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From Flashcardlet > Respiratory Exam > Flashcards

Respiratory Exam Flashcards

1
Q

s/s of respiratory distress

*make sure u read the choices and question

A

.

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2
Q

If a pt has a dx of pleural effusion, what is the treatment for that.

A

Thoracenthesis

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3
Q

if pt has an epistaxis what position they should be in?

A

The client should be assisted to a sitting position with the head tilted slightly forward, and pressure should be applied to the nares by pinching the nose toward the septum for 10 minutes.

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4
Q

the medical term for: loss of speech

A

Dysphonia

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5
Q

def. of aspiration is

A

.

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6
Q

COPD pt, what is their chest going to look like

A

barrel chested

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7
Q

s/s for rhinitis

A

.

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8
Q

pt with rhinitis, what would be the drug of choice for a temp?

A

.

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9
Q

why we give histamines

A

.

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10
Q

pt that has a chest tube, and water level is fluctuation on aspiration and expiration

A

The presence of fluctuations in the fluid level in the water-seal chamber indicates a patent drainage system. With normal breathing, the water level rises with inspiration and falls with expiration. The apparatus and all connections must remain airtight at all times, and the drainage is never emptied. Encouraging the client to deep breathe is unrelated to this observation. The client is not told to hold his or her breath.

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11
Q

before you give a pt proventil, what do you need to check on the pt before you give it?

A

HR, Resp.

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12
Q

pt that has thick sputum, what kind of nursing intervention can you do to help with that?

A

hint: increase fluid intake, using cough drops, avoid lung irritants, cough suppressant, expectorants. avoid caffeine and alcohol, cutting back in smoking. breathing moist air from humidifier, hot shower.

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13
Q

pt that has a chest tube, and pt has a lot of prudulent excudate, what is that called

A

.

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14
Q

quickest way to asses oxygen saturation?

A

Pulse Oximetry

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15
Q

pt with COPD and admitted with cor pumonale?

A

its a late complication of emphysema.

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16
Q

best body position for a post-op trach.

A

Semi-fowlers to High-fowlers

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17
Q

post-op patient you want to help prevent respiratory failure, how would you do that?

A

Encourage the use of an incentive spirometry and deep breathing and coughing exercises.

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18
Q

Adult pt that had a tonsillectomy done, what nursing interventions do you need to teach the pt.

A

drink cool liquid, ice collar pack, do not sneeze or talk, don not clear your throat or cough.

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19
Q

pt who had an episode of epistaxis and they have done nasal packing, what discharge teaching do u need to give the pt

A

Do not pick your nose or sneeze with mouth open

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20
Q

s/s of acute bronchitis

A

Flu-like symptoms, wet mucus cough, discolored thick mucus.

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21
Q

s/s of TB

A

.Rationale:
-The client with TB usually experiences a low-grade fever, weight loss, pallor, chills, and night sweats. The client also will complain of anorexia and fatigue. Pulmonary symptoms include a cough that is productive of a scant amount of mucoid sputum. Purulent, blood-stained sputum is present if cavitation occurs. Dyspnea and chest pain occur late in the disease.

-The client with tuberculosis may report symptoms that have been present for weeks or even months. The symptoms may include fatigue, lethargy, chest pain, anorexia and weight loss, night sweats, low-grade fever, and cough with mucoid or blood-streaked sputum. It may be the production of blood-tinged sputum that finally forces some clients to seek care.

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22
Q

s/s of pulmonary edema.

*select all that apply

A

.

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23
Q

what the first line of drugs would be for TB

A

.

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24
Q

what a bronchoscopy is

* spell it

A

.

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25
Q

with deviated septum, what is the most likely cause of it

A

.

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26
Q

know what the primary manifestation of an upper airway obstruction

A

.

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27
Q

know what the frequent manifestation of sinusitis is?

A

.

28
Q

pt that has pharyngitis, what is the highest priority for this pt?

A

.

29
Q

what the first symptoms of carcinoma of the larynx is?

A

.

30
Q

what a common symptom of analectasis is?

*select all that apply

A

Hint: Lobes

31
Q

which group of people are at highest risk for TB?

