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U-world Respiratory > U world Respiratory > Flashcards

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
Q

Peak Flow Meter: Yellow Zone

A

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

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25
Q

Peak Flow meter: Red Zone

A

Medical Alert

Need immediate treatment if level does not return to yellow after rescue meds

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26
Q

Mild-Mod Manifestations of CO poisoning

A

Headache

Confusion

Malaise

Nausea

Dizzy

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27
Q

Severe Manifestations of CO poisioning

A

Seizure

Syncope

Coma

Myocardial ischemia

arrhythmias

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28
Q

Preventing Post Op Pneumonia

A

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
Q

Symptoms of Sleep Apnea

A

Sleed disturbance

snoring

morning headache

daytime sleepiness

difficulty concentrating

forgetfulness

mood changes

depression

30
Q

Interventions for sleep Apnea

A

CPAP machine

limit alcohol

weight loss

avoid sedating meds

Avoid napping during day

Avoid eating at bedtime

31
Q

First Nursing intervention for suspected epiglottis

A

Position child in tripod position on parents lap

32
Q

Peritonsillar Abscess

A

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
Q

Management for Rib Fractures

A

1 Pain Control (IV morphine)

34
Q

Clamping a clients chest tube

A

DO NOT DO

Can cause tension pneumothorax

35
Q

S/S of PE

A

Chest Pain

Dyspnea/hypoxemia

tachypnea/tachycardia

cough

unilateral leg swelling, erythema, or tenderness

36
Q

Pleural Effusion

A

collection of fluid in pleural space preventing lung from expanding fully resulting in ineffective gas exchange

37
Q

Pleural effusion diagnosis

A

Chest x-ray or CT

38
Q

Tx of pleural effusion

A

Thoracentesis

39
Q

S/S of pleural effusion

A

dyspnea

non-productive cough

chest pain w/ respirations

diminished breath sounds

dullness to percussion

decreased fremitus (vibrations transmitted thru body)

40
Q

Interventions to remove secretions

A

Chest physiotherpay

Huff coughing

Increase fluids

Fowlers position

*cough suppressants suppress cough (not remove fluids)

40
Q

Interventions to remove secretions

A

Chest physiotherpay

Huff coughing

Increase fluids

Fowlers position

*cough suppressants suppress cough (not remove fluids)

41
Q

Best indicator of effectiveness of antibiotics

A

White Blood cell count

42
Q

Nursing Steps for Patient with acute Respiratory Distress

A
  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
Q

Priority for dislodged tracheostomy tube

A

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
Q

Pleurisy is characterized by?

A

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
Q

Montelukast

A

Long term asthma control

(not given during an asthma attack0

46
Q

Immediate-acting meds to give during asthma attack

A
  1. Oxygen to maintain sats above 90
  2. Alubterol and ipratropium treatments q20 min
  3. systemic corticosteroids (solumedrol)
47
Q

NSAIDS and Aspirin in asthma patients

A

Can worsen asthma symptoms

48
Q

Steps in using a Peak Flow Meter

A
  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
Q

Greatest Risk factor fro developing Pneumonia

A

Age over 65

50
Q

S/S of Pneumonia

A

Crackles

Chest Pain

SOB

Increased Fremitus

Bronchial breath sounds

Unequal chest expansion

Dullness

51
Q

Do not give ____ to patients with COPD

A

Codeine, Benzos (sedatives)

depresses cough reflex=accumulates secretions=harder to breath

52
Q

Instructions to patient during chest tube removal

A

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
Q

Priority for a “suckling chest wound”

A

cover wound with petroleum glaze taped on 3 sides

(prevents air from entering pleural space)

54
Q

What to never do when suctioning a patient

A

Apply suction when inserting catheter into airyway

(Suction is applied when removing catheter)

55
Q

CPAP

A

prescribed for pts w/ sleep apnea=provides positive pressure to keep airway open

56
Q

a pt on a CPAP O2 sats drop during night. What should nurse first do?

A

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
Q

What is the best indicator of Ventilator-associated pneumonia

A

Positive, purulent sputum culture**

leukocytosis

increased temp

new infiltrates on x-ray

58
Q

Common Adv effects of Codeine

A

Constipation

N/V

ortho hypo

dizzy

59
Q

Interventions on preventing codeine adv effects

A

Increase fluids, fiber, and lax=prevents constipation

Change positions slowly=prevents ortho hypo

take med with food=prevents GI upset

60
Q

Assessment finding of pt with CF that needs immediate action

A

Sudden drop in O2 from baseline

ex: 92%-88% on room air

(indicates mucus plug obstruction)

61
Q

Normal CO2 level

A

35-45

62
Q

elevated Co2 indicates

A

hypercapneic respiratory failure

63
Q

BiPap

A

provides positive pressure oxygen and expels CO2 from lungs

-used in COPD pts when CPAP doesn’t work

64
Q

Submersion Injury

A

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
Q

Immediate action when chest tube becomes dislodged

A

Apply an occlusive sterile dressing on 3 sides

65
Q

Immediate action when chest tube becomes dislodged

A

Apply an occlusive sterile dressing on 3 sides

66
Q

Best indicator of effectiveness of treatment for acute asthma exacerbation

A

increase in O2 saturation (reflects gas exchange)

67
Q

COPD can cause nutritional issues. What are interventions to improve nutritional status

A
  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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