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Respitory function
nur 305 respitory
| Question | Answer |
|---|---|
| Pulmonary Function Test is used for | 1.Evaluation of lungs and pulmonary reserve. 2.Evaluation to response to bronchodilator therapy. 3.Differentiation between restrictive and obstructive forms of chronic pulmonary disease. 4.Screening tool. |
| Pulmonary test contraindications | 1.pt is in pain unable to cooperate 2.pts unable to cooperative b/c of age or mental status |
| Pulmonary test preparation | 1.Explain to pt about the procedure. 2.Assure the pt can sit up and cooperative with test. 3.No smoking for 6 hrs-vasconstriciton 4.Do not use inhalers- want a true representation |
| Post procedure of pulmonary function test | 1.patient is usually tire 2.assess lung sounds 3.assess resp rate, rhythm, effort |
| Relief measures for dyspnea | High fowlers position and O2 |
| Cough significance | 1.description of the cough 2.coughing at pm- L-sided hrt failure or asthma coughing in the am w/ sputum- bronchitis cough worsen supine-sinusitis |
| Cough relief measures | 1.Cough suppressants w/ ccaution 2.Drinking warm beverages |
| Sputum relief measures | 1.hydration 2.aerosolized solutions 3.smoking cessation 4.oral hygiene and wise selection of food(citrus juices) |
| chest pain significance | 1.pleuritic pain- sharp on inspiration 2.pt are more comfortable lying on the affected side |
| chest pain relief measures | analgesic and NSAIDS |
| Wheezing | airway narrowing on expiration |
| Clubbing | 1.found in chronic hypoxia conditions 2.lung diseases |
| Hemoptysis | 1.spitting up blood 2.amount is not always proportional to the 3.seriousness of the situation |
| Cyanosis | 1.5g/dl of deoxgenated hgb 2.anemina doesnt always mean you have it 3.Polycythemia person can be cyanotic 4.not a reliable indicator of hypoxia 5.central cyanosis is reliable method |
| Rate and depths of resp | 1.eupnea- normal 12-18 2.bradypnea- <10 3.Tacyonea- >24 |
| Atelectasis | 1.tactile fremitus- absent 2.percussion- flat 3.decrease to absent breath sounds |
| Pneumothorax | 1.tactile fremitus- decrease to absent sounds 2.percussion- hyperresonant 3.absent breath sounds |
| Consolidation | 1.tactile fremitus- increased 2.percussion- dull 3.bronchial breath sounds and crackle |
| bronchitis | 1.tactile fremitus- normal 2.percussion-resonant 3.normal to decrease breath sounds, weezing |
| emphysema | 1.tactile fremitus- decrease 2.percussion- hyperresonant 3.decrease intensity of breath sounds and prolong expirations |
| Asthma | 1.tactile fremitus- normal to decrease 2.percussion- resonant to hyperresonant 3.wheezes |
| Sputum studies | 1.clear the nose and throat, rinse the mouth, take deep breaths, cough using diaphragm 2.specimen should be taken to the lab within 2 hrs |
| Bronchoscopy is use for | 1.direct inspection and examination 2.collect specimen and location of pathologic process 3.dx bleeding sites 4.remove foreign body 5.remove secretions |
| bronchoscopy complications | 1.infection 2.aspiration 3.broncospasm 4.hypoxemia 5.pneumothorax 6.bleeding 7.perforation |
| bronchoscopy nursing management | 1.signed consent 2.NPO 6hr pre procedure 3.Remove dentures 4. administer sedation as ordered 5.topical anesthetic-so they wont gag 6.post procedure NPO intil cough reflex 7.after cough reflex returns, ice chips and liquids afte |
| Broncochoscopy interventions | monitoring resp status, breath sounds ans assessments |
| Thoracoscopy is use for | evaluation of pleural effusins, pleural disease and tumor staging |
| Thoracoscopy intervention | post procedure is to monitor for SOB,air hunger, hypoxia, chest drainage system |
| Rhinitis manifestations | rhinorrhea, common nasal symptoms |
| Rhinitis | 1.infectious/inflammatory 2.acute/chronic 3.alllergic/non 4.trement depends on cause |
| nursing management of rhinitis | 1.allergic rhinitis avoid exposure to allergens 2.pt edu about OTC-read labels cautiously 3.pt edu about environmental control 4.pt edu about nasal sprays 5.handwashing |
| common cold manifestations | common nasal symptoms, sore throat,asso w/ herpes symplex |
| common cold management | 1.fluids 2.rest 3.prevent chilling 4. salt water 5.NSAID-for pain 6.decongestants-caution |
| acute/chronic sinusitis s&s | facial pain, pressure over sinuses, sore throat,eyelid edema,fatigue,headache earache,dental pain |
| acute/chronic sinusitis risk factors | exposure environmental hazards |
| acute/chronic sinusitis complications | meninigitis and lung abscess |
| upper respitory nursing interventions include? | 1.maintain patent airway-control secretions 2.promote comfort-cool/warm compressor 3.promote communication-in writing 4.fluid intake-2-3L 5.patient teaching-stop smoking |
