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Med Surg > Respiratory > Flashcards

Respiratory Flashcards

1
Q

organ of smell, mucous membranes with rich blood supply

A

nose

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2
Q

3 bones - increase surface area for filtering, warming and humidifying air

A

turbinates

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3
Q

passageway for both respiratory and digestive tract. Behind oral and nasal cavities

A

pharynx

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4
Q

Voice box- contains C shaped cartilage and vocal cords

A

layrnx

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5
Q

provide resonance to speech, decrease weight of skull and act as shock absorbers

A

sinuses

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6
Q

lower airway- in front of esophagus. Branches to R/L mainstem bronchi at carina junction. Contains cartilage rings

A

trachea

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7
Q

Where the trachea joins the mainstem bronchi

A

Carina

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8
Q

begin at the carina, cartilage tissue

A

mainstem bronchi

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9
Q

branch from mainstem bronchi. Complete cartilage and resist collapse. Lined with ciliated mucous membrane

A

lobar, segmental, subsegmental bronchi

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10
Q

smaller and smaller tubes, no cartilage and depend on elastic recoil of lung to remain open

A

bronchioles

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11
Q

resemble grapes- basic units of gas exchange

A

alveoli

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12
Q

fatty protein that reduces surfactant tension

A

surfactant

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13
Q

smooth membrane with 2 surfaces that totally enclose the lungs

A

pleura

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14
Q

lines the inside of chest cavity and upper surface of diaphragm

A

parietal

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15
Q

covers lung surfaces - allows the surfaces to glide across each other smoothly during breathing

A

visceral

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16
Q

thin fluid filled space between visceral and parietal pleura

A

pleura cavity

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17
Q

What hx is important when assessing a patients respiratory system?

A

smoking (what kind), hobbies, work enviornment, pack years, allergies, asthma

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18
Q

physical assessment of Resp system

A

cough, sputum, SOB, chest pain, length of illness

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19
Q

What labs do you use to assess resp system?

A

O2, RBC, H&H, ABGs

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20
Q

What radiographic tests are done?

A

Chest X ray, CT

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21
Q

Noninvasive resp assessment tools

A

pulse ox, PFTS, Skin tests (turgor), PFTS

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22
Q

invasive resp exam

A

endoscopy, thoracentesis, lung biopsy

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23
Q

needle aspiration of pleural fluid from pleural space for diagnostic purposes

A

thoracentesis

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24
Q

obtain tissue for histologic anaylsis, culture or diagnosis

A

lung biopsy

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25
Q

low levels of O2 in the blood

A

hypoxemia

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26
Q

decreased tissue oxygenation

A

hypoxia

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27
Q

increased CO2

A

hypercarbia

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28
Q

best measure to determine the need for O2 therapy?

A

ABGs

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29
Q

non invasive measurement of blood oxygen

A

pulse oximetry

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30
Q

What is important to tell patients with oxygen?

A

no smoking or candles

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31
Q

1-6 L (long term O2 therapy)

A

nasal cannula

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32
Q

minimum flow of 5L (emergency situations)

A

simple face mask

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33
Q

6-11 L (bag must remain slightly inflated)

A

partial rebreather mask

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34
Q

highest O2 level, unstable RR and possible intubation

A

non-rebreather mask

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35
Q

provides the most accurate O2 saturation

A

venturi mask

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36
Q

useful for facial trauma/burns

A

face tent

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37
Q

when high humidity is needed

A

aerosol mask

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38
Q

high humidity needed inserted in the trach

A

trach collar

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39
Q

Bi level positive airway pressure

A

Bipap

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40
Q

continuous positive airway pressure - used to fix atelectasis

A

CPAP

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41
Q

What is important to have at the bedside for trach patients at ALL times?

A

a replacement and step down at all times

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42
Q

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.

A

72, matured, replacement. recusisitate using a manual ventilation bag, rapid response

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43
Q

what is cuff pressure supposed to be set at?

A

14-20 mm

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44
Q

What is the importance of air warming and humidification?

A

without humidification, tracheal damage can occur

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45
Q

How do you suction properly?

