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Adult Health Nursing I > Respiratory Disorders > Flashcards

Respiratory Disorders Flashcards

1
Q

Airway Resistance

A

Constriction – Wheezing

Thickening of mucosa – Inflammation

Obstruction of the airway – Mucus

Loss of lung elasticity – food, tumor, emphysema

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2
Q

Pulmonary Function Testing Purpose

A

Determine the function of the respiratory system

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3
Q

Pulmonary Function Testing Assessment

A

Flow of inspiration/expiration, medical diagnoses, how much air the lungs can hold

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4
Q

Pulmonary Function Testing Patient Preparation

A

Assess for analgesic use, assess for bronchodilators, tell patient not to smoke, have patient empty bladder, remove dentures, do not eat a heavy meal 4-6 hours prior

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5
Q

Total Lung Capacity

A

Volume in lungs after maximal inhalation

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6
Q

Normal pH of Human Blood

A

7.35-7.45

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7
Q

Respiratory Alkalosis

A

pH is increased

Headache, lightheadedness, vertigo, mental status changes, paresthesia, hypokalemia, hypocalcemia, tetany, convulsions

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8
Q

Nursing Interventions of Respiratory Alkalosis

A

Maintain airway

Emotional support

Encourage appropriate breathing pattern

Monitor ventilator

Monitor potassium and calcium medications

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9
Q

Respiratory Acidosis

A

pH is decreased

More common

Post-op, atelectasis, depression of respiratory status, brain trauma

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10
Q

Respiratory Acidosis Signs and Symptoms

A

Visual disturbances, diaphoresis, cyanosis, hyperkalemia, rapid pulse, dysrhythmia, hypoventilation, mental status change

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11
Q

Nursing Interventions of Respiratory Acidosis

A

Airway, monitor for respiratory distress

Oxygen administration, Semi-Fowlers, TCDB

Hydration, suction

Monitor for electrolytes (especially potassium)

Antibiotics, bronchodilators

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12
Q

Pulse Oximetry

A

SpO2 less than 70% is life-threatening

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13
Q

FiO2

A

Fraction of inspired oxygen

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14
Q

Nasal Cannula

A

Low to moderate concentration (1-6 L) of oxygen, safe and simple, easy to control, allows mobility

Easily dislodged, skin breakdown, mouth breathing makes it useless

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15
Q

Face Mask

A

40-60% FiO2, 5-8 L

High skin breakdown potential, unable to eat, hot, good for mouth breathers

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16
Q

CPAP

A

Continuous positive airway pressure

Used for sleep apnea

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17
Q

BiPap-Bilevel Therapy

A

Low pressure on exhalation, high pressure on inhalation

Adjusts the pressure

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18
Q

Postural Drainage

A

Do not perform if they are bleeding

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19
Q

Allergic Rhinitis and Allergic Conjunctivitis

A

Hay Fever

Caused by antigen/antibody reactions –> increased secretions, decreased ciliary response, and increased capillary permeability

Can lead to secondary bacterial infection

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20
Q

Diagnostic Testing of Hay Fever

A

Interview, observation

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21
Q

Signs and Symptoms of Hay Fever

A

Similar to a cold, photophobia, tearing, blurry vision, itchy eyes, swelling of the eyes, inflammation and clear colorless drainage, can’t breathe through the nose, ears full, sneezing, coughing, headache, nosebleeds

