MedSurge-Respiratory
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| ABG - pH, value: | 7.35 - 7.45
🗑
|
||||
| ABG - PaO2 | 80 - 100 mmHg
🗑
|
||||
| ABG - SaO2 | >95%
🗑
|
||||
| ABG - PaCo2 | 32 - 48 mmHg
🗑
|
||||
| HCO3 | 22 - 26 mEq/L
🗑
|
||||
| Tissue hypoxia and cardiac dysrhythmias can be expected at PaO2 /SpO2 values? | <40 PaO2 / <75 SpO2
🗑
|
||||
| SpO2 is? | hemoglobin saturation (the degree to which oxygen is bound to hemoglobin)
🗑
|
||||
| PaO2 is? | plasma saturation (how much oxygen is avail. in the alveoli to dissolve in the blood)
🗑
|
||||
| PaCO2 is? | the measurement of the partial pressure of carbon dioxide dissolved in the plasma
🗑
|
||||
| Resonance: sound / location? | low-pitch / over normal lungs
🗑
|
||||
| Hyperresonance: sound / location? | loud, low-pitch / hyperinflated lungs (eg. asthma, chronic obstructive lung disease)
🗑
|
||||
| Dull: sound / location? | medium intensity pitch / solid and lung tissue, liver, pneumonia, fluid filled pleural space
🗑
|
||||
| Flat: sound / location? | soft, high-pitch / dense tissue w/no air (posterior chest below diaphragn)
🗑
|
||||
| Lung tissue, sound? | resonant
🗑
|
||||
| Liver, sound? | dull
🗑
|
||||
| Heavy muscles and bones, sound? | flat
🗑
|
||||
| Stomach, sound? | tympany
🗑
|
||||
| Spinous process, sound? | flat
🗑
|
||||
| Scapula, sound? | flat
🗑
|
||||
| viscera, sound? | flat
🗑
|
||||
| The body's oxygen is carried attached to? | hemoglobin molecules
🗑
|
||||
| Formula for SpO2? | (maximum oxygen capacity/actual oxygen content) x 100
🗑
|
||||
| Oxygen's affinity for hemoglobin changes depending on? | pH, temperature, CO2, 2,3-DPG
🗑
|
||||
| 2,3,-DPG is a? | metabolic by-product which competes with O2 for binding sites
🗑
|
||||
| In a left shift, O2's affinity for hemoglobin? | increases; more hemoglobin saturated w/O2
🗑
|
||||
| Tissue hypoxia | result of very high SpO2, but O2 rides back to lungs without being used
🗑
|
||||
| Left shift conditions? | alkalosis, hypothermia
🗑
|
||||
| Right shift conditions? | acidosis, fever
🗑
|
||||
| In a right shift, O2's affinity for hemoglobin? | decreases; less O2 carried from the lungs
🗑
|
||||
| Mechanical ventilation can be delivered via? | endotracheal tube / tracheostomy tube / nasal or face mask
🗑
|
||||
| Volume in endotracheal cuff should be checked every ____ hours? | 8
🗑
|
||||
| Pressure of endotracheal cuff should be maintained below ____ mm Hg? | 20; to reduce the risk of tracheal necrosis, inadequate oxygenation and/or accidental extubation
🗑
|
||||
| Reposition the oral endotracheal tube every ____ hours? | 24 (minimum); check for skin breakdown
🗑
|
||||
| Following extubation, monitor clients for signs of respiratory distress, such as? | ineffective cough, dyspnea, and stridor
🗑
|
||||
| Endotracheal Suctioning (ETS) should be performed wearing a ____ ____ and ____ ____. | face mask / STERILE gloves
🗑
|
||||
| Suctioning should be applied while? | withdrawing the catheter and rotating it with the thumb and forefinger
🗑
|
||||
| Suctioning of non-sterile oropharyngeal cavity should be performed (before / after) endotracheal? | after; to prevent cross contamination
🗑
|
||||
| Constant suctioning can result in? | hypoxia
🗑
|
||||
| ABG sample, nursing intervention? | perform Allen test prior to obtaining the sample / aspirate in heparinized syringe / hold pressure at site for 5 min
🗑
|
||||
| Structural changes in the skeletal system of cancer pts., result in a decrease in _____ _____. | diaphragmatic expansion
🗑
|
||||
| Assessment finding of pt. with lung cancer? | rust-colored or blood-tinged sputum / Hoarseness / Dyspnea / Unilateral wheezing / Muffled heart sounds / Fatigue, weight loss, or anorexia / Fever / Clubbing of fingers
🗑
|
||||
| Tactile Fermitus usually (increases / decreases) with lung cancer? | increases; due to air spaces being replaced with tumor tissue or fluid
🗑
|
||||
