Respiratory Flashcards
1
Q
organ of smell, mucous membranes with rich blood supply
A
nose
2
Q
3 bones - increase surface area for filtering, warming and humidifying air
A
turbinates
3
Q
passageway for both respiratory and digestive tract. Behind oral and nasal cavities
A
pharynx
4
Q
Voice box- contains C shaped cartilage and vocal cords
A
layrnx
5
Q
provide resonance to speech, decrease weight of skull and act as shock absorbers
A
sinuses
6
Q
lower airway- in front of esophagus. Branches to R/L mainstem bronchi at carina junction. Contains cartilage rings
A
trachea
7
Q
Where the trachea joins the mainstem bronchi
A
Carina
8
Q
begin at the carina, cartilage tissue
A
mainstem bronchi
9
Q
branch from mainstem bronchi. Complete cartilage and resist collapse. Lined with ciliated mucous membrane
A
lobar, segmental, subsegmental bronchi
10
Q
smaller and smaller tubes, no cartilage and depend on elastic recoil of lung to remain open
A
bronchioles
11
Q
resemble grapes- basic units of gas exchange
A
alveoli
12
Q
fatty protein that reduces surfactant tension
A
surfactant
13
Q
smooth membrane with 2 surfaces that totally enclose the lungs
A
pleura
14
Q
lines the inside of chest cavity and upper surface of diaphragm
A
parietal
15
Q
covers lung surfaces - allows the surfaces to glide across each other smoothly during breathing
A
visceral
16
Q
thin fluid filled space between visceral and parietal pleura
A
pleura cavity
17
Q
What hx is important when assessing a patients respiratory system?
A
smoking (what kind), hobbies, work enviornment, pack years, allergies, asthma
18
Q
physical assessment of Resp system
A
cough, sputum, SOB, chest pain, length of illness
19
Q
What labs do you use to assess resp system?
A
O2, RBC, H&H, ABGs
20
Q
What radiographic tests are done?
A
Chest X ray, CT
21
Q
Noninvasive resp assessment tools
A
pulse ox, PFTS, Skin tests (turgor), PFTS
22
Q
invasive resp exam
A
endoscopy, thoracentesis, lung biopsy
23
Q
needle aspiration of pleural fluid from pleural space for diagnostic purposes
A
thoracentesis
24
Q
obtain tissue for histologic anaylsis, culture or diagnosis
A
lung biopsy
25
low levels of O2 in the blood
hypoxemia
26
decreased tissue oxygenation
hypoxia
27
increased CO2
hypercarbia
28
best measure to determine the need for O2 therapy?
ABGs
29
non invasive measurement of blood oxygen
pulse oximetry
30
What is important to tell patients with oxygen?
no smoking or candles
31
1-6 L (long term O2 therapy)
nasal cannula
32
minimum flow of 5L (emergency situations)
simple face mask
33
6-11 L (bag must remain slightly inflated)
partial rebreather mask
34
highest O2 level, unstable RR and possible intubation
non-rebreather mask
35
provides the most accurate O2 saturation
venturi mask
36
useful for facial trauma/burns
face tent
37
when high humidity is needed
aerosol mask
38
high humidity needed inserted in the trach
trach collar
39
Bi level positive airway pressure
Bipap
40
continuous positive airway pressure - used to fix atelectasis
CPAP
41
What is important to have at the bedside for trach patients at ALL times?
a replacement and step down at all times
42
It is an emergency if the tube becomes dislodged within ____ hours of surgery as the trach has not yet ________ and _______ is difficult. One needs to ______________________ and call the ____________ asap.
72, matured, replacement. recusisitate using a manual ventilation bag, rapid response
43
what is cuff pressure supposed to be set at?
14-20 mm
44
What is the importance of air warming and humidification?
without humidification, tracheal damage can occur
45
How do you suction properly?
only 3 passes, twirling motion- no more than 10-15 seconds
46
when inspiration is less than expiration
bronchial
47
inspiration = expiration
bronchovesicular
48
when expiration is shorter than inspiration
vesicular
49
what is important after a throacentesis?
STAT chest X ray
50
Oxygen helps relieve _____ an _______
hypoxemia and hypoxia
51
Is oxygen a drug?
yes
52
What is the goal in oxygen therapy?
Use the lowest amount
53
What is carcinoma in situ?
Cancer in one place
54
Well- differentiated?
Borders
55
benign grapelike clusters of mucous membrane and connective tissue
polyps
56
disruption in breathing during sleep that lasts atleast 10 seconds atleast 5 times an hour
obstructive sleep apnea
57
What are some causes of sleep apnea?
obesity, short neck. enlarged tonsils
58
nosebleed
epistaxis
59
what should you check after a radical neck dissection?
shoulder drop
60
The number one cause of oral cancer is
smoking
61
Most common signs and symptoms of oral cancer?
change in voice, sores that dont heal, white patches
62
Fractured nose nursing implications
no coughing, no NSAIDS, VS q4 hr, semi fowler, no bearing down, watch for frequent swallowing
63
What do you do for epistaxis?
pinch nose, lean forward
64
What is number one intervention for facial trauma?
establish and maintain airway
65
What is important to have always for a patient with IMF?
wire cutters at all times
66
What are the two obstructions of asthma?
