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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
Created by: fluency