Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS112 > Week 4 Respiration > Flashcards

Week 4 Respiration Flashcards

1
Q

What flow range can you administer with a Nasal Cannula?

A
  • 1L-2L (24-30%)
  • 3-4L (30-38%)
  • 5-6L (38-44%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When do you attach a humidifier for NC?

A

>4L flow rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the flow range for a Simple Face Mask?

A

8-12L (35-60%)

6-10L?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the flow range for a partial non-rebreather?

A

6-10L (40-60%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the flow range for a 100% non-rebreather?

A

8-15L (60-100%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Venturi Mask flow range?

A
  • Varies w/ adapter valve (24%-65%)
  • 2-15L
  • Usually percentages are used not LPM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some risks that result from various O2 therapies?

A
  • NC can cause skin break down behind ear
    • Dry air can irritate nose
  • All mask type O2 devices can have a risk of aspiration if pt is nauseous and throws up with mask on
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Asthma?

A
  • Disorder of bronchial airways
  • Periods of reversible bronchospasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the etiology and risk factors of Asthma?

A
  • May be inherited
  • Environmental factors: allergens, smoke, foods, dust, etc
  • excitatory states
  • exercise
  • changes in temp
  • strong odors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does a patient w/ asthma undergo (clinical manifestations)?

A
  • Shortness of breath (dyspnea)
  • chest tightness
  • wheezing on expiration
  • WOB
    • nasal flaring
    • accessory muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the pathophysiology of Asthma?

A
  • Chronic inflammation
  • mucosal edema/secretion
  • airway inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How and why does airway constriction and capillary dilation occur?

A
  • mast cells release chemical mediators of inflammation (histamine and prostaglandins for ex) inducing capillary dilation to attempt to wash away allergen
  • Same chemicals also promot bronchoconstriction to close airway in attempt to prevent inhalation of more allergen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the difference between the late and early phase of Asthma?

A
  • In general both have chemical mediators that induce an airway response
  • In late phase, however, other inflammatory cells are attracted that create a self-sustaining cycle of obstruction and inflammation
  • causes hyper responsiveness of airways to triggers such as cold weather
  • delayed rxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why does the O2 sat of an asthma patient still remain normal?

A
  • issue w/ air trapping
  • can inhale not exhale for the most part
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the classifications of Asthma?

A
  • mild intermittent (< 2x per week)
  • mild persistant (>2x per week, <1 per day)
  • moderate persistent (daily, affects activity)
  • severe persistent (contiual symptoms, frequent exacerbations)
  • status asthmaticus (severe, life threatening, unresponsive to meds, paradoxal pulse, pneumothorax, acidosis can begin, cardiac arrest)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What things do we need to address in order to medically manage asthma patient?

A
  1. airway spasm
  2. mucous production
  3. inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can you reverse airway spasm in asthma pts?

A
  • administer Beta-agonsists
    • dilate airways
  • nebulized atropine
    • anticholinergic blocks parasympathetic system
  • IV steroids
    • decrease inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can you control inflammation in Asthma pts?

A
  • inhaled corticosteroids
    • prevents mast cell from emptying/ attracting inflammatory mediators
    • reduces edema/spasms
  • mast cell stabilizers
    • surpresses bronchoconstrictive substance release
  • leukotriene modifiers
    • block action of leukotrienes (cause of smooth muscle constriction, vascular permeability, edema or airway mucosa, and attract eosinophils which promote inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are three possible nursing diagnoses for Asthma?

A
  1. ineffective breathing pattern
  2. ineffective airway clearance
  3. impaired gas exchange
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What outcomes would result from the RN Dx of ineffective breathing pattern?

A
  • improved breathing patterns
  • RR w/n normal limits
  • decreased dyspnea
  • ” nasal flaring
  • ” accessory muscles
  • “anxiety
  • return of ABG levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are outcomes for the RN Dx ineffective airway clearance?

A
  • client will have effective airway clearance AEB decreased inspiratory/expiratory wheezing/ other breath sounds, and decrease coughin
  • regular RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the outcomes for the RN Dx impaired gas exchange?

A
  • adequate gas exchange w/ O2 sat >94%/ PaO2 >80%
  • normal skin color
  • same as ineffective airway clearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are possible interventions for RN Dx of ineffective breathing pattern?

