test 1 Flashcards
How is COPD diagnosed based on assessment?
-productive cough
-dyspnea
-accessory muscles to breathe
-wheezing
-hypoxia
-hypercapnia
-resp. acidosis
-increased HGB and Increased resp rate
-digital clubbing
-Sputum culture
Barrel chest
-Chronic weight loss
Col Pulmonale
- Right side heart failure due to lung condition
- can lead to peripheral edema
- distended neck veins
Position for COPD position
Tripod position. Expands thoracic area
Commonly used for COPD patients PRIOR to exercising
Bronchodilators
Contraindicated for pts. with asthma
P.A.M
- Propanalol
- Atenolol
- Metropolol
Albuterol
- rescue inhalers used during asthma attack
- bronchodilator: short acting beta-adrenergic agonists
Mucomyst
A Mucolytic that helps break down mucus and can actually cause patients to have bronchial spasms
When do you know asthma tx. is effective?
Patients lung is clear to auscultation
Concepts related to chest tube. what is it used for?
-For drainage of fluid, gas, or solids in the lungs (pleura space)
Minimal air leak technique
used by physicians during tracheostomy insertion using pressures less than 25 cm H2O to avoid tracheal dilation
What do you do whenever a dysrhythmia takes place during suctioning?
nurses should stop suctioning and ventilate patient with 100% oxygen
what do you do If resp. rate increases while on a ventilator?
Suction
If secretions are thick
May be due to dehydration. Patient needs fluids
What can you do if pt. hyperventilates while on ventilator (CO2 and PaCO2 drops)?
Decrease the resp. rate on the ventilator and it may help
ABGs
pH: 7.35-7.45 PaO2: 80-100 PaCO2: 35-45 HCO3: 21-28 SaO2: 95-100
If patient has trouble weaning what do you do?
-Stop weaning
What do you do if pt. Self-extubates?
Nurse should manually ventilate patient with 100% oxygen
What do you do if there is a change in the position of an ET tube?
Listen to breath sounds
Mucus
Protective mechanism from the body to help trap dirt, particles, and bacteria
What should the patient do if they are presenting exacerbation of emphysema?
Pursed lip breathing
Surfactant
prevents the alveolar in the lungs from collapsing. Also allows for gas exchange to happen.
Diseases involved in COPD
C.A.E
- chronic bronchitis
- asthma
- emphysema
How long should a patient be suctioned for?
10-15 seconds
What is the first thing to fo when a patient is admitted for shortness of breath?
ASSESS
Interstitial edema in the lungs
leads to thickened alveolar membranes;
- which is alveolar filling up with fluid and failure of gas exchange to occur by diffusion across the membrane
Changes that occur with aging that can affect the respiratory system are things like:
Weakened cough, kyphosis (hunchback), decrease in the body fluid and muscle weakness
One way valves when used for trachs
are used with the intent to allow patients to speak
Process of cleaning a tracheostomy
- gather equip
- position ppt
- don PPE
- Set up equip
- don sterile gloves
- Unlock and remove inner cannula
- place cannula in sterile saline
- cleanse
- rinse
- reinsert
what are antibiotics used for?
to treat infections caused by bacteria
what are obturators used for?
-to help guide the trach tube be inserted.
when patient presents with epistaxis, patient should:
Avoid sneezing, rest until epistaxis threat is gone, and avoid rubbing the nose
early sign of hypoxia
restlessness
Treatments for TB
- Induction phase
- continuation phase
- latent phase
induction phase
-stops active cell division
-IRPE ( 2months)
iosonazide, rifampin, pyrazinamide, ethambutol
Continuation
to eliminate intracellular persisters
- IR (4 months)
- Isoniazide & Rifampin
Latent phase
Isoniazide (6-9 months)
D.O.T
Directly observed therapy
-a strategy used to help control and cure TB
Bacterial pneumonia
Can show thick sputum that may be different coloe (greeN0
Prednisone
glucocorticoid that can be used to treat the inflammatory component of asthma
Symptoms that a patients presents when have active TB
- progessive fatigue
- malaise
- anorexia
- weight loss
- chronic productive cough
- night sweats
- low grade fever during the late afternoon
- pleuritic chest pain
Mechanisms of respirations
3 processes:
-1) ventilation: intake of air in and out due to change of pressure in chest cavity
2) Diffusion/perfusion: oxygen will go in through capillary wall to the capillaries from alveoli
3) cellular respiration
Mechanisms that oxygen is transported in the blood
- adequate perfusion
- satisfactory diffusion
- successful ventilation
adequate perfusion
passage of blood through pulmonary vessels
satisfactory diffusion
Movement of oxygen and carbon dioxide across alveolar capillary membrane
Successful ventilation
exchange of air between alveolar spaces and the atmostphere
What is the nerve that gets stimulated and allows for breathing to happen
phrenic nerve
