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Nursing Med-Surg > Respiratory Unit > Flashcards

Respiratory Unit Flashcards

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1
Q

Respiratory Excursion

A

Estimation of thoracic range and expansion, May disclose information about movement during breathing. Should be symmetrical.

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2
Q

Tactile Fremitus

A

Detection of palpable sound vibrations transmitted to the chest wall as the patient speaks. Air does not conduct sound well; but solid substances (tumors, fluids) enhances fremitus.

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3
Q

Crepitus

A

Subcutaneous emphysema is air bubble present in the subcutaneous tissue or underlying muscle. Upon palpation crackles can be heard.

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4
Q

Thoracic percussion

A

Normal lung sound - resonant dullness - over a bone (tumor)

Hyperresonant - louder and lower pitched are associated with COPD/pneumothorax

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5
Q

Thoracic auscultation - what is it used to assess?

A

Useful in assessing the flow of air through the bronchial tree and in evaluating the presence of fluid or solid obstruction in the lung.

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6
Q

Tidal volume

A

volume of each breath, around 500 mL

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7
Q

Minute ventilation

A

amount of expiration in one minute (RR x Tidal Volume)

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8
Q

Forced vital capacity

A

Maximum inhale and exhale

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9
Q

Atelectasis

A

Not using all of the lungs, causing a collapse in alveoli. Decrease gas exchange.

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10
Q

Who’s at risk for atelectasis

A

thoracic and abdominal surgeries

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11
Q

Age related changes >40/>50

A

>40 - decreased surface area of alveoli

>50 - alveoli lose elasticity

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12
Q

What is ARDS

A

Acute respiratory distress syndrome - fluids leak into lungs from capillaries

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13
Q

What’s PND

A

Paroxysmal nocturnal dyspnea - awaken client from sleep with inability to breathe (CNS problem)

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14
Q

Dead space

A

No gas exchange in the lungs

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15
Q

Dry and irritating cough

A

upper respiratory viral infection

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16
Q

High pitched irritating cough

A

Laryngotracheitis

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17
Q

Brassy cough

A

Tracheal lesion

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18
Q

Long, stridor inspiratory noise (whoop before cough)

A

Pertussis

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19
Q

Hacking

A

Pneumonia

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20
Q

Changing cough

A

cancer

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21
Q

Cough in AM

A

Bronchitis

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22
Q

Worse when supine

A

post-nasal drip

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23
Q

Coughing after food

A

aspiration

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24
Q

purulent sputum

A

bacterial lung abscess, bronchiectasis

yellow-green in color

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25
Q

small amount of purulent

A

bronchitis, pneumonia

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26
Q

Currant jelly sputum

A

Klebsiella

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27
Q

Rust colored sputum

A

Pneumococcal

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28
Q

Musty smelling sputum

A

Pseudomonas

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29
Q

pink tinged mucoid

A

lung cancer

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30
Q

frothy white

A

pulmonary edema

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31
Q

3 Effects of smoking

A
  1. Decreased ciliary action
  2. Increases bronchial secretions
  3. Causes inflammation and reduces surfactant (increases lubrication of the lungs)
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32
Q

Joint commission required documentation of what?

A

Screening for and a tobacco treatment was offered

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33
Q

Crackles

A

May be cleared with coughing Inflammation Heard on inspiration Pneumonia, bronchitis, HF, bronchiectasis, pulmonary fibrosis “popping” Non-continuous

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34
Q

Wheezes

A

Change in diameter in the lumen that air flowing through expiration Asthma continuous musical sounds

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35
Q

Stridor

A

Demands immediate attention High pitch

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36
Q

ABGs

A

Measures blood pH and arterial oxygen and CO2 tensions

37
Q

Restrictive Disorder

A

Makes lung stiff

Upper respiratory

Decreases the amount of air that the lungs can hold

Decrease in elasticity

ex. Fulmonary fibrosis, asbestosis, sarcoidosis

38
Q

Obstructive Disorder

A

Causes a narrowing or blockage in exhaled airflow and are commonly associated with COPD

39
Q

Chronic bronchitis primary teaching

A

smoking cessation

40
Q

Report what after bronchoscopy (not gag)

A

Bronchospasms

41
Q

V/Q imbalance is from

A

inadequate perfusion or ventilation

42
Q

What does a V/Q scan do

A

trace and measure perfusion through the lungs and evaluation of blood flow abnormalities

43
Q

Atmosphere FiO2 + add __% per L of O2

A

21% (add 4% per L of O2)

44
Q

Ventilation but no perfusion

A

Deadspace

45
Q

Perfusion but no ventilation

A

shunt

46
Q

No ventilation or perfusion

A

Silent unit (cardiac arrest)

