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SOPN Test 7
SOPN Resp Dysfuction Test 7 (2 of 3)
| Question | Answer |
|---|---|
| A cough that last more than 3 weeks? | May indicated Pulmonary Disease |
| Paroxysmal cough? | Spasmotic type, difficult to stop, occuring repeatedly without warning. |
| Cause of Paroxysmal cough? | Asthma, chronic bronchitis |
| Dry Cough? Productivie cought | Dry: with out sputnum Productive with sputnum. |
| What is the cause of excessive nasal secretions? | URI: nasal secretion are purulent and nasal mucosa is red. From dust, irritants fumes. Allergies: Nasal mucosa is pale and nasal secretions are watery. |
| Bloody Sputum? | Hemoptysis sometimes seen with TB and Cancer. |
| Lung Tissue does or does not feel pain? | Does not. |
| Pleuritis Pain: | Very sharp, intensified with deep breathing. |
| Intercostal Pain: | Achy pain from intercostal muscles when coughing or straining. |
| Hypoxemia: | Insufficient 02 in blood (PA02 decreased to <75mm Hg) |
| Hypoxia: | Inadequate tissue oxygenation causes: high altitude, anemia's, circulation impairment (hypotension decreased C02) monoxide posioning, cyandie poisoning. |
| Early Signs of Respiratory Dysfunction? | Restlessness, tachycardia, increased RR, irratability, apprehension. |
| Late Signs of Respiratory Dysfunction? | Cyanosis, heart arrythmias, impaired judgement, decreased level of consiousness, confusion, coma, death. |
| Hypercapnia: | INCREASE CO2 in the ARTERIAL BLOOD. (>45MG hG) NORMAL IS 35-45 aveolar ventilation cannot eliminate CO2 as CO2 increase there is an increase in Hydrogen ions resulting in ACIDOSIS |
| Cause of Hypercapnia? | Respiratory depression, pneumonia, pulmonary edema, & COPD. |
| Hypocapnia: | DECREASE C02 in ARTERIAL BLOOD too much CO2 is blown off (<35) |
| Cause of Hypocapnia: | Drug overdose, anethesea, head trauma, MD, Polio, asthma, embolism, brain tumor, any thing that effect respiratory system. |
| Respiratory Failure: | A non-specif diagnosis in which the repiratory system is unable to supply the body with sufficent 02 and cannot get rid of CO2 waste. |
| Cause of Respiratory Failure: | Acute or Chronic, airway obstruction depression in respiratory center "medulla". Impaired transmission from neverous system from medulla to respiratory muscles. |
| What do you include in Respiratory Assessment? | Pt Hx, chief complaint, signs & symptoms, smoking & working history (asbestos), cough, SOB, secretions, pain, how long symptoms last, do you need pillow to sleep (orhopnea). |
| What should you check during Respiratory Exam? | Nutrition, clubbing, skin color, nail beds, RR, observe chest. |
| Kussmauls breathing is? | Exceptionally deep respirations. |
| Cheyne-Stokes breathing is? | Cycles of apnea wth increased RR and depth then decreaed periods of apnea. |
| Barrel Chest in Respiratory Assessment? | Chest is rounded and anteriro to posterior diameter in increased, seen alot in EMPYSEMA. |
| Funnel Chest in Respiratory Assessment? | Decrease AP a congential depression of the sternum |
| Pigeon Breat in Respiratory Assessment? | Prominence of sternum with inceased AP diameter. |
| Kyphois in Respiratory Assessment? | Hunch back exaggerated curve of the thoraic spine. |
| Scoliosis Later Deformity in Respiratory Assessment? | S shaped curvature of the thoraci and lumbar spine. |
| Say "99" palpation test | Fremitus: Feel sound vibs with palms on chest. Increased in pneumonia, decrease with tumors and obstruction. |
| Percussion: Flat | Over a solid area |
| Percussion: Dull | Normal sound over the diaphragm, can mean consolidation over the lung. |
| Percussion: Tympany | Over the chest in ABNORMAL. |
| Percussion: Resonant | Normal is over the chest |
| Percussion: Hyperrsonant | Abnormal in emphysema |
| Normal Diaphragmatic excursion | 2.5 - 7 cm. Decreased in emphysema, Increase asicties or paralysis or pregnancy. |
| Vesicular Breath Sound | Normal: Quiet Low pitched sounds of air moving in and out of the aveoli and bronchioles. |
| Bronchial Breath Sound | Normal: Higher pitched, louder and longer the normal breath sound over the trachea |
| Broncho Vesicular Breath Sound | Normal: in between trachea and bronchioles. |
| Fine Crackles (rales) | Abnormal = originate in alveoli sounds like hair strands next to your ear = FLUID IN LUNGS. |
| Coarse Crackles (Rales) | Abnormal: Loud gurgling sounds = FLUID IN LUNGS. |