1. inflammation 2. airway hyper-responsiveness
67
PFT - GREEN YELLOW RED
Green- continue regular meds, Yellow- may need more meds , Red- stop, seek medial attention
68
If a patient with asthma is going to workout, what would you teach them to do?
Use bronchodilator 30 min before exercise
69
Is status asthmaticus a medical emergency?
yes- call rapid response
70
short acting beta agonists
bronchodilators (albuterol)
71
long acting beta agonists
daily maitenence
72
anti inflammatory agents for asthma
corticosteroids
73
How many minute do you wait in between the same medication? How many min after rescue can you use corticosteroid?
1 min - 5 min
74
What order do you use inhalers
short acting, long acting, then steroids
75
a loss of elasticity which overstretches and enlarges the alveoli
emphysema
76
What can bronchitis lead to?
right sided heart failure
77
inflammation of bronchi- lots of mucus production
bronchitis
78
Why do you need to taper off steroids?
Your body does not know to make them again that quickly and you can go into adrenal crisis
79
What is a diet recommended for COPD patients?
high calorie, high protein, low carbs
80
What is the highest level of O2 therapy for a COPD patient?
4L
81
Why would you order a CBC for a COPD patient?
check H and H for polycythemia
82
What will the pH be for a fully compensated ABG
pH will be WNL
83
genetic autosomal recessive disease caused by blocked NaCl transport leading to mucus with little water content
Cystic Fibrosis
84
"restrictive" lung disease
stiff lung
85
continuous inflammation process beyond normal healing time: s/s: sob, cough, shallow respirations, clubbing
idiopathic pulmonary fibrosis
86
fast growing lung cancer that spreads to other organs
oat cell
87
bronchi cancer, easy to resect
squamous cell
88
outer edges of lunch
adenocarcinoma
89
inflammation of the nasal mucosa
rhinitis
90
s/s of acute rhinities
fever, runny nose, sore throat, headache
91
inflammation of the pharynx
pharyngitis/ sore throat
92
what type of pharyngitis causes a fever?
bacterial
93
inflammation and infection of tonsils and surrounding lymphatic tissue
tonsilitis
94
infection that spreads to tonsils and surrounding tissue forming an abcess
peritonsillar abcess
95
what causes an abcess?
strep
96
acute viral respiratory infection
flu
97
when is the flu contagious?
24 hours before sx and 5 days after start of sx
98
what kind of precautions for flu?
droplet
99
inflammation of the lung parenchyma caused by microbial agents resulting in excess fluid in the lungs
pneumonia
100
occurs within the community setting or the first 48 hr of hospitalization
community acquired pneumonia
101
onset of sx 48 hours after admission
nosocomial pneumonia
102
crackles, fever, productive cough, low pulse ox, tired
pneumonia
103
what vaccine is given to elder adults to prevent pneumonia
pneumococcal
104
highly contagious disease with airborone precautions
tuberculosis
105
greatest risk for TB
travelers, 3rd world countries, immunocompromised, long term care, prisons, drugs and alcohol, homeless
106
what confirms a diagnosis of TB?
sputum culture positive for M. tuberculosis
107
what is the TB test called?
Mantoux
108
A positive Mantoux test tells you what?
that exposure is positive, not that active disease is present
109
what kind of mask do you use for TB?
N95
110
Very high death rate, death occurs one hour after formation
pulmonary embolism
111
sudden onset of dyspnea, chest pain, cough, tachycardia, hypotension
pulmonary embolism
112
What are 3 do nots when giving sub q lovanox or heparin?
do not aspirate, do not massage, do not expel air bubble
113
antidote for heparin and lovanox
protamine sulfate
114
antidote for coumadin
vitamin K
115
sudden and progressive pulmonary edema, increasing infiltrates bilaterally, dyspnea, hypoxemia despite o2 therapy
ARDS
116
what happens usually when someone has ards?
ventilation
117
direct causes of ARDS
pneumonia, aspiration, drowning
118
indirect causes of ARDS
sepsis, pancreatitis, drug overdose, major burn
119
ARDS PaO2
< 60 mm Hg
120
ARDS PaCO2
> 50 mm Hg
121
perfusion is normal but ventilation is inadequate
ventilatory failure
122
ventilation is normal but lung perfusion is decreased
oxygenation failure
123
poor respiratory movements, poor tissue perfusion
ventilatory-oxygenation failure
124
What is happening with ARDS
capillary membrane leaks fluid
125
noninvasive, changes pressure in the chest cavity rather than forcing air directly into the lungs
negative pressure
126
during inspiration generated pressure pushes air into the lungs and expands the chest
positive pressure
127
What is important when caring for a patient on a ventilator?
Patient first, ventilator second
128
Vent facts: Make sure alarms are on and functioning at all times
True
129
What is important to do before extubation?
hyperoxygenate
130
What is a risk with a rib fracture?
can cause a pneumothroax
131
inward movement of the thorax during inspiration and outward movement during exhalation
flail chest- paradoxic chest movements
132
any chest injury causing air to enter the pleural space rising intrathoracic pressure and reduction in vital capacity
pneumothorax
133
dyspnea, tachycardia, pleural pain, asymmetrical chest wall expanion
pneumothorax s/s
134
tension pneumothorax can cause:
tracheal deviation: due to pressure to uneffected sign
135
blood in pleural
hemothorax
136
what is a dangerous amount of drainage in a test tube?
100 mL/ hr
137
Should there be bubbling in the water seal chamber?
NO
