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
Respiratory
| Question | Answer |
|---|---|
| Alveolar ducts | Basic unit of Gas Exchange |
| What percent of lung function is from the right lung | 60-65% |
| What is the most significant factor in chronic respiratory illness and lung cancer | Smoking |
| Atelectasis | Alveolar collapse -reduce gas exchange because alveolar surface area is reduced |
| Age related changes in respiratory system | Lose elasticity after age 50 -decreased cough efficiency and reduced ciliary activity -Vital capacity decreases -Increased lung rigidity or loss of elastic recoil -Increased susceptibility to infections -Muscle atrophy |
| What are some factors that predispose a patient to respiratory problems? | -Anesthesia, LOC, Narcotics, Aspiration, Pollution, Smoking/Tobacco, Bed rest, Alcohol, DVT/PE, corticosteroids, chemotherapy, COPD |
| What are the risks to smoking | -Decreased lung capacity, vasoconstriction, destroy cilia action, inhibits macrophages can cause a cough |
| Left tracheal shift | Alkalosis and decreased DPG |
| Right tracheal shift | Decreased pH, increased metabolic demand, increased body temp and hypoxia |
| What could cause a tracheal deviation from midline away from the affected area | Tension pneumothorax, large pleural effusion, mediastinal mass and neck tumors |
| What could cause a tracheal deviation from midline toward the affected area | Pneumonectomy, fibrosis, and atelectasis |
| Health promotion and maintenance | -Minimize exposure to inhalation irritants (home, occupations, work exposures) -Smoking cessation- hookah, water pipe, vaping -Limit or cease exposure to second hand and third hand smoke |
| RBC | 4-6 million/m3 -Increased level= polycythemia- often related to excessive production of erythropoietin in response to chronic hypoxic status -Decreased level= indicate possible anemia, hemorrhage, or hemolysis |
| ABG | PaO2= 80-100 mm Hg PaCO2= 35-45 mm Hg pH= 7.35-7.45 HCO3= 22-26 mEq/L SpO2= 95-100% |
| PaO2 | Increased= indicates possible excessive O2 admin Decreased= possible COPD, chronic bronchitis, cystic fibrosis, atelectasis, hypoxia |
| PaCO2 | Increased= possible COPD, astma, pneumonia, anesthesia effects, or use of opioids Decreased= Hyperventilation/respiratory alkalosis |
| pH | Increased= metabolic or respiratory alkalosis Decreased= metabolic or respiratory acidosis |
| HCO3 | Increased= Metabolic acidosis Decreased= Metabolic alkalosis |
| SpO2 | Decreased= Possible impaired ability of hemoglobin to release O2 to tissues |
| What is the best way to determine need for oxygen therapy | ABG |
| pH + PaCO2 | Resiratory (acidosis and alkalosis) |
| pH + HCO3 | Metabolic (acidosis and alkalosis) |
| Chest x-ray | Evaluate status of chest and provide a baseline for comparison with future changes -used to assess lung pathology -can also detect pleural fluid and placement of endotracheal tube |
| CT | Assess soft tissues with consecutive cross-sectional views of entire chest |
| Pulse oximetry | Identifies hemoglobin saturation with oxygen -Uses a wave of infrared light and sensor placed on patients finger, toe, nose or earlobe -Does not replace ABG measurement |
| Capnometry and capnography | Measures amount of CO2 present in exhaled air, which is an indirect measurement of arterial CO2 levels |
| Pulmonary function tests | Measures lung volume and capacities, flow rates, diffusion capacity, gas exchange, airway resistance and distribution of ventilation -Used to detect abnormalities in respiration and extent of those abnormalities |
| Bronchoscopy | Visualization of tracheobronchial tree via a scope advanced through mouth or nose |
| Thoracentesis | Aspiration of pleural fluid for therapeutic or diagnostic purposes -Fluid collected is sent to lab and assessment for: specific gravity, glucose, protein, pH, culture and sensitivity |
| What is a complication of thoracentesis | Pneumothorax |
| Lung biopsy | Performed to obtain histologic analysis, culture or cytologic examination -performed in radiology department |
| Hypoxemia | Low levels of oxygen in BLOOD |
| Hypoxia | Decreased TISSUE oxygenation |
| What is an early sign of hypoxemia | Restlessness, tachycardia, increased BP, anxiety and change in respiratory patterns |
| What is a late sign of hypoxemia | Confusion, stupor, cyanosis of skin, bradypnea, bradycardia, hypotension, cardiac dysrhythmias |
