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204 Exam 2 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Lung major function

A

Provides continuous gas exchange

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2
Q

Three processes in lungs

A

Ventilation
Perfusion
Diffusion

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3
Q

Upper airway filters what?

A

Airborne particles, humidifies & warms inspired gases

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4
Q

Lower airway serves?

A

for gas exchange

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5
Q

Respiration is controlled by

A

brainstem

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6
Q

Accessory muscles of inspiration

A

SCM
Scalene
Intercostals

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7
Q

Expiration is

A

passive

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8
Q

Diaphragm is what?

A

primary muscle of inspiration

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9
Q

Diaphragm contracts

A

moves down

Exhale: moves up

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10
Q

Before beginning exam (4 things)

A

Quiet environment
Proper positioning
Bare skin for auscultation
Patient comfort

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11
Q

Observe pt breathing patterns

A

Rate
Depth
Effort

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12
Q

Assess what else?

A

A-P diameter

patients color

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13
Q

Pertinent History

A 
Chronic conditions
Exposure to a new medication
Recent change in diet
Substance abuse/overdose
Prior DVT, PE
Recent trauma to chest
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14
Q

Abnormal retractions of interspaces during respiration

A

Retractions: sinking in of soft tissues
Lower interspaces
Supraclavicular in acute asthma exacerbation

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15
Q

Impaired respiratory movement

A

Flail Chest & paradoxical

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16
Q

i. Put thumbs about 2 in apart on back
ii. Have them take a breath
iii. The thumbs should move up symmetrically

A

Chest excursion

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17
Q
  1. Sounds waves when you talk cause vibrations

2. Use ulnar surface of hand

A

vocal or tactile remits (palpable vibrations)

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18
Q

Percussion helps to identify

A

Underlying tissues are air-filled, fluid-filled, or solid

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19
Q

when fluid or solid tissue replaces air containing lung

A

Dullness

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20
Q

Examples of dullness sounds

A

i. Pleural Effusions
ii. Hemothorax (blood in one cavity of lung)
iii. Tumor

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21
Q

Example of Unilateral Hyperresonance

A

Pneumothorax

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22
Q

More air

A

Hyperresonance

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23
Q

Example of generalized hyperresonance

A

COPD

24
Q

Ausculation: how many locations

A

8 anterior, 8 lateral

10 posterior

25
Q

Where do you start auscultating?

A

posteriorly & symmetrically

26
Q

Should listen to at least

A

6 locations anteriorly and posteriorly

27
Q

Normal breath sounds

A

Bronchial
Bronchovesicular
Vesicular

28
Q
  1. heard over trachea, high-pitched

2. expiration > inspiration

A

i. Bronchial

29
Q
  1. heard over major bronchi, between the scapulae, around the sternum, medium-pitched
  2. inspiration = expiration
A

ii. Bronchovesicular

30
Q
  1. heard over peripheral lung fields, soft-pitched

2. inspiration > expiration

A

Vesicular

31
Q

Abnormal Sounds

A

Absent
Decreased
Bronchial (if heard in other locations of lung)

32
Q
  1. Discontinuous, intermittent, nonmusical, brief sounds
    heard with inspiration
    more at bases
A

Crackles

33
Q

Crackles caused by

A

air moving through secretions and collapsed alveoli

34
Q

Associated conditions with crackles

A
  1. pulmonary edema and early heart failure, pneumonia, fluid
35
Q
  1. Continuous, high pitched, musical sound, longer than crackles
    heard greater with expiration
A

Wheeze

36
Q

Associated conditions with wheezing

A

a. Asthma, (COPD) chronic obstructive pulmonary disease

37
Q
  1. Loud, low pitched, snoring quality, rough sound
  2. Heard high up, over trachea & bronchi
    Acute bronchitis
A

Rhonchi

38
Q
  1. Inspiratory musical wheeze
  2. Loudest over trachea
  3. Suggests obstructed trachea or larynx
A

Stridor

39
Q

a. Created by turbulent air flow
loudest during inspiration
softest during expiration

A

normal breath sounds

40
Q

i. Air moves to smaller airways hitting walls

ii. More turbulence, Increased sound

A

inspiration

41
Q

i. Air moves toward larger airways

ii. Less turbulence, Decreased sound

A

expiration

42
Q

Causes of decreased of absent breath sounds

A 
Asthma
COPD
Pleural Effusion
Pneumothorax
Adult Respiratory Distress Syndrome (ARDS)
Atelectasis
43
Q

early RAT (hypoxia)

A

Restless
Anxiety
Tachycardia/tachypnea

44
Q

late to BED (hypoxia)

A

i. Bradycardia
ii. Extreme restlessness
iii. Dyspnea

45
Q

In pediatrics: FINES (hypoxia)

A

i. F: Feeding difficulty
ii. I: Inspiratory Stridor
iii. N: Nares Flare
iv. E: Expiratory grunting
v. S: Sternal Retractions

46
Q

i. Encourages pt post-operatively
ii. Want lungs to expand
iii. Providing pain medication prior
iv. 5-10x an hour

A

a. Incentive Spirometry

47
Q

i. Helps clear lungs of mucous
ii. Vibrates
iii. Cystic fibrosis

A

b. Acapella Device

48
Q

a. Group of tests that measure how well the lungs take in & release air

A

R. Pulmonary Function Test (PFT)

49
Q

S. Assessment Methods

A

Peak flow meter
pulse ox
sputum collection (best in AM)

50
Q

Positioning

A

High Fowlers

51
Q

very precise amount

i. 1-6L/min

A

nasal cannula

52
Q

i. Never less than 5L/min – can retain CO2

A

face mask

53
Q

see most often)

1. 6-12L/min

A

simple mask

54
Q

10-15 L/min

A

partial rebreather non rebreather

55
Q

4-10L/min; most precise flow concentration

A

Venturi Mask

204 Exam 2 (9 decks)

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