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ESPNLSIII RESPIRATOR

ESPN LSIII RESPIRATORY

QuestionAnswer
What happens to air as it passes through the nose Filtered Moistened Warmed
What is sneezing Forcefull expellation of air
What is the purpose of sneezing To dislodge irritants
The nose is lined with what Mucous membrane
The purpose of the turbinates is to __________ which allows more time for ___ & ______ cause the air to move over large surfaces warming and moisturizing
The distal pharynxis is divided into the __, ____ & ______ nasopharynx oropharynx laryngopharnx
Explain why pharyngeal infections spread so easily to the ear, especially in children Because inner lining of pharynx and eustachian tabe are continuous Mucous membrane continuous to eustachian tube
What organ automatically connects the pharynx with the trachea Larynx
What protects the larynx when swallowing Epiglottis
The opening between the vocal chords is called Glottis
What is the fuction of cilia in the respiratory tracht Sweep dust and debris upward toward the nasal cavity
What normal physiological functions are lost when a patient has a tracheostomy Speaking Talking, speech and nose breathing, smell Can't warm or mosten air so gets dry
What problems might occur because of this (trach) aspiration, local bleeding Infection decrease appetite with wt. loss decrease warming and filtering of air increase fluids
****KNOW THIS Which lobe aspiration is pneumonia Right lower
Which bronchus (right or left)do foreign objects usually end up in Right Bronchus why? left bronchus is smaller in diameter and slightly horizontal in position
****KNOW THIS What is the function of the alveoli Gas exchange diffusion of CO2 and O2 occurs Shaper and forms to lungs
What artery provides the blood supply to the lung Pulmonary artery
The movement of gasses from an area of high concentration to an aarea of low concentration occurs by Diffusion
What are the physiological consequences of a pleural effusion Pleural space becomes distended & puts pressure on the lungs, make it hard to breathe
Which is longer inspiration or expiration Expiration
Inhaled air is __% oxygen and & exhaled air is __% oxygen Inhaled = 21% Exhaled = 16%
Normal respiratory rate is ___/minute 12-20/minutes
The parts of the brain responsible for controlling respiration Medulla oblongata& pons
Specialized receptors that are sensitive to blood CO2 levels are called _____and are located in the ______ & ________ Chemoreceptors carotid and aortic bodies
What part of the brain controls the cough reflex a center in the medulla
Carbonic acid is how what is carried in the blood CO2
What are the 3 changes in the blood that will trigger the receptors Higher acid Deviation of ph Carbon dioxide
The more CO2 that is in the blood the more alkaline or acidic it is Acidic
List 3 subjective symptoms you should assess in a client in respiratory distress Shortness of breath dyspnea on exertion cough
List 3 objective symptoms you should assess in a client in respiratory patients expression Chest movements Respiration Flaring,nostrils, anxious face, pulse ox, grunting, drooling
Cyanosis is an early or late sign of hypoxia Late
Yellowish green, cloudy, thick mucous is often an indication of a _______pneumonia bacterial or broncopneumonia
Rusty or dark colored mucous is usually an indicative of _____ Pneumococcal pneumonia
Hemoptysis (Blood in sputum) is usually associated with Pulmonary edema, Lung cancer, TB or erroded tumor
Respiratory stridor usually indicates Upper respiratory obstruction
List 5 specific respiratory conditions tat canbe diagnosed by chest x ray Pneumotorax Pneumonia Pleural effusion pulmonary edema, pulmonary tuberculosis
Lsit 4indications for a thoracentesis Removal of fluid for diagnostic purposes Biopsy of the pleura removalof fluid when it is a threat to patient safety or comfort Instillation of medication into the pleural space
***KNOW THIS What position should the patient be in for thoracentesis Patient at edge of bed with head and arms resting on pillow on overbed table Orthopenic position - breath better
KNOW THIS What do you do for a patient with a nose bleed Apply pressure
True or False Apatient with a pulse ox of 89% will always feel dyspneic False
True or False ABGs measure respiratory & metabolic status True used to check O2 and CO2 and bicarbonate levels, serum ph
True or false An SaO2 below 90 is considered lifethreatening False Below 70 is life threatening normal is 95%