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22
Q

Treatment of Hay Fever

A

Antihistamines, decongestants (not long term), corticosteroids, analgesics

Avoid the allergen

Hot packs over facial sinuses

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23
Q

Acute Rhinitis

A

Common cold

Characterized by edema, swelling of the nasal mucosa

Viral in origin

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24
Q

Signs and Symptoms of Acute Rhinitis

A

Thin, serous nasal exudates

Productive cough

Sore throat, fever

Muscle aches, fatigue and loss of appetite

Dyspnea, congestion

Red and swollen throat

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25
Treatment of Acute Rhinitis
Monitor vital signs, especially temperature Analgesics, antipyretics, cough suppressants, expectorants, antibiotics (if infection is present) Encourage fluids and rest Humidification
26
Sinusitis
Upper respiratory infection, drainage occlusion Can be viral, bacterial, or fungal
27
Signs and Symptoms of Sinusitis
Constant, severe headache Purulent exudate Malaise, fatigue Fever Anorexia due to decreased sense of smell Facial congestion with edematous eyelids Throat irritation due to postnasal drip
28
Treatment of Sinusitis
Saline and nasal irrigation to rinse irritants Nasal corticosteroids to fight inflammation Oral or injected corticosteroids (only if severe) Decongestants (only for a few days) Antibiotics Analgesics Surgery (polypectomy) Vaporizers, moist pack, increase the head of the bed, rest, fluids
29
Complications of Sinusitis
Can spread to cause meningitis, osteomyelitis, septicemia
30
Acute Pharyngitis
Pharynx is inflamed May be viral or bacterial
31
Signs and Symptoms of Acute Pharyngitis
Fever Dry cough Tender, enlarged tonsils with exudate Enlarged cervical lymph glands Red, sore throat (scratchy --> severe) Dysphagia due to severe pain
32
Diagnosis of Pharyngitis
Rapid strep screen (2 swabs)
33
Treatment of Pharyngitis
Antibiotics, analgesics, antipyretics Educate on antibiotics, gargle with salt water, encourage fluids, popsicles, rest, vaporizer, oral hygiene, monitor input and output and temperature
34
Complications of Pharyngitis
Can lead to rheumatic fever, otitis media, sinusitis, and/or glomerulonephritis
35
Chronic Pharyngitis
Caused by irritants, smoking, chronic alcohol ingestion, respiratory/cardio diseases
36
Signs and Symptoms of Chronic Pharyngitis
Irritated throat, increased mucus, cough, dysphagia
37
Treatment of Chronic Pharyngitis
Avoid irritant, treat underlying conditions, antihistamines, analgesics, lozenges, hydration
38
Acute Follicular Tonsillitis
Inflammation of the tonsils caused by airborne, foodborne, viral, or bacterial (strep) means
39
Signs and Symptoms of Acute Follicular Tonsillitis
Sore throat Fever, chills, anorexia Hypertrophied, purulent tonsils Enlarged, tender cervical lymph nodes Muscle aches, malaise Elevated WBCs
40
Diagnosis of Tonsillitis
Throat swab, observation
41
Treatment of Tonsillitis
Warm saline gargles Tonsillectomy for recurrent tonsillitis Oral care to decrease risk of infection
42
Complications of Tonsillitis
Peritonsillar abscess Nephritis Rheumatic fever Carditis
43
Peritonsillar Abscess
Caused by tonsillitis
44
Signs and Symptoms for Peritonsillar Abscess
Increasing pain Difficulty swallowing Thick secretions Swollen soft palate
45
Treatment of Peritonsillar Abscess
Surgery and antibiotics
46
Tonsillectomy and Adenoidectomy
Performed on patients with repeated infections Performed 4-6 weeks after acute infection Screen for recent illnesses during Pre-Op
47
Postoperative Tonsillectomy and Adenoidectomy
Hemostasis is most important Assess swallowing of blood, dripping of blood Keep head up and slightly tilted to the side Ice to vasoconstrict and decrease pain impulses Nutrition should consist of cold liquids, IV, and avoid spicy foods Avoid coughing, sneezing, nose blowing, and overexertion Call if increased pain, fever, or bleeding Hematemesis should be dark, not bright red
48
Laryngitis
Secondary to respiratory infection, may lead to respiratory distress Caused by infection, abuse of vocal cords, inhalation of irritating fumes