| OSA risk factors | 1.obesity 2.older age 3.smoking |
| OSA alerts | 1.excessive daytime sleeping 2.noctural awakening 3.insomnia 4.loud snoring 5.morning headaches- alter co2 o2 6. intellectual deterioration 7. peronality changes 8.impotence 9. systemic/ pulmonary hypertension 10. dysrhythemia-vtacy 11.enuresis |
| OSA management | 1. avoid sleeping on the back-sleep on side 2.avoid alcohol and meds- depresss the resp sys 3.CAP or BIPAP 4.surgical procedure asso with tracheostomy |
| atelectasis manifestations | 1.common in the post op pt and immobilize pt 2.low grade fever is a common sign |
| atelectasis assessment | 1.increase breathing 2.decreased breath sounds-crackles 3.hypoxemia and low o2 sat |
| atelectasis prevention | 1.frequent turning-2hrs 2.early mobilization 3.deep breathing exercise-incentive spirometers 4.coughing |
| atelectasis treatment | 1.MDI for meds 2.suction and chest PT 3.thoracentesis-pleural effusion compression the lung tissue |
| What is HAP | 1.onset of symptoms more than 48 hrs post adm 2.most lethal nosocomial infection |
| what is CAP | occurs within community or within 48 hrs of hospitalization |
| pneumonia risk factors | 1.obstruction and interference of lung drainage 2.immunosuppressed 3.smoking 4.immobility 5.depressed cough reflex 6.NG tube 7.alcohol intoxication 8.general anesthesia |
| pneumonia in immunocompromised | greatest in AIDS, chemotherapy and organ transplant patients |
| pneumonia signs and symptoms | 1.fever 2.pleurtic pain 3.chest pain 4.SOB 5.myalgia 6.orthopnea 7.fatigue 8.diaphoresis |
| pneumonia interventions | 1.hydration 2.humidification 3.coughing 4.deep breathing 5.incentive spirometry 6.chest physical therapy 7.promote rest and conserve energy 8.fluid intake 9.maintain nutrition 10. prevent complications |
| tb risk factors | 1.close contact 2.immuniocompromised status 3.subtance abuse 4.medical condition 5.inadequate health 6.emigration from countries with high prevalence 7.jail 8.high risk procedures 9.immunosuppressed |
| ppd test | 1.intradermal layer-inner forearm 2.4" below the elbow 3.test read in 48-72hr- beyond that may not be accurate. |
| ppd interpetation: size of duration | 1.0-4 not sig-unless immunocompromise 2.>5 sig 3.>10 sig 4. sig means exposure to the M.TB or BCG 5.>5 HIV= + |
| ppd results | 1.+ reaction doesn't always mean you have TB 2.- does not alway exclude one from the infection(immunosuppressed pt can not develop immune response that can produce a + test) |
| spread of tb | 1.military tb 2. late reactivation of a dormant in the lung or elsewhere 3. assess pt contacts |
| tb classification | 1.class 0-no exposure/no infection 2.class-exposure/no evidence of infection 3.class 2-latent- + ppd but no evidence of tb 4.class 3-disease clinically active 5.class 4-disease not clinical active 6.class 5-dx is pending |
| tb assessment includes | fever,anorexia,weight loss,night sweats,fatigue cough and sputum production |
| tb complications include | malnutrition, side effects of meds, multidrug resistance, spread of tb |
| tb pharmacolgy therapy | 1.person considered noninfectious after 2-3 wks of continous med therapy-stay home 2.vitB12 administer with INH- to prevent peripheral neuropathy 3.meds taken on empty stomach or 1hr after meals 4.INH- avoid foods with tyramine |
| nursing management of tb include | 1. - pressure rooms 2.special masks 3. pt edu- cover mouth when coughing and proper disposal of tissues and handwashing |
| tb nursing intervention | 1.promote airway clearance 2.advocate adherence to treatment regimen 3.promote activity and nutrition 4.monitor for complications 5.bld work monitoring of LFT,BUN and creatine |
| what is asthma | 1.intermittent,reversible airflow obstruction affecting the airway 2.inflammation resulting in a narrow airway 3.hyperresponsiveness |
| asthma physical findings | 1. mild to moderate asthma- no symptoms 2.wheeze on expiration 3. increase resp rate and coughing 4. accessory muscles 5. muscle retraction at sternum,suprasternal notch and between ribs 6.severe asthma- barrel chest |
| asthma lab results | 1.increase in ERS and IgE 2.alter ABG 3.decrease of FEV/PEF(15-20%) during an attack |
| PEF | 1.measures the amount of airflow during a forced expiration 2. daily monitoring is recommend for moderate-severe cases. 3. PEF can drop hrs or days before asthma symptoms occur- teach pt to monitor |
| asthma treatment goals | decrease inflammation and improve air flow |
| asthma client education | 1.avoid trigger-NSAIDS 2.bronchodilators before exercise 3.rest 4.reduce stress and anxiety 5.monitor PEF 6.seek emergency care |
| COPD | 1.airflow limitation and not fully reversible 2.emphysema or chronic bronchitis |