A

only 3 passes, twirling motion- no more than 10-15 seconds

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46
Q

when inspiration is less than expiration

A

bronchial

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47
Q

inspiration = expiration

A

bronchovesicular

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48
Q

when expiration is shorter than inspiration

A

vesicular

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49
Q

what is important after a throacentesis?

A

STAT chest X ray

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50
Q

Oxygen helps relieve _____ an _______

A

hypoxemia and hypoxia

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51
Q

Is oxygen a drug?

A

yes

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52
Q

What is the goal in oxygen therapy?

A

Use the lowest amount

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53
Q

What is carcinoma in situ?

A

Cancer in one place

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54
Q

Well- differentiated?

A

Borders

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55
Q

benign grapelike clusters of mucous membrane and connective tissue

A

polyps

56
Q

disruption in breathing during sleep that lasts atleast 10 seconds atleast 5 times an hour

A

obstructive sleep apnea

57
Q

What are some causes of sleep apnea?

A

obesity, short neck. enlarged tonsils

58
Q

nosebleed

A

epistaxis

59
Q

what should you check after a radical neck dissection?

A

shoulder drop

60
Q

The number one cause of oral cancer is

A

smoking

61
Q

Most common signs and symptoms of oral cancer?

A

change in voice, sores that dont heal, white patches

62
Q

Fractured nose nursing implications

A

no coughing, no NSAIDS, VS q4 hr, semi fowler, no bearing down, watch for frequent swallowing

63
Q

What do you do for epistaxis?

A

pinch nose, lean forward

64
Q

What is number one intervention for facial trauma?

A

establish and maintain airway

65
Q

What is important to have always for a patient with IMF?

A

wire cutters at all times

66
Q

What are the two obstructions of asthma?

A
  1. inflammation 2. airway hyper-responsiveness
67
Q

PFT - GREEN YELLOW RED

A

Green- continue regular meds, Yellow- may need more meds , Red- stop, seek medial attention

68
Q

If a patient with asthma is going to workout, what would you teach them to do?

A

Use bronchodilator 30 min before exercise

69
Q

Is status asthmaticus a medical emergency?

A

yes- call rapid response

70
Q

short acting beta agonists

A

bronchodilators (albuterol)

71
Q

long acting beta agonists

A

daily maitenence

72
Q

anti inflammatory agents for asthma

A

corticosteroids

73
Q

How many minute do you wait in between the same medication? How many min after rescue can you use corticosteroid?

A

1 min - 5 min

74
Q

What order do you use inhalers

A

short acting, long acting, then steroids

75
Q

a loss of elasticity which overstretches and enlarges the alveoli

A

emphysema

76
Q

What can bronchitis lead to?

A

right sided heart failure

77
Q

inflammation of bronchi- lots of mucus production

A

bronchitis

78
Q

Why do you need to taper off steroids?

A

Your body does not know to make them again that quickly and you can go into adrenal crisis

79
Q

What is a diet recommended for COPD patients?

A

high calorie, high protein, low carbs

80
Q

What is the highest level of O2 therapy for a COPD patient?

A

4L

81
Q

Why would you order a CBC for a COPD patient?

A

check H and H for polycythemia

82
Q

What will the pH be for a fully compensated ABG

A

pH will be WNL

83
Q

genetic autosomal recessive disease caused by blocked NaCl transport leading to mucus with little water content

A

Cystic Fibrosis

84
Q

“restrictive” lung disease

A

stiff lung

85
Q

continuous inflammation process beyond normal healing time: s/s: sob, cough, shallow respirations, clubbing

A

idiopathic pulmonary fibrosis

86
Q

fast growing lung cancer that spreads to other organs

A

oat cell

87
Q

bronchi cancer, easy to resect

A

squamous cell

88
Q

outer edges of lunch

A

adenocarcinoma

89
Q

inflammation of the nasal mucosa

A

rhinitis

90
Q

s/s of acute rhinities

A

fever, runny nose, sore throat, headache

91
Q

inflammation of the pharynx

A

pharyngitis/ sore throat

92
Q

what type of pharyngitis causes a fever?