| What would the presence of Crackles in Breath sounds indicate? | Fluid in lungs, especially with pulmonary edema and left sided CHF. |
| Wheezes in breath sounds indicate what? | Is common wiht COPD and emhysema, obstructionHigh pitched = Asthma Low Pitch = Emphysema, COPD |
| Inspiratory Reserve | Amount of air you can inspire after a normal breath. |
| Tidal Volume | Normal amount of air inspired and expired in a normal breath. |
| Expiratory Reserve | Amount of air you can expire after a normal breath |
| Residual Volume | Amount of air left in your lung after a maximal inspiration and expiration done by way of a recording device. |
| ABG's | PH = 7.35 - 7.45 Pa02 = 75 - 100 PaCO2 = 35 -45 HC03 = 23 - 29 Sa02 = 94% |
| Respiratory Acidosis: | If bicarb is normal if uncompensated If bicarb is increased if compensated via the kidneys. |
| Respiortory Alkalosis: | Bicarb is normal is uncompensatedBicarb is decreased if compnsatd via the kidneys. |
| Pulse Oximetry | Measurement of oxygen saturation with a pulse oximeter |
| Sputum Studies | Best obtained in AM pt shoul brush teeth first. Put in sterile container, no saliva, just sputnum. |
| What does CXR Show? | Size, shape, poistion & Symentry of the lungs, heart, diaphragm and rib cage A & P view, many times doctor also orders lateral views. |
| Fluoroscopy views what? | Movement of chest and strucutures to be observed. Can also see the movement of the diaphragm. |
| Lung Scans Two types: | Ventilation: view air flowPerfusion: determines blood flow by radioisotopes IV. |
| Pulmonary Angiography | XRay of pulmonary vasculature (blood vessels) after the injection of contrast dye. Used to detect PULMONARY EMBOLI, TURMORS, LESIONS, OF PULMONARY VESSELS. |
| Nursing Intervention for Pulmonary Angiography? | Check peripheral pulses distal to the injetion site for obstruction. Check for bleeding, hemotoma, swelling or infection. Check CSM of the extremity. |
| Allergies to check for with Pulmonary Angiography? | Contrast Dye injected thru RA then through RV into the pulmonary artery. |
| What is direct visualization of the trachea and bronchus via endoscope called a brochoscope? | Bronchoscopy |
| What is Bronchoscopy used for? | Check for tumors, bleeding sites, collecting a biopsy via bronchial wash or brushing. |
| NI: For what? Check for Cough & Gag Reflex, Respiratory Distress, expect blood streaked sputnum, not fank bleeding, pt lying side position, sore throat? | Bronchoscopy. |
| What is Patient medicated with during Brochoscopy? | Atropine, which dries secrections, also a sedative to depress vagus never which could cause bradycardia, dysrhythmias, hypotension. |
| Drug to supress cough and gag reflex during Brochoscopy? | Idocaine |
| Direct visulization of larynx using laryngoscope? | Laryngoscopy |
| What drug is used during Larynoscopy and what is Laryngoscopy | Atropine, to dry secreations, used to check for inflammation, biopsy, evaluate laryngoscope. Done under local anethesia. |
| Endoscopic examination of the mediastinum | Mediastinoscopy, to detect cancer of lung, lymph nodes or biopsy. Done in OR. |
| What is the aspiration of fluid or air from pleural space? | Thoracentesis, to relieve repiratory distress d/t fluid in intra plueral space. |
| Procedure: Done at bedside or treatment room, 3 way stopcock and sterile container? | Thoracentesis, CXR after to determine if a pnuemothoax has occurred which is a COMPLICATION of this procedure. Monitor RR & respiratory distress. |
| Complications of Lung Biopsy? | Pneumothorax, air embolism, & hemorrage. |
| Management of Respiratory Disorders? | Breathing exercies, pursed lip breathing: prolongs expiration, to help prevent collapse of aveoli, more emptying of CO2 increased fresh air in. Thur nose out lips, practices blowing air bubbles thru straw in H20. |
| Abnormal Breath sounds? | Adventitious |
| Decreased Breath Sounds? | Obstruction or decreased air passing through the lungs. |
| Left Sided CHF breath sounds? | Crackles indicate pulmonary edema, Left sided CHF, congested heart failure. |
| Rhonchi Low pitched continous rumbling, snoring or rattling common with what disease? | Emphysema, and COPD. |
| When would pulse oximety be inaccurate? | In hyptotension, inflated BP cuff, vasoconstricting drugs, and nail polish. |
Created by:
keldog09
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