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AH2 Exam 2 > Ventilation/Chest tubes (saunders) > Flashcards

Ventilation/Chest tubes (saunders) Flashcards

1
Q

cause for rib fracture

A

blunt chest truama

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2
Q

complications for rib fracture

A

pneumothorax
hemothorax
pulmonary contusion
pneumonia

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3
Q

s/s of rib fracture

A

pain at site
shallow respirations
client splints using pillow

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4
Q

interventions for rib fracture

A

ribs usually reunite
fowlers position
intercostal nerve block

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5
Q

causes of flail chest

A

blunt chest truama

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6
Q

s/s of flail chest

A

PARADOXICAL RESPIRATIONS
cyanosis
tachycardia
HOTN
severe chest pain

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7
Q

interventions for flail chest

A

fowlers
o2
cough and deep breathing
bed rest
PEEP
pain med

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8
Q

pulmonary contusion is what

A

interstitial hemorrhage

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9
Q

what is a major complication of pulmonary contusion

A

ARDS
crackles
wheezes
restlessness
hypoxemia

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10
Q

interventions for pulmonary contusion

A

fowlers position
o2
bed rest
give fluids
PEEP

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11
Q

what is pneumothorax

A

air in pleural space

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12
Q

what is open pneumothorax

A

opening of chest wall allows positive pressure into pleural space

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13
Q

what is tension pneumothorax

A

because by blunt chest injury/mechanical ventilation with PEEP when buildup of positive pressure in pleural space

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14
Q

interventions for pneumothorax

A

dressing over wound
o2
fowlers position

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15
Q

s/s for pneumothorax

A

cyanosis
HOTN
TRACHEAL DEVIATION TO UNAFFECTED SIDE
chest pain
distended neck veins

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16
Q

pneumonia is what

A

infection of pulmonary tissue causing inflammation to lungs

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17
Q

what will xray show in pneumonia

A

consolidation or pulmonary infiltrates

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18
Q

s/s for pneumonia

A

high temp
chills
myalgia
tachycardia,tachypnea
rhonci, wheezes

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19
Q

interventions for pneumonia

A

o2
encourage cough and deep breathing
IS
change position
nasotracheal suctioning
high kcal
high protein
bronchodilators
cough suppressants
mucolytic agents

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20
Q

client education for pneumonia

A

importance rest
proper nutrition
increase fluids to 3L

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21
Q

what is pleural effusion

A

collection of fluid in pleural space

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22
Q

s/s of pleural effusion

A

progressive dyspnea
dry/non productive cough
tachycardia
decreased breath sounds
elevated temp
pleuritic pain

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23
Q

what will show in the chest xray/ct scan

A

pleural effusion and a mediastinal shift away from the fluid if effusion more than 250 ml

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24
Q

interventions for pleural effusion

A

fowlers position
cough and deep breathing
prep for thoracentesis
pleurectomy
pleurodesis

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25
Q

what is pleuroctomy

A

stripping the parietal pleura away from the visceral pleura
-produces an inflammation that adheses together

26
Q

what is pleurodesis

A

instills a substance in pleural space via thoracotomy tube. creates an inflammatory response that scleroses tissue together.

27
Q

intervention for pulmonary embolism

A

elevate HOB
o2
monitor vitals
rapid response
prep for abg to be drawn

28
Q

s/s for pulmonary embolism

A

chest pain
cyanosis
diaphoresis
HOTN
tachypnea
tachycardia
distended neck veins

29
Q

steps for extubation

A

hyperoxygenate prior
semi fowler
deflate cuff: have client inhale and at peak inspiration, remove the tube and suction as you leave the throat.
apply 02
assess stridor
hoarseness/sore throat is normal

30
Q

what is excessive bubbling mean in water seal chamber

A

air leak

31
Q

what is intermittnent bubbling in water seal chamber?

A

it is normal for pneumothorax

32
Q

suction control chamber type of bubble

A

gentle and continous bubbling

33
Q

collection chamber interventions

A

70-100ml/hr or bright red- call MD
mark drainage every 1- 4 hrs

34
Q

what does it mean if the fluctuation in the water seal chamber stops?

A

kinked/obstructed/ lung re expanded.

35
Q

suction control interventions

A

gentle continuous bubble is ok

36
Q

additional interventions for chest tubes

A

cough/turn/position
dont strip/milk chest tube
assess respiratory status
never clamp unless told

36
Q

what to bring at bedside for chest tubes

A

-occlusive dressing
-chest xray to see if lung expanded
-drainage system below the chest and free of kinks
-keep clamp

37
Q

what do you if the drainage system cracks/breaks

A

place the tubey in NS, and change new system

38
Q

what happens if the tubey get disconnected from the patient

A

apply gauze and have them do valsalva.

39
Q

type of cardiogenic pulmonary edema

A

left ventricular failure
valvular disease
mi
increases PVP

40
Q

types of noncardiogenic pulmonary edema

A

ARDS
ALI
or any damage to lining

41
Q

s/s of ARDS

A

acute/rapid dyspnea
hypoxemia
patchy bilateral infiltrates
stiff lungs
tachypnea

42
Q

what causes ARDS

A

-ALI (noncardiogenic pulmonary edema)
-sepsis
-aspiration
-drugs
-hematologic
-high o2
-high smoke
-infection
-metabolic -disorders(pancreatitis, uremia)
-shock
-surgery
-fat

43
Q

management for ARDS

A

tx hypovolemia
prone position
antibiotics
PEEP

44
Q

what is the ABG in ARDS (early stage)

A

respiratory alkalosis

45
Q

how is ARF diagnosed

A

pH less than 7.35
PaO2 less than 60
PaCO2 more than 4

46
Q

causes for ARF

A

ventilation failure
oxygenation failure

47
Q

causes for ARF

A

neuromuscular
CNS dysfunction
chemical depression

48
Q

what causes ventilatory failure

A

copd\ards

49
Q

what causes oxygenation failure

A

altitudes
hypovolemic shock
hypoventilation
PE
ARDS
CHF
pneumonia
smoke

50
Q

early s/s of ARF

A

hypoxemia
hypercapnia
fatigue
air hunger
tachycardia
HTN

51
Q

late s/s of ARF

A

confusion
tachypnea
HOTN
respiratory arrest
diaphoresis
cyanosis
use accessory muscle
decreased breath sounds

52
Q

tx for ARDS

A

o2
I and O
VS
assess respiratory status
treat the cause of ARF (antibiotics, bronchodilators, etc)
turning/cough
oral hygiene
ROM

53
Q

s/s of pulmonary emboli

A

chest pain
tachypnea/tachycardia
crackles
hypoxia
fever low grade
s3, s4 heart sound
syncope
cyanosis

54
Q

dx for Pulmonary emboli

A

cta
ecg
cxray
d dimer
BNP
ABG

55
Q

tx for pulmonary emboli

A

VTE rick
oxygen
elevate HOB
IV
vasopressor
anticoag
thrombolytics

56
Q

complications of pulmonary emboli

A

hypoxemia
death
pleural effusion
lung infarction

57
Q

what is pleural effusion

A

collection of fluid in pleural space which is secondary to another disease

58
Q

s/s of pleural effusion

A

dyspnea
cough
chest pain
decreased lung sound
dull/flat percussion
tracheal deviation away from affected side

59
Q

tx for pleural effusion

A

thoracentesis (needs suck out liquid)
chest test (empyema)
pleurodesis

60
Q
A

AH2 Exam 2 (4 decks)

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