A
  • assessment
  • position of comfort: semi-fowlers position
  • O2 therapy
  • nebulizer treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the possible interventions of RN Dx of ineffective airway clearance?

A
  • suctioning
  • sputum eval/culture
  • encourage fluids
  • position changes
  • oral care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the possible interventions of RN Dx impaired gas exchange?

A
  • monitor pulse ox
  • assess lung sounds
  • O2 therapy
  • admin meds
  • reassess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are some medications for asthmatics?

A
  • Albuterol
    • rescue Inhaler
  • Salmeterol
    • long acting inhaler
  • Fluticasone
    • inhaled corticosteroid
  • Cromolyn
    • mast cell stabilizer
  • Singular
    • leukotriene modifier
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the etiology and risk factors for chronic bronchitis?

A
  • irritants in cigarrette smoke
  • chronic respiratory infections
    • sinusitis
    • bronchitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the pathophysiology of chronic obstructive bronchitis?

A
  • Inflammation of bronchi
  • Mucus
  • chronic cough
  • 3months of year for 2 years
  • Decreased FEV1/FVC ratio
  • Increase in size and number of submucous glands
  • Increased number of goblet cells
  • Impaired ciliary fxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What causes the SOB in chronic bronchitis?

A
  • airways collapse because of thick mucous and inflamed brochi
  • reduced alveolar ventilation
  • increase PaCO2 retention
  • decrease PaO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why would a patient with bronchitis be more susceptible to infection

A
  • impaired mucociliary fxn
  • causes even more mucous production and thick inflamed bronchial walls
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the clinical manifestations of chronic bronchitis?

A
  • productive cough
  • decreased exercise tolerance
  • wheezing, rhonchi, moist breath sounds
  • Barrel chest
  • SOB
  • prolonged expiration
  • copous sputum
  • frequent pulmonary infections
  • chronic hypoxemia/hypercapnia
32
Q

Why would someone appear puffy with chronic bronchitis?

A

Use of steroids to treat inflammation

33
Q

Which nursing diagnosis from those presented w/ Asthma would be the priority diagnosis for Chronic Bronchitis?

A
  • ineffective airway clearance based on the fact that mucous is overproduced with these type of pts
34
Q

What is the pathophysiology of emphysema?

A
  • alveolar walls destroyed
  • permanent over-distention of air spaces
  • air passages obstructed
  • destruction of walls between alveoli
  • partial airway collapse (crackles)
  • loss of elastic recoil
  • bleb formation
  • increased ventilatory dead space
35
Q

Why does WOB increase w/ emphysema pts?

A
  • less fxnl lung tissue to exchange O2&CO2
  • decreased O2 perfusion due to destruction of pulm capillaries
36
Q

What are the clinical manifestations of emphysema?

A
  • progressive DOE
  • thin appearance
  • use of accessory muscles
  • chest is hyperresonant to percussion
  • CXR shows over inflation and flattened diaphragms
  • normal ABG’s until latter stages
  • enlarged heart/RV
  • cyanosis
  • clubbed fingers
  • pitting peripheral edema
  • tachypenea (fast RR)
  • WOB
37
Q

Which nursing diagnosis for asthma would be the priority diagnosis for emphysema?

A

Impaired gas exchange RT destroyed alveolar fxn

38
Q

What are the complications of COPD?

A
  • CB
    • infections more common
  • Emphysema
    • spontaneous pneumothorax more common
  • Both
    • infections
    • acute respiratory failure
    • worsens at night
    • spontaneous pneumothorax
39
Q

What things should one address when attempting to manage COPD?

A
  • improve ventilation
  • facilitate removal of bronchial secretion
  • prevent complications
  • remove bronchial secretions
    *
40
Q

How can we improve ventilation in COPD pt?

A
  • bronchodilators
  • anticholinergic agents
  • theophylline
  • corticosteriods
  • O2
41
Q

How can we remove bronchial secretions in COPD patients?

A
  • pulm hygiene
  • bronchodilators
  • postural drainage
  • chest physiotherapy
  • positive pressure air flow (Bipap or CPAP)
42
Q

How can we prevent complications in COPD pts?

A
  • treat edema
    • steroids; bronchial meds
  • promote exercise
  • home O2
  • breathing exercises
    • diaphragmatic breathing
    • pursed lip breathing
43
Q

How can you assess the management of the COPD pt?

