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Foundations 2 > Unit 2- Respiratory > Flashcards

Unit 2- Respiratory Flashcards

1
Q

hypoxemia

A

•low oxygen levels in blood

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2
Q

hypoxia

A

•decreased tissue oxygenation

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3
Q

atelectasis

A
  • alveolar collapse

* causes a reduction in gas exchange b/c reduces surface area

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4
Q

dyspnea

A
  • shortness of breath

* difficulty breathing

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5
Q

tachypnea

A

•rapid respiratory rate

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6
Q

hemoptysis

A

•blood in sputum

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7
Q

paroxysmal nocturnal dyspnea (PND)/sleep apnea

A

•intermittent dyspnea during sleep, causing pt to awaken

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8
Q

orthopnea

A
  • difficulty breathing when lying down

* relieved by sitting up

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9
Q

bronchospasm

A

•narrowing/constriction of bronchial tubes

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10
Q

bronchoscopy

A
  • visualization of larynx, trachea, and bronchi thru flexible or rigid bronchoscope
  • used to visualize abnormalities and obtain biopsies
  • can be done under general or conscious anesthesia
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11
Q

pulmonary fxn tests (PFTs)

A
  • determine lung fxn and breathing difficulties

* measure lung volumes/capacities, diffusion/gas exchange, flow rates/distribution, airway resistance

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12
Q

forced expiratory volume in first second (FEV1)

A

•vol. air blown out as hard and fast as possible during first second of most forceful exhalation

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13
Q

peak expiratory flow (PEF)

A

•fastest airflow rate at any time during expiration

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14
Q

thoracentesis

A
  • surgical perforation of chest wall and pleural space w/ large-bore needle
  • used to obtain specimens, admin meds, remove fld/air
  • local (conscious) sedation
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15
Q

asthma

A

•chronic, intermittent condition with reversible airway obstruction
•caused by allergens, irritants, etc
•leads to…
1. inflammation
2. airway hyperresponsiveness, causing bronchoconstriction

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16
Q

asthma s/s

A
  • audible wheezing (esp. expiration)
  • inc. resp. rate
  • coughing
  • use of accessory muscles
  • barrel chest (severe)
  • hypoxia
  • inc. WBC in allergic
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17
Q

ABG levels in asthmatic

A
  • hypoxemia- decreased PaO2

* hypercarbia- inc. PaCO2 b/c can’t expel

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18
Q

asthma medications

A
  • bronchodilators- inhaler
  • anti-inflam- steroids/leukotriene agonists
  • combo agents- broncho/anti-inflam
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19
Q

pneumonia

A

•excess of fluid in lung, resulting from inflammatory process triggered by infectious organism or inhalation of resp. irritants
•if untreated can lead to sepsis (infection in bloodstream) or empyema
•two types
1. community-acquired (CAP)
2. hospital-acquired (HAP/VAP)

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20
Q

empyema

A

•infection in pleural space causing collection of pus

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21
Q

hospital-aqcuired pneumonia (HAP)

A
  • most often ventilator-associated (VAP)

* preventable w/ strict hand hygiene, oral care q6h (w/ chlorohexadine), HOB > 30°

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22
Q

pneumonia s/s

A
  • flushed, fever, chills
  • chest discomfort
  • myalgia
  • headache
  • cough (w/ sputum)
  • tachy
  • dyspnea (crackles/wheeze)
  • hemoptysis
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23
Q

myalgia

A

•muscle pain

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24
Q

hemothorax

A

•blood accumulation in pleural cavity

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25
Q

pneumothorax

A
  • collapsed lung due to air or gas accumulation in pleural space (b/t lungs and chest wall)
  • have to insert CT b/c pressure on lungs, heart, etc
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26
Q

spontaneous pneumothorax

A

•air accumulation in pleural space, causing lung collapse w/ no evidence of trauma or dz

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27
Q

pleural effusion

A

•fld accumulation b/t pleural layers

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28
Q

chest tube

A

•catheter inserted thru intercostal space to remove air/fld/blood
•restores neg. pressure in pleural space
•attached to water-seal drainage device
•used after chest surgery and lung collapse
•either wall suction or water seal
*under high MD control

29
Q

chest tube placement

A
  • air- anterior lung apex
  • blood/fld- lateral base
  • insertion site covered w/ air-tight dressing
30
Q

Pleur-Evac system

A
  • most common disposable chest tube drainage system

* one piece w/ drainage collection, water seal, and suction regulator chambers

31
Q

drainage collection catheter

A
  • collects fld draining from pt

* measured hourly for first 24 hr

32
Q

water seal chamber

A
  • prevents air from flowing back into pt’s pleural space
  • must have 2cm of H2O
  • one way valve
  • bubbles as air passes thru until it escapes (exhale)
  • fld rise/fall from 2 to 4 cm upon inhalation/exhalation
33
Q

suction regulator chamber

A
  • connected to wall suction (usually 20cm)

* causes continual bubbling

34
Q

bubbling w/ chest tube system

A
  • always occurs when CT is connected to continuous suction
  • bubble w/ only water seal indicates air passing thru chamber w/ higher intrathoracic pressure (exhale, cough, sneeze)
  • excessive bubbling may indicate leak
35
Q

