardiac failure (cor pulmonale)
- acute respiratory failure
CBC changes in COPD
high hemoglobin and hematocrit to compensate for decreased oxygenation
drug therapy for COPD (5)
- beta-adrenergic agents
- anticholinergics
- methylxanthines
- mucolytics
- corticosteroids
warning signs of lung cancer (5)
- hoarseness
- blood in sputum, hemoptysis
- persistent cough
- chest tightness/pain
- shoulder pain
post-op care of lung cancer (lobectomy, wedge resection)
- chest-tube placement and care
- pain management
- respiratory management - possible mechanical ventilation
obstructive sleep apnea (OSA) definition
breathing disruption during sleep that lasts at least 10 seconds and occurs at least 5 times an hour
OSA manifestations
- heavy snoring
- excessive daytime sleepiness
- irritability, personality changes
- inability to concentrate
- headache
how do you manage OSA?
non-invasive positive pressure ventilation (NPPV) during sleep:
- BiPAP - high pressure during inspiration, low pressure during exhalation
- CPAP - continuous positive airway pressure
ABG changes for acute respiratory failure (ARF)
pO2 < 60 mmHg AND pCO2 > 50 mmHg
what do you need to monitor for someone who is on mechanical ventilation? (9)
- vital signs
- ABGs
- breathing pattern (focused assessment)
- monitor for pulmonary infections (VAP)
- alarms - recognition and intervention
- DOPE = displaced tube, obstruction, pneumothorax, equipment problems
causes of high pressure ventilator alarm (6)
- secretions, mucus plugs
- coughing, gagging, biting tube
- obstruction
- asynchrony (“fighting” ventilator)
- airway displaced or moved
- pulmonary complications - bronchospasm, pneumothorax, pneumonia
causes of low pressure ventilator alarm (2)
- leak in circuit or cuff
- loss of spontaneous breathing or decreased respiratory effort
