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ATI-MedSurge-Respir
ATI-MedSurge-RESPIRATORY
| Question | Answer |
|---|---|
| Nasal cannula | FiO2 – 24% to 44% at flow rates of 1 to 6 L/min -Pt. are able to eat, talk, and ambulate |
| Simple face mask | FiO2 – 40% to 60% at flow rates of 5 to 8 L/min -may be more comfortable than a nasal cannula |
| Partial rebreather mask | FiO2 – 60% to 75% at flow rates of 6 to 11 L/min -allows pt. to rebreathe 1/3 exhaled air + room air |
| Nonrebreather mask | FIO2 – 80% to 95% at flow rates of 10 to 15 L/min -delivers highest O2 possible (except intubation) |
| Venturi mask | FIO2 – 24% to 55% at flow rates of 4 to 10 L/min via different sized adaptors -delivers most precise O2 |
| Aerosol mask, face tent | FiO2 – 24% to 100% at flow rates of at least 10 L/min -for pts. w/facial trauma, burns, and/or thick secretions |
| T-piece | FiO2 – 24% to 100% at flow rates of at least 10 L/min -for pt.w/ tracheostomy, laryngectomy, or endotracheal tube |
| Cromolyn sodium (Intal) | anti-inflammatory agent; asthma maintenance |
| Albuterol (Proventil) | short-acting B2 adren-agonist, acute asthma attack |
| Fluticasone and Salmeterol (Advair Discus) | glucocorticoid / long-acting B2 adren-agonist; asthma maintenance |
| Prednisone (Deltasone) is indicated after? | severe exacerbation of asthma for anti-inflammatory effects |
| Acute respiratory failure (ARF), is caused by? | failure to adequately ventilate and/or oxygenate |
| Ventilatory failure, is due to... | a mechanical abnormality of the lungs/chest, diaphragm, or respiratory control center of the brain |
| Oxygenation failure, is due to... | lack of perfusion to pulmonary capillary bed (a pulmonary embolism) or alteration of gas exchange(pulmonary edema, pneumonia) |
| Acute respiratory distress syndrome (ARDS), is? | a state of acute respiratory failure with a high mortality rate |
| A reduction in surfactant does what to alveoli? | weakens the alveoli, leads to worsening edema |
| Severe acute respiratory syndrome (SARS) | result of a viral infection (mutated corona viruses) a group of viruses that also cause the common cold |
| Pt. taking Albuterol should be monitored for? | Tachycardia |
| Respiratory failure, lab findings? | Room air: PaO2 <60 mm Hg, SaO2 <90%, PaCO2 >50 mm Hg, pH <7.30 (hypoxemia, hypercarbia) |
| COPD, pt. education? | -encourage flu / pneumonia vaccine -high calorie/protein meals -rest periods -hand hygiene -meds / Oxygen as prescribed -smoking cessation |
| Montelukast (Singular), used for? | Leukotriene antagonists; prophylaxis of asthma exacerbation |
| Montelukast (Singular), should be administered? | daily, evenings |
| A pulmonary embolism (PE) occurs when? | a substance (solid, gaseous, or liquid) enters venous circulation and forms a blockage in the pulmonary vasculature |
| The most common cause of a pulmonary embolism is? | emboli originating from deep vein thrombosis (DVT) |
| Highest nursing priority for pt. w/just diagnosed with pulmonary embolism? | administration of an anticoagulants – eg. Enoxaparin (Lovenox), heparin, and warfarin (Coumadin) |
| Tracheotomy suctioning should be applied when? | on withdrawal of the catheter |
| Thoracentesis, is used to confirm? | hemothorax |
| The greatest risk following a thoracentesis is? | pneumothorax indicated by decreased breath sounds |
| COPD pt. has productive cough w/green sputum, nursing intervention? | notify HCP |
| COPD, S/S? | crackles and wheezes heard upon auscultation / SOB / Clubbing of fingers and toes / Rapid and shallow breathing |
| ABG - pH measures? | the amount of free hydrogen ions in arterial blood 7.35 to 7.45 |
| ABG - PaCO2 measures? | partial pressure of carbon dioxide 35 to 45 mm Hg |
| ABG - HCO3 measures? | concentration of bicarbonate in arterial blood 22 to 26 mEq/L |
| ABG - PaO2 measures? | partial pressure of oxygen 80 to 100 mm Hg |
| ABG - SaO2 measures? | percentage of O2 bound to Hgb as compared to amount that can be carried 95 to 100% |
| Arterial puncture - preprocedure? | - obtain heparinized syringe - perform Allen's test prior to puncture |
| Allen's test is performed to? | test patency of radial / ulnar arteries |
| Allen's test is performed by? | compressing radial (ulnar) pulse / pt. forms fist / patient relax hand while nurse release artery pressure, hand should turn pink quickly |
| Purified protein derivative skin tests are performed on TB pts. for how long? | life; even when disease is not active |
| Rifampin (Rifadin), turns urine and secretions _____ | orange |
| Rifampin (Rifadin), should be taken when? | mornings, on an empty stomach |
| The current four-medication regimen includes? | isoniazid (Nydrazid), rifampin (Rifadin),pyrazinamide (PZA), and ethambutol hydrochloride(Myambutol) |
| The three types of ventilator alarms are? | volume, pressure, apnea |
| Volume (low pressure) alarms indicate a low exhaled volume due to? | a disconnection, cuff leak, and/or tube displacement |
| Pressure (high pressure) alarms indicate? | excess secretions, client biting the tubing, kinks in the tubing, client coughing, pulmonary edema, bronchospasm, and/or pneumothorax |
| Apnea alarms indicate? | that the ventilator does not detect spontaneous respiration in a preset time period. |
| A Bronchoscopy can identify? | airway problems, cancer and lung disease |
| Bronchoscopy - PREprocedures - Nursing Actions | Check pt. for allergies / use of anticoagulants, remove dentures (if appl), pt. NPO 8 to 12 hr, obtain baseline vitals / place pulse oximeter, admin meds |
| Bronchoscopy - POSTprocedures - Nursing Actions | ensure gag reflex , monitor vitals and pulse oximeter E. 15 min until stable, monitor for significant fever, productive cough, significant hemoptysis, hypoxemia, encourage coughing and deep breathing E 2 hr. |
| Bronchoscopy - pt. Education | Instruct pt. to gargling with salt water or use of throat lozenges, discourage: smoking, talking, and coughing for several hours |
| If chest tube becomes disconnected, nurse should have in pt. room? | a pair of padded clamps; in case tubing becomes disconnected |
| In bacterial pneumonia, temperature? | rises; (38.8 C / 101.8 F) |
| Following total laryngectomy for laryngeal cancer, priority assessment is? | airway patency |
| Expected findings of chest tube insertion? | tidaling in the water seal chamber / continuous bubbling ONLY in the SUCTION CHAMBER, fluctuation of draining on respiration, small-dark red clots in tubing, draining > 100mL in 1st hr PostOP |
| Nasopharygeal suctioning is contraindicated in pts. with? | closed head injuries |
| Continuous bubbling in water seal chamber is an indication of? | an air leak, requires immediate action |
| Chest tube drainage of <100mL / hr following thoracic surgery (is / is not) an expected finding? | is, does not require further action |
| Small-red clots in chest tube (is / is not an expected finding? | is, does not require further action |
| Tactile Fermitus is (decreased /increased) in pt. with lung cancer? | increased; due to airspace being replaced with tumor tissue |
| Masses in lung tissue will sound? | dull or flat on percussion |
| Peripheral edema (is / is not) associated with lung cancer? | is not |
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