| Masses in lungs will sound? | dull or flat
🗑
|
||||
| Best position to promote breathing in pt. with emphysema | high Fowler's with arms supported on the over-bed table
🗑
|
||||
| For active tuberculosis, nurse should implement _____ precautions? | airborne
🗑
|
||||
| Tachypnea is? | an abnormally rapid rate of breathing
🗑
|
||||
| A pneumothorax is? | the presence of air or gas in the pleural space that causes lung collapse
🗑
|
||||
| In tension pneumothorax tracheal deviation is toward the (affected / unaffected) side? | unaffected
🗑
|
||||
| Effectiveness of mechanical ventilation is assessed best via? | ABG testing
🗑
|
||||
| Chronic bronchitis (blue bloaters), S/S... | obese, frequent cough, use of accessory muscles, coarse rhonchi and wheezing, may have signs of right HF
🗑
|
||||
| Emphysema (pink puffers), S/S... | may be very thin with a barrel chest, no cough, may adopt the tripod sitting position, breathing w/purses lips & accessory muscles, wheezing, heart sounds very distant
🗑
|
||||
| Total hip arthroplasty, places pt. at risk for a ____ ____ | pulmonary embolus; due to surgery & decreased mobility of affected extremity
🗑
|
||||
| Surfactant is? | a lipoprotein that lowers the surface tension in the alveoli
🗑
|
||||
| Surfactant function? | reduces the amount of pressure needed to inflate the alveoli and decreases the tendency of the alveoli to collapse
🗑
|
||||
| During inspiration, the diaphragm? | contracts; increasing intrathoracic volume and pushing the abdominal contents downward
🗑
|
||||
| During inspiration, the external intercostal muscles and scalene muscle? | contract; increasing the lateral and anterioposterior dimension of the chest
🗑
|
||||
| The ability of the lungs to oxygenate arterial blood adequately is determined by examination of? | the partial pressure of oxygen in arterial blood (PaO2) and arterial oxygen saturation (SaO2)
🗑
|
||||
| Respiratory defense mechanisms include? | filtration of air, the mucociliary clearance system, the cough reflex, reflex bronchoconstriction, and alveolar macrophages
🗑
|
||||
| When the curve shifts to the right? | blood picks up oxygen less rapidly in the lungs but delivers oxygen more readily to the tissues
🗑
|
||||
| The right shift is seen? | in cases of acidosis and hyperthermia and when the PaCO2 is increased
🗑
|
||||
| Early symptoms of inadequate oxygenation include? | unexplained restlessness and irritability
🗑
|
||||
| With aging, costal cartilages? | calcify; interfere with chest expansion
🗑
|
||||
| Auscultation should proceed from the lung ... | apices to the bases; if pt. will tire, start at the base
🗑
|
||||
| The term abnormal breath sounds is used to describe? | bronchial or bronchovesicular sounds heard in the peripheral lung fields
🗑
|
||||
| Thoracentesis is? | the insertion of a large-bore needle through the chest wall into the pleural space to obtain specimens for evaluation, remove pleural fluid, or instill medication
🗑
|
||||
| Kussmaul respirations, possible etiology? | Metbolic acidosis; ↑ rate aids in CO2 exertion
🗑
|
||||
| Abdominal paradox is? | inward instead of outward movement on inspiration
🗑
|
||||
| COPD, usual inspection finding? | barrel chest, cyanosis, tripod position, use of accessory muscles
🗑
|
||||
| Hematocrit Hematocrit finding in chronuc hypoxemia? | ↑ hematocrit
🗑
|
||||
| Hemoglobin values | M: 13.2 - 17.3
F: 11.7 - 16.0
🗑
|
||||
| Hematocrit values | M: 39 - 50%
F: 35 - 47%
🗑
|
||||
| ABGs test syringe to use for collection? | heparinized
🗑
|
||||
| Gram stain sputum collection, best done when? | A.M., after mouth care
🗑
|
||||
| Prior to CT Scan insure pt. is not allergic to? | shellfish (test is iodine based)
🗑
|
||||
| Ventilation/Perfusion (V/P) test performed to? | access V/P of lungs; V w/o P suggests pulmonary embolus
🗑
|
||||
| Positron Emission Tomography (PET) performed to? | distinguish between benign and malignant pulmonary nodules
