Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
AH II
respiratory
| Question | Answer |
|---|---|
| Atelectasis | collapse of lung tissue at any structural level (segmental,lobar, basilar, microscopic) |
| Who is at risk for atelectasis | post-op, elderly, obese, bedridden, chronic critically ill |
| assessment of atelectasis | x-ray, hypoxemia, dyspnea, tachypnea, tachycardia, cyanosis, diminished breathsounds or crackles in lower lobes |
| severe atelectasis | tracheal shift toward affected side, decrease in tactile fremitus over affected side,dull percussion over affected side, decreased chest movement over affected side |
| prevention of atelectasis | position changes, early ambulation, cough, deap breath, IS |
| teatment of atelectasis | O2, postural drainage, suctioning, bronchoscopy |
| risk factors for pnuemonia | advanced age, smoker, URI, immobility, immunosuppression,malnutrition, dehydration, chronic disease,tracheal intubation |
| pathophys of pnuemonia | inflammation, loss of defense mechanisms (cilia, cough, immunoglobulins A), Alveolar exudate (mucous), bacterial pneumonia is usually more virulent than viral |
| pnuemonia assessment | fever, chills/sweats, pleuritic chest pain, cough,sputum, hemoptysis,fatigue, crackles, increased whispered pectroliloquy(e sounds like a) |
| diagnosis of pnuemonia | sputum culture, x-ray, blood/urine cultures, ABG's, bronchoscopy |
| Tx of pneumonia | antibiotics (penecillin,levoquin),O2, postural drainage, resp.tx, suctioning, bronchodilators (beta 1 agonist) |
| nursing interventions for pneumonia | increase fluid intake, antibiotics, C&DB w/ IS, positioning, suctioning, monitor O2 |
| preventing pneumonia | handwashing, protective equipt., fluid intake, control pain, C&DB w/ IS, prevent aspiration, monitor tube feed residual |
| Tuberculosis | common in underdeveloped countries, Mycobacterium TB, increased in HIV, multiple resistant strains, spread by air droplet |
| TB latent infection | causes no symptoms and is not contagious, positive skin test, can become active later |
| TB active infection | display symptoms, contagious, positive skin test |
| extrapulmonary TB | occurs outside the lung, kidneys, growth plates, lymphatics, bone marrow, widespread dissemination is known as miliary TB |
| TB assessment | cough (initial sx), fatigue, anorexia, wt loss, night sweats, low-grade fever, dyspnea, hemoptysis,dull or pleuritic chest pain,chest tightness, crackles |
| TB screen & diagnosis | mantoux (purified protien derivative), QFT, MODS |
| mantoux test | read in 48-72 hrs, > 5mm of induration positive for HIV & IV drug abusers, >10mm positive for all other high-risk groups, >15mm positive for low-risk groups |
| QFT (quantiferon-TB Gold | blood test, detects bacteria in the blood |
| MODS (microscopic-observation drug-susceptibility | sputum test very reliable in detecting MDR-TB |
| TB diagnosis after a positive skin test | acid-fast Bacillus smear (sputum), 3 sputum collections for 3 mornings, chest x-ray |
| TB induction phase meds (1st 2-4 months) | isniazid (on empty stomache), rifampin(orange pee) |
| TB continuation phase meds (4-8 months after) | isoniazid, rifampin |
| new TB drug | rifater, combo of isoniazid, rifampin & pyrazinamide |
| prevention of transmission of TB | early ID, private negative airflow room, UVlamp/hepa filter, TB mask, monitoring hc workers |
| Main risk factor of lung cancer | smoking |
| small cell cancer | rapid growth considered metastatic upon diagnosis |
| squamous cell cancer | slower growth, can metastasize, smokers, cental bronchus causing air obstruction, esophagus, more infectious, does develop symtoms |
| adenocarcinoma | slow growth, can metastasize, secondhand smoke, periphery of the lung, glandular often no symptoms, diagnosed later than SCCA |
| large cell cancer | slow growth, can metastasize |
| signs & symptoms of lung cancer | persistent cough, hemoptysis, rust-colored/purulent sputum, wt loss, fatigue, chest sholder back or arm pain, recurring pleural effusion, pnuemonia, bronchitis, dyspnea |
| metastasis of lung cancer | laryngeal nerve involvement (change quality of voice), lymph node involvement (palpable), dysphagia, suppression of vena cava |
| diagnosis of lung cancer | x-ray, CT scan, bone scan, PET scan, MRI |
| tx of lung cancer | radiation, chemotherapy |
| what lab is noted for CT & bone scans | creatinine |
| surgical procedures for lung cancer | pulmonary resection, pneumonectomy |
| wedge resection | remove small localized section of tissue |
| segmental resection | remove one or more segments of lung |
| lobectomy | removal of entire lobe, remaining lung over expands to fill empty space |
| pneumonectomy | remove entire lung, serous fluid fills empty thoracic cavity |
| post-op thoracotomy care | pain is priority, altered gas exchange, ineffective airway clearance |
| at risk for what after thoracotomy | tension pneumothorax, shock, post-op infection |
| chest tube | closed to the atmospheric pressure,negative pressure system, remove air, serosanguineuos or blood fluid from plueral space, re-expand lung tissue, prevent mediastinal shift (which can compress the heart & blood vessels) |
