Respiratory System

Question 1

Respiratory Therapies from Simple and Non-invasive to Complex?

Answer 1

simple-oxygen, nebulizer(small volume to SVN), chest physiotherapy (CPT), Breathing Retraining
complex-intubation, mechanical ventilation, and surgery

Question 2

Hypoxemia

Answer 2

decrease in arterial oxygen tension in the blood, manifested by mental status changes, dyspnea, increased BP, changes in HR, dysrhythmias, cyanosis, diaphoresis and cool to the touch extremities

Question 3

hypoxia

Answer 3

decrease in oxygen supply to cells, tissues by outside sources.

Question 4

hypercapnia

Answer 4

excessive carbon dioxide in the bloodstream

Question 5

cues for a patient whom needs oxygen?

Answer 5

changes in respiratory status/ pattern. Neurologic changes, lack of coordination and impaired judgement.

Question 6

hypoxic drive

Answer 6

stimulus for breathing in patients with COPD is a decrease in blood oxygen rather than elevation of carbon dioxide.
maintain on lowest liter flow of oxygen while maintaining saturations at 90-93%.

Question 7

Nasal Cannula

Answer 7

flow rate of 1-6 liters

Question 8

simple face mask

Answer 8

flow rate of 6-10 liters

Question 9

non-rebreather (oxygen reservior inflated)

Answer 9

flow rate of 10-15 liters

Question 10

Tracheostomy collar

Answer 10

flow rate of 8-10 liters

Question 11

Incentive Spirometry

Answer 11

method of deep breathing that provides visual feedback to encourage the patient to inhale slowly and deeply to maximize lung inflation and prevent or reduce lung collapse.

Question 12

Atelectasis

Answer 12

Complete/Partial collapse of the entire lung or area (lobe)
most common abnormality identified on a chest x-ray.
s/s include dyspnea, cough, sputum production, tachycardia, pleural pain.
Diminished lung sounds occur early with crackles appearing late in condition.

Question 13

Tracheostomy

Answer 13

procedure where the physician may create a surgical opening in the trachea called a tracheotomy and insert a tracheostomy tube-can be permanent or temporary.

Question 14

COPD

Answer 14

Chronic Obstructive Pulmonary Disease, often preventable and treatable, even irreversible, is known as a slowly progressive respiratory disease of airflow obstruction.
Usually broken down to two problems-chronic bronchitis or emphysema
manifestations are the following:
Chronic Cough, Sputum Production and dyspnea.

Question 15

Emphysema

Answer 15

impaired oxygen/ carbon dioxide exchange due to destruction of the walls of over-distended alveoli.

Question 16

Chronic bronchitis

Answer 16

Disease of the airways, presence of cough and sputum production for at least 3 months in a 2 year span.

Question 17

Risk Factors of COPD

Answer 17

include environmental exposures and host factors such as tobacco, age, occupational exposure to dust or chemicals, pollution, genetic abnormalities such as alpha1-antitriypsin deficiency. smoking is known as an important factor as well.

Question 18

normal AP Diameter to Transverse Diameter Ratio

Answer 18

1:2

Question 19

Weight loss and Dyspnea relationship?

Answer 19

Due to the inability to eat and breath, this causes a lack of nutrition in patients whom are suffering from Dyspnea.

Question 20

PQRST Assessment

Answer 20

P-provoking events (onset)
Q-quality of symptoms (character)
R-region and radiation(location)
S-severity
T-time frame (duration)

Question 21

CT Scan

Answer 21

Computed Tomography Scan

type of X-ray used to make cross-sectional scans

Question 22

AAT Test

Answer 22

Alpha1-antitrypsin deficiency screen

used to diagnose deficiency that can be developing with anti trypsin in lung disease-used to screen at an earlier time

Question 23

SABA

Answer 23

Short Acting Beta Agonists
ex: Albuterol /Levalbuterol
relaxes muscles in the airways to allow for opening.

Question 24

LABA

Answer 24

Long Acting Beta Agonists

ex:

Question 25

Corticosteroids

Answer 25

steroid that aids in reducing inflammation

ex: Prednisone, Cortisone or methyl prednisone

Question 26

Antibiotics

Answer 26

reduces/destroys/disrupts the function of bacteria

Question 27

Leukotriene Inhibitors

Answer 27

blocks 5-lipoxygenase, aids in Leukotriene formation.

ex: Montelukast (Singulair)

Question 28

Xanthine Derivative

Answer 28

improves breathing by opening passages, by relaxing bronchial smooth muscle, promoting bronchodialation, suppresses airway responsiveness to stimuli that trigger bronchospasm.
ex: Oxytriphylline / Dexofylline
Aminophylline-given only iv and not recommended for acute asthma or COPD care

Question 29

Inhaler

Answer 29

can be rescue-metered dosed or multi dose
steps:
tilt head back, take lid off canister, shake inhaler, exhale fully and depress canister while taking in full breath. hold for 10 seconds and slowly release breath. repeat if necessary

Question 30

Asthma

Answer 30

a reversible, reactive airway disease, which is often accompanied by increased mucous and characterized by cough, chest tightness, wheezing and dyspnea. can occur in any age group and can have irritants that exacerbate or bring out symptoms.

Question 31

Peak Flow Meter

Answer 31

used to show gas exchange and quantity of lungs used while aiding in identifying early asthma symptoms
ranges:
Green-80-100
Yellow-50-79
Red-less than 50%

Question 32

Status Asthmaticus

Answer 32

A medical emergency that includes severe bronchospasm, mucus plugging, and abnormal ventilation-perfusion ratio which can result in death without quick and astute medical and nursing care.Can be severe and persistent asthma and have no response to conventional treatment.

Question 33

First Generation-Antihistamines

Answer 33

Inhibits smooth muscle constriction in blood vessels and respiratory and GI tracts
Decreased capillary permeability
Decreases salivation and tear formation
ex: Benadryl (Diphenhydramine)
considerations: can cause drowsiness and CNS depression, especially in the elderly
monitor those whom are pregnant

Question 34

Second Generation-Antihistamines

Answer 34

Competes with histamine receptor sites and prevents allergic reactions
does not cross blood-brain barrier and does not cause CNS depression/ drowsiness
Ex: Fexofenadine (Allegra), Cetirazine (Zyrtec), Levocetirizine (Xyzal), Loratidine (Claritin).

Question 35

Anticholinergics

Answer 35

chemically related to atropine and blocks muscarinic acetylcholine receptors in the smooth muscles of the bronchi in the lungs, inhibiting bronchoconstriction and mucus secretion.
Ex: Ipatropium (Atrovent), Tiotropium (Spiriva)