Respiratory Exam 1 Flashcards
Pneumothorax
The presence of air or gas in the pleural space that cause lung collapse.
Hemothorax
The accumulation of blood in the pleural space.
pleural effusion
A buildup of fluid between the tissues that line the lungs and the chest.
hypoxia
Decreased o2 in the tissues
hypoxemia
decreased 02 in the blood
partial airway obstruction
In partial airway obstruction the patient will be able to breathe and cough, although there may be a ‘crowing’ noise (stridor) as air passes through a narrowed space.
respiratory distress
Condition in which fluid collects in the lungs’ air sacs, depriving organs of oxygen.
Normal range of adult VS plus SA02 range
Sa02 95% - 100%
diaphragm
a dome-shaped muscle separating the thoracic and abdominal cavities. It contracts and flattens to increase both the chest (pleural) space and the pleural vacuum
oropharynx
part of the pharynx extending from the uvula to the epiglottis
surfactant
The walls of the alveoli are composed of a single layer of cells and are lined with a chemical called surfactant, which helps to prevent the alveolar walls from collapsing between breaths.
pleura in lungs
The lower respiratory tract contains a smooth double-layered sac of serous membrane called
nasal mucosa
The mucosa, or mucous membrane, is a type of tissue that lines the nasal cavity. Mucous membranes are usually moist tissues that are bathed by secretions such as in the nose.
larynx
From the pharynx, air passes into the larynx, a box-like structure made of cartilages held together by ligaments.
pharnx
Air travels from the nose to the pharynx, a tube-shaped passage for air and food.
epiglottis
A lid or cover of cartilage called the epiglottis (“trap door cartilage”) guards the entrance to the larynx.
nasopharnyx
It is a passageway for air only.
trachea
the windpipe
medulla and pons
Normal breathing occurs as a result of nervous stimulation of the respiratory center in the brain’s medulla. The medulla sends impulses to the diaphragm and the intercostal muscles.
The pons has centers that work with the medulla to produce a normal breathing rhythm.
Name the protective reflexes of the respiratory system.
sneezing. yawning.
trace the flow of air you breathe once it goes through the nose and mouth
through nose and nostrils. nasal cavity where air is warmed and moistened. hairs and sticky mucous trap particles. clean air entered trachea. trachea branches to to bronchi. branches to bronchioles. these end in air sacs called alveoli. surrounded by capillaries. enters blood stream.
the purpose of chest suction is to restore the negative pressure where and how
the depth of the water in the suction bottle determines the amount of negative pressure that can transmitted to the chest.
describe what exactly “aerosol therapy” is about
aerosol therapy use of an aerosol for respiratory care in the treatment of bronchopulmonary disease. The major purpose of this is the delivery of medications or humidity or both to the mucosa of the respiratory tract and pulmonary alveoli. Agents delivered by aerosol therapy may act in a number of ways: (1) to relieve spasm of the bronchial muscles and reduce edema of the mucous membranes, (2) to render bronchial secretions more liquid so that they are more easily removed, (3) to humidify the respiratory tract, and (4) to administer antibiotics locally by depositing them in the respiratory tract
what equipment would you need to do aerosol therapy
a metered dose inhaler
nebulizer. tubing, mask, medication
why is the purpose of having serous fluid between the lungs pleural membranes
The main function of pleural membranes is to hold the two lungs within their pleural cavity. These membranes do this while ensuring that the lungs remain expanded during out-breaths and can move along each other smoothly during the process of breathing.
when teaching patients about their oxygen use why do we need to stress the importance not smoking, candle use, ungrounded electrial
Oxygen tanks are extremely dangerous in a sense that it can combust
no smoking, no wool hoodies.
what is the use of accessory muscles indicate
in labored breathing, the use of muscles other than the diaphragm and intercostals. the sternocleidomastoid, spinal, neck, and abdominal muscles and even the platysma, may be used. their use is a sign of an abnormal or labored breathing pattern.
what exactly does the pulse oximetry tell us? how does it work?
