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respiratory
| Question | Answer |
|---|---|
| wheezes (condition) | asthma and COPD |
| crackles (condition) | pneumonia, pulmonary edema, and atelectasis |
| rhonchi (condition) | bronchitis |
| absent/diminished (condition) | pneumothorax, pleural effusion, or severe atelectasis |
| wheezes (cause) | bronchoconstriction and narrowed airways |
| crackles (cause) | fluid or collapsed alveoli |
| rhonchi (cause) | secretions accumulate in the larger airways and may clear with coughing |
| absent/diminished (cause) | reduced airflow to lung tissue |
| Nasal cannula: | 1–6 L/min (mild need) |
| Simple mask: | 5–10 L/min |
| Venturi mask: | Precise FiO₂ (COPD) |
| Nonrebreather: | 10–15 L/min (emergency) |
| High-flow NC: | Heated high O₂ |
| Trach collar/face tent: | Humidified O₂ |
| spirometry | measures lung function (volumes/airflow) |
| coughing/deep breathing/incentive spirometry | prevents atelectasis, expands lungs, clears secretions |
| peak flow meter | monitors asthma control |
| tracheostomy care and suctioning | keeps airway open; prevents infection |
| CPT and postural drainage | loosens and removes secretions |
| Thoracentesis def | Removes air or fluid from the pleural space for diagnosis or to improve breathing |
| Thoracentesis teaching/responsibilities | Position patient upright, leaning forward over table, Remain still and avoid coughing during procedure, Report chest pain or shortness of breath afterward |
| Bronchoscopy def | Visualizes airways to diagnose, biopsy, remove secretions, or remove foreign bodies |
| bronchoscopy teaching/responsibilities | Keep patient NPO 6–8 hours prior, Do not eat or drink until gag reflex returns, monitor for bleeding or resp distress |
| PPD Test (Tuberculin Skin Test) def | Screens for exposure to tuberculosis |
| PPD Test (Tuberculin Skin Test) teaching/responsibilities | Do not scratch or cover tightly, Must return for reading within 2–3 days. |
| postoperative nursing care for patients having thoracic surgery | assess airway, chest tube management, pain control, elevate HOB, early ambulation |
| preoperative nursing care for patients having thoracic surgery | deep breathing, coughing, incentive spirometer, pain management plan, early ambulation, education of chest tube (if needed) |
| chest tube management | keep below chest level, maintain ordered suction level if prescribed, asses resp status frequently, monitor drainage, complications to monitor: sudden incresae in drainage, resp problems, SQ emphysema |
| pH | 7.35 – 7.45 |
| PaCO₂ | 35 – 45 mmHg |
| HCO₃⁻ | 22 – 26 mEq/L |
| respiratory acidosis causes | hypoventilation (r/t drug overdose, alc intox, CNS depression), resp depression - retaining CO2 |
| respiratory alkalosis causes | hyperventilation, fear, anxiety (blowing off CO2) |
| Sx of respiratory acidosis | shallow breathing, cyanosis, confusion |
| Sx of respiratory alkalosis | tachypnea, kussmaul breathing ,anxiety |
| nursing care for respiratory acidosis | improve O2 |
| nursing care for respiratory alkalosis | paper bag, give medication to treat anxiety |
| metabolic acidosis causes | DKA, diarrhea, kidney failure - can't get rid of acid |
| Sx of metabolic acidosis | bradycardia, weak pulse (+1), hypotension, change in LOC, dysrhythmias, kussmaul |
| nursing care for metabolic acidosis | give insulin, admin sodium bicarb |
| metabolic alkalosis causes | excess sodium bicard, vomitting, NG tube suctiong |
| Sx for metabolic alkalosis | tachycardic, slow and shallow resp, dysrhthymias |
| nursing care for metabolic alkalosis | antiemetic (for vomiting), turn off suctioning (NG tube) |
| Acute Respiratory Distress Syndrome (ARDS) - def | Severe lung inflammation causes leaky capillaries → fluid in alveoli (noncardiogenic pulmonary edema) → impaired gas exchange → severe hypoxemia that does not improve with oxygen. |
| Acute Respiratory Distress Syndrome (ARDS) - Sx | severe hypoxemia, dyspnea, tachypnea, use of accessory muscles, crackles, decreased lung compliance (stiff lungs), cyanosis, restlessness |
| Pneumothorax patho | Air enters pleural space → lung collapses |
| pneumothorax Sx | Sudden dyspnea, unilateral absent breath sounds, chest pain |
| pneumothorax treatment | chest tube |
| pneumothorax nursing care/teaching | Monitor breath sounds, keep chest tube below chest (teaching - report sudden SOB) |
| Tension Pneumothorax patho | Air trapped → pressure compresses lung and heart |
| Tension Pneumothorax Sx | Severe respiratory distress, tracheal deviation, hypotension |
| Tension Pneumothorax treatment | Needle decompression → chest tube |
| tension pneumothorax nursing care/teaching | emergency recognition (teaching - immediate reporting or worsening breathing) |
| Flail Chest patho | Multiple rib fractures → unstable chest wall |
| flail chest Sx | Paradoxical chest movement, pain, hypoxia |
