Respiratory System Flashcards
Respiratory Therapies from Simple and Non-invasive to Complex?
simple-oxygen, nebulizer(small volume to SVN), chest physiotherapy (CPT), Breathing Retraining
complex-intubation, mechanical ventilation, and surgery
Hypoxemia
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
hypoxia
decrease in oxygen supply to cells, tissues by outside sources.
hypercapnia
excessive carbon dioxide in the bloodstream
cues for a patient whom needs oxygen?
changes in respiratory status/ pattern. Neurologic changes, lack of coordination and impaired judgement.
hypoxic drive
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%.
Nasal Cannula
flow rate of 1-6 liters
simple face mask
flow rate of 6-10 liters
non-rebreather (oxygen reservior inflated)
flow rate of 10-15 liters
Tracheostomy collar
flow rate of 8-10 liters
Incentive Spirometry
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.
Atelectasis
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.
Tracheostomy
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.
COPD
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.
Emphysema
impaired oxygen/ carbon dioxide exchange due to destruction of the walls of over-distended alveoli.
Chronic bronchitis
Disease of the airways, presence of cough and sputum production for at least 3 months in a 2 year span.
Risk Factors of COPD
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.
normal AP Diameter to Transverse Diameter Ratio
1:2
Weight loss and Dyspnea relationship?
Due to the inability to eat and breath, this causes a lack of nutrition in patients whom are suffering from Dyspnea.
PQRST Assessment
P-provoking events (onset) Q-quality of symptoms (character) R-region and radiation(location) S-severity T-time frame (duration)
CT Scan
Computed Tomography Scan
type of X-ray used to make cross-sectional scans
AAT Test
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
SABA
Short Acting Beta Agonists
ex: Albuterol /Levalbuterol
relaxes muscles in the airways to allow for opening.
LABA
Long Acting Beta Agonists
ex:
Corticosteroids
steroid that aids in reducing inflammation
ex: Prednisone, Cortisone or methyl prednisone
Antibiotics
reduces/destroys/disrupts the function of bacteria
Leukotriene Inhibitors
blocks 5-lipoxygenase, aids in Leukotriene formation.
ex: Montelukast (Singulair)
Xanthine Derivative
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
Inhaler
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
Asthma
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.
Peak Flow Meter
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%
Status Asthmaticus
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.
First Generation-Antihistamines
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
Second Generation-Antihistamines
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).
Anticholinergics
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)