49
Signs and Symptoms of Laryngitis
Hoarseness, voice loss Scratchy and irritated throat Persistent cough
50
Diagnosis of Laryngitis
Laryngoscope, edema, drainage, redness
51
Treatment of Laryngitis
If viral, wait it out If bacterial, use antibiotics Limit use of voice Warm or cool mist vaporizer Analgesics Limit causes Rest voice Increase humidity and fluids
52
Acute Bronchitis
Inflammation of the trachea/bronchial tree
53
Signs and Symptoms of Acute Bronchitis
Productive cough, wheezes Dyspnea and chest pain Low-grade fever Malaise, headache
54
Treatment of Acute Bronchitis
Cough suppressants, antipyretics, analgesics, bronchodilators Vaporizers Encourage fluids and bedrest Monitor vital signs
55
Severe Acute Respiratory Syndrome (SARS)
Infection caused by the coronavirus Spread through contact or airborne
56
Signs and Symptoms of SARS
Temperature above 100.4 degrees, headache, aches After 2-7 days: cough, shortness of breath, difficulty breathing, hypoxia
57
Diagnostic Tests for SARS
Chest radiograph Serum antibody testing, tissue cultures Nasopharyngeal and oropharyngeal swabs History of travel within 10 days of onset
58
Treatment of SARS
Oxygen, respiratory isolation, corticosteroids, antiviral medications MUST NOTIFY THE PUBLIC HEALTH DEPARTMENT
59
Causes of Pneumonia
Infection (viral, bacterial, fungal) Oversedation (hypostatic pneumonia, TCDB to prevent, get them up or into sitting position) Aspiration (stroke, impaired swallowing, alcoholics, GERD)
60
Classifications of Pneumonia
Lobar Bronchopneumonia Interstitial
61
Signs and Symptoms of Pneumonia
Productive cough, chest pain (bacterial), painful cough (bacterial), rusty sputum (bacterial), fever, chills, increased HR and RR, shallow breaths, cyanosis Viral is less severe, "walking" Bacterial is acute and serious
62
Diagnosis of Pneumonia
Sputum culture, chest x-ray, WBC
63
Treatment of Pneumonia
Antibiotics, codeine, analgesics, bronchodilators, TCDB, Semi-Fowler's position, splinting, vaccinations
64
Complications of Pneumonia
Death, atelectasis, pleural effusion, pericarditis, meningitis, heart failure
65
Atelectasis
Collapse of the lung tissue related to occlusion of airways Ventilation/Perfusion mismatch, pressure on the lungs, shallow breathing, abdominal pressure
66
Treatment of Atelectasis
Bronchodilators, mucolytic agents, antibiotics, analgesics TCDB, early ambulation Respiratory treatments (incentive spirometry, intermittent positive-pressure breathing, oxygen, chest percussion and postural drainage) Chest tube
67
Pneumothorax
Air in the thoracic cavity that affects the lungs' normal negative-pressure breathing Caused by trauma, rupture
68
Signs and Symptoms of Pneumothorax
Decreased breath sounds, sharp chest pain with dyspnea, diaphoresis, tachycardia, tachypnea, no chest movement on affected side, sucking chest wound
69
Diagnosis of Pneumothorax
Signs and symptoms, chest x-ray
70
Treatment of Pneumothorax
Chest tube to water-seal drainage system, oxygen, analgesics
71
Chest Tube Purpose
Continuously drains fluid, blood, or air in the chest cavity Sutured in place
72
Nursing Interventions for Chest Tubes
Monitor VS, pain, lung sounds Assess for subcutaneous emphysema (crunchy on palpation) Monitor patency of tube, keep below the level of the chest TCDB, tape connections
73
Lung Cancer
Malignant tumor/tumors anywhere inside the lung Caused by smoking, occupational hazards, genetics
74
Signs and Symptoms of Lung Cancer
Cough, hemoptysis Dyspnea, wheezing, hoarseness Chest pain Fever, chills, repeated URI Pleural effusion Fatigue, anorexia, weight loss
75
Diagnosis of Lung Cancer
Biopsy, CT scan, bronchoscopy
76
Treatment of Lung Cancer
Depends on the stage Surgery, thoracotomy, segmental resection, lobectomy, pneumonectomy (no chest tube afterwards) Radiation, chemotherapy
77
Pre-Op Interventions for Lung Cancer
Encourage, educate, VS, monitor tracheal deviation, pain meds
78
Post-Op Interventions for Lung Cancer
Pain meds, education, bronchodilators, clears to high calorie meals, high protein, high vitamins
79