| What is the chronic or land standing sign of hypoxemia | Lethargy, inattention, apathy, delayed reaction time |
| Oxygen toxicity | Related to concentration of O2 delivered, duration of O2 therapy and degree of lung disease present -initial problems- Dyspnea, nonproductive cough, chest pain beneath sternum, GI upset and crackles on auscultation |
| Absorption atelectasis | New onset of crackles/decreased breath sounds |
| Cyanosis | Caused by desaturation of hemoglobin -Very late indicator of hypoxia |
| Carbon Dioxide | Reflection of respiratory component of acid-base balance status -lung control amount of CO2 in blood by increased or decreased respiratory rate |
| Hypercapnia (Hypercabia) | PaCO2 > 45 mm Hg -Hypoventilation (ventilatory failure) -Symptoms- increased HR, BP, RR, headaches, confusion, drowsiness, mental cloudiness |
| Hypocapnia (Hypocabia) | PaCO2 <35 mm Hg -Hyperventilation -Symptoms- Inability to concentrate, numbness and tingling in extremities, tinnitus, and at times of LOC |
| Low flow O2 delivery system | Does not provide enough flow to meet total O2 and air volume -Nasal cannula, simple facemask, partial rebreather mask, non-rebreather mask |
| Nasal Cannula | -Flow rates of 1-6 L/min -Assess patency of nostrils, changes in RR and depth |
| Anatomical dead space | Place where airflows but the structures are too thick for gas exchange |
| Simple facemask | Deliver O2 up to 40-60 % minimum of 5 L/min -Mask fits securely over nose and mouth -Monitor closely for aspiration |
| Partial rebreather mask | Provides 60-75% with flow rate of 6-11 L/min -1/3 exhaled tidal volume with each breath |
| Non-rebreather mask | Can deliver FIO2 greater than 90% -Used for unstable patients requiring intubation -Ensure valves are patent and functional |
| High flow O2 delivery system | Can deliver 24-100% at 8-15 L/min -Venturi mask, and T-piece |
| Venturi Mask | Deliver most accurate O2 concentration without intubation -Switch to nasal cannula during mealtimes |
| T-piece | Apparatus for attachment to an endotracheal or tracheostomy tube -ensures humidification through creation of mist |
| When should mist be used on a O2 delivery system | Any time the O2 flow rate is higher than 5 L/min |
| NPPV | Noninvasive positive-pressure ventilation -uses positive pressure to keep alveoli open, improve gas exchange without airway |
| BIPAP | Cycling machine delivers a set of INSPIRATORY positive airway pressure each time patient begins to inspire |
| CPAP | Effect to open collapsed alveoli -Delivers set positive airway pressure throughout each cycle of INHALATION and EXHALATION -opens collapsed alveoli |
| Transtracheal oxyen delivery | Long term delivery of O2 into the lungs -Small flexible catheter is passed into trachea through small incision |
| Home oxygen therapy | Compressed gas in tank or cylinder -Liquid oxygen in reservoir -Oxygen concentrator |
| Facial trauma | -Priority action is airway assessment (for GAS exchange) -Manifestations- Stridor, Dyspnea, anxiety/restlessness, Hypoxia, hypercabia, decreased O2 saturation, loss of consciousness and cyanosis |
| Cricothyroidectomy | Creation of temporary airway by making a small opening in the throat between thyroid cartilage and cricoid cartilage |
| Tracheotomy | Surgical incision into trachea to create an airway |
| Fixed Occlusion | wiring the jaws together with mouth in a closed position |
| Sleep Apnea | Periodic cessation of breathing during sleep -Most common in men over 50 and postmenopausal women |
| Sleep apnea symptoms | Loud snoring, frequent night walking, morning headaches, intellectual deterioration, irritability or other personal changes, physiologic changes such as HTN and cardiac arrhythmias |
| Pickwickian syndrome | Obesity hypoventilation syndrome |
| Obstructive Sleep apnea | Breathing disruption during sleep that lasts at least 10 seconds and occurs a minimum of five times per hour (hypopnia) -Excessive day time sleepiness, inability to concentrate, irritability |
| What factors contribute to obstructive sleep apnea | Sleep apnea include obesity, large uvula, short neck, smoking, enlarged tonsils or adenoids and oropharyngeal edema |
| Obstructive sleep apnea-treatment | Nonsurgical- change in sleep position, weight loss, positive-pressure ventilation Surgical- adenoidectomy, uvulectomy or uvulopalatopharyngoplasty |
| Apnea impairs ___________ and increased blood ______ and decreased _______ | Gas exchange, CO2, pH |