A

bacterial

93
Q

inflammation and infection of tonsils and surrounding lymphatic tissue

A

tonsilitis

94
Q

infection that spreads to tonsils and surrounding tissue forming an abcess

A

peritonsillar abcess

95
Q

what causes an abcess?

A

strep

96
Q

acute viral respiratory infection

A

flu

97
Q

when is the flu contagious?

A

24 hours before sx and 5 days after start of sx

98
Q

what kind of precautions for flu?

A

droplet

99
Q

inflammation of the lung parenchyma caused by microbial agents resulting in excess fluid in the lungs

A

pneumonia

100
Q

occurs within the community setting or the first 48 hr of hospitalization

A

community acquired pneumonia

101
Q

onset of sx 48 hours after admission

A

nosocomial pneumonia

102
Q

crackles, fever, productive cough, low pulse ox, tired

A

pneumonia

103
Q

what vaccine is given to elder adults to prevent pneumonia

A

pneumococcal

104
Q

highly contagious disease with airborone precautions

A

tuberculosis

105
Q

greatest risk for TB

A

travelers, 3rd world countries, immunocompromised, long term care, prisons, drugs and alcohol, homeless

106
Q

what confirms a diagnosis of TB?

A

sputum culture positive for M. tuberculosis

107
Q

what is the TB test called?

A

Mantoux

108
Q

A positive Mantoux test tells you what?

A

that exposure is positive, not that active disease is present

109
Q

what kind of mask do you use for TB?

A

N95

110
Q

Very high death rate, death occurs one hour after formation

A

pulmonary embolism

111
Q

sudden onset of dyspnea, chest pain, cough, tachycardia, hypotension

A

pulmonary embolism

112
Q

What are 3 do nots when giving sub q lovanox or heparin?

A

do not aspirate, do not massage, do not expel air bubble

113
Q

antidote for heparin and lovanox

A

protamine sulfate

114
Q

antidote for coumadin

A

vitamin K

115
Q

sudden and progressive pulmonary edema, increasing infiltrates bilaterally, dyspnea, hypoxemia despite o2 therapy

A

ARDS

116
Q

what happens usually when someone has ards?

A

ventilation

117
Q

direct causes of ARDS

A

pneumonia, aspiration, drowning

118
Q

indirect causes of ARDS

A

sepsis, pancreatitis, drug overdose, major burn

119
Q

ARDS PaO2

A

< 60 mm Hg

120
Q

ARDS PaCO2

A

> 50 mm Hg

121
Q

perfusion is normal but ventilation is inadequate

A

ventilatory failure

122
Q

ventilation is normal but lung perfusion is decreased

A

oxygenation failure

123
Q

poor respiratory movements, poor tissue perfusion

A

ventilatory-oxygenation failure

124
Q

What is happening with ARDS

A

capillary membrane leaks fluid

125
Q

noninvasive, changes pressure in the chest cavity rather than forcing air directly into the lungs

A

negative pressure

126
Q

during inspiration generated pressure pushes air into the lungs and expands the chest

A

positive pressure

127
Q

What is important when caring for a patient on a ventilator?

A

Patient first, ventilator second

128
Q

Vent facts: Make sure alarms are on and functioning at all times

A

True

129
Q

What is important to do before extubation?

A

hyperoxygenate

130
Q

What is a risk with a rib fracture?

A

can cause a pneumothroax

131
Q

inward movement of the thorax during inspiration and outward movement during exhalation

A

flail chest- paradoxic chest movements

132
Q

any chest injury causing air to enter the pleural space rising intrathoracic pressure and reduction in vital capacity

A

pneumothorax

133
Q

dyspnea, tachycardia, pleural pain, asymmetrical chest wall expanion

A

pneumothorax s/s

134
Q

tension pneumothorax can cause:

A

tracheal deviation: due to pressure to uneffected sign

135
Q

blood in pleural

A

hemothorax

136
Q

what is a dangerous amount of drainage in a test tube?

A

100 mL/ hr

137
Q

Should there be bubbling in the water seal chamber?

A

NO

Med Surg (9 decks)

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