| why are chest tubes inserted | pneumothorax, hemothorax, pleural effusion, post thoracotomy, post CABG, chylothorax |
| chlylothorax | occurs after surgical procedures when lymphatics are nicked & large amounts of milky/serous drainage |
| types of chest drainage systems | bottle, pluer-evac, atriaseal, thora-seal |
| whater seal chamber | tidaling, bubbling, suction control: 10-20cm H2O (> 50 cm dangerous) |
| tidaling | normal, rises with inspiration, falls with expiration |
| bubbling | intermittent-common after thoracotomy & clears with time, continuous is not normal (may be air leak) |
| wall suction | more than 20, 30-40 cm H2O pressure |
| chest tube drainage | must always be below clients chest |
| milking/stripping | creates pressure of -100cm H2O, can strip w/ MD orders |
| drainage volume | > 100 cc/hr is surgical emergency, call MD, can be discontinued if drainage stops after 24 hrs |
| chest tube air leaks | inspect insertion site, check dressing, briefly clamp tube & ask client to cough, if air leak still in chamber its the system if not its the pt |
| nursing management of chest tube | positioning, dressing change, activity, monitor, assess pain |
| penetrating chest injuries | open sucking wound, hemothorax, hemoneumothorax, combined w/ abdomen, diaphragm, trachea & great vessel injuries |
| blunt chest injuries | pneumothorax (tracheal shift away), hemothorax, diaphragm injury, aortic rupture, trachea/bronchus rupture, cardiac injury, fracture sternum, rib fracture |
| pneumothorax | presence of air in the plueral space, impairs complete lung expansion, |
| closed pneumothorax | puncture or tare internal respiratory structures, fractured rib most common cause, spontaneous rupture of internal structures |
| open pneumothorax | sucking chest wound, accidents, surgical trauma |
| tension pneumothorax | emergency, with each inspiration air trapped in pleural space, medialstinum shift |
| hemothorax | blood in pleural space, >300cc for sx to occur |
| flail chest | consists of 2 or more adjacent ribs on same side broken, flail section floats moving paradoxical w/ inspiration/expiration (see saw movement) |
| assessment of chest injuries | tachypnea, dyspnea, abrasions, burns, asymmetrical chest expansion, accessory muscles, shallow breathing, pain w/inspiration, see saw movement |
| palpation of chest injury | chest expansion, subq emphysema (rice crispies) decrease fremitus (movement of air) trachea displacement |
| trachea displacement for pneumothorax | away from injured side |
| trachea displacement for hemothorax | toward injured side |
| percussion of chest injury | tympany= pneumothorax, dull= hemothorax or rupture diaphragm |
| auscultation of chest injury | decrease breath sounds, absent breath sounds, bowel sounds heard in chest |
| nursing intervention for chest trauma | cough, deep breath, IS, pain meds, splinting, chest tube maintenance |
| ARDS (acute respiratory distress syndrome) | ischemia, toxins, sepsis, inflammation |
| patho of ARDS | inflammation, increased capilary permeability, decreased lung surfactant, alceolar collapse, fibrosis |
| pulmonary edema | abnormal accumulation of fluid in the interstitial spaces in lungs, cardiogenic |
| most common cause of pulmonary edema | heart failure (red frothy sputum) |
| clinical manifestatins of ARDS | severe hypoxia, tachypnea, dyspnea, lung sound may be normal or abnormal (from inflammation not fluid overload) |
| medical management of ARDs | mechanical ventilation, prone position (1 hr to promote profusion), diuretics don't work |
| needs for emergency intubation | anesthesia, suction, ambu bag, O2, intubation kit, sedation, tape or ties, chest x-ray |
| care of intubated patient | reassurance, sedation, comfort, assess lung sounds (q 2-4 hrs), oral care, suction, SaO2 monitoring, ABGs, maintain placement, monitor for skin breakdown, monitor cuff inflation, position changes |
| indication for tracheostomy | airway obstruction, chronic resp failure, prevent aspiration, promote pulmonary hygiene |
| fenestrated trach | speaking valves |
| when to change cannula | every shift, maintain dry dressing |
| tracheomalacia | softening of trach |
| decannulation | dislodgement of trach |
| suctioning trachs | saline, hyperoxygenate, monitor SpO2, HR, VS, insert catheter until you elicit a cough, suction for 10-15 sec |
| risk factors for cancer of the larynx | smoking, drinking |
| cardinal syptom of larynx cancer | hoarseness, > 2 weeks w/ no symptoms of URI see MD |
| larynx cancer diagnosis | laryngoscopy, CT, tissue biopsy |
| tx for larynx cancer | chemo/radiation 1st to shrink, then surgery |
| larynx cancer post-op concerns | bleeding, infection, aspiration, loss of voice, trach will be converted to stoma |
| epiglottis | inflammation of epiglottis = emergency |
| causes of epiglottis | H. influenza, recent URI |
| symptoms of epiglottis | stridor, painful sore throat, inability to swallow, DROOLING |
| tx of epiglottis | IV steroids, antibiotics |
Created by:
aclelan
Popular Nursing sets