A

Rationale:
People at high risk for acquiring tuberculosis include children younger than 5 years of age; homeless individuals or those from a lower socioeconomic group, minority groups, or immigrant group; individuals in constant, frequent contact with an untreated or undiagnosed individual; individuals living in crowded areas, such as long-term care facilities, prisons, and mental health facilities; older clients; individuals with malnutrition, an infection, or an immune dysfunction or human immunodeficiency virus infection, or individuals who are immunosuppressed as a result of medication therapy; and individuals who abuse alcohol or are intravenous drug users.

32
Q

with pulmonary embolism, which diagnostic test will they do to 100% confirm it?

A

.

33
Q

albuterol (proventil)-in respiratory

A

Short acting Bronchodilator

34
Q

aminophylline-in respiratory

A

Bronchodilator

35
Q

serevent-in respiratory

A

Long-acting beta2-receptor agonist. Causes bronchodilation; used in prevention of exercise induced asthma

36
Q

corticosteroids-in respiratory

A

Prednisone (Deltasone), Methylprednisolone (Medrol), Hydrocortisone (Cortef). Make sure to rinse mouth after use and taper off medication.

37
Q

what diagnostic procedure they would use to determine lung volume/ventilation

A
  • pg. 380
  • pulmonary function testing (PFTs)
  • total lung capacity is calculated to determine the volume of air in the ing after a maximal inhalation
  • ventilation tests evaluate the volume of air inhaled or exhaled in each respiratory cycle
38
Q

know: vancenase

A

corticosteroid. same as Beconase

39
Q

Know: beconase

A

corticosteroid. S/S of seasonal or perennial and nonallergic rhinitis; prevention of recurrence of nasal polyps after surgical removal.

40
Q

know drug category for meds that are short acting for bronchodilation

A

short-acting beta2-receptor agonists
Proventil
Ventolin

41
Q

major use of corticosteroid in respiratory system

A

to reduce inflammation

42
Q

teach a pt how to do pursed lips breathing

A

Pursed-lip breathing facilitates maximal expiration for clients with obstructive lung disease. The client should close the mouth and breathe in through the nose. The client then purses the lips and breathes out slowly through the mouth, without puffing the cheeks. The client should spend at least twice the amount of time breathing out that it took to breathe in. The client should use the abdominal muscles to assist in squeezing out all of the air. The client also is instructed to use this technique during any physical activity, to inhale before beginning the activity, and to exhale while performing the activity. The client should never hold the breath.

43
Q

mucomist is and why we use it

A

Mucolytic agent
-thin mucous secretions to help make the cough more productive
-also used as antidote in acetaminophen overdose
-can increase airway resistance and should not be used in clients with asthma
USES:
bronchitis
COPD
atelectasis
-decreases viscosity of mucus in respiratory disorders.
Can be oral, muco mist, and injectible

44
Q

medical term for surgical repair of the septum

A

Septoplasty

45
Q

pt that is having an asthma attack and give a bronchodialator how do u know the drug is affective?

A

It will open up their airway and able to breath better

46
Q

pt with epistaxis is at risk for aspiration, why do u tell them to expectorate the blood rather than swallow it.

A

it can cause nausea and vomiting.

47
Q

difference between tb infection and tb disease

A

Latent Tb: bacteria become inactive. most people who breath TB, do not feel sick, cannot spread TB to others, usually tb positive skin test
Active: the disease, the immune system can not fight it, the bacteria start to multiple and cause active TB.

48
Q

when u have fluid in the plural space and becomes infected, what is the condition?
*spelling

A

empyema

usually seen as a result of bacterial infection, as in pneumonia, TB, or blunt chest trauma

49
Q

if u are monitoring a pts O2 sat, which vital sign can have a direct affect of its accuracy.

A

BP temp, anything blocking circulation.

50
Q

know blood gasses and identify, respiratory acidosis/alkolosis, metabolic acidosis/alkolosis

A

pH: 7.35-7.45
PO2: 80-100
PCO2: 35-45
1. determine whether the pH reflects acidity of alkalinity
pH+7.45 : alkalinity
2. Paco2 reflects respiratory factors; HCO3 reflects metabolic factors
Paco2>45 : acidity
HCO3>45 : alkalinity
respiratory acidosis pH45
respiratory alkalosis pH>=7.45, Paco2=7.45, HCO3>28

51
Q

pt in acute pulmonary edema, know what the primary sign of pulmonary edema is

A

pink (blood-tinged), frothy sputum

52
Q

doing a pulse ox on a pt, how would you explain the procedure to the pt

A

Several factors can interfere with the reading of accurate oxygen saturation levels on a pulse oximeter. To ensure accurate readings, the nurse should ask the client to limit motion of the area attached to the sensor. The nurse should apply the device to a warm area because hypotension, hypothermia, and vasoconstriction interfere with blood flow to the area. If possible, the nurse should avoid placing the sensor distal to any invasive arterial or venous catheters, pressure dressings, or blood pressure cuffs. The nurse needs to know that very dark nail polish (black, brown-red, blue, green) interferes with accurate measurement.

