ATI-MedSurge-RESPIRATORY
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| Nasal cannula | FiO2 – 24% to 44% at flow rates of 1 to 6 L/min
-Pt. are able to eat, talk, and ambulate
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| Simple face mask | FiO2 – 40% to 60% at flow rates of 5 to 8 L/min
-may be more comfortable than a nasal cannula
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| Partial rebreather mask | FiO2 – 60% to 75% at flow rates of 6 to 11 L/min
-allows pt. to rebreathe 1/3 exhaled air + room air
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| Nonrebreather mask | FIO2 – 80% to 95% at flow rates of 10 to 15 L/min
-delivers highest O2 possible (except intubation)
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| Venturi mask | FIO2 – 24% to 55% at flow rates of 4 to 10 L/min via different sized adaptors
-delivers most precise O2
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| Aerosol mask, face tent | FiO2 – 24% to 100% at flow rates of at least 10 L/min
-for pts. w/facial trauma, burns, and/or thick secretions
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| T-piece | FiO2 – 24% to 100% at flow rates of at least 10 L/min
-for pt.w/ tracheostomy, laryngectomy, or endotracheal tube
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| Cromolyn sodium (Intal) | anti-inflammatory agent; asthma maintenance
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| Albuterol (Proventil) | short-acting B2 adren-agonist, acute asthma attack
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| Fluticasone and Salmeterol (Advair Discus) | glucocorticoid / long-acting B2 adren-agonist; asthma maintenance
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| Prednisone (Deltasone) is indicated after? | severe exacerbation of asthma for anti-inflammatory effects
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| Acute respiratory failure (ARF), is caused by? | failure to adequately ventilate and/or oxygenate
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| Ventilatory failure, is due to... | a mechanical abnormality of the lungs/chest, diaphragm, or respiratory control center of the brain
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| Oxygenation failure, is due to... | lack of perfusion to pulmonary capillary bed (a pulmonary embolism) or alteration of gas exchange(pulmonary edema, pneumonia)
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| Acute respiratory distress syndrome (ARDS), is? | a state of acute respiratory failure with a high mortality rate
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| A reduction in surfactant does what to alveoli? | weakens the alveoli, leads to worsening edema
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| Severe acute respiratory syndrome (SARS) | result of a viral infection (mutated corona viruses) a group of viruses that also cause the common cold
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| Pt. taking Albuterol should be monitored for? | Tachycardia
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| Respiratory failure, lab findings? | Room air: PaO2 <60 mm Hg, SaO2 <90%, PaCO2 >50 mm Hg, pH <7.30 (hypoxemia, hypercarbia)
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| COPD, pt. education? | -encourage flu / pneumonia vaccine
-high calorie/protein meals
-rest periods
-hand hygiene
-meds / Oxygen as prescribed
-smoking cessation
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| Montelukast (Singular), used for? | Leukotriene antagonists; prophylaxis of asthma exacerbation
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| Montelukast (Singular), should be administered? | daily, evenings
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| A pulmonary embolism (PE) occurs when? | a substance (solid, gaseous, or liquid) enters venous circulation and forms a blockage in the pulmonary vasculature
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| The most common cause of a pulmonary embolism is? | emboli originating from deep vein thrombosis (DVT)
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| Highest nursing priority for pt. w/just diagnosed with pulmonary embolism? | administration of an anticoagulants – eg. Enoxaparin (Lovenox), heparin, and warfarin (Coumadin)
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| Tracheotomy suctioning should be applied when? | on withdrawal of the catheter
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| Thoracentesis, is used to confirm? | hemothorax
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| The greatest risk following a thoracentesis is? | pneumothorax indicated by decreased breath sounds
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| COPD pt. has productive cough w/green sputum, nursing intervention? | notify HCP
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| COPD, S/S? | crackles and wheezes heard upon auscultation / SOB / Clubbing of fingers and toes / Rapid and shallow breathing
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| ABG - pH measures? | the amount of free hydrogen ions in arterial blood
7.35 to 7.45
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| ABG - PaCO2 measures? | partial pressure of carbon dioxide
35 to 45 mm Hg
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| ABG - HCO3 measures? | concentration of bicarbonate in arterial blood
22 to 26 mEq/L
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| ABG - PaO2 measures? | partial pressure of oxygen
80 to 100 mm Hg
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| ABG - SaO2 measures? | percentage of O2 bound to Hgb as compared to amount that can be carried
95 to 100%
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| Arterial puncture - preprocedure? | - obtain heparinized syringe
- perform Allen's test prior to puncture
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| Allen's test is performed to? | test patency of radial / ulnar arteries
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| Allen's test is performed by? | compressing radial (ulnar) pulse / pt. forms fist / patient relax hand while nurse release artery pressure, hand should turn pink quickly
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| Purified protein derivative skin tests are performed on TB pts. for how long? | life; even when disease is not active
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| Rifampin (Rifadin), turns urine and secretions _____ | orange
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| Rifampin (Rifadin), should be taken when? | mornings, on an empty stomach
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| The current four-medication regimen includes? | isoniazid (Nydrazid), rifampin (Rifadin),pyrazinamide (PZA), and ethambutol hydrochloride(Myambutol)
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| The three types of ventilator alarms are? | volume, pressure, apnea
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| Volume (low pressure) alarms indicate a low exhaled volume due to? | a disconnection, cuff leak, and/or tube displacement
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| Pressure (high pressure) alarms indicate? | excess secretions, client biting
the tubing, kinks in the tubing, client coughing, pulmonary edema,
bronchospasm, and/or pneumothorax
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| Apnea alarms indicate? | that the ventilator does not detect spontaneous respiration in a preset time period.
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| A Bronchoscopy can identify? | airway problems, cancer and lung disease
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| Bronchoscopy - PREprocedures - Nursing Actions | Check pt. for allergies / use of anticoagulants, remove dentures (if appl), pt. NPO 8 to 12 hr, obtain baseline vitals / place pulse oximeter, admin meds
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| Bronchoscopy - POSTprocedures - Nursing Actions | ensure gag reflex , monitor vitals and pulse oximeter E. 15 min until stable, monitor for significant fever, productive cough, significant hemoptysis, hypoxemia, encourage coughing and deep breathing E 2 hr.
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| Bronchoscopy - pt. Education | Instruct pt. to gargling with salt water or use of throat lozenges, discourage: smoking, talking, and coughing for several hours
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| If chest tube becomes disconnected, nurse should have in pt. room? | a pair of padded clamps; in case tubing becomes disconnected
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| In bacterial pneumonia, temperature? | rises; (38.8 C / 101.8 F)
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| Following total laryngectomy for laryngeal cancer, priority assessment is? | airway patency
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| Expected findings of chest tube insertion? | tidaling in the water seal chamber /
continuous bubbling ONLY in the SUCTION CHAMBER, fluctuation of draining on respiration, small-dark red clots in tubing, draining > 100mL in 1st hr PostOP
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| Nasopharygeal suctioning is contraindicated in pts. with? | closed head injuries
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| Continuous bubbling in water seal chamber is an indication of? | an air leak, requires immediate action
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| Chest tube drainage of <100mL / hr following thoracic surgery (is / is not) an expected finding? | is, does not require further action
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| Small-red clots in chest tube (is / is not an expected finding? | is, does not require further action
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| Tactile Fermitus is (decreased /increased) in pt. with lung cancer? | increased; due to airspace being replaced with tumor tissue
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| Masses in lung tissue will sound? | dull or flat on percussion
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| Peripheral edema (is / is not) associated with lung cancer? | is not
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