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NCLEX > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

pre-procedure for thoracentesis you need ___ and baseline ____

A

CXR

VS

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2
Q

position for thoracentesis

A

sitting up leaning over bedside table

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3
Q

if they can’t sit up what position for thoracentesis

A

lie on unaffected side with HOB at 45 degrees

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4
Q

since you are removing fluid with a thoracentesis you may put the client into a fluid volume ____

A

deficit

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5
Q

post procedure for thoracentesis

A

another CXR

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6
Q

if a chest tube is placed in the upper anterior chest it is for the removal of ____

A

air

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7
Q

if the chest tube is placed laterally in the lower chest then it is for the removal of _____

A

fluids

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8
Q

3 chambers of the chest tube drainage system

A

drainage collection chamber
water seal chamber
suction control chamber

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9
Q

you will see ____ in the water seal chamber

A

tidaling

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10
Q

you want to see what in the suction control chamber

A

slow gentle continuous bubbling

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11
Q

record drainage from a chest tube every hour for ___ hrs and then every ____ hrs

A

24 hrs

8hrs

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12
Q

notify dr when there is ____ ml of drainage from chest tube in one hour

A

100

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13
Q

who can transfer a client with a chest tube?

A

RN

LPN

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14
Q

tidaling (fluctuations) will stop when what has occurred?

A

lung re-expansion

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15
Q

what do you do if the tubing becomes disconnected?

A

another sterile connector at bedside

reconnect dirty one as fast as you can

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16
Q

the water seal chamber has ___ml of water in it

A

2

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17
Q

what if the chest tube is accidentally pulled out

A

occlusive dressing on 3 sides

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18
Q

when is bubbling a problem?

A

if there is continuous bubbling in the water seal chamber

19
Q

how do you remove a chest tube?

A

have client take a deep breath and hold and place an occlusive dressing over the site

20
Q

sx of hemo/pneumothorax

A 
SOB
increased HR
diminished breath sounds
less movement on affected side
chest pain
cough
21
Q

treatment for hemo/pneumothorax

A

thoracentesis
chest tubes
daily CXR

22
Q

if a pneumothorax is present and the client has a chest tube, what type of bubbling would be expected in the water seal chamber?

A

intermittent bubbling

23
Q

causes of tension pneumothorax

A

trauma
PEEP
clamping a chest tube
taping all 4 sides

24
Q

pressure has built up in the chest/pneural space and has collapsed the lung

pressure pushes everything to the opposite side

A

tension pneumothorax

25
Q

sx of tension pneumothorax

A

subQ emphysema
absence of breath on one side
asymmetry of thorax
resp. distress

26
Q

treatment of tension pneumothorax

A

large bore needle is place into 2nd intercostal space

27
Q

opening through the chest allows air into the pleural space

A

open pneumothorax

28
Q

tx of open pneumothorax

A

valsava
3 sided petroleum gauze
sit client up

29
Q

most common injuries from chest trauma

A

rib and sternum fracture

30
Q

sx of rib and sternum fractures

A

pain and tenderness
crepitus
shallow respirations
respiratory acidosis

31
Q

treatment of rib and sternum fractures

A

non-narcotic analgesics
nerve block
support injured area with hands

no chest binders

32
Q

flail chest occurs with multiple ___ fractures

A

rib

33
Q

sx of flail chest

A

pain
paradoxical chest wall movement
dyspnea
increased pulse

34
Q

treatment of flail chest

A

stabilize area
intubate
ventilate

(PEEP, CPAP, and BiPAP)

35
Q

with PEEP, the client is on the ____

A

vent

36
Q

on end expiration, the vent exerts pressure down into the lungs to keep the ____ open

A

alveoli

37
Q

the classic reason to use PEEP is for?

A

ARDS

38
Q

causes of pulmonary embolism

A 
dehydration
venous stasis
BC pills
clotting disorders
A. fib
39
Q

sx of pulmonary embolism

A 
hypoxemia
SOB
increased D-dimer
positive VQ scan
a positive CT
40
Q

treatment for pulmonary embolism

A

prevent
oxygen
ABGs
decrease pain

41
Q

what are the common anticoagulant drugs?

A

heparin
warfarin
enoxaparin

42
Q

normal aPTT

A

30-40 seconds

43
Q

normal PT

A

11-12.5 seconds

44
Q

therapeutic INR

A

2-3

NCLEX (10 decks)

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