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150 Cards in this Set

  • Front
  • Back
natrual defense mechanism; reflexive act to clear the airway
nonproductive cough
dry w/no sputum
productive cough
wet and congested
What are the nursing implications for a cough
contain secretions, dispose of properly, planned C&DB
normal secretions approximately 100cc/24hr.
What should a nurse look for when assessing sputum
color, amount, and character
dyspnea, orthopnea
distressing sensaition related to the feeling of inadequate ventilation
What are the signs of dyspnea
anxious, flared and dilated nostrils