CT implications

A
  • milk tube to move obstruction (need MD order)
  • DON’T clamp (except leak, change, discharge)
  • keep lower than pt chest
  • keep pt in semi-fowlers for pneumothorax
  • keep pt in fowlers for hemothorax/pleural effusion
  • measure fld hourly for first 24 hrs
36
Q

CT complications (notify MD)

A
  • redness/swelling/purulence/bleeding
  • tracheal deviation
  • sudden/increased dyspnea
  • SaO2 < 90%
  • drainage > 70 mL/hr
  • crepitus
  • accidental disconnect (immediately submerge in sterile H2O or cover w/ vasoline gauze)
37
Q

crepitus (subcutaneous emphysema)

A
  • coarse crackling sensation palpated over skin

* indicates air leak into subQ tissue -> pneumothorax

38
Q

dry suction control system

A
  • CT system that allows for high suction pressure
  • used for pts w/ massive air leak, emphysema, viscous pleural effusion, or reduction in pulmonary compliance
  • constant bubbling
39
Q

pneumostat

A
  • mobile CT w/ one-way valve attached directly to tube to collect fld.
  • used for small or partial pneumothorax
  • doesn’t allow for high suction pressures
40
Q

Heimlich valve

A
  • mobile CT w/ one-way flutter valve that allows air to escape, but keeps it from re-entering
  • used for small/partial pneumothorax
  • doesn’t allow for fld. collection or high suction pressures
41
Q

pneumonectomy

A
  • removal of entire lung
  • no upper CT needed b/c no lung to expand
  • no lower CT needed b/c expect fluid to fill empty space
42
Q

acute respiratory distress syndrome

A
  • progressive hypoxemia despite supplemental O2 admin

* initial s/s include restlessness, apprehension, anxiety

43
Q

flail chest

A
  • portion of chest wall pulls inward on inspiration and expands outward on exertion (floats)
  • indicates fracture of 2+ ribs
44
Q

chronic obstructive pulmonary disease (COPD)

A
  • most often caused by smoking
  • other causes include fumes, dust, pollution, genetic disorder
  • two types: emphysema & chronic bronchitis (most have both)
45
Q

emphysema

A
  • type of COPD
  • major changes in lung elasticity and hyperinflation
  • results in dyspnea, tachypnea
46
Q

Chronic bronchitis

A
  • type of COPD
  • inflammation of bronchi/bronchioles
  • results in cough, mucus production, and SOB
47
Q

severe COPD complications

A
  • hypoxemia
  • hypercarbia
  • respiratory acidosis
  • respiratory infection
  • dysrhythmias
  • HF
  • decrease resp. drive (NEVER give > 2 L)
48
Q

indication of tension pneumothorax

A

•tracheal deviation to side opposite of pneumothorax

49
Q

1 preventable cause of prematures dz/death

A

•tobacco use

*Healthy People 2020 goal is to reduce to 12% or less

50
Q

why medication assistance for tobacco use cessation

A 
•relieves withdrawal symptoms
•reduces cravings
•reduces satisfaction from use
•helps control weight gain
*patch, gum, lozenge, inhaler, nasal spray, Zyban, Chantix
51
Q

how does atelectasis reduce gas exchange

A

•reduced alveolar surface

52
Q

pt w/ 2 chest tubes on R side; clients trachea is pointing toward L upper chest. What’s RN’s best action

A

•notify MD or Rapid Response team

53
Q

elderly w/ pneumonia has symptoms of

A

•altered mental status and dehydration

54
Q

which pathophysiological mechanisms of lung parenchyma allows pneumonia to develop?

A

•inflammation

55
Q

atelectasis and brochiectasis indicate…

A

•collapse of portion of airway

56
Q

what finding confirms diagnosis of asthma

A

•inspiratory and expiratory wheezing

57
Q

7 y/o tachypneic, afebrile, RR=38, and nonproductive cough. PT most likely has

A

•acute asthma

58
Q

19 y/o in ED w/ acute asthma attach; RR=44 bpm; acute resp. distress. Which action should RN take first

A

•give bronchiodilator by nebulizer

59
Q

79 y/o w/ bacterial pneumonia who is vegetarian and OCD about germs, What is predisposing factor for pneumonia?

A

•age

60
Q

what data significant from pt w/ pneumonia

A
  • quality of breath sounds
  • chest pain
  • color of nail beds
61
Q

pt w/ bacterial pneumonia is to be started on IV abx. what must be completed first?

A

•sputum culture to determine which abx to use

62
Q

what should be included in plan of care for pneumonia pt?

A

•frequent linen changes b/c likely diaphoretic and at risk for skin breakdown

63
Q

pleuritic chest pain is…

A

•moderate pain that worsens on inspiration

64
Q

which measure most likely to reduce pleuritic chest pain?

A

•teach pt to splint rib cage b/c talking about pain

65
Q

what indicates presence of resp infection in pt w/ asthma

A

•cough productive of yellow sputum

66
Q

30 y/o male w/ stab wound has CT inserted b/c…

A

•CT serve as method of draining blood/fld

67
Q

what are expected findings of CT after thoractomy

A
  • 50 mL drainage in chamber

* drainage system below pt chest

68
Q

continuous bubbling in suction control chamber requires…

A

•no action

Foundations 2 (10 decks)

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