| flail chest treatment | Oxygen, pain control, ventilation if severe |
| flail chest nursing care/teaching | Support breathing, manage pain (teaching - Deep breathing despite pain) |
| Pneumonia patho | infection → alveoli fill with fluid/pus |
| Pneumonia Sx | Fever, cough, crackles, sputum, dyspnea |
| Pneumonia treatment | Antibiotics, oxygen, fluids |
| Pneumonia nursing care/teaching | incentive spirometry, ambulation (teaching - Finish antibiotics, vaccines) |
| bronchitis Sx | Productive cough, wheezing, rhonchi, mild dyspnea |
| Influenza patho | Viral respiratory infection |
| Influenza Sx | Fever, body aches, fatigue, cough |
| Influenza treatment | Antivirals early, fluids, rest |
| Influenza teaching | Vaccination, hand hygiene, stay home when sick |
| Pleuritis patho | pleural inflammation |
| Pleuritis common causes | infection, PE, pneumonia |
| Pleuritis Sx | Sharp pleuritic chest pain worse with breathing, shallow respirations |
| COPD | Patho: Progressive airflow limitation Sx: Chronic cough, dyspnea, wheezing Treatment: Bronchodilators (albuterol, ipratropium), steroids, oxygen (low flow) Nursing Care: Monitor O₂ (88–92%), pursed lip breath Teaching: Smoking cessation, inhaler use |
| Chronic Bronchitis | Patho: Chronic inflammation → excess mucus → airway obstruction S/S: Productive cough ≥3 months for 2 years, rhonchi, wheezing Treatment: Bronchodilators, steroids, oxygen Complications: Cor pulmonale Teaching: Avoid irritants, vaccines |
| Emphysema | Patho: Alveolar wall destruction → loss of elasticity → air trapping Sx: Barrel chest, minimal cough, prolonged expiration Treatment: Bronchodilators, oxygen (careful use) Complications: Pneumothorax Teaching: Pursed-lip breathing, energy conservation |
| asthma | Patho: Reversible bronchoconstriction + inflammation S/S: Wheezing, chest tightness, dyspnea Treatment: Rescue - Albuterol Control - Inhaled corticosteroids Nursing Care - Peak flow monitoring Teaching - Avoid triggers, rinse mouth after steroids |
| TB | Patho: Mycobacterium infection → granulomas in lungs Sx: Night sweats, weight loss, chronic cough, hemoptysis Treatment: RIPE therapy (long-term) Nursing Care: Airborne precautions (N95) Teaching: Take full 6–9 months of meds |
| Cancer of the Larynx — Post-Op (risks) | Airway obstruction, bleeding |
| Cancer of the Larynx — Post-Op (nursing care) | Maintain airway (trach care, suction PRN) Humidified oxygen Monitor for bleeding Elevate HOB |
| Cancer of the Larynx — Post-Op (patient teaching) | Clean and protect stoma Use alternative communication methods Avoid swimming; cover stoma in cold air Smoking cessation |
| Cystic Fibrosis (CF) | Patho: Thick, sticky mucus from genetic disorder → blocks lungs & pancreas Sx: Chronic cough, thick sputum, frequent infections, salty skin, poor weight gain |
| Cystic Fibrosis (CF) treatment and teaching | Treatment: CPT, bronchodilators, pancreatic enzymes Teaching: High-calorie diet, enzyme replacement, infection prevention |
| Pharyngitis | Cause: Viral or strep (Group A strep) S/S: Sore throat, fever, swollen lymph nodes Treatment: Antibiotics if strep Teaching: Finish antibiotics; replace toothbrush after 24 hrs of antibiotics |
| Tonsillitis (Post-op risks) | Bleeding, airway obstruction |
| Tonsillitis (nursing care/things to avoid) | Nursing Care: Side-lying position Monitor for frequent swallowing (bleeding sign) Assess throat for bright red blood Give cold fluids, ice collar Avoid: Red fluids, straws, coughing |
| Epiglottitis | Patho: Swollen epiglottis → airway obstruction S/S: Drooling, high fever, tripod position, stridor Priority: DO NOT put tongue blade in mouth Treatment: Airway management, IV antibiotics |
| Laryngotracheobronchitis | Patho: Viral inflammation → upper airway swelling S/S: Barking cough, inspiratory stridor Treatment: Humidified air, steroids, racemic epinephrine Teaching: Cool mist, monitor breathing |
| RSV (Respiratory Syncytial Virus) | Patho: Viral bronchiolitis → mucus & airway swelling S/S: Wheezing, crackles, retractions, apnea in infants Treatment: Supportive care, oxygen Precautions: Contact precautions Priority: Monitor hydration & respiratory status |
| Pediatric Asthma | Patho: Reversible airway inflammation + bronchospasm S/S: Wheezing, coughing (worse at night), SOB Treatment: Albuterol (rescue), inhaled steroids (control) Teaching: Spacer use, avoid triggers, peak flow monitoring |
| asthma safety zones | Green: No symptoms → continue routine meds Yellow: Cough, wheeze, SOB → use rescue inhaler and monitor Red: Severe symptoms, rescue inhaler not helping → seek emergency care |
| peds vs adults with resp issues | “Small, soft, fast, easily tired → pediatric lungs are vulnerable.” |
| Sx of respiratory distress in the pediatric patient. | “Fast, flaring, retracting, noisy, tired → distress.” |
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