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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
what is pleuroctomy
stripping the parietal pleura away from the visceral pleura -produces an inflammation that adheses together
26
what is pleurodesis
instills a substance in pleural space via thoracotomy tube. creates an inflammatory response that scleroses tissue together.
27
intervention for pulmonary embolism
elevate HOB o2 monitor vitals rapid response prep for abg to be drawn
28
s/s for pulmonary embolism
chest pain cyanosis diaphoresis HOTN tachypnea tachycardia distended neck veins
29
steps for extubation
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
what is excessive bubbling mean in water seal chamber
air leak
31
what is intermittnent bubbling in water seal chamber?
it is normal for pneumothorax
32
suction control chamber type of bubble
gentle and continous bubbling
33
collection chamber interventions
70-100ml/hr or bright red- call MD mark drainage every 1- 4 hrs
34
what does it mean if the fluctuation in the water seal chamber stops?
kinked/obstructed/ lung re expanded.
35
suction control interventions
gentle continuous bubble is ok
36
additional interventions for chest tubes
cough/turn/position dont strip/milk chest tube assess respiratory status never clamp unless told
36
what to bring at bedside for chest tubes
-occlusive dressing -chest xray to see if lung expanded -drainage system below the chest and free of kinks -keep clamp
37
what do you if the drainage system cracks/breaks
place the tubey in NS, and change new system
38
what happens if the tubey get disconnected from the patient
apply gauze and have them do valsalva.
39
type of cardiogenic pulmonary edema
left ventricular failure valvular disease mi increases PVP
40
types of noncardiogenic pulmonary edema
ARDS ALI or any damage to lining
41
s/s of ARDS
acute/rapid dyspnea hypoxemia patchy bilateral infiltrates stiff lungs tachypnea
42
what causes ARDS
-ALI (noncardiogenic pulmonary edema) -sepsis -aspiration -drugs -hematologic -high o2 -high smoke -infection -metabolic -disorders(pancreatitis, uremia) -shock -surgery -fat
43
management for ARDS
tx hypovolemia prone position antibiotics PEEP
44
what is the ABG in ARDS (early stage)
respiratory alkalosis
45
how is ARF diagnosed
pH less than 7.35 PaO2 less than 60 PaCO2 more than 4
46
causes for ARF
ventilation failure oxygenation failure
47
causes for ARF
neuromuscular CNS dysfunction chemical depression
48
what causes ventilatory failure
copd\ards
49
what causes oxygenation failure
altitudes hypovolemic shock hypoventilation PE ARDS CHF pneumonia smoke
50
early s/s of ARF
hypoxemia hypercapnia fatigue air hunger tachycardia HTN
51
late s/s of ARF
confusion tachypnea HOTN respiratory arrest diaphoresis cyanosis use accessory muscle decreased breath sounds
52
tx for ARDS
o2 I and O VS assess respiratory status treat the cause of ARF (antibiotics, bronchodilators, etc) turning/cough oral hygiene ROM
53
s/s of pulmonary emboli
chest pain tachypnea/tachycardia crackles hypoxia fever low grade s3, s4 heart sound syncope cyanosis
54
dx for Pulmonary emboli
cta ecg cxray d dimer BNP ABG
55
tx for pulmonary emboli
VTE rick oxygen elevate HOB IV vasopressor anticoag thrombolytics
56
complications of pulmonary emboli
hypoxemia death pleural effusion lung infarction
57
what is pleural effusion
collection of fluid in pleural space which is secondary to another disease
58
s/s of pleural effusion
dyspnea cough chest pain decreased lung sound dull/flat percussion tracheal deviation away from affected side
59
tx for pleural effusion
thoracentesis (needs suck out liquid) chest test (empyema) pleurodesis
60

AH2 Exam 2 (4 decks)

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