How does packing the nose with epinephrine help stop the bleeding? Promotes local vasoconstriction
How can a foley catheter be used to control epistaxis Traction is placed on the catheter so the vessel in the area is compressed
Why might a patient who's had an epistaxis be prone to infection Open area/Breakin skin, Breach in mucous membranes to cause infection with koodies
What are 2 things you can teach your patient to do to prevent further nosebleeds Do Not pick, scratch, or irritate nares Not to blow nose vigoursly and to avoid dryness of the nose No foreign objects inserted in the nose Use vaporizer to keep nasal mucous membranes moist
What is the medical treatment for Legionnaire's disease Ventilation, temporary Renal dialysis, antibiotics(erythroomycin) early in disease O2therapy,IV Fluidtherapy to main. hydration & electrolyte status
What population see a high incidence of TB Hispanic & African Americans - Urban area, poor people, older person, AIDS
Why is TB seen so frequently in patients with AIDS? TB occurs in individuals with incompetant immune systems as in HIV infected people (Affectsolder adults , people receiveing immunosuppressants the the malnutritions)
Are aids patients exposed to TB more frequently than the general population NO
True or False Most people who are exposed to TB will become infected False
True or False Persons who have a positive PPD test are infected with TB, but don't necessarily have the disease True
True or False A negative reactionto a PPD testrules out a TB infection False
True or False Acid fast staining is a good way to diagnose TB since the mycobacterium that casues it is the only organism that stains acid fast False
True or False Sputum cultures are a quick way to confirm a diagnosis of TB False it takes awhile before you can get it to grow w/sputum
True or False The TB organism can only infect lung parenchyma False Can go other places than lymph
Why is TB treated with more than 1 drug To prevent the emergence of organisms resistant to the other, thus increase therapeutic effectiveness of treatment
What is the single most effective to prevent TB from spreading from one person to another Handwashing Patient cover their nose and mouths when coughing or sneezing patient in isolation
How long can the tubercle bacilli survive in human tissue before actually causing the disease? Greater than 50 years
***KNOW THIS How is pneumonia diagnosed Chest X ray
Wht causes the crackles heard in the patient wiht pneumonia Respiratory passage narrowed by fluid mucous, pus, air passing thru mucous (exudate)
When might a chest tube be indicated for the patient with pneumonia If an accumulation of (empyema) pus in the pleural space occurs
**** Know this Crackles sound like Crackling or bubbling sounds
What is the name of the surgery done to correct a deviated nasal septum Nasoseptoplasty
how can otis media develop in the patient with allergies Ciliary actioon slows, mucosal gland secretion increase leukocyte (eosinophil) infiltration occurs local tissue edema Build up of mucous in eustachian tubes Complain of ear fullness, ear popping or decreased hearing
What are somecommon causes of upper airway obstruction Dentures,aspiration of vomit or secretions, most common in unconscious person - the tongue
***KNOW THIS List 5 risk factors for laryngeal cancer Tobacco use, heavy alcohol use, chronic laryngitis, vocal abuse & family history - Male at higher risk
**KNOW THIS When is a "Radical Neck Dissection" Indicated Extension of the tumor becomes affixed to one of the cords or extends upward or downward from the larynx
***KNOW THIS What should you do immediately if a trach tube becomes completely occluded with mucous and the patient is unable to breath SUCTION Take inner cannula out
Why do patients with a trach commonly lose their appetitie Senseof smell is gone
Ture or false Patients with acute rhinitis should be treated with antibiotices False because it is viral
**KNOW THIS What sign or symptom is a reliable indicator that a post T & A patient is hemorrhaging? Seeing blood Frequent swallowing
Why is mouth care important following a T & A Promotes comfort and assist in combatting infection
What are 6 complications that can occur with tonsillitis sore throat, fever, chills, anorexia, tonsils become enlarged and contain purulent exudate (Become Kreptic)
Sinusitus is often a complication of ??? & ??? Pneumonia or nasal polyps
