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NCLEX: Med Surg > Respiratory System > Flashcards

Respiratory System Flashcards

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1
Q

The nose, mouth, pharynx, larynx and trachea are part of the _____ respiratory system

A

Upper

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2
Q

Function of the upper respiratory system

A

Warm, humidify, and filter air we breathe

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3
Q

The bronchi, bronchioles, alveolar ducts, and alveoli are part of the _____ respiratory system

A

Lower

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4
Q

Function of the lower respiratory system

A

Gas exchange

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5
Q

The functional units for gas exchange

A

Alveoli

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6
Q

The flow of air in and out of the alveoli

A

Ventilation

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7
Q

The exchange of oxygen and carbon dioxide between the alveoli and red blood cells in the bloodstream

A

Diffusion

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8
Q

The exchange of oxygen and carbon dioxide between the red blood cells and the body’s tissues

A

Perfusion

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9
Q

Structure that surrounds and cushions the lungs

A

Pleura

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10
Q

Normal pH

A

7.35-7.45

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11
Q

Normal PaCO2

A

35-45

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12
Q

Normal HCO3

A

22-26

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13
Q

Normal PaO2

A

80-100

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14
Q

Normal SaO2

A

95-100%

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15
Q

Insertion of a tube into a patient’s airway that allows for visualization of the airway and collection of specimen

A

Bronchoscopy

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16
Q

Pre-procedure nursing care for bronchoscopy

A

NPO (ranges between 4-8 hours)

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17
Q

Post-procedure nursing care for bronchoscopy

A

Assess for return of gag reflex before providing anything to eat or drink

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18
Q

T or F: the nurse should educate the patient that a sore, dry throat and blood tinged mucus is expected following a bronchoscopy

A

True

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19
Q

The nurse should monitor the patient for complications such as _________ following a bronchoscopy

A

Pneumothorax

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20
Q

The insertion of a needle into the patient’s posterior chest to remove fluid or air from the pleural space

A

Thoracentesis

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21
Q

Pre-procedure nursing care for thoracentesis

A

Have patient sit upright with arms supported on bedside table or pillows

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22
Q

Nursing care during thoracentesis

A

Advise patient to remain perfectly still (do NOT talk, move, or cough)

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23
Q

Post-thoracentesis, the nurse should monitor the patient for complications such as

A

Pneumothorax, bleeding, hypotension

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24
Q

T or F: an SpO2 of 90% is an expected finding in a patient with COPD

A

True

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25
Q

Nasal cannula O2 delivery

A

1-6 L/min

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26
Q

A patient receiving O2 over 4 L/min via nasal cannula may experience drying of the nares. What can the nurse provide to prevent this?

A

Water-based lubricant; humidified oxygen

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27
Q

Simple face mask O2 delivery

A

6-10 L/min

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28
Q

The nurse should inflate the bag attached to a partial rebreather and a non-rebreather mask to about ___ full. Flow rate should be adjusted to keep the bag inflated to this fullness to prevent the patient from suffocating.

A

2/3

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29
Q

Non-rebreather flow rate

A

10-15 L/min

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30
Q

Partial rebreather flow rate

A

10-12 L/min

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31
Q

Which oxygen delivery device provides high humidifcation and the most precise oxygen delivery without intubation?

A

Venturi mask

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32
Q

Venturi device flow rate

A

Depends on mask attached to it; varies between 4-12 L/min

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33
Q

Face tents are ideal for patients with facial trauma. This device provides high humidification and delivers over ___ L/min

A

15

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34
Q

Insufficient O2 in the arterial blood (<80 mmHg)

A

Hypoxemia

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35
Q

Insufficient tissue oxygenation

A

Hypoxia

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36
Q

Restlessness, irritability, abnormal breathing (use of accessory muscles, nasal flaring, adventitious lung sounds), tachycardia, hypertension and pallor are _____ signs of hypoxia

A

Early

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37
Q

Decreased LOC, increases lactic acid levels (lactic acidosis), dysrhythmias, bradypnea, bradycardia, hypotension, and cyanosis are _____ signs of hypoxia

A

Late

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38
Q

S/S of oxygen toxicity

A

Non-productive cough, nasal congestions, substernal pain, headache, N/V, fatigue, sore throat

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39
Q

Sleep apnea is defined as breathing disruption that occurs during sleep lasting at least ___ seconds and occurs ___ or more times per hour

A

10; 5

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40
Q

Sleep apnea risk factors

A

Obesity, large tonsils, neuromuscular/endocrine disorders

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41
Q

S/S of sleep apnea

A

Persistent daytime sleepiness or irritability

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42
Q

Chronic inflammatory disorder of the airway that is intermittent and reversible

A

Asthma

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43
Q

S/S of asthma

A

Dyspnea, wheezing, chest tightness, coughing, tachypnea, use of accessory muscle, prolonged expiration, barrel chest (w/ severe and prolonged asthma)

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44
Q

The nurse should educate the patient to keep tabs on their asthma using a _________ which alerts the patient to airway narrowing before they even experience symptoms

A

Peak flow meter

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45
Q

How should the nurse instruct the patient to use their peak flow meter for asthma?