it tells us the amount of oxygen circulating in the blood. It’s a red light
what do ABG’s tell us
An arterial blood gas (ABG) test measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery
what age related changes happen to the respiratory system
- lung capacity decreases
- ability to cough is less effective
- SOB on exertion
- airway size decreases
- kyphosis
define dyspnea
difficult breathing
define valsalva maneuvers
the action of attempting to exhale with the nostrils and mouth, or the glottis, closed. This increases pressure in the middle ear and the chest, as when bracing to lift heavy objects, and is used as a means of equalizing pressure in the ears.
define ventilation
Ventilation (breathing) is the mechanical process of respiration that moves air to and from the alveoli.
define perfusion
oxygenation. the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue.
define inspiration
Breathing air in is called inhalation or inspiration
define vasovagal response
A sudden drop in heart rate and blood pressure leading to fainting, often in reaction to a stressful trigger.
bradycardia
define eupnea
Normal respiration
define orthopnea
Difficulty breathing while lying down, relieved by sitting upright (orthopneic position)
define hyperpnea
Increase in depth of breaths; maybe increase in rate (no feeling of increased respiratory effort
define productive cough vs non productive cough
A cough is considered productive when it brings up and removes secretions, such as sputum and mucus, as well as exudates from a lung infection. A cough is considered nonproductive when it is dry and irritating and no secretions are produced.
define TCDB
Turning, Coughing, and Deep Breathing
define pulmonary function test (PFT)
The pulmonary function test (PFT) measures how much air a client inhales (inspiration) and exhales (expiration) in one breath and assesses the client’s general respiratory status.
define postural drainage
Postural drainage uses position and gravity to drain secretions and mucus from the individual’s lungs
define adventitious breath sounds
an abnormal lung sound
define respiratory excursion
excursion is when the diaphragm is moved up and the lungs can’t get full expansion
define IPPB
intermittent positive pressure breathing (IPPB). IPPB is used almost exclusively for children with cystic fibrosis
define thoracentesis
removal of fluid from the thoracic cavity
define bronchoscopy
Bronchoscopy is an invasive procedure in which a bronchoscope (a lighted endoscope) is advanced through the pharynx into the trachea and bronchi. The purpose of this test may be to observe lung tissue, obtain a biopsy or bronchial washings, remove mucous plugs or foreign objects, or determine the location and extent of a mass (tumor).
define purse lip breathing
Pursed lip breathing (PLB) is a breathing technique that consists of exhaling through tightly pressed (pursed lips) and inhaling through the nose with the mouth closed.
helps control respiratory rate
unless ordered, how much oxygen are we allowed to give to the patient and why
2L/min. standing order.
where does gas exchange take place, through what process
in the lungs between the alveoli and a network of tiny blood vessels called capillaries, which are located in the walls of the alveoli
describe exactly why we do the Airway, Breathing, and Circulation, disability and safety (ABCDE’s)m in this order
Airway, breathing, and circulation, therefore work in a cascade; if the patient’s airway is blocked, breathing will not be possible, and oxygen cannot reach the lungs and be transported around the body in the blood, which will result in hypoxia and cardiac arrest. Ensuring a clear airway is therefore the first step in treating any patient; once it is established that a patient’s airway is clear, rescuers must evaluate a patient’s breathing, as many other things besides a blockage of the airway could lead to an absence of breathing.
why is it so very important to make sure to give patients their ordered pain medication prior to starting any therapy such as ambulating
patients will ultimately be in some sort of pain following any movement post surgery.
How are PFT’s done
LUNG FUNCTION TEST.
Using a spirometer, client takes in maximal inhalation and then exhales forcefully and as rapidly as possible. Room air, helium, or 100% oxygen may be used.
Peak flow: blowing outward hard
why is it so very important to stress the importance of NOT smoking at least 6-8 hours prior to its doing their pFT
Smoking before will alter the test results
describe what would you hear with each lung:
coarse crackles
stridor
wheezing
crackles: sounds like a loud velcro being torn apart
stridor: Stridor is a high-pitched wheezing sound caused by disrupted airflow
wheezing: a sort of continuous sound, with a buzzing quality to it
describe what normal respirations would look like in your patient
Normal respirations is a count between 12-20 RPM. Note no distress while inhaling. The stomach should not be moving
what is the appropriate technique and supplies used to obtain a throat culture
cotton-tipped applicator and applied to a slide or culture medium
describe what a pt with a partial airway obstruction would be doing
The signs of partial airway obstruction includeunusual breath sounds, skin discoloration(cyanosis), or changes in breathing pattern. Theconscious patient will usually make clutching mo-tions toward the neck, even when the obstructiondews not prevent speech. For the conscious pa-tient with an apparent partial obstruction, en-courage him or her to cough
what types of oxygen masks are available for all types of patients
nasal cannula simple face mask partial facial mask nonrebreather venturi mask face tent
describe reasons why we might use a venturi mask vs a regular disposable mask
for the highest o2 quality.
