test 1! Flashcards
difference between rhonchi and rales
rhonchi is long pitched sounds, snoring or rattle like sounds.
rales are fine crackles/popping sound; similar to velcro being pulled apart
when would you here rhonchi sounds
(COPD), bronchiectasis, pneumonia, chronic bronchitis, or cystic fibrosis
Stridor, Grunting, Sub Q, Wheezing
Laryngeal-tracheal
what all does an ABG measure
oxygen status
acidity of the blood
HCO3 in arterial blood
acid-base balance
To detect early signs or symptoms of inadequate oxygenation, the nurse would examine the patient for
Apprehension and restlessness
blood studies
CBC, ABG
what is an assessment
anytime you’re getting new information or gathering information from a patient
monitors exhaled CO2
Capnography ; much better tool than pulse ox
says whether the RBC are saturated and how much
pulse ox
if someone has been exposed to carbon monoxide what is a useless tool at that point
pulse ox
most commonly performed radiological test
chest x ray
Provides anatomical location and appearance of the lungs
chest x ray
Direct Visualization of the larynx, trachea and bronchi with a fiberoptic bronchoscope
bronchoscopy
removal of fluid
centesis
Removal of fluid or air from the pleural space via a transthoracic aspiration
Thoracentesis
looks for mismatches between ventilation and perfusion
v and p scan ; usually done for pulmonary embolism
Used to evaluation lung function with spirometer
pulmonary function; used for obstructive pulmonary disease
what do you use the pulmonary function test for
COPD and asthma patients; not invasive!!
whats associated with a deviated septum
allergies
with CSF leaks what are we worried about
meningitis
what to do for a nasal fracture
maintain airway in upright position
give ice for swelling
no hot showers
give tyelnol but no NSAIDS! (can increase bleeding)
differences in nasal surgery
rhinoplasty- cosmetic surgery
Septoplasty- medical surgery
what to teach patient after having nose surgery
blowing nose, avoid pools, avoid strenuous activities
what are we worried about with epistaxis
observe for respiratory distress. posterior bleeds are hard to stop
what does sinusitis effect
maxillary and frontal sinuses
whats important nursing intervention for a person with sinusitis
keeping them hydrated because they are losing fluids through secretions
Can be viral, bacterial or fungal
pharyngitis
what do we worry about with pharyngitis
paratonsil or abscess
White, irregular patches suggest
fungal infection with Candida Albicans; yeast infection
what kind of organism is a yeast infection
opportunistic organism; meaning it doesn’t cause infection unless it has the opportunity to do so
what do we treat strep with
penicillin
what do we treat fungal pharyngitis with
nystatin
Complication of acute pharyngitis or acute tonsillitis
Peritonsilar Abscess
influenza deaths occur in what age group
60 or older
upper airway sound that means obstruction
stridor
unconscious patient what do you do first
jaw thrust to open the airway and to stabilize the cervical spine
risk factors for OSA
obesity, short and wide neck, and large uvuvla
direct risk factors of having OSA
stroke, hypertension, heart failure,
profusely sweating
DIAPHORESIS
2 viral infections that are most overprescribed
acute bronchitis and sinusitis
48-72 hours after intubation
ventilator associated pneumonia
Within 48 hrs or longer after admission
hospital acquired
Encompasses 3 forms (HAP, VAP, & HCAP)
medical care associated
In hospital for 2 days/longer w/in 90 days, resided in long-term care facility, IV anti bx, chemo, or wound care w/in 30 days, attended hospital or dialysis clinica
health care associated
an older adult who is newly confused, what should you think
infection first -UTI and/or pneumonia
increased fremitus means
increased vibrations
what is a test you can do on your patient with pneumonia while listening to lung sounds
egophony ; E sounds turn to A
Most common bacterial infection WORLDWIDE
TB
how is TB transmitted
airborne precautions- N95 mask
when is a TB patient not considered contagious
when they’ve had 3 negative AFB smears
whats the main sign of active TB
persistent cough, also night sweats, fever, chills
what is the TB test
mantoux
most common origin for a pulmonary embolism
DVT
what is the priority for a person with a PE
put them on an anticoagulant- heparin/coumadin
thrombolytics
they go in and break up clots; can cause bleeding
ptt, inr, bnp labs
know values
keeps clot from enlarging, prevents formation of new clots
heparin
lab value to look for when taking heparin
ptt
started on third day of heparin use
Coumadin
lab value to look for when taking coumadin
inr
if someone has heart failure what lab are you interested in
BNP
normal inr
0.8-1.2
therapeutic inr
2-3
Which drug is INR used to determine dosing?
o Warfarin
o Ptt goes with heparin
normal ptt
21-35
antidote for heparin
protamine sulfate
antidote for warfarin
vitamin k
1 trigger for asthma
respiratory infections followed by allergies
what is albuterol given for
patients with asthma; it dilates the bronchial tube so more air can move through
asthma is
an unpredictable course
what are people with asthma on a corticosteroid
because inflammation is one of their major problems; corticosteroid helps with inflammation; acute exasterbation
how much volume of air a person is getting out
peak flow meter
how much volume of air a person is keeping in
incentive spirometry
what does a spacer for an inhaler do
it helps trap the medicine so if patient didn’t get all of it on the first puff they will on the second; every patient with an inhaler should be prescribed a spacer
someone with an asthma attack, if not treated they can end up having
respiratory acidosis
preventable and treatable disease but not reversible
copd
largely reversible airflow limitation
asthma; if we dont treat patients appropriately then it can become irreversible
cor pulmonale
right sided heart failure ; copd complication
4 or more L of nasal can requires
humidifier
upper air way can’t get air in
stridor
is lower respiratory can’t get air out
wheezing; asthma and copd
