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Nur210 Respiratory

Pharmacology respiratory

Where does gas exchange occur? In the alveoli of the lungs.
What is ventilation? The body's ability to get air in and out; chest expansion
What is compliance? Ability to expand bronchioles and alveoli Compliance is decreased by inflammation, infection, and increased mucus production which can be manifested by bronchospasms, mucus, CHF, pulmonary edema, and atelectasis
What are factors that affect diffusion? Decreased surface area Thickness of alveoli membrane Perfusion inadequate to alveoli More vasculature in lower part of lungs because of gravity pulling blood downward
What affects transportation of oxygen and carbon dioxide? Decreased cardiac output Decreased hemoglobin
Is it ventilation compliance, diffusion or transportation? Pneumonia (bacteria in alveoli) diffusion Bronchitis (bronchials affected) compliance Anesthesia (loss of sensation) Ventilation Fractured ribs ventilation Anemia Transportation CHF Transportation and diffusion Asthma compliance PE transp/diffusion
What are symptoms of acute hypoxia? Agitated, confused Respiratory rate increases Pulse rate goes up
What are symptoms of chronic hypoxia? Fatigue and lethargy Increased hemoglobin - makes blood thicker, so harder to breathe Increased muscle use
What are some assessment findings of respiratory status? Tachypnea - fast breathing Bradypnea - slow breating Hyperventilation - faster, deeper breaths Hypoventilation - slower, shallow breaths SOB - shortness of breath Dyspnea - difficulty breathing/objective Orthopnea - cardiac patients; SOB while lay
Breathing pattern symptoms of hypoxia are? Rales occur in alveoli Rhonci occur in bronchioles (mucus, fluid) Wheezing - tubing system collapsing on itself
What are some diagnostic tests for respiratory status? PEFR - peak expiratory flow rate Chest x-ray Lung scan Thoracentesis Endoscopy Pulse oximetry, < 86% emergency; < 80% life threatening Arterial blood gases Sputum specimens
What are nursing interventions for respiratory distress? Monitor - symptoms of hypoxia, breathing pattern, lung sounds, diagnostic tests Actions - maintain open airway, elevate HOB, TC & DB, chest physiotherapy (massage), suctioning, nebulization
Major causes of airway obstruction are? Problems with compliance Bronchial smooth muscle contraction Mucus hypersecretion Inflammation - chronic bronchitis, asthma Infection - pneumonia
What are medications used to improve respiratory function? Antibiotics to treat bacterial infections Bronchodilators Glucocroticoid steroids
How are inhaled medications classified? Bronchodilators - selective beta-2-agonists Metered dose inhaler (MDI), nebulizer Relievers -SABA - immediate relief Controllers - LABA - delayed onset
What are ADRs of bronchodilators? Increased pulse Increased BP Fine muscle tremors Anxiety
What is a glucocorticoid? Inhaled steroid Inhibits inflammation First line of therapy for moderate to severe asthma
What are ADRs of glucocorticoids? Oropharyngeal candidiasis (fungal infection) Dysphonia (hoarseness) Promotes bone loss (less than oral steroids, though)
What education should nurses give to patients about glucocorticoids? Gargle after administration Use a spacer Take calcium with vitamin D One minute between dosages Hold breath after administration and breathe through pursed lips Administer bronchodilator before steroid
What is oral steroid therapy used for? When symptoms not controlled with safer drugs Used for rheumatoid arthritis, systemic lupus, inflammatory bowel disease, allergies
What are primary uses of oral steroid therapy? Anti-inflammatory K+ loss Na+ retention Immunosuppressor Too many side effects with long-term therapy
What are nursing interventions with oral steroids? Monitor for K+ levels (hypokalemia), fluid retention (retaining Na+), osteoporosis, gastric ulcers, infections Actions - increase K+ intake, prevent infection, increase Ca2+ intake
What must patients be taught about oral steroids? Do not stop taking abruptly Mood swings possible Take with food No NSAIDs - increase GI ulcer incidence
What are some properties of methylxanthines? Caffeine, theophylline (oral), aminophylline (IV) Bronchodilators - relax smooth muscle of bronchi Narrow TI Toxicity - arrythmias and seizures Early sign of ADR - nausea
Created by: ssbourbon



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