A
  • review hx for COPD dx source
  • assess resp muscles/degree of respiratory distress
  • assess ability to speak in full sentences
  • baseline O2 sat/RR/ABGs
  • LOC
  • lung sounds
44
Q

What are the possible RN Dx for COPD?

A
  • impaired gas exchange RT decreased ventilation/mucus plugs
  • ineffective airway clearance RT excessive secretions and ineffective coughing
  • anxiety RT acute breathing difficulties/fear of suffocation
  • activity intolerance
  • imbalanced nutrition
  • distrubed sleep pattern
45
Q

What are the desired outcomes for COPD pts?

A
  • adequate gas exchange AEB:
    • ABG values PaO2>60%
    • ph w/n normal limits 7.35-7.45
    • PaCO2<50%
    • O2 Sat >90%
    • minimal anxiety
    • LOC at baseline
  • improved airway clearance AEB effective cough/patent airway
  • increase in psychological comfort/ demonstrate effective coping mechanisms
  • improved activity tolerance AEB maintaining realistic activity level and demonstrating energy conservation techniques
  • eat 75% of meals and maintain normal body weight
  • adequately rested
46
Q

What are some RN Interventions for COPD pts?

A
  • monitor RR, pattern, O2 sat
  • admin. O2
  • adjust positioning of pt
  • meds
  • recognition of decreasing resp fxn
  • lung sounds every 2-8 hrs
  • hydration
  • supervise cough techniques
  • IS
  • oral care
  • paced activity w/ rests
    *
47
Q

What is pneumonia?

A
  • inflammatory process in the parenchyma
  • increase in interstitial/alveolar fluid
  • 2nd most common HAI
48
Q

What is the etiology and risk factors for pneumonia?

A
  • bacterial
  • virus
  • mycoplasms
  • fungus
  • age, hx of smoking, URI, intubation, prolonged immobility
  • aspiration of food, fluids, vomit
  • inhalation of toxic air
  • immunosupressive therapies
  • malnutrition
  • dehydration
  • chronic disease states
49
Q

What is the pathophysiology of pneumonia?

A
  • inflammatory pulm response to offending agent
  • distruption of mechanical defenses of cough/ ciliary motility
  • inflamed/fluid filled alveolar sacs cannont exchange O2
50
Q

What are the clinical manifestations of pneumonia?

A
  • fever(elderly might not), chills, sweats
  • pleuritic chest pain
  • cough
  • sputum (green/yellow)
  • hemoptysis
  • dyspnea
  • headache
  • fatigue
  • crackles/breathsounds over consolidations
  • dulled percussion sounds
51
Q

Why is the RLL more commonly infected w/ infiltrates during pneumonia caused by aspiration?

A

During aspiration, the sloping angle of the right bronchus makes it easier for substances to travel in the right lung

52
Q

What are the types of pneumonia?

A
  • segmental (one segment)
  • lobar (usually RLL)
  • bilateral (both R&L)
53
Q

How can you manage a pt w/ pneumonia?

A
  • O2
  • antibiotics
  • fluid/electrolyte management
  • respiratory support if needed
    • bronchodilator meds
    • chest physiotherapy
    • tracheal suctioning
  • nutritional support
54
Q

What are the RN Dx for pneumonia?

A
  • ineffective airway clearance
  • impaired gas exchange
  • ineffective breathing pattern
  • activity intolerance
55
Q

What are some interventions for a pneumonia pt?

A
  • meds
  • IS, effective coughing
  • repositioning every 2 hours, encourage mobility
  • SIMS, Good lung down
  • monitor O2; keep 92%
  • splint chest wall for coughing
  • teach to avoid risky conditions
    • smoking, temp extremes, weight gain, stress
56
Q

How can you prevent pneumonia?

A
  • Wash hands; gloves!
  • HOB 30 degrees
  • oral care am/pm/between meals
  • hourly IS use
  • proper nutrion/fluids
  • prevent aspiration risks
  • control pt pain so they can breath deeply and cough adequately
  • pneumococcal vaccine (65y or older)
57
Q

What are the respiratory changes that occur due to age?

A
  • calcification of costal cartilage interfering w/ chest expansion
  • decreased elastic recoil
  • ” respiratory muscle strength
  • ” fxnl alveoli
  • ” cough effectiveness/secretion clearance
  • ” ciliary fxn
  • ” ability to mainatin acid-base balance
58
Q

What is the physiological phenomena that causes a BP drop on inspiration?