A

Use three times and record the highest number of the three attempts

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46
Q

For exercise-induced asthma, the patient should take their bronchodilator ___ min before exercise

A

30

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47
Q

A life threatening complication of asthma is _____ _____ which is airway obstruction that is unresponsive to usual therapy. This can lead to pneumothorax and respiratory arrest

A

Status asthmaticus

48
Q

S/S of status asthmaticus

A

Extremely labored breathing, gasping/inability to speak, decreased LOC, cyanosis, neck vein distention, pulsus paradoxus (decrease in systolic BP during inspiration)

49
Q

Chronic Obstructive Pulmonary Disease (COPD) is a combination of two conditions including

A

Emphysema; chronic bronchitis

50
Q

T or F: COPD is reversible

A

False

51
Q

_________ is characterized by destruction of the alveoli leading to decreased lung elasticity, hyperinflation, and air-trapping in the lungs

A

Emphysema

52
Q

_________ is characterized by inflammation of the airway and hypersecretion of mucus leading to hypoventilation, hypoxemia, and hypercapnea (retention of CO2 in lungs)

A

Bronchitis

53
Q

What is the number 1 risk factor for COPD?

A

Smoking

54
Q

S/S of COPD

A

Cough, excess sputum, crackles/wheezes in lungs, hyperresonance during percussion (d/t trapped air), barrel chest, use of accessory muscle when breathing, clubbing of fingers, cyanosis, rapid shallow respirations, tripod position (helps breathe more effectively)

55
Q

A patient with COPD will have _________ PaCO2 and _________ PaO2

A

Elevated; decreased

56
Q

COPD nursing care

A
  • place patient in upright position (for breathing)
  • administer O2 as ordered by provider
  • monitor for complications such as R-sided HF
57
Q

COPD patient education

A
  • smoking cessation
  • abdominal and pursed-lip breathing
  • effective coughing and use of incentive spirometer (breathe IN! 10x/hr while awake)
58
Q

COPD diet

A

Small, frequent meals; increase fluids, calories, and protein

59
Q

Cystic fibrosis is a genetic __________ _________ disorder that severely impairs lung function

A

Autosomal recessive

60
Q

S/S of cystic fibrosis

A

Respiratory symptoms (d/t thick mucus), steatorrhea, elevated sweat chloride

61
Q

Pancreatic enzymes are given to patients with cystic fibrosis…

A

With meals and snacks

62
Q

Percussion, vibration, postural drainage, to help loosen respiratory secretions in patients with CF

A

Chest physiotherapy

63
Q

When should chest physiotherapy sessions be scheduled?

A

Before meals or several hours after meals to prevent vomiting

64
Q

Bronchodilators should be administered ___ to ___ before chest physiotherapy

A

30 min to 1 hr

65
Q

CF diet

A

Increase fluid, protein, calorie intake; fat soluble vitamin supplements

66
Q

What is a key complication of pulmonary hypertension?

A

Cor pulmonale (increased resistance in lungs that causes back flow of blood and enlargement of right ventricle of heart)

67
Q

Influenza is a viral infection spread primarily through

A

Droplets

68
Q

Tamiflu (antiviral) can be given within the first ___ hrs of the onset of influenza symptoms

A

48

69
Q

Excess fluid in the lungs due to inflammation

A

Pneumonia

70
Q

Pneumonia labs: CBC, PaO2, PaCO2

A

CBC - WBC elevated
PaO2 - decreased
PaCO2 - increased

71
Q

Pneumonia treatment nursing consideration

A

Collect sputum culture PRIOR to antibiotic therapy (early morning sample is preferred!)

72
Q

Tuberculosis mode of transmission

A

Airborne

73
Q

S/S of tuberculosis

A

Cough lasting >3 wks, purulent or bloody sputum, night sweats, unexplained weight loss, lethargy

74
Q

A mantoux skin test for tuberculosis requires the client to return 48-72- hours after initial injection. A positive result is indication if

A

Client has induration of 10 mm or more (this means the client has an active TB infection or has had a previous TB infection)

75
Q

A ___ mm induration indicates a positive TB result in immunocompromoised patients

A

5

76
Q

T or F: people who have lived internationally and have received a BCG vaccine may end up with a false positive TB result

A

True

77
Q

An acid-fast bacilli sample can be used for diagnosis of TB infection using ___ early morning sputum samples

A

3

78
Q

Medications often used to treat TB

A

Rifampin, isoniazid, pyrazinamide, ethambutol (RIPE)

79
Q

Treatment for TB includes combination antibiotic therapy for up to _________

A

1 year

80
Q

TB nursing care

A

Negative airflow room, airborne precautions, wear N95 mask, if patient leaves room they must wear surgical mask, screen family for TB, sputum sample required every few weeks during therapy

81
Q

After how many negative sputum samples is a patient no longer infectious with TB?