53
Q

if taking a pt to radiology with a chest tube, what would you do with the closed drainage system?

A

Secure the bag and let it drain by gravity.

54
Q

pt with chest tube in place, are they allowed to ambulate?

A

there is no contraindication to ambulation with a chest tube in place, as long as the water-seal bottle remains below the level of the chest.

55
Q

pt that is 1day post-op after a chest tube, how do you know its working?

A
  • 50 mL of drainage in the drainage-collection chamber.
  • The drainage system is maintained below the client’s chest.
  • An occlusive dressing is in place over the chest-tube insertion site.
  • Fluctuation of water in the tube of the water-seal chamber during inhalation and exhalation

Rationale:
The bubbling of water in the water-seal chamber indicates air drainage from the client. This is usually seen when intrathoracic pressure is greater than atmospheric pressure, and it may occur during exhalation, coughing, or sneezing. Excessive bubbling in the water-seal chamber may indicate an air leak, which is an unexpected finding. The fluctuation of water in the tube in the water-seal chamber during inhalation and exhalation is expected. An absence of fluctuation may indicate that the chest tube is obstructed, the lung has re-expanded, or no more air is leaking into the pleural space. Gentle (not vigorous) bubbling should be noted in the suction-control chamber. A total of 50 mL of drainage is not excessive in a client returning to the nursing unit from the recovery room; however, drainage of more than 70 to 100 mL/hr is considered excessive and requires health care provider notification. The chest-tube insertion site is covered with an occlusive (airtight) dressing to prevent air from entering the pleural space. Positioning the drainage system below the client’s chest allows gravity to drain the pleural space.

56
Q

what hypoxemia (hypoxia) is

A

Low blood oxygen, usually due to respiratory disorders or heart conditions

57
Q

know which pts are at risk for DVTs

A

prior thrombophlebitis
recently had surgery
been pregnant, or given birth
women who are taking contraceptives on a long-term basis
history of congestive heart failure
obesity
immobilization from fracture
-immobilization appears to be a key consideration
-thrombus can become dislodged, carried to the lungs in the bloodstream, and cause a pulmonary embolus
-pulmonary embolism is a life threatening complication

58
Q

why don’t we use antibiotics for head colds?

A

Because a cold is caused by a virus not from bacteria. Antibiotics only kill bacteria.

59
Q

when they are doing PFT on a pt, what does the pt have to breath into, for the procedure to work?

A

a spirometer

60
Q

normal range for PCO2.

A

35-45 mmhg

61
Q

aminophylline, what’s the primary reason for giving this

A 
Bronchodilator
increased ability to breathe
-bronchial asthma
-bronchospasm associated with chronic bronchitis
-emphysema
62
Q

correct way to do postural drainage on a client

A

a patient with a chest tube in place is usually positioned on the unaffected side to keep the tube from becoming kinked; never elevate the drainage system to the level of the patient’s chest, since this would cause fluid to drain back into the pleural cavity.

63
Q

client that is using an arisol inhalier, how long would they hold their breath after releasing it?

A

10-15 seconds

64
Q

pt had a bronchi done what test do they need to do before they can have any fluids or foods.

A

Check gag reflux

65
Q

what position for a pericenthesis?

A
  • the patient sits on the edge of the bed with the head and arms resting on a pillow placed on an overbid table
  • if the patient cannot sit up, turn him or her to the unaffected side with the head of the bed elevated 30-45 degrees
66
Q

when do you know when to suction a patient that has a trach.

A
  • assess patient’s tracheostomy for sanguineous exudate, edema, and respiratory obstruction
  • suction as often as necessary
  • suction as needed and assess patient’s ability to mobilize secretions
  • auscultate
67
Q

A client is being prepared for a thoracentesis. The nurse assigned to care for the client assists the client to which of the following positions for the procedure?

A

Lying in bed on the unaffected side with the head of the bed elevated 45 degrees

From Flashcardlet (17 decks)

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