What are 3 serious complications of Legionnaire's disease tha can precipitate death Respiratory failure, Renal failure Bacteremic shock
***KNOW THIS What promotes comfort after a T & A for the patient Use of an ice bag
***KNOW THIS How do chest percussion (vibrates loose) and postural drainage help in the treatment of pneumonia To encourage cough and deep breath to maximize ventilatory capabilities
How is viral pneumonia treated Analagesics and anti pyretics, expectorant and broncho dilators are often presecibed . Humidication with humidifier or nebulizer if secretion are tenacious and copiriusis useful. O2 if less than 91%
List the 4 physiological processes that occur with pneumonia Secretions become infected, inflammed, cilia cannot remove accumulated secretions, decrease O2 & CO2 exchange
What is the term for dyspnea that occurs when a person is lying down Orthopnea
Orthopnea is a symptom of what kind of heart failure Left ventricular heart failure
Paroxysmal nocturnal dyspnea is a sudden acute type of dyspnea commonly seen in patients with what Left sided CHF
What organ is most susceptible to an oxygen deficit Brain
Why is the brain most susceptible to an oxygen deficit It has little storage capacity for O2 and yet had a constant demand
What are 3 ways our body compensates for hypoxia d/t respiratory impairments Increase Cardiovascular activity eg tachycardia, Increase BP Erythropoetin secretions is increased stimulating bone marrow to produce RBC Stimulation of sympatheric Nervous system
What acid/base imbalance is likely to occur in pts. with respiratory disorders Reapiratory acidosis d/t excess CO2 is more commmon and results from impaired expiration Resp. alkalosis occurs when resp. rate increases usually because of acute anxiety or excessive intake of aspirin
What is the organism most commonly involved in epiglottitis H influenza Type B
What is the treatment for influenza Symptomatic (pallitive)
Briefly describe the pathophysiology involved in bronchiolitis necrosis and inflamed in sm. bronchi and bronchioles with edema, Increased secretion and reflex bronchospasm leads to ibstruciton of sm, airways
In what lobe does bronchopneumonia often occur Lower Lobes
Describe what caseation necrosis looks like Cheese like substance
List 2 reasons why incidence of TB is increasing Number if increasing AIDS patient Multi drug resistant
The mucous membrane of the nose secretes an average of how much fluid each day 1 liter
***KNOW THIS Post precedure for a patient having a thoracentesis you should monitor for what Monitor for signs of pneumothorax Air embolism Pulmonary edema
***KNOW THESE Regarding ABGs What are normal pH PCO2 HCO2 PO2 O2saturation What is pH = 7.35 - 7.45 PCO2 = 35 - 45 mmHG HCO2 = 22 - 27 mEq/l PO2 = 80 - 100 mmHG O2 saturation = 96-100%
***KNOW THIS Normal ratio between bicarb and carbonic acid is 20:1 20 base to 1 acid
**KNOW THIS Describe the chest tube drainage system Returns negative pressure to the intrapleural space Used to remove abnormal accumulations of air and fluids from the pleural space
***KNOW THIS What is tidaling water oscillates (moves up as the client inhales and moves down as the client exhales
**Know this What is constant bubbling in the water seal chamber of chest tube drainage system an indication of An air leak
**KNOW THIS If a patient is in respiratory alkalosis what what you use for a treatment Sedation or breath into a paper bag to rebreath CO2 that is exhaled Give a paper bag to breath into
***KNOW THIS If an emphasema patient goes home on O2 do not turn off O2 for ABGs unless ABGs ordered on Room air
**KNOW THIS In regards to Intermittent Positive pressure Breathing waht is negatrive pressure
**KNOW THIS Where do you put a pulse oximetery to avoid a false high or false low
In regards to the patient with a chest tube drainage system what are a couple imperative nursing interventions Encourage cough and deep breathing Keep a clamp and a sterile occlusive dressing at the bedside at all times
***KNOW THIS What is PEEP and when is it used PEEP = Positive end expiratory pressure Applies positive pressure to airways and alveoli furing exhalation Used when patient has decreased lung compliance such as AARDS Pneumonia, Fibrosis, Pulmonary edema
Aperson with a Epistaxis (nose bleed) will have a high blood pressure What should a nurse do for this Apply pressure for 10 -15 minutes by pinching the nose
Waht is laryngeal cancer malignant turmor of the larynx metastasos to the lung is common Causes include cigarette smoking, alcohol abuse, exposure to pollutants, voice strain
What should you check post op of the patient with Laryngeal Cancer Assess gag and cough reflex and ability to swallow
What should you teach laryngeal cancer patient about what not to do Teach clean suction technique avoid swimming, showering, and using aerosol sprays Advise to obtain Medic alert bracelet
In order to help prevent SIDS what should you teach new parents Lay infant in Supine position
Your patient had a tonsillectomy He is having an increased pulse and restlessness this is an indication of ?? 1st sign of hemorrhage
Tonsillectomy patient post op what do you the nurse do Check for bleeding - visualize the throat, Fluids no red stuff or acidic stuff Ice collar
Patient has a rib fracture Impaired ventilation and inadequate cough and deep breath
One way to diagnose Rib fracture Pain with movement Fractures seen on chest x ray
What is a pneumothorax Accumulation of atmospheric air in the pleural space, loss of negative intrapleural pressure resulting in a collapsed lung. you want negative pressure. Diagnosed with a chest xray
What are signs andsymptoms of pneumothorax Absent breath sounds on affected side Cyanosis Hypotension Subcutaneous emphysema
What are some nursing interventions for pneumothorax Administer O2 ASAP High fowlers to breath better prepare for chest tube placement apply pressure dressing over an open chest wound
What is ARDS (Adult Respiratory Distress Syndrome A serious complication caused by a diffuse lung injury, leading to extravascular lung fluid
In regards to ARDS what do the ABGs identify Respiratory Acidosis
What are signs and symptoms of ARDS Tachypnea Dyspnea, Decreased breath sounds Hypoxia even with High doses of O2 Decreased oukmonary compliance, pulmonary infiltrates show on exray
Treatment for ARDS includes Identify and treat Administer O2, High fowlers, restrict fluid intake, provide respiratory treatments, administer diureticsm anticoagulants or steroids, MS Expect intubation and mechanical ventilation
What is prognosis for ARDS 40% mortality rate with organ failure death is 100%
What is pneumonia Inflammator process involving the interstitial spaces, the alveoli and the bronchioles, inflammation stiffens the lung community acquired or nosecomeal infection (hospital acquires)
How do you diagnose pneumonia chest exray WBC's abd erythrocyte sedimentation rate ar elevated
What core measures are done in hospital with pneumonia oxygen assessment within 24 hours ABG's or pulse ox pneumocccal screening and or vaccination smoking cessation counseling arrival time to first antibiotic is 4 hours
Signs and symptoms of pneumonia chills, elevated temperature, pleuritic pain, crackles, rhonchi, and wheezes use of accessory muscles, cyanosis, mental status changes
What is rusty green or bloody sputum a sign of pneumococccal pneumonia
What is yellow green sputum a sign of bronchopneumonia
What are some very key interventions for pneumonia Prevent the spread of infection by handwashing and th e proper disposal of secretions high calorie high protein diet wiht small frequent meals encourage fluids to 3 liters a day increase activity gradually
What is pleurisy Inflammation of the visceral and parietal membranes These memebranes rub together during repiration and cause very painful pain
What data is collected for pleural effusion chest eray, pleuritic pain, tachycardia
How do we treat pleural effusion treat underlying cause encourage cough and ddep breath, prepare for thoracentesis to get rid of fluid so lung can reexpand
What is pleurectomy Consists of surgically stripping the parietal pleura away from the visceral pleura Produces an anflammatory reaction that promotes adhesion formation between the two layers during healing
What is pleurodesis involves the instillation of a sclerosing substance into the pleural spae via a thoracotomy tube. Creates an inflammatory response that scleroses tissues together
**KNOW THIS What is empyema Pus within the pleural cavity
What are the 4 major types of lung cancer Small cell - (Oat cell) epidermal (squamous cell) adnocarcinoma large cell anaplastic carcinoma
What is curative surgery the removal of a tumor when it appears to be confined to one area
What is palliative surgery makes the patient more comfortable laser surgery for the removal of an obstruction or opening of an airway
What are some nonsurgical implementations for lung cancer Radiation therapy for localized intrathoracic lung cancers Chemotherapy to promote tumor regression immunotherapy interferon or interleukin
What do you do for the patient with an pneumonectomy Avoid turining client onto the operative side
What is the prognosis for the lung cancer patient not so good only 10 - 15% ive 5 years or longer only 20 % ar early detected
What patients are at risk for pulmonary embolism Those at risk for deep vein thrombosis eg, surgery, obesity, pregnancy, CHF, A-fib,, Age, prior history of
**KNOW THIS what is treatment for pumonary embolism Aimed at preventing venous stasis and includes Early ambulation spirometer, RM, blood thinners, ted hosem scd's heparin, lovenox
pulmonary emphysema aka Pink puffer What happens to make a barrel chest
Blue Boater aka chronic bronchitis Is it irreversible
What are normal ABG's Pao2 Paco2 Sao2 Hct Pao2 = 45 - 60 mm Hg Paco2 = 50-60 mm Hg Sao2 = less than 90% Hct =
What is the dilator Albuterol or proventil used for Good for acute attacks
What is the dilator Alupent used for Good for exercise induced asthma
What is the dilator Serevent used for Has a slow onset and is not good for acute attacks
What is the dilatorxopenex HHN used for Lasts up to 8 hours
What is the dilator epinephrine or adrenalin, sus Phrine used for side efects increase heart rate
***KNOW THIS Which dilator is used for long acting Serevent, Salmeterol
***KNOW THIS What do mucolytic do Mucomyst inhalation helps break up secretions (Tylenol OD)
***KNOW THIS How and what is Flonase Flonase is a nasal spray IV = is Solumedrol PO = Prednisone
***KNOW THIS What much you watch for in the elderly patient taking theopphylines Increase heart rate and increase in seizures
***KNOW THIS Where can you place the pulse ox to obbtain a reading if doesn't work on finger Can place on ear lobe
***KNOW THIS If your patient has COPD what is the safe leel to set there O2 at Must be low doses 1 -2 LPM
***KNOW THIS Is COP reversible No COPD is irreversible
***KNOW THESE What are the signs and symptoms of ASthma DOE Wheezes Tachynpea, use of accessory muscles nasal flaring, increased anxiety
**KNOW THIS What is Statis Asthmaticus Severe unrelenting attack that fails to respond to treatment Respiratory Failure Death if not reversed
**KNOW THIS What is the intervention for asthma and COPD to help with breathing Purse lip breathing
***Know these What is TB Ahighly communicatable disease casued by Mycobacterium tuberculosis
**KNOW this What is (MDR - TB) multi drug resistant Goal is to prevent transmission control symptoms prevent progression of disease
**KNOW What are risk factors for TB alcoholism, IV drug use, malnutrition infection, elderly,homeless, refuges, minority children under 5, individ livingin crowded cond, long term care,prisons, frequent contact with untreated individuals HIV, unpast milk if cow infected
**KNOW How is TB transmitted aerosolization, airborne cough, laugh, froplet
**KNOW After infected individual has received TB meds for 2 to 3 weeks the risk of transmission greatly reduced
What are th clinical manifestations of TB May be asymptomatic in primary infection fatigue anorexia, wt. loss chills and low grade fever night sweats persistant cough, dull achy chest pain
**KNOW how do you make a confirmed diagnosis of TB SPUTUM CULTURE POSITIVE FOR TB BACILLI
*** KNOW WHAT is Matoux's test A small amount of purified protein derivative is administered intradermally in forearm a positive reaction does not mean that active disease is present but indicates exposure to TB'Once positive result always a positive result in future
***KNOW THIS How do you read a Mantoux's Test An area of indur. meas. 10mm or more in diam, 48-72 hours after inject. indicates exposure to TB For indiv with HIV or immunosuppressed a 5mm or more is consid + Once a + test a chest Xray must be done to rule out act TB or to detect old, healed lesions
**KNOW THIS What must the nurse wear when attending to a person with TB The nurse must wear a particulate repirator not a surgical mask A gown when theres a possibility of contamination of clothing N-95 Hands must always thoroughly washed before and after caring for the client
**KNOW THIS What is the standard treatment to take for 2 months for TB Isoniazid rifampin ethambutol and pyrazinamide
After 2 months - 4 months meds for TB fewer meds and watch for up to 9 months
