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Nursing 202 - Midterm > Respiratory - Ch 23 > Flashcards

Respiratory - Ch 23 Flashcards

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1
Q

Atelectasis

S/S (both acute & chronic)

A

Insidious/increasing dyspnea, cough, sputum production

Acute: tachycardia, tachypnea, pleural pain, central cyanosis

Chronic: similar to acute, but pulmonary infection may be present

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2
Q

Atelectasis

Abnormal assessment findings

A
  • Increased WOB, hypoxemia
  • Decreased breath sounds & crackles over affected area
  • CXR
  • SpO2 may demonstrate low sat < 90%
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3
Q

ICOUGH Program

A
  • IS
  • Coughing & deep breathing
  • Oral care
  • Understanding (patient & staff)
  • Getting out of bed at least 3x/day
  • HOB elevation
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4
Q

Atelectasis

Management

A
  • Improve ventilation and remove secretions —> frequent turning, early ambulation, lung vol expansion maneuvers
  • ICOUGH
  • PEEP, CPAP, bronchoscopy
  • CPT
  • ET intubation, mechanical ventilation
  • Thoacentesis to relieve compression
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5
Q

Pneumonia, strep

S/S

A

Sudden onset of chills, fever, pleuritic chest pain, tachypnea, respiratory distress

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6
Q

Pneumonia, viral

S/S

A

Relative bradycardia

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7
Q

Pneumonia

General S/S

A

HA, low-grade fever, pleuritic pain, myalgia, rash, pharyngitis, ortopnea, crackles, increased tactile fremitus, purulent sputum

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8
Q

Pneumonia

DX

A

CXR
Blood culture
Sputum examination
Bronchoscopy may be used for severe infection

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9
Q

Pneumonia

Management

A
  • Admin of appropriate ABX

- IVF, oxygen, antipyretics, antitussives, decongestants, antihistamines

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10
Q

Pneumonia

Complications

A 
Sepsis/septic shock 
Respiratory failure
Atelectasis 
Pleural effusion
Delirium
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11
Q

Pneumonia

Nursing interventions

A
  • Oxygen w/humidification to loosen secretions (face mask, NC)
  • Coughing techniques
  • Chest physiotherapy
  • Position changes
  • IS
  • Nutrition
  • Hydration
  • Rest
  • Activity as tolerated
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12
Q

Aspiration

S/S

A

Tachycardia, dyspnea, central cyanosis, HTN, hypotension, potential death

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13
Q

Aspiration

Nursing interventions

A
  • HOB > 30
  • Avoid stimulation of gag reflex w/suctioning
  • Check for placement before tube feedings
  • Thickened fluids for swallowing problems
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14
Q

Pleurisy

A

Inflammation of both layers of pleura

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15
Q

Pleurisy

Key characteristic

A

Pleuritic pain w/respiration

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16
Q

Pleurisy

Abnormal findings

A
  • Pleural friction rub

- CXR, sputum analysis, thoracentesis

17
Q

Pleurisy

Nursing interventions/TX

A
  • TX of underlying cause
  • Provide analgesia
  • Teaching to splint rib cage when coughing
18
Q

Pleural effusion

S/S

A

Fever, chills, pleuritic pain, dyspnea

19
Q

Pleural effusion

Abnormal findings

A
  • Decreased/absent breath sounds, decreased fremitus, dull/flat sound on percussion
  • Tracheal deviation away from affected side
  • CXR, chest CT, thoracentesis
20
Q

Empyema

A

Accumulation of thick, purulent fluid in pleural space

Complication of bacterial PNE or lung abscess

21
Q

Empyema

Abnormal findings

A
  • Decreased or absent breath sounds over affected area

- Chest CT, diagnostic thoracentesis

22
Q

Empyema

TX

A

Drain fluid and admin ABX for 4-6 weeks

23
Q

ARDS

Risk factors

A
  • Aspiration,
  • Drug ingestion/overdoses
  • Hematological disorders (DIC, massive transfusions, cardiopulmonary bypass)
  • Prolonged inhalation of high concentrated O2, smoke, corrosive substances
  • Localized infection
  • Metabolic D/O (pancreatitis, uremia)
  • Shock
  • Trauma (pulmo contusion, FX, TBI)
  • Major SX
  • Fat or air embolism
  • Sepsis
24
Q

ARDS

Major S/S

A

Characterized by sudden, progressive pulmonary edema, increasing B/L lung infiltrates visible on CXR, absence of an elevated L-atrial pressure

HYPOXEMIA THAT DOES NOT RESPOND TO O2 THERAPY

25
Q

ARDS

Management

A
  • ID & TX underlying cause
  • Intubation, mechanical vent w/PEEP to keep alveoli open
  • Hypovolemia treated
  • Pone position best for oxygenation, frequent repositioning to protect skin
  • Nutritional support, enteral feedings preferred
  • Reduce anxiety
26
Q

PE

Risk factors

A 
Trauma
SX
Pregnancy
HF
Hypercoagulability 
Immobility, venous stasis 
Dyspnea = MOST COMMON

Nursing 202 - Midterm (12 decks)

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