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U world Respiratory Flashcards

1
Q

Theophylline

A

Bronchodilator

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2
Q

Therapeutic Range of Theophylline.

A

10-20 mcg

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3
Q

_____&_______ can dramatically increase theophylline levels (need to avoid using

A

Cimetidine & Ciprofloaxcin

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4
Q

S/S of theophylline Toxicity

A

Headache

Insomnia

N/V

Seizures (Deadly)

Arrhythmias (Deadly)

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5
Q

Theophylline Teaching

A

Avoid caffeine (coffee, cola, chocolate)

Monitor drug levels periodically

Report S/S of toxicity

  • anorexia
  • nausea
  • vomiting
  • restlessness
  • insomnia
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6
Q

S/S of impaired gas Exchange from bacterial infectious process

ex: Bacterial pneumonia

A

SOB

Tachypnea

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7
Q

Refractory Hypoxemia

A

inability to improve oxygenation with increases in oxygen concentration

Hallmark of ARDS

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8
Q

Complication of Tonsillectomy

A

Post-op bleeding

Manifests as:

continuous swallowing and/or coughing from blood

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9
Q

Discharge teaching following Tonsilectomy

A
  • Avoid coughing, clearing throat or blowing nose
  • limit physical activity
  • avoid milk products (coat throat prompting coughing)
  • avoid oral mouth rinses, gargling, or vigorous toothbrushing to prevent irritation
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10
Q

CYSTIC FIBROSIS

A
  • inherited disorder
  • dysfunction of epithelial cells and pancreatic exocrine glands causing mucus plugs to obstruct airways, endocrine ducts, and intestinal linings
  • pancreatic exocrine gland dysfunction leads to inability to break down proteins, carbs, and fats
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11
Q

Plan of care in Cystic Fibrosis

A

-aerobic exercise: improves muscle strength, increases lung capacity, and promotes thinning of airway secretions

-Chest physiotherapy

-social support services

-increased fluid intake

-high fat/high calories diet

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12
Q

Teaching for Pt w/ COPD

A
  • consume high calorie diet
  • seek medical attention for signs of infection: increased sputum, worsening dyspnoea, fever
  • vaccinations: influenza, pneumococcal
  • albuterol for worsening SOB
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13
Q

Priority Intervention for Carbon monoxide poisoning

A

Administer 100% oxygen using nonrebreather mask w/ flow rate of 15L/min

A pulse ox will not be useful in identifying hypoxia in CO poisoning, would need a blood gas sample

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14
Q

First line treatment of latent TB infection

A

Isoniazid

Also combined with other drugs for active TB

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15
Q

Two serious Adv effects of Isoniazid

A

Hepatotoxicity

Peripheral neuropathy

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16
Q

Teaching plan when taking Isoniazid

A

Avoid alcohol

Limit use of hepatotoxic agents (Acetomenaphine)

Take Vit B6 to prevent neuropathy

Avoid aluminum containing antacids (aluminum hydroxide) w/I 1 hour of taking

Report changes in vision

Report S/S of hepatoxcity: jaundice, vomit, dark urine, fatigue

Report S/S of Neuropathy: numbness & tingling

Can cause red/orange discoloration of body fluids (normal)

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17
Q

Environmental interventions to reduce exposure to allergens

A

Athama Pt: avoid carpets in homes, otherwise vacuum DAILY

Dust mite allergens: Wash bed lines 1x/week with HOT water and use special mattress and pillow covers

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17
Q

Purpose of “Pursed Lip Breathing”

A

helps decreases SOB

used in clients with COPD

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18
Q

Steps for Pursed Lips breathing

A
  1. Relax neck and shoulders
  2. Inhale for 2 seconds through nose w/ mouth closed
  3. Exhale for 4 seconds through pursed lips
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19
Q

Clinical Manifestations of Respiratory Failure

A

PaCO2 greater than 45 (hypercapnia & hypoventilation)

