Test 1 Flashcards
upper respiratory system
warms, filters, humidifies inspired air
Upper respiratory system components
nose, pharynx, larynx
Nose
lined with mucous membrane that warms and moistens the air
Pharynx
passageways for moving air to the lungs and food to the esophagus
Larynx
The glottis is the space between the folds of the vocal cords, attached to the front and back of the larynx.
Movements of the the mouth, lips, jaws, and tongue convert the sounds made by the rush of air through the glottis into speech sounds.
Tonsils and adenoids
part of the lymphatic system
if they become inflamed and enlarged, they may interfere with breathing.
Epiglottis
when swallowing begins, the epiglottis closes over the larynx, preventing aspiration of food and secretions into the lungs.
Paranasal Sinuses
the paranasal sinuses (maxillary, frontal sphenoid and ethmoid) are air filled cavities lined the mucous membrane and situated among the facial bones around the nasal cavity.
Lower respiratory system functions
conduction of air, micro-ciliary clearance, production of pulmonary surfactant (lowers surface tension, keeping alveoli from collapsing)
Lower respiratory system components
Trachea
right and left mainstem bronchi
segmental bronchi
terminal brochioles
Ventilation
the process of ventilation involves both acquiring oxygen (inspiration) and removing carbon dioxide (expiration) from the blood.
ventilation
the transport of oxygen through the lungs is the ONLY mechanism for acquiring oxygen.
ventilation cont…
oxygen is required for cellular metabolism, which means that for a cell to expand energy efficiently and perform its designated function, oxygen MUST be present. The release of carbon dioxide is equally as important because optimal cell functioning occurs within a narrow pH range.
oxygen delivers to what?
the alveolar membrane for diffusion into the blood.
what does that diaphragm do during inhalation?
moves down and intercostal muscles expand
pleura consists of what?
two layers: visceral pleura (covers each lung) and parietal pleura (lines inner wall of chest cavity)
mucous membrane contains what?
cilia that traps and propels small inhaled foreign particles toward the entrance of the respiratory tract.
vesicular breath sounds
low to medium pitch with a soft whooshing quality; inspiration is two to three times the length of expiration.
bronchovesicular breath sounds
moderate to high pitch with a hollow, muffled quality; equal time of inspiration and expiration.
bronchovesicular breath sounds
moderate to high pitch with a hollow, muffled quality; equal time of inspiration and expiration.
bronchial breath sounds
high pitch with a loud, harsh, tubular quality; inspiration half as long as expiration
crackles
sounds when air moves through airway contains fluid
wheezes
high pitch musical sound heard on expiration and sometimes on inspiration.
rhonchi
low pitch sound that can be heard on inspiration or expiration caused by blockages the main airways by mucous or lesions etc, often compared to snoring
pleural friction rub
caused by movement of inflamed pleural surfaces against each other (pneumonia, PE, etc) grating sounds
stridor
death! high pitched caused by narrowed airway
PFT’s (pulmonary function test)
to determine integrity of mechanical function and gas exchange function of the lungs.
nursing implication: done within 1-2 hr eating
no smoking
stop taking bronchodilator and corticosteroid
bronchoscopy
inspect bronchi, to remove foreign objects or mucous plugs, to biopsy lesions.
control of respiration
Respiratory center (pons and medulla, located in the brainstem
what controls both involuntary and voluntary respiration?
central nervous system
What factors affect the exchange of oxygen and carbon dioxide?
change in surface area available thickening of alveolar capillary membrane: edema, fluid partial pressure solubility chronic lung disease
what are some normal lung sounds?
vesicular breath sounds
bronchovesicular breath sounds
bronchial breath sounds
abnormal (adventitious) lung sounds
crackles wheezing rhonchi pleural friction rub stridor
what causes a respiratory disorder?
trauma or disease: perfusion cardiac disease emboli bacteria fungi other disorders of the heart and pulmonary blood vessels
what are the two major types of ventilatory disease?
restrictive (decreased lung volume)
obstructive (narrowed air passages)
restrictive conditions
(scoliosis and kyphosis)
decrease lung capacity
obstructive disorders
problems moving air in and out the lungs
asthma, emphysema, and chronic bronchitis and obstructive disorder
causes of respiratory issures?