🗑
|
||||
| Bronchoscopy, nursing interventions? | pt. NPO 6 - 12 hrs prior / get signed consent / after, keep pt. NPO until gag reflex returns
🗑
|
||||
| Test performed after Thoracentesis? | chest x-ray, tk check for pheumothorax
🗑
|
||||
| Positive TB response is? | >= 5 mm induration
🗑
|
||||
| False negative TB test can occur within? | 8 - 10 weeks of infection
🗑
|
||||
| False positive TB test can occur with previous? | BCG Vaccine
🗑
|
||||
| Tidal Volume is? | volume of air inhaled/ exhaled during each breath
🗑
|
||||
| Normal Tidal Volume is? | 0.5 L
🗑
|
||||
| Max lung capacity is? | 6.0 L
🗑
|
||||
| FEV is? | forced expiratory volume
🗑
|
||||
| PEFR is? | peak expiratory flow rate (max airflow during expiration
🗑
|
||||
| In allergic rhinitis, Corticosteroid and Mast Cell Stabilizer nasal sprays should be started? | 2 weeks prior to pollen season, 10 - 15 min prior to exposure to trigger
🗑
|
||||
| 1st generation antihistamines cross the? | Blood-Brain barrier, causing sedation
🗑
|
||||
| 2nd generation antihistamines dont take with? | MAOIs
🗑
|
||||
| Nasal spray, don't take longer than? | 3 days, longer can cause rebound
🗑
|
||||
| Temperature of ________ indicates _______? | 100.4, Infection
🗑
|
||||
| Pt. position to alleviate dyspnea? | low fowler's - 30 - 40 degrees
🗑
|
||||
| Pt. position to decrease aspiration risk? | high fowler's - 90 degrees
🗑
|
||||
| Inflation of endotracheal/tracheostoma cuff should be kept between _____ and _____ mm Hg. | 15, 20
🗑
|
||||
| Examples of equipment that can allow speech with trachea tube? | small cuffless tube / fenestrated tube, speaking valve / speaking track tube
🗑
|
||||
| Trachea care should be done every ____ to ____ hrs as appropriate | 4, 8
🗑
|
||||
| When a supraglottic laryngectomy is performed, pt (can / cannot) speak? | CAN speak; true vocal cords remain intact, but pt. must lean a new way to swallow
🗑
|
||||
| Leukoplakia / Erythoplakia patches are? | white / red patches inside the mouth
🗑
|
||||
| Comprehensive pain assessment should include? | location, characteristics, onset/duration, frequency, quality, intensity, precipitating factors
🗑
|
||||
| Laryngectomy/Radical Neck Surgery speech aides include? | tracheal-esophageal prosthesis / artificial larynx / electrolarynx / esophageal speech
🗑
|
||||
| Tracheal stenosis is? | a narrowing of the trachea that causes breathing problems
🗑
|
||||
| Esophageal speech involves? | swallowing air, trapping it in the esophagus, then releasing to create sounds
🗑
|
||||
| LPNs can do trachea care on pts. who are? | stable with non-acute airway problems
🗑
|
||||
| PORT (Pneumonia Patient Outcomes Research Team), SI (Severity Index) used to? | supplement clinical judgment as to where (home or hospital) to treat patient
🗑
|
||||
| PORT Scale - Low Risk : Outpatient | None - Class I / <70 - Class II / 71-90 - Class III
🗑
|
||||
| PORT Scale - Moderate Risk : Inpatient | 91 - 130 - Class IV
🗑
|
||||
| PORT Scale - High Risk : Inpatient | >130 - Class V
🗑
|
||||
| Asplenia is? | absence of normal spleen function and is associated with some serious infection risks
🗑
|
||||
| Patients with high gastric residuals are at risk for? |
🗑
|
||||
| Reaction to TB occurs ____ to ____ weeks after initial exposure? An induration reading of ____ is considered positive. | 2, 12, induration >=5 mm
🗑
|
||||
| TB Drug : Isonizaid (INH), S/E? | hepatitis
🗑
|
||||
| TB Drug : Rifampin (Rifadin), S/E? | hepatitis, thrombocytopenia, orange secretions
🗑
|
||||
| TB Drug : Pyrazinamide (PZA), S/E? | hepatitis, arthralgias, hyperuricemia
🗑
|
||||
| TB Drug : Ethambutol (Myambutol), S/E? | ocular toxicity (decreased red/green color discrimination / acuity)
🗑
|
||||
| QuantiFERON-TB (QFT) is a ____ ____ ____? | rapid diagnostic test for TB
🗑
|
||||
| The A___ F___ B___ test is done for ___ consecutive days to test for TB? | Acid Fast Bacilli, 3 days (A.M.)