A

3

82
Q

Hallmark sign of fat emboli

A

Petechiae (along with s/s of PE)

83
Q

What lab will be elevated in the presence of blot clots?

A

D-Dimer

84
Q

What is the most common cause of a pulmonary embolism (PE)?

A

Deep Vein Thrombosis (DVT)

85
Q

Accumulation of air in the pleural cavity

A

Pneumothorax

86
Q

Accumulation of blood in the pleural cavity

A

Hemothorax

87
Q

Accumulation of fluid in the pleural cavity

A

Pleural effusion

88
Q

S/S of pleural disorder

A

Respiratory distress, decreased or absent breath sounds on affected side

89
Q

Percussion assessment of pneumothorax

A

Hyperresonance

90
Q

Percussion assessment of hemothoracx or pleural effusion

A

Dull percussion

91
Q

Pleural disorder treatment

A

Chest tube (removes accumulation air, blood, fluid), Benzos (anxiety), opioids (pain)

92
Q

What are the three chambers of chest tubes?

A

Drainage collection, water seal chamber, suction control chamber

93
Q

Chest tube drainage greater than ___ mL/hr should be reported to the provider

A

100

94
Q

T or F: tidaling and continuous bubbling is normal in the water seal chamber of chest tube

A

FALSE; tidaling is normal, however, continuous bubbling indicates an air leak

95
Q

Continuous bubbling is expected for which chamber of chest tubes?

A

Suction control chamber

96
Q

Chest tube nursing care/best-practices

A
  • chest x-ray to confirm placement
  • occlusive dressing over insertion site
  • check insertion site regularly for subcutaneous emphysema (trapping of air under skin - feels like rice crispies)
  • monitor site for signs of infection
  • only clamp if ordered by provider
97
Q

What should the nurse do if the chest tube becomes disconnected from the drainage system?

A

Place end of tube in sterile water

98
Q

What should the nurse do if the chest tube is accidentally removed from the patient’s chest?

A

Place dry, sterile gauze over insertion site and notify provider

99
Q

Occlusion of a chest tube is a key risk factor for

A

Tension pneumothorax

100
Q

The trapping of air in the pleural cavity under positive pressure (air enters pleural space upon inspiration, but cannot escape upon expiration)

A

Tension pneumothorax

101
Q

Tension pneumothorax can lead to

A

Lung collapse

102
Q

S/S of tension pneumothorax

A

Tracheal deviation towards unaffected side, absent breath sounds on affected side, asymmetry of thorax, respiratory distress, neck vein distention

103
Q

Tension pneumothorax treatment

A

Immediate insertion of large bore needle into pleural space to remove air and allow for lung re-expansion; placement of chest tube

104
Q

Respiratory failure that occurs due to non-cardiac pulmonary edema

A

Acute Respiratory Distress Syndrome (ARDS)

105
Q

The inability of the lungs to maintain arterial oxygenation or to eliminate CO2 from the body leading to tissue hypoxia

A

Acute Respiratory Failure (ARF)

106
Q

Optimal position for patient with ARF

A

Good lung down

107
Q

Low pressure alarms of mechanical ventilation are due to

A

Leaks (disconnection, cuff leak, tube displacement)

108
Q

High pressure alarms of mechanical ventilation are due to

A

Increase in pressure r/t pulmonary edema, pneumothorax, bronchospasm, biting, secretions, cough, kink (remember: 2 PB sandwiches can make you SiCK)

109
Q

Mechanical ventilation setting that describes the volume of gas delivered with each breath

A

Tidal volume (VT)

110
Q

Mechanical ventilation setting that describes the O2 concentration of the air being delivered to patient

A

Fraction of inspired oxygen (FiO2)

111
Q

FiO2 can vary between ___-___%

A

21-100

112
Q

Normal I:E (duration of inspiration to expiration) ratio of mechanical ventilation

A

1:2 or 1:1.5

113
Q

Mechanical ventilation setting that describes the pressure applied at the end of expiration to distend the alveoli and prevent collapse

A

Positive end expiratory pressure (PEEP)

114
Q

What supplies should be kept at the bedside of a client who is mechanically ventilated?

A

Manual resuscitation bag, reintegration equipment including two different tube sizes

115
Q

ET tubes should be repositioned every ___ hours or more frequently to prevent skin breakdown

A

24

116
Q

What complication should the nurse monitor for in a mechanically ventilated patient?

A

Ventilator-associated pneumonia

NCLEX: Med Surg (10 decks)

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