Pulmonary Embolism
Embolism in the lungs from a DVT, leads to a perfusion problem
80
Signs and Symptoms of Pulmonary Embolism
Sudden dyspnea, tachypnea, tachycardia, shock, chest pain, cyanosis, cough, hemoptysis, elevated temperature, increased WBCs, can be fatal
81
Predisposing Factors of Pulmonary Embolism
Inactivity, recent surgery, stroke, birth control pills, pregnancy
82
Diagnosis of Pulmonary Embolism
Gold-standard pulmonary ateriography
83
Treatment of Pulmonary Embolism
Anticoagulants, fibrinolytic agents, oxygen, HOB up 30 degrees, surgery, umbrella filter
84
Prevention of Pulmonary Embolism
TED hose, sequential compression devices, measure peripheral pulses, heparin therapy
85
Sarcoidosis
Inflammatory, autoimmune disease in the lung T-Cells accumulate and lead to granulomas
86
Signs and Symptoms of Sarcoidosis
Night sweats, fever, weight loss, cough, skin nodules, polyarthritis, weakness, SOB, wheezing, suffocation, erythema nodosum, blurred vision, photophobia
87
Treatment of Sarcoidosis
Systematic monitoring, steroids
88
Diagnosis of Sarcoidosis
Chest x-rays, blood test, biopsy
89
Occupational Lung Disease
Caused by exposure to environmental or occupational fumes, dust, vapors, gases, bacterial or fungal antigens, and allergens
90
COPD includes...
Chronic bronchitis and emphysema
91
Pathophysiology of COPD
Goblet cells increase --> hypersecretion Submucosal glands enlarge --> hypersecretion Airway walls thicken --> airway narrowing Fibrotic changes --> airway narrowing Exudate --> airway narrowing
92
Chronic Bronchitis
Cough, sputum production for at least 3 months out of the year for at least 2 years Caused by irritants, smoking, flare-ups in the winter
93
Acute Bronchitis
More sudden and severe symptoms Related to a pathogen
94
Emphysema Pathophysiology
Impaired oxygen and carbon dioxide exchange Alveolar wall destruction --> increased dead space, impaired oxygen diffusion, impaired carbon dioxide elimination --> hypercapnia and respiratory acidosis Chronic inflammation Pulmonary capillary bed reduced --> Cor pulmonale (right sided heart failure)
95
COPD Risk Factors
Exposure to tobacco smoke (damages cilia, distends alveoli, carbon monoxide piles up in the blood) Increased age Irritant exposure Genetic abnormalities (Alpha 1-Antitrypsin; treat with IV infusion)
96
Primary Symptoms of COPD
Chronic cough, sputum production, dyspnea
97
Other Signs and Symptoms of COPD
Tachycardia (early), cyanosis (late), wheezing, barrel chest (related to air trapping), clubbing of fingers (long-term hypoxia)
98
Complications of COPD
Risk for respiratory infections leading to respiratory failure Cor pulmonale/heart failure Spontaneous pneumothorax Cardiac dysrhythmias (atrial fibrillation --> high risk for blood clots) Depression
99
Diagnosis of COPD
Spirometry, chest x-ray, CT scan, serum (CBC, WBCs, hematocrit and hemoglobin), sputum culture
100
Treatment of COPD
Bronchodilators (inhalers), corticosteroids (first line of defense), antibiotics, mucolytics, antitussives, vasodilators, narcotics, vaccines Low-flow oxygen Bullectomy, lung volume resection surgery, lung transplant
101
Long Term Continuous Oxygen
Used if there is evidence of PaO2 < 55 mmHg, tissue hypoxia, organ damage, polycythemia, edema from heart failure, mental status changes
102
Blebs
Air bubbles on the lungs that can rupture and lead to a pneumothorax
103
Pulmonary Rehabilitation
Goal is to reduce symptoms, improve quality of life, increase physical and emotional participation in activities Benefits include increased exercise capacity and decreased perceived breathlessness Includes assessment, education, smoking cessation, physical conditioning, and nutrition counseling
104
COPD Nursing Interventions
Education Low-flow oxygen Activity pacing Nutrition (high protein, high calories, easy to chew, small and frequent meals) Increased fluids (to thin secretions) No smoking
105
Pursed Lip Breathing
Releases trapped air, decreases carbon dioxide buildup, keeps airways open, good for relaxation

Adult Health Nursing I (22 decks)

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