Week 2 Resp

Question 1

Obstruction of pulmonary artery or branch by blood clot, air, fat amniotic fluid, or septic thrombus is known as

Answer 1

PE

Question 2

In PE, what happens with obstructed area?

Answer 2

Diminished or absent blood flow

Area is ventilated, but no gas exchange occurs

237000-nonfatal
294000- fatal

Question 3

What is the pathology of PE?

Answer 3

Inflammatory process causes regional blood vessels to constrict, further increasing
1. Pulmonary vascular resistance, 2.Pulmonary artery presure
3. RIght Ventricular workload

Question 4

In PE what may happen?

Answer 4

Ventilation-perfusion imbalance, RVF, and shock can occur

Question 5

Name the Risk Factors for PE

Answer 5

Venous Stasis- d/t immobility
Hypercoagulability
Venous endothelial disease
Certain disease states- heart disease, trauma, postop/ postpartum, DM, COPD
-Pregnancy, obesity, oral contraceptives, constrictive clothing
Previous hx of thrmobophlebitis
Long bone fxs

Question 6

What are the manifestations of PE?

Answer 6

Restless, anxiety, agitation
- Tachycardia, tachypnea, hypotension, fever
- Chest pain
-Hemoptysis
- Mental staus change
- decreased LOC
- Cyanosis
- Hx of thromboembolism
- Crackles

Question 7

Describe how a PE forms

Answer 7

1. Embolus breaks off
2. Embolus travels through the vein to the lung
3. Embolus travels through heart and gets dislodged in blood vessel of the lungs

Question 8

How to prevent PE

Answer 8

Exercises to avoid venous stasis
Early ambulation
Anticoagulant therapy
SCDs

Question 9

Tx of PE

Answer 9

Measures to improve resp., CV status
ANticoagulation, thrombolytic therapy

Question 10

Mangement of PE includes

Answer 10

O2
Anticoagulants
Embolectomy
Thrombolytic therapy
Intracaval Filter

Question 11

Phamacology for PE includes anticoags which are?

Answer 11

Heparin-P
Enoxaparin
Daltepaarin
Fondaparinux
Low molecular weight
SubQ vs IV

Question 12

What vitamin k anatgonist can you give for PE?

Answer 12

Warfarin

Question 13

Direct thrombin inhibitors for PE include

Answer 13

Dabigtran
Argatroban
Bivalirudin
Desirudin
Rivaroxaban

Question 14

Factor Xa Inhibitors for PE include

Answer 14

Rovorxaban
Apixaban
Edoxaban

Question 15

Antiplatlet drugs for PE include

Answer 15

Adenosine diphosphate receptor antagonists- Clopidogrel

Others- Aspirin, abciximab, dypyridamole

Question 16

Thrombolytic drugs for PE include

Answer 16

Alteplase, Drotregogin alfa, reteplase, streptokinse, tenecteplase, urokinase

Question 17

Drugs to control bleeding include

Answer 17

Aminocaproic acid
Prtoamine Sulfate
Tranexamic acid
Vitamin K- phytonadione

Question 18

Interferes with the activation of fibrin and fibrinogen from thrombin and keeps the clots from forming

Answer 18

Heparin

Question 19

Heparin prevents fibrin from what?

Answer 19

Clot and helps prevent DVT and PE. Prevents new clots from forming.

Question 20

Rapid acting
IV or SUBq
Check Aptt
Need bleeding precautions

Answer 20

Heparin

Question 21

RANDI
Bleeding precautions means what?

Answer 21

Razor-electric
A-NO
N- Needles small gauges
D- Decrease needle sticks
I- Protect from injury

Question 22

With Heparin observe for ?

Answer 22

Hematuria
Nose Bleeds
Gingival bleeding
Bruising

Implement when using anticoags
Liver disease present
decreased platelets
Hemophilia present
When using thrombolytic medications

Question 23

IVC umbrella filter used for

Answer 23

Capturing a clot

Question 24

Name examples of chest trauma

Answer 24

Blunt trauma
Sternal, rib fractures
Flail chest
Pulmonary contusion; heart
Penetrating trauma
Hemothorax
Pneumothorax
Spontaneous or simple
Traumatic
Tension pneumthorax

Question 25

Flail chest

Question 26

Flail chest

Question 27

Air collected in the chest is known as

Answer 27

Pneumothorax

Question 28

Air collected between the lung and chest wall is called what?

Answer 28

Small pneumothorax

Question 29

A lot of air that collects and pushes on the lung and heart is called?

Answer 29

Large Pneumothorax

Question 30

What do we usually treat a large pneumothorax?

Answer 30

Use a chest tube

Question 31

Air enters the pleural space and disrupts the negative pressure and causes the lungs to collapse

Answer 31

Pneumothorax

Question 32

Air enters the pleural space, but it can't exit Accumulated air compresses the lungs and shifts the mediastinum Elevated intrathoracic pressure lowers venous return and consequently, cardiac output, Shock.

Answer 32

Tension

Question 33

Manifestations of Pneumothorax includes?

Answer 33

Dyspnea Tracheal deviation toward unaffected side Diminished breath sounds on affected side Percussion dullness on affected side unequal chest expansion decreases on affected side Crepitus over the chest CXR ABG with decreased PO2

Question 34

Chest drainage is used to treat what?

Answer 34

Spontaneous and traumatic pneumothorax/ hemothorax - Establishes negative pressure, drain fluid/ air, helps facilitate expansion

Question 35

Name the types of drainage systems

Answer 35

1.Traditional water seal- Wet suction- Peura Vac 2. Dry suction Water Seal 3. Dry Suction- No water seal

Question 36

This collects drainage and is measurable output.

Answer 36

Drainage Chamber

Question 37

Air exits and prevents air from flowing back to chest. Filled to 2cm mark to maintain underwater seal. Fluctuates as client breathes.

Answer 37

Water Seal Chamber

Question 38

Re-establish negative intrathoracic pressure; fill with water to proper level- 20 cm Some use dry suction- No water

Answer 38

Suction Control Chamber

Question 39

Know the parts of Drainage Collection system and

Answer 39

Pneumostat and Heimlich Valve

Question 40

Is tidaling normal in management of chest tube?

Answer 40

Yes normal in 2ml water seal Make sure to maintain occlusive dressing Secure with heavy tape at the connection site

Question 41

Where should the chest tube be located?

Answer 41

Below the level of chest. Never clamp without an order.

Question 42

It is important to maintain water seal chamber fluid level?

Answer 42

True Maintain water inn suction control chamber Monitor output measure the amount and color Monitor Resp. status

Question 43

Position client and chambers Multiple tubes and pleura vacs Do not clamp, strip Keep hemostats, sterile water, and dressing supplies Complications: Leaks, removal ( 3 side dressing, clamp)

Answer 43

Managements of Chest Tube

Question 44

Know Pleura Vac Setup and Maintenance

Answer 44

Chest tube setup and maintenance Chest Drain Education Chest Tubes Nursing Care Management Assessments NCLEX Review - Youtube