| Upper airway obstruction | Interruption in airflow through nose, mouth, pharynx or larynx -Life-threatening emergency -early recognition essential in preventing further complication, including respiratory arrest |
| Upper airway obstruction-causes | Tongue edema, tongue occlusion, laryngeal edema, peritonsillar and pharyngeal abscess, head and neck cancer, thick secretions, stroke and cerebral edema, smoke inhalation |
| Pulmonary Embolism | Obstruction of pulmonary artery or one of its branches by an embolus -Often associated with: trauma, surgery, pregnancy, CHF, age older than 50, hypercoaguable states, prolonged immobility |
| How do most PE develop | from thrombi-originate in deep veins of legs |
| What is the clinical manifestations of a PE | Dyspnea, chest pain, fever, tachycardia, apprehension, cough, hemoptysis, diaphoresis, syncope -Death usually occurs within 1 hour of symptoms |
| PE-NI | Prevention is key -leg exercises, no crossing legs, TED hose and SCD's -prophylactic heparin, early ambulation, active and passive ROM |
| Asthma | Often a chronic condition in which airflow obstruction in airways occurs intermittently -intermittent and reversible airflow obstruction |
| Asthma can produce three main airway responses: | Smooth muscle spasm of bronchi and bronchioles -Edema of mucus membranes -Accumulation of tenacious secretions |
| Common irritants of Asthma | Seasonal and Perreneal, Exertion, stress, emotional upsets, sinusitis and GERD |
| What are the three common signs of Asthma | Cough, dyspnea and wheezing |
| Status asthmaticus | Severe life threatening acute episodes of airway obstruction that intensifies once it begins and often does not respond to usualy therapy -patient can develop pneumothorax and cardiac arrest |
| Long Acting Beta Agonists | Causes bronchodilation through bronchiolar smooth muscle by binding to and activating pulmonary beta-receptors (Salmeterol or Indacaterol) |
| Short Acting Beta Agonists | Primary use is fast acting reliever drug to be used either during an asthma attack or just before engaging in activity (Albuterol) |
| Cholinergic antagonists | Causes bronchodilation by inhibiting parasympathetic nervous system, allowing sympathetic system to dominate (Ipratropium) |
| Cromone | Stabilize membranes of mast cells and prevents release of inflammatory mediators (Nedocromil) |
| Leukotriene Modifier | Blocks leukotriene receptor, preventing inflammation (Montelukast) |
| Chronic Obstructive pulmonary disease (COPD) | Include emphysema and chronic bronchitis -Progressive and irreversible and may be associated with airway hyperactivity |
| COPD Nutrition | Small meals throughout the day (more frequent) -No gas producing foods -High carb, high protein and low sugar -Before eating cough and clear mucus, and use bronchodilator (~30 mins before eating) -Avoid eating dry and crumbling foods) |
| Chronic Bronchitis | Inflammation of bronchi and bronchioles -Caused by chronic exposure to irritants -Inflammation, vasodilation, congestion, mucosal edema, bronchospasm |
| Emphysema | Loss of lung elasticity -Hyperinflation of lung and present in COPD -Air trapping occurs |
| Air trapping | loss of elastic recoil in alveolar walls, over stretching and enlargement of alveoli into air-filled spaces called bullae and collapse of small bronchioles |
| COPD-NI | -O2 therapy- low concentration to raise PO2 to 65-80 mm Hg -Pulmonary rehab- increased fluids to 3 L/day, teach purse lip breathing -Nutrition- Small meals throughout day high protein -Prevent weight loss, minimize anxiety |
| COPD-Nonsurgical management | -Breathing techniques, positioning (upright), effective coughing (improve airflow), O2 therapy (relief of hypoxia), Exercise conditioning, suctioning and hydration |
| Cystic fibrosis | Lack of CFTR causes improper regulations of chloride channel and chloride is prevented from leaving cells -Affects many organs besides lungs including GI, liver, pancreas -Mean survival age is 30 -Autosommal recessive disorder |
| Clinical manifestations of CF | -Failure to regain 10% of weight loss at birth -Failure to thrive -Protruding abdomen with atrophy of extremities and buttocks -Cardiac enlargement, RV hypertrophy -Presence of cough or wheezing during first 6 months of age |
| How to diagnosis CF | Sweat test, Amniocentesis, chronic villus sampling |
| Sweat test | Sweat chloride analysis- positive for CF when chloride levels in sweat ranges between 60-200 mEq/L |