muscles of diaphragm and chest are paralyzed, apnea occurs
fractured ribs or injured
factors that increase risk for respiratory infection
age older than 65 smoking chronic respiratory disorders residing in an extending care facility congenital or chronic cardiovascular disorder
what are the guidelines for PPDS?
must be checked after 48-72 hours
15mm-general public without known factors
10mm-residents and employees of long term care facilities, IV drug abusers and recent immigrants (<5 years )
D-dimer measures what?
to assess thrombin and plasmin activity as test provides assay of fibrin degradation
diagnosis of pulmonary embolism and DIC
light blue top
CBC measures what?
adequacy of hemoglobin to carry oxygen and to determine if infection is present
lavender top
Thoracentesis
removes pleural fluid, instill medication or obtain fluid for diagnostic studies
Thick, tenacious and “ropey”; difficult to cough up
chronic bronchitis. emphysema
Scant, sticky, rusty colored
Pneumococcal pneumonia
Frothy, pinkish or blood-tinged
Pulmonary edema
Yellow, yellow-green or grayish yellow, with foul odor or taste
Pulmonary infection
Respiratory Acidosis (throw acid on them…)
Hypoventilation-Hypoxia Cant breath low BP headache muscle weakness, hyperreflexia drowsiness, dizziness, disorientation
Respiratory Alkalosis (doing the most)
Hyperventilation tachycardia low or normal bp hypokalemia numbness and tingling extremities seizures increased anxiety increased irritability muscle cramping
what position should put your patient to promote proper breathing?
high folwer’s
Orthopnea means what?
when patient is having trouble breathing when supine
orthopenic position?
sit upright, lean over the overbed table (which is padded with pillows) and elevate and round the shoulders to allow maximum expansion of the lungs
what allergy prevents someone from getting the influenza vaccine?
eggs
how long is an upper respiratory infection normally?
7 to 11 days but may take 14 days before all symptoms are gone
upper respiratory infection and rhinitis treatment
antihistamines steroids mast cell stabilizers decongestants complementary and alternative therapies- echinacea; goldenseal; or combination of herbs, minerals, vitamins and amino acids
Antihistamines-1st Generation
Diphenhydramine (Benadryl)
Relives sneezing, excessive secretions, itching, and nasal congestion
Antihistamines- 2nd Generation
Loratadine (Claritin), Fexofenadine (Allegra), Cetirzine (Zyrtec), Desloratadine (Clarine), Levocetirizine (Xyzal)
Relives sneezing, excessive secretions
less likely to cross the blood brain, producing less drowsiness than 1st generation
Intranasal Antihistamines
Azelastine (Astelin), Olopatadine intranasal (Patanase)
Topical H1 receptor antagonists
may release nasal congestion
inhibits the release of histamine
instruct not to use if patient has glaucoma or prostatic hypertrophy
Corticosteroid Spray
Budesonide (rhinocort), fluticasone (flonase), Triamcinolone (nasacort), monetaone (nasonex)
Inhibits inflammatory response
Have low systemic absorption with normal doses
*can result in nosebleed
use daily
Mast cell stabilzer
Cromolyn sodium spray (Nasalcrom)
stabilizers mast cells, preventing inflammatory reaction
Decongestants
Oral: pseudoephedrine (sudafed)
spray: phenylephrine (neo-synephrine), saline nasal spray or rinse
promotes vasoconstriction by stimulating adrengic receptors on blood vessels
Aspirin
should not be given to children younger than 18 years of age, association with reye’s syndrome
Sinusitis
inflammation of the mucosal lining of the sinuses
`Acute sinusitis diagnostic criteria
physical examination
ESR
CRP
WBC
Sinusitis treatment
pain control
promote sinus drainage
control infection
what are epistaxis?
Nosebleed
Epistaxis treatment
sit forward and apply direct pressure by pinching the nose for 10-15 minutes
cold compress
may require cauterization, packing or small balloon to stop bleeding
*avoid bending over and not blowing nose
Endotracheal incubation
tube inserted into the trachea via the nose or mouth with the use of a laryngoscope
Tracheostomy
surgical incision into the trachea for the propose of inserting a tube through which the patient can breathe.
influenza
acute, highly infectious disease of the upper and lower respiratory tract.
three types A,B,-seasonal each year. C- mild respiratory illness