what is the initial set up for 02 therapy via mask or nasal cannula
2L/min
your patient is receiving IPPB what are we constantly monitoring for during procedure and why?
ability to breath better
post bronchoscopy: what are you monitoring for and why
gag reflex. we use numbing ointment in the throat and patients can aspirate on food or water if they don’t have it.
lung sounds and respirations
What is the equipment and prep for insertion of a chest tube, as well as pt teaching we do?
insertion tray tube local anesthetic suturing supplies sterile gloves sterile water gauze suction setup and tubing chest tube collection system vaseline gauze silk tape
What is the chest tube care after insertion?
xray for placement, vitals, keep below chest level, cough and deep breath q2h, loc, lay on unaffected side
Why would a PCP request a chest X-Ray before and after placement of the chest tube?
to check and make sure the tube is in the right spot.
What type of mask would be used if your pt had pulmonary TB?
N95
What mask is used to deliver the highest concentration of oxygen?
venturi mask
Why encourage TCDB if you hear fine crackles during your pts assessment. Why?
will help loosen up phlegm in the lungs. could just be stagnant.
What does a Mediastinal shift have to do with a Thoracentesis?
The lung on the affected side collapses, and pressure on the mediastinum shifts the thoracic organs to the unaffected side of the chest, placing pressure on the opposite lung as well. Ventilation is severely compromised, and venous return to the heart is impaired. Hypotension and distended neck veins are evident as tension pneumothorax affects venous return and cardiac output. The mediastinal shift also displaces the trachea toward the unaffected side.
What supplies and equipment would be needed for a Thoracentesis?
insertion tray tube local anesthetic suturing supplies sterile gloves sterile water gauze suction setup and tubing chest tube collection system vaseline gauze silk tape
When removing a chest tube what do we instruct the pt to do PRIOR to removing and why?
they will take pain medication half hour prior to procedure.
instruct client to take a deep breath, exhale, and bear down. valsalva maneuver.
apply airtight petroleum jelly gauze dressing
If the tubing comes undone from the chest tube collection system what action do we do immediately and why?
If a chest tube is completely dislodged, cover the site immediately with a sterile gauze dressing. If you can hear air leaking out of the site, make sure the dressing is not occlusive. If it is, it can cause a tension pneumothorax.
How does the skin feel on a pt whose chest tube is leaking into his tissues?
subq emphysema
crepitus. like bubble wrap
Airway suctioning for ADULTS is no longer than ————- why?
10 seconds at a time followed by 1 minute intervals 3 times only.
What would you expect to see happen in the pt with a vasovagal experience?
BP and HR increase
Abrupt fall of BP and HR
Supine on floor
Why should pts cough deeply a AFTER postural drainage?
allows for air to fully expand the lungs
When is the best time to perform postural drainage
before eating to prevent vomiting up food.
How do we know that postural drainage is actually effective?
when patients can breath effectively and or cough up loose phlegm.
If your pt is unconscious what position should you place him/her in to facilitate drainage and avoid aspiration? Why?
semi fowlers on their side. allows fluid to leave the mouth
so they don’t aspirate
Explain pulmonary circulation.
Pulmonary circulation is the portion of the cardiovascular system which carries deoxygenated blood away from the heart, to the lungs, and returns oxygenated (oxygen-rich) blood back to the heart.
What are the respiratory centers of the brain?
medulla and pons
Respiratory disorders using a CT scan.
allows you to see exactly where a problem is at
What is respiratory excursion?
Diaphragmatic excursion is the movement of the thoracic diaphragm during breathing
Difference between ventilation and respiration
respiration is an automatic process that allows for oxygen to be gained into red blood cells, through diffusion via either passive or active transport. … The physical movement of pulling/pushing air throughout the body is breathing/ventilation
diffusion
gas exchange. alveoli