**KNOW this Re: the hospitalized patient with TB When are they no longer considered infectious After the infected indiv has received TB meds for 2-3 weeks greatly reduced When the results of 2 sputum cultures are negative the patient is no longer considered infectious
What is Epiglottitis Abacterial form of croup most commonly caused by Haemophilus influenzae Type B or Streptoccocus pneumonia. Usually ages 3 - 7 considered and emergency situation
Waht are Signs and symptoms of epiglottitis High fever red or inflammed throat difficult swallowing, drooling, Inspiratory stridor Absence oif cough
What are the nursng actions for Epiglottitis Monitor airway status Monitor nasal flaring, and the presence of stridor Do not upset the child NOattempts should be made to look at the throat
What other nursing actions for Epiglottitis Administer analagesisc and antipyretics Tyelnol Provide cool mist oxygen therapy Do nothing to upset child until resusicitation equipment nearby
**KNOW THIS What is laryngotracheobronchitis - CROUP Inflammation of larynx, trachea, and bronchoi
**KNOW THIS What are signs and symptoms of laryngotracheobronchitis - CROUP fever, irritability, restlessness, hoarse voice Seal bark and brassy cough, Inspiratory stridor and laboed respirations
Name some nursing actions for Laryngotracheobronchitis - CROUP keep patent airway Prov hum O2 - cool mist tent Avoid cough syrups & cold med. may dry & thick secret Admin bronchodilators to relax smooth muscle & relive stridor admin antibiotics if bacterial admin corticosteroids if ordered for anti inflamm effect
What is bronchiolitis An inflammation of the bronchioles that causes production of a thick mucous that occludes bronchiole tubes and small bronchi
What causes Bronchiolitis RSV (Respiratory syncytial virus )is a common cause
What is RSV While RSV is not airborne it is highly communicable and is usually transferred by the hands
***KNOW THIS What is the main nursing action for Bronchiolitis Maintain patent airway Monitor VS Provide cool humidified oxygen Assess for dehydration
What do you do for the child with RSV Isolation Don't care for these kids along with other high risk kids Wear gowns when soiling of clothing may occur Ribavirin(Virazole) respiratory med No Vaccine
What is Cystic Fibrosis A chronic multisystem disorder affecting Exocrine gland function
****KNOW THIS How is Cystic Fibrosis transmitted A person with CF must inherit two defective CF genes - one from each parent it is Heritary
****KNOW THIS What is the SWEAT TEST Sweating is stimulated on the child's forearm with pilocarpine, and the amount of sodium and chloride is measured skin taste salty
How do you prevent Cystic Fibrosis There is NO WAY to prevent Cystic Fibrosis
What is the term for bubbling sound through alveole Crackles
What part of lung gas is exchanged Alveoli
What is the number 1 risk factor for COPD Cigarette Smoking
What is pneumectomy Lung surgery
What is a common complication of the flu Pneumonia
What rate do you set the oxygen for the COPD patient 1 -2 liters
Name 2 breathing techniques for the COPD patient Pursed lips and abdominal breathing
What does ABG's show Respiratory status
what is blue bloaterh with bronchitis Thick mucous and occ of broc
Waht position is used for post pneumectomoy laying down on back slightly 30 degree
What are the primary muscles of respiratory intercostals, diapram
What is risk factor for cancer Smoking
How is TB diagnosed Sputum culture
What is the # killer of men and women Lung cancer
What is the term for bubbling sound through alveole Crackles
What part of lung gas is exchanged Alveoli
What is the number 1 risk factor for COPD Cigarette Smoking
What is pneumectomy Lung surgery
What is a common complication of the flu Pneumonia
What rate do you set the oxygen for the COPD patient 1 -2 liters
Name 2 breathing techniques for the COPD patient Pursed lips and abdominal breathing
What does ABG's show Respiratory status
what is blue bloaterh with bronchitis Thick mucous and occ of broc
Waht position is used for post pneumectomoy laying down on back slightly 30 degree
What are the primary muscles of respiratory intercostals, diapram
What is risk factor for cancer Smoking
How is TB diagnosed Sputum culture
What is the # killer of men and women Lung cancer
Created by: gmabrender
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