A

Negative pressure in the chest: Inhale = neg pressure; Exhale = positive pressure

59
Q

What is the class, fxn, and treatment method albuterol (proventil)

A
  • SABA; Bronchodilator
  • asthma through rescue inhaler
  • monitor for increased HR/BP
    • CNS stimulation/excitation
    • risk of dysrythmias
60
Q

What is the class, fxn, and treatment method of ipratropium (atrovent)?

A
  • anti-cholinergic
  • block bronchoconstricting effect of parasymp nervous system (relaxer)
  • COPD & Asthma
  • quick relief
  • used only when one can’t tolerate SABA
    • can be nebulized w/ SABA
61
Q

What is the class, fxn, and treatment method of levelbuterol (xopenex)?

A
  • SABA
  • Asthma, rescue enhaler
  • Recommended for ppl having issues w/ albuterol
    • reduced HR increases
62
Q

What is the class, fxn, and treatment method of mutelukast (Singulair)?

A
  • leukotriene modifier (receptor blockers)
    • leukotrines/inflammatory mediators
  • tablets
  • long-term asthma therapy
63
Q

What is the class, fxn, and treatment method of fluticasone/ salmeterol (Advair)?

A
  • fluticasone: corticosteroid
  • salmeterol: LABA
  • ASTHMA, combined inhaler
  • rinse mouth AFTER use
64
Q

What is the class, fxn, and treatment method of Combivent (ipratropium/albuterol)?

A
  • Ipratropium: anti-cholinergic
  • albuterol: SABA
  • Asthma, quick relief
  • combined inhaler
65
Q

What is the class, fxn, and treatment method of methylprednisolone (solumedrol, medrol)?

A
  • corticosteroid - decrease inflammation
  • COPD/long term Asthma therapy
  • MONITOR
    • increase BP/HR
    • Glucose
66
Q

What is the class, fxn, and treatment method of dexamethasone (Decadron)?

A
  • corticosteroid
  • COPD exacerbation
  • similar to Solumedrol
67
Q

What is the class, fxn, and treatment method of magnesium?

A
  • IV: bronchodilation in acute severe asthma/COPD exacerbations
68
Q

What is the class, fxn, and treatment method of theophylline?

A
  • methylxantheine
  • bronchodilator/anti-inflammatory
  • alternate therapy for mild persistant asthma
  • MONITOR
    • serum blood levels
    • high incidence of interaction w/ other drugs
69
Q

What is the class, fxn, and treatment method of cefazolin (Ketzol)?

A
  • antibiotic
  • can be given pre-op to prevent infection
70
Q

What is the class, fxn, and treatment method of ceftriaxone (Rocephin) and Azithromycin (Zithormax, Zmax)?

A
  • antibiotic
71
Q

What is the class, fxn, and treatment method of heparin?

A
  • anti-coagulant
  • prevent DVT
    • increase oxidation in COPD exacerbations
  • affects PTT
  • risk of bleeding
72
Q

What is the class, fxn, and treatment method of enoxaparin sodium (Lovenox)?

A
  • anti-coagulant
  • prevent DVT
  • affects PTT
  • risk of bleeding
73
Q
A
74
Q

What is the class, fxn, and treatment method of pantoprazole (Protonix) and esomeprazole (Nexium)?

A
  • PPI (proton pump inhibitor)
  • acid reflux
  • PPI’s okay for elderly, but AVOID
    • H2 blockers: Zantac, Pepcid, Cimetidine
  • side effects: diarrhea, nausea, vomiting, headaches, rash/dizziness
75
Q

What is the class, fxn, and treatment method of morphine?

A
  • opiod analgesic/narcotic
  • pain
  • ASSESS RR
  • side effects
    • constipation
    • itching
    • nausea
    • vomiting
    • sedation
    • urinary retention
76
Q

What are the class, fxn, and intended treatment for hydrocodone/acetaminophen (Norco, Lortab)?

A
  • Hydrocodone: Opioid analgesic
  • Acetaminophen: Non-Opioid
  • Pain
  • ASSESS RR
    • side effects

constipation

itching

nausea

vomiting

sedation

urinary retention

NURS112 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions