Respiratory Flashcards
Thoracentesis: get ___ x-ray and baseline ____ before procedure, position client leaning over ________ or lie on ______ side with HOB at _____–good lung _____
client must stay very _____–no ___ or deep ____, because fluid is being removed, client could go into __________ so check _____; get another _____ x-ray post-procedure
chest, VS
bedside table
unaffected, 45, down
still, coughing, breathing
FVD, VS, chest
Chest Tubes
used to _____ a collapsed lung, purpose of cdu is to restore normal _____ in pleural space by utilizing _____ system
three chamber system, water seal promotes ____ flow to prevent ____ from moving back into chest, this chamber has ___ cm of water and may have _____ bubbling with ____, ___, or ____ and _____ is the expected fluctuation in water seal chamber with normal breathing; suction chamber is filled with _____ water up to ____ cm, wall vacuum used so you should observe ____ and ___ continuous bubbling
re-expand
pressure, one-way
one-way
air
2, intermittent
exhaling, sneezing, coughing, tidaling
sterile, 20
slow
gentle
Chest tube dressing must be kept _____, report SpO2 under ____%, notify provider for drainage greater than _____mL in one hour or change in color to ________, watch _____ chest x-rays for lung ________; keep CDU ______ level of chest, keep tubing free of ____ and NEVER ______ or ____ it, tidaling will _____ when the lung has ____ or there is a ___/clot in tubing
tight 90 100, bright red daily, re-expansion below, kinks clamp, milk, stop re-expanded, kink
If chest tube is pulled out, use ______ gauze on ____ sides
Bubbling becomes a problem when there is _______ bubbling in the ________ chamber = ______ leak
clamping could lead to ________ pneumothorax
petroleum, 3
continuous
water seal, air
tension
Hemothorax/Pneumothorax
blood or air in _____ space = lung _______
S/S include _____, ____ HR, diminished sounds on _____ side, ____ movement on affected side, ___ pain, cough
treated with thoracentesis, ______ tubes, _____ CXR
Tension Pneumothorax = ______ has built up in _____ and pushes everything to _____ side (______ shift)
S/S include _______ of breath sounds on one side, ______ of thorax, subcutaneous _____, respiratory _____
Open Pneumothorax needs ______-sided _____ gauze for ______ valve/____ vent, have client _____ up but _____ clients stay flat until other injuries are ruled out
pleural, collapse
SOB, increased, affected
decreased, chest
chest, daily
pressure, pleural space
opposite, mediastinal
absence
asymmetry, emphysema, distress
3, petroleum
flutter, air, sit
trauma
immobilization with chest binders/straps is _____ recommended for fractures of ribs/sternum d/t potential for _____ breathing, _____ and penumonia
____ chest occurs with ______ rib fractures
s/s include ______ chest movement–assess by standing ________, dyspnea, cyanosis, ______ HR
NOT
shallow, atelectasis
flail, multiple
paradoxical
at the food of the bed, increased
Pressure Ventilation Settings
PEEP: _____ _____ _____ pressure
requires _______, keeps alveoli _____ by exerting _____ during _______, _____ work of breathing and _____ gas exchange, _____ and realigns ribs
used for rib ______, pulmonary ______, severe ______ and ______
BiPAP: ____ ____ ____ pressure
used for ARDS in clients with _____, ______ and _____ apnea
exerts varying levels of ______ pressure support
CPAP: _____ ______ _____ pressure
pressure delivered _____ during ______ breathing during _______ and _______
used for OSA: ______ _______ ______
ANY TIME YOU SEE PEEP, CPAP or BiPAP: PRIORITY NURSING ASSESSMENT IS: _______ lung sounds every ____ hours
positive end expiratory mech. ventilator, open pressure, expiration, decreasing improving, expands fractures, edema, hypoxemia ARDS
bi-level positive airway
COPD, HF, sleep
positive
continuous airway pressure
continuously, spontaneous
inspiration, expiration
obstructive sleep apnea
bilateral
2
NEVER WITHHOLD OXYGEN FROM A DEAD PERSON–COPDER CODING? GIVE 2L or 12L? ________ THEY NEED THE _______
12 L (100%) OXYGEN
Pulmonary Embolism #1 symptom is ______, PaO2 will be _____, SOB, cough, _____ RR d/t ______; sharp, stabbing _____ pain, CXR will show ________, pulmonary ______ = risk for _______–check _______
d-dimer: ____ but this doesn’t tell _____ the clot is, only that there is one
VQ scan: ____, more specific for ______ embolus
post-op client will have clots near incision so _____ will be increased, better test for PE is _______
prevention is KEY: _____ and ______
decrease ____, O2, ABGs, ______ precautions r/t _______ therapy– can give ______ AND ______ at same time since heparin will be _____ prior to D/C
LIMIT FOODS HIGH IN VITAMIN _____: DON’T WANT THEM EATING THE ANTIDOTE TO _______
____ will avoid dislodging the clot, elevate extremities to ______ venous return and ______ pooling plus _____ hose and ______
______, moist heat to _____ inflammation–NEVER put _____ or ____ on vein d/t _____ vasoconstriction/vasodilation
hypoxemia
low, increased, hypoxia
chest, atelectasis
hypertension, RHF, CVP
increased, where
positive, pulmonary
d-dimer
VQ
ambulate, hydrate
pain, bleeding
anticoagulant, heparin, warfarin
weaned
K
Warfarin
bedrest
promote, decrease, TED
SCDs
WARM, decrease
COLD, HOT, excessive