PaO2 less than 60 (hypoxemia)

Low PH

Mental Status Changes

Paradoxical Breathing

Absence of wheezing and silent chest

Single word dyspnea (inability to speak)

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20
Q

Contributing Factors to development of COPD

A

Past and Present Tobacco smoking

Occupational exposure to chemicals

Air pollution

Genetics

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21
Q

Methods to mobilize/thin secretions and improve sleep in chronic bronchitis

A

Increase fluids

Cool mist humidifier

Guaifenesin cough suppressant (drink full glass of water with med)

Abdominal breathing with the huff cough technique

chest physiotherapy

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22
Q

Peak Flow Meter

A

Device used to measure degrees of asthma

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23
Q

Peak Flow Meter: Green Zone

A

asthma under control and Peak Expiratory flow (PEF) is 80-100% of personal best

In this zone: no worsening cough, wheezing, or trouble breathing

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24
Peak Flow Meter: Yellow Zone
Means caution, symptoms getting worse; **even on a return to green zone after use of rescue meds** PEF=50-80% Further meds or change In treatment needed
25
Peak Flow meter: Red Zone
Medical Alert Need immediate treatment if level does not return to yellow after rescue meds
26
Mild-Mod Manifestations of CO poisoning
Headache Confusion Malaise Nausea Dizzy
27
Severe Manifestations of CO poisioning
Seizure Syncope Coma Myocardial ischemia arrhythmias
28
Preventing Post Op Pneumonia
Pain Control (Caution w/ opioids) Ambulate w/I 8 hrs after surgery Coughing with splinting Deep breathing and incentive spirometer Fowlers position Swab mouth with chlorhexidine swab q12 hours (mouth care) Turn and reposition q12 hrs Hand hygiene
29
Symptoms of Sleep Apnea
Sleed disturbance snoring morning headache daytime sleepiness difficulty concentrating forgetfulness mood changes depression
30
Interventions for sleep Apnea
CPAP machine limit alcohol weight loss avoid sedating meds Avoid napping during day Avoid eating at bedtime
31
First Nursing intervention for suspected epiglottis
Position child in tripod position on parents lap
32
Peritonsillar Abscess
an emergent complication of tonsillitis that can lead to life-threatening airway obstruction S/S: fever sore throat **trismus (inability to open mouth)** drooling muffled voice deviation of uvula to one side
33
Management for Rib Fractures
#1 Pain Control (IV morphine) #2 Coughing, deep breathing, Incentive Spiro
34
Clamping a clients chest tube
DO NOT DO Can cause tension pneumothorax
35
S/S of PE
Chest Pain Dyspnea/hypoxemia tachypnea/tachycardia cough unilateral leg swelling, erythema, or tenderness
36
Pleural Effusion
collection of fluid in pleural space preventing lung from expanding fully resulting in ineffective gas exchange
37
Pleural effusion diagnosis
Chest x-ray or CT
38
Tx of pleural effusion
Thoracentesis
39
S/S of pleural effusion
dyspnea non-productive cough chest pain w/ respirations diminished breath sounds dullness to percussion decreased fremitus (vibrations transmitted thru body)
40
Interventions to remove secretions
Chest physiotherpay Huff coughing Increase fluids Fowlers position \*cough suppressants suppress cough (not remove fluids)
40
Interventions to remove secretions
Chest physiotherpay Huff coughing Increase fluids Fowlers position \*cough suppressants suppress cough (not remove fluids)
41
Best indicator of effectiveness of antibiotics
White Blood cell count
42
Nursing Steps for Patient with acute Respiratory Distress
1. Place in high fowlers (promotes oxygenation) 2. Perform oropharyngeal suctioning (prevents aspiration) 3. Admin 100% O2 by nonrebreather mask 4. Assess lung sounds 5. notify HCP
43
Priority for dislodged tracheostomy tube