| COPD risk factors | 1.smoking-passive or active 2.AAT-modify the environment 3.air polluntant |
| COPD complications include? | 1.hypoxemia and acidosis 2.RTI 3.cardiac prolems |
| Chronic bronchitis | 1.disease of the airway 2.cough and sputum for 3mos for >2yrs |
| emphysema | 1.distended alveoli resulting in impair gas exchange 2.hypercania 3. cor pumonale is a complication |
| COPD lab | 1.ABG- hypoxemia/hypercarbia 2.respitory acidosis-late sign would be metabolic 3.polycythemia |
| nursing management for COPD | 1.oxygen therapy 2.drug therapy 3. breathing techniques(diaphragmatic, purse lips, position) 4.exercise 5.energy conservation 6.hydration |
| PE risk factors | 1.venous statsis- prolong immobility 2.hypercoagulability 3.venous endothelial disease certain disease state- trauma, post op period, COPD 4.age 5.obesity 6.pregnancy 7.birth control pill 8.DVT 9.constrictive clothing |
| PE symotoms | 1.depends on size and the area being occluded 2.DVT-sudden pain, swelling and warmth in the extremity, skin discolration 3.dyspnea and tacypnea- most common 4.chest pain-sudden pleuritic 5.apprehensive 6.fever, cough, diaphoresis 7.hemoptysis 8.syn |
| PE prevention | 1.active leg exercise 2.early ambulation 3.elastic compression stockings 4.avoid sitting with legs crossed or sitting for long period of time 5.drink fluids 6.SCD 7.anticoagulant therapy 8.thrombolytic therapy |
| PE surgical management | 1.pulmonary embolectomy 2.transvenous catheter embolectomy 3.inferior vena cava umbrella |
| PE nursing management | 1.minimize risk for PE 2.prevent thrombus formation-ambulation,leg exercises, feet should rest on the flr, iv's- dont prolong 3.assess for potential PE 4.monitor thrombolytic therapy- vitals-q2hr, avoid invasive procedure, test INR and PTT 3-4 hr after |
| PE nursing management part 2 | 1.mange pain-semilfowler,turning the pt- to improve ventilation perfusion ratio, meds 2.manage o2 therapy-deep breathing, monitoring o2 sat and managing hypoxemia 3.relieving anxiety 4.monitoring for complications 3. |
| PE assessment findings | 1.chest xray- may not show infiltrates,elevated diaphragm on the affected side or pleural effusion 2.ECG-sinnus tacy, pr interval depression 3.ABG- hypoxemia, hypocapnia- also ABG can be normal even if the presence of PE 4.angiography-best dx of PE |
| Occupational lung disease: silicosis manifestations | 1.dyspnea, weight loss, fever, cough 2. progression of the disease is rapid 3.chronic problem with long latency |
| Occupational lung disease: asbestosis manifestations | 1.progressive dyspnea,persistent dry cough, anorexia,malasie,chest pain, anorexia 2. early findings include-end inspiratory crackles 3.advance is cor pulmonale, clubbing, resp failure 4. persons with great expurse or hx of smoking die from lung cancer |
| Occupational lung disease: black lung disease | 1. first sign-chronic cough and sputum production 2.dyspnea 3. sputum production of melanoptysis (smokers) 4. cor pulmonale and resp failure |
| Pheumothorax: 3 types | 1.simple- spontaneous;disfuse intertitual lung disease and severe emphysema 2.tramatic-rib fx's, gun shot, invasive procedure 3.tension- air drawn into pleural space from a lacerated lung- lung collaspes, heart, trachea is shifted to the unaffected side |
| pheumothorax manifestation | 1.sudden pleurtic pain 2.tacypnea 3.air hunger 4.agitation 5.hypoxemia 6.central cyanosis 7.hypotension 8.tacycardia 9. profuse diaphoresi 10.tracheal deviation |
| pneumothorax assessment findings | 1.airway 2.trachial-midline/shifted 3.breath sounds 4.circulation 5.vitals 6.possible cause |
| pneumothorax interventions | 1.maintain patent airway 2.notify the doc 3.needle thoracostomy 4.insertion of chest tuibe 5.chest xray 6.o2 7.monitor vitals 8.assess for shock |
| lung cancer risk factors | 1.smoking-active/passive 2.environmental and occupation exposure-radon have been associated with cancer 3.genetics 4.dietary factors-low intake of fruits and vegetables |
| adenocarcinoma | 1.occurs peripherally and often metastasize 2.least associated with smoking |
| lung cancer clinical signs | 1.cough and chage in cough 2.wheezing 3.dyspnea 4.hemoptysis 5.fever 6.URI 7.chest or shoulder pain 8.hoarseness |
| lung cancer prevention | restrictive advertising |
| lung cancer treatment | 1.sugery 2.radiation 3.chemotherapy 4.palliative therapy |
| radiation | 1.may reduce size of tumor 2.make inoperable tumor operable 3.relieve pressure 4.may help to relieve symptoms of cancer 5.may lead to problems of normal tissue-esophagitis,pneumonitis,lung fibrosis |
| lung cancer nursing management include? | 1.mangae symtoms of treatment 2.relieve breathing problems 3.reduce fatigue |
Created by:
sm08042n
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