47
Q

Most people can do ____% of vital capacity in 1 second

A

80%

48
Q

Examples of shunting

A

Mucous plug

Atelectasis

Infection

Tumor

49
Q

Deadspace example

A

PE

50
Q

Emphysema is…

A

Exertional dyspnea

Prolonged expiratory time

Short, jerky sentences

Use of accessory muscles

Thin

Pink puffer

Increased CO2

Hyperresonance during chest percussion

Affects alveoli shape - large and flabby with decreased air for gas exchange

51
Q

Chronic bronchitis is…

A

Blue Bloater

Increased Hgb

Increased RR

Clubbing

Recurrent cough and sputum

Hypoxia

Hypercapnea

Cough and sputum for at least 3 months in each of the two years

Affects airway, not alveoli

52
Q

COPD is severe if FEV1 is

A

< 50%

53
Q

SABAs are quick relief in

A

Asthma and COPD

54
Q

Tiotropium is recommended for COPD or asthma

A

COPD patients (and people who have asthma AND COPD)

55
Q

Ipatropium is a …

A

SAAC - short acting anticholinergic

56
Q

Tiotropium is a …

A

LAAC - long-acting anticholinergic

57
Q

Tiotropium should not be …

Do not take with…

A

SWALLOWED

Ipatropium

58
Q

Creatinine clearance greater than 50 mL/min allows for use of Tiotripium (Spiriva) for bronchospams (T/F)

A

T

59
Q

LABA example

A

Salmeterol (Serevent)

60
Q

SABA example

A

Levalbuterol (XOPENEX)

albuterol (ProAir, Proventil, Ventolin)

61
Q

Risk factors for COPD

A

Smoking

environment

asthma

infection

alpha1-antitrypsin deficiency

62
Q

Why is cardiac failure a complication of COPD

A

Heavy workload on the right side of the heart (pushing out oxygenated blood)

63
Q

Bronchodilator reversibility tests help distinguish between

A

asthma and COPD

64
Q

Mast cell stabilizer examples

A

Cromolyn Sodium (oral solution)

Nedocromil

65
Q

Mast cell stabilizers are used when (what does it do too)

A

Patients not tolerating corticosteroids

Exercise-induced asthma

Mast cell stabilizers -> stabilize mast cells. Mast cells are cells that create a histamine release in the body that creates an allergic/inflammatory process. Mast cell stabilizers therefore reduce inflammatory process.

66
Q

Corticosteroids end in (or have) these letters. Preventer/Reliever?

A

-son(e)

Preventer

67
Q

Monoclonial antibodies are given how? What are they for?

A

additional therapy for patients with severe persistent asthma who are sensitive to specific allergies.

IV

(anti-IgE)

68
Q

Monoclonial antibody example. Class?

A

Omalizumab (Xolair)

Anti-asthmatics

69
Q

Leukotrienes examples. Class?

A

SIngulair (montelukast)

Zilueton (Zyflo)

Bronchodilator

(leukotriene antagonist)

70
Q

Leukotrienes do what?

A

Inhibit effects of leukotrines (decrease inflammation).

Prevention/chronic treatment of asthma and allergic rhinitis

71
Q

Methylxanthines/Xanthines examples Class?

A

Aminophylline

Theophylline

Bronchodilator

72
Q

Corticosteroids do what to the immune system?

What’s the white throat called?

A

Suppress it

Thrush

73
Q

Emphasize these three things with asthma education

A

Identify triggers

s/s of an acute episode

take meds AS DIRECTED

74
Q

Obstructive sleep apnea is an upper or lower airway obstruction?

A

Upper

75
Q

How many obstructive events per hour classifies OSA

A

five

76
Q

Which mechanical issue can cause OSA

A

large tonsils (recommend a tonsillectomy)

77
Q

Pathophysiology of OSA

A

Airway obstrution -> apneic events caused by reduction in VENTILATION

78
Q

What lab values will you see in OSA?

A

Decreased oxyhemoglobin, increased RR

79
Q

Complication of OSA

A

Hypercapnia

80
Q

What populations should be screened for OSA

A

Hypertension

CAD

HF

Metabolic syndrome

Diabetes

81
Q

Risk factors for OSA

A

Obesity

male

older age

large tonsils

smoking

short neck

82
Q

S/s of apneic event

A

Loud snoring with breathing cessation for 10+ seconds

83
Q

1 Medication for OSA to remember

A

Modafinil (Provigil)

84
Q

Diagnosing OSA

A

sleep study

Epworth sleepiness scale (likelihood of falling asleep during scenarios)

85
Q

CPAP vs BiPAP

A

CPAP is one setting of pressure for inhalation and exhalation

BiPAP is two levels for inspiration and exhalation

86
Q

Biggest problem with CPAP

A

compliance (due to skin irritation/dryness/eye irritation)

87
Q

SABA/LABA interactions

A

beta blockers

diuretics (non-K sparing - furosemide) because it lowers potassium levels

MAOIs (lead to HTN crisis)

Stimulants

Digoxin (decrease serum digoxin levels)

88
Q

Status asthmaticus

A

when the inhaler doesn’t work

Nursing Med-Surg (3 decks)

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