Insert new tube using bedside obturator\* (If tube can't be reinserted=cover stoma with sterile occlusive dressing and provide ventilation with bag-valve mask)
44
Pleurisy is characterized by?
stabbing chest pain increasing with inspiration or cough due to inflammation Can hear **pleural friction rub (MUST REPORT)** it is a complication of pneumonia
45
Montelukast
Long term asthma control (not given during an asthma attack0
46
Immediate-acting meds to give during asthma attack
1. Oxygen to maintain sats above 90 2. Alubterol and ipratropium treatments q20 min 3. systemic corticosteroids (solumedrol)
47
NSAIDS and Aspirin in asthma patients
Can worsen asthma symptoms
48
Steps in using a Peak Flow Meter
1. Position indicator on flow meter scale to lowest value and assume upright position 2. inhale deeply, place mouthpiece in mouth, and use lips to create seal 3. exhale as quickly and completely as possible 4. repeat 2 more times w/ 5-10 second rest periods 5. record highest of 3 measures in log
49
Greatest Risk factor fro developing Pneumonia
Age over 65
50
S/S of Pneumonia
Crackles Chest Pain SOB Increased Fremitus Bronchial breath sounds Unequal chest expansion Dullness
51
Do not give ____ to patients with COPD
Codeine, Benzos (sedatives) depresses cough reflex=accumulates secretions=harder to breath
52
Instructions to patient during **chest tube removal**
**Take a deep breath, hold it, and bear down (valsava maneuver)** -prevents air from re-entering causing a pneumothorax **Site then converted with a sterile air-tight petroleum jelly guaze** **Post x-ray needed**
53
Priority for a “suckling chest wound”
cover wound with petroleum glaze taped on 3 sides (prevents air from entering pleural space)
54
What to never do when suctioning a patient
Apply suction when inserting catheter into airyway (Suction is applied when removing catheter)
55
CPAP
prescribed for pts w/ sleep apnea=provides positive pressure to keep airway open
56
a pt on a CPAP O2 sats drop during night. What should nurse first do?
**Must make sure straps are tight and hold mask in place** **If loose=air leaks and loss of positive pressure** **ex: O2 sats drop during the night**
57
What is the best indicator of Ventilator-associated pneumonia
**Positive, purulent sputum culture\*\*** leukocytosis increased temp new infiltrates on x-ray
58
Common Adv effects of Codeine
Constipation N/V ortho hypo dizzy
59
Interventions on preventing codeine adv effects
Increase fluids, fiber, and lax=prevents constipation Change positions slowly=prevents ortho hypo take med with food=prevents GI upset
60
Assessment finding of pt with CF that needs immediate action
Sudden drop in O2 from baseline ex: 92%-88% on room air **(indicates mucus plug obstruction)**
61
Normal CO2 level
35-45
62
elevated Co2 indicates
hypercapneic respiratory failure
63
BiPap
provides positive pressure oxygen and expels CO2 from lungs -used in COPD pts when CPAP doesn't work
64
Submersion Injury
possible pt aspirated can least to respiratory compromise observe for at least 6 hours decreased RR or increased effort of breathing = respiratory fatigue ex: pt who received CPR after injury, RR dropped from 61-18 (PRIORITY)
65
Immediate action when chest tube becomes dislodged
Apply an occlusive sterile dressing on 3 sides
65
Immediate action when chest tube becomes dislodged
Apply an occlusive sterile dressing on 3 sides
66
Best indicator of effectiveness of treatment for acute asthma exacerbation
increase in O2 saturation (reflects gas exchange)
67
COPD can cause nutritional issues. What are interventions to improve nutritional status
1. Drink fluids **between meals** (rather than before or during) 2. eat small frequent meals high in calories and protein 3. perform oral hygiene before meals 4. Avoid exercise 1 hour before and 1 hour after eating 5. avoid gas forming foods (broccoli, beans, cabbage, carb beverages)

U-world Respiratory (1 decks)

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