🗑
|
||||
| What two TB drugs cannot be used together for latent TB? | Rifampin and Pyrazinamide; severe liver injury/death
🗑
|
||||
| Fungal Infection: HISTOPLASMOSIS | found in soil of N.America / generally self-limiting
🗑
|
||||
| Fungal Infection: COCCIDIODOMYCOSIS | found in semiarid regions SW-US / symptomatic in 1/3 exposures
🗑
|
||||
| Fungal Infection: BLASTOMYCOSIS | SW-US & NW-US / insidious progression, skin involvement
🗑
|
||||
| Fungal Infection: CRYPTOCCOSIS | true yeast, worldwide soil, pigeon excreta / possible meningitis
🗑
|
||||
| Fungal Infection: ASPERGILLOSIS | true mold in mouth / risk of necrotizing pneumonia
🗑
|
||||
| Fungal Infection: CANDIDIASIS | leading cause mycotic infections, upper respiratory & GI tract
🗑
|
||||
| Fungal Infection: ACTINOMYCOSIS | not a true fungus (anaerobic) / lower lobes w/abscess or emphysema
🗑
|
||||
| Fungal Infection: NOCARDIOSIS | not a true fungus (aerobic) / infection from nature / rarely in sputum
🗑
|
||||
| Fungal Infection: PNEUMOCYSTIC PNEUMONIA (PCP) | fungus in environment / opportunistic
🗑
|
||||
| Oxygen-hemoglobin Dissociation curve right shift caused by? | Increased acid / CO2 / temperature / BPG
🗑
|
||||
| SAO2 on tissue level, when right shift is (improved / worsened)? | Improved; More O2 loose for quicker binding in tissues
🗑
|
||||
| Possible causes of left shift? | Alkalosis / hypothermia
🗑
|
||||
| Oxygen-hemoglobin Dissociation curve left caused by? | Decreased acid / CO2 / temperature / BPG
🗑
|
||||
| Intravesical indicates what type of cancer? | bladder
🗑
|
||||
| Intrarterial indicates what type of cancer? | osteogenic sarcoma
🗑
|
||||
| Intrathecal indicates what type of cancer? | brain
🗑
|
||||
| Intraperitoneal indicates what type of cancer? | colorectal
🗑
|
||||
| Intravenous indicates what type of cancer? | leukemia
🗑
|
||||
| Chest tubes are inserted through what type of incision? | thoracotomy
🗑
|
||||
| Chest tube water seal allows air to? | exit pleural space on exhalation; stop air from entering on inhalation
🗑
|
||||
| For chest tube intra-procedure, position pt. in? | supine or semi-Fowler's position
🗑
|
||||
| For chest tube post-procedure, position pt. in? | Fowler's or semi-Fowler's position
🗑
|
||||
| Asthma and emphysema pts. chest presentation? | barrel chest
🗑
|
||||
| COPD pts. usually have _____-sided heart failure? | right
🗑
|
||||
| Right sided heart failure is when? | this side of the heart cannot effectively return blood from the body, or the veins, to the lungs
🗑
|
||||
| Right sided heart failure, S/S? | abdominal pain, nausea, and loss of appetite, unintentional weight gain, edema
🗑
|
||||
| Tracheostomy care - accidental decannulation within first 72 hrs. post-surgery, nursing action | call for assistance, this is a medical emergency; tract has not matured and replacement is difficult
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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
Created by:
fluency
Popular Nursing sets