| CF-NI | -Chest physiotherapy, CP, PD, humidification -Balanced nutrition, increased salt, increased calcium, double door vitamins |
| Corona Virus Disease | -Caused by an infection with severe acute respiratory syndrome -highly transmissible among humans -Risks- elderly and immunosuppressed (children too) |
| COVID Clinical manifestations | Fever, chills, cough, fatigue, myalgia, arthralgia, hepatic and renal dysfunction, pneumonia |
| What do labs show for COVID? | Lymphacytopenia, leukopenia, thrombocytopenia, elevated inflammatory biomarkers |
| Rhinosinusitus | Inflammation of mucous membranes of one or more of the sinuses and usually associated with rhinitis |
| What causes rhinosinusitus | Anything that blocks sinuses from draining -Hay fever or Allergies -viral resolves (7-10 days) -Bacterial resolves (10 + days) |
| Clinical manifestations Rhinosinusitus | Headache, nasal irritation and congestion, sneezing, rhinorrhea, (purulent nasal drainage, fever, erythema, swelling and fatigue) |
| Rhinosinusitus interventions | -Antihistamines, leukotriene inhibitors, mast cell stabilizers, decongestants, antipyretics, and antibiotics -complimentary-vitamin C and zinc -Surgical- if all else fails endoscopic sinus surgery |
| Influenza | Acute viral respiratory infection -Viruses continually change over time, usually by mutation -Risks- older than 65 or under 5, nursing home patients, COPD patients, cardiac disease, diabetics, and chronic renal disease |
| What are the complications of influenza | Pneumonia |
| What is the treatment for influenza | Prevention is key (influenza vaccine) -Symptomatic treatment -Antiviral influenza |
| Pneumonia | Inflammation of lung parenchyma that is caused by a microbial agent -Inflammatory reaction may occur in alveoli and produce exudate that interferes with O2/CO2 diffusion |
| Community acquired pneumonia | Occurs in community setting or within the first 48 hours of hospitalization |
| Hospital acquired pneumonia | Nosocomial- onset of symptoms more than 48 hours after admission |
| Aspiration pneumonia | Entry of endogenous or exogenous substances into the lower airway -origin of aspirated material bacteria from upper airway, gastric contents, exogenous chemicals, irritating gases |
| Gas-exchange exemplar pneumonia | Excess fluid in lungs resulting from inflammatory process -Inflammation triggered by infectious organisms, inhalation of irritants |
| Risk factors for Pneumonia | Smoker, prolonged immobility, alcohol/substance abuse, advanced age, general anesthesia, and immunosupressed |
| Treatment of Pneumonia | If bacterial- a culture and sensitivity on blood and sputum will be obtained first, then started on antibiotic therapy -Encourage fluids- 2500-3000 mL/day if not contraindicated -Pneumococcal vaccine (prevention) |
| Complications of Pneumonia | Shock, respiratory failure, atelectasis, pleural effusion and superinfection |
| Tuberculosis | A disease caused by mycobacterium tuberculosis -can affect any part of body but usually attacks the lungs -increased incidence secondary to HIV infections |
| Risk factors for TB | Substance abuse, immunocompromised, dose contact, living crowded substandard condition, instuitionalized, emigrate, healthcare worker |
| Early infection signs of TB | Immune system fights infection -Fever, paratracheal lymphadenopathy or dyspnea |
| Early Primary progression of TB | Immune system does not control initial infection -inflammation of tissues ensues -nonproductive cough develops |
| Late primary progression of TB | Cough becomes productive -Patient are susceptible to reactivation of disease -infection can reappear when immunosuppression occurs |
| Latent TB | No signs or symptoms occur -patient does not feel sick |
| How to diagnosis TB | PPD skin test (Mantoux) , Blood analysis, Sputum culture |
| TB-NI | Promote airway clearance -decreased drug resistance and infection spread -Manage anxiety, improve nutrition and manage fatigue |
| Treatment for TB | Bed rest, prophylactic therapy -High carb, high protein, high vitamin diet -INH (Isoniazid) |
| Pertusis | Highly contagious, bacterial respiratory infection |
| First phase of pertusis | catarrhal- symptoms resemble the common cold |
| Second phase of pertusis | Paroxysmal- severe coughing, coughing spasms, thick exudate in small airways |
| Third phase of pertusis | Covalescent- recovery can last for months |
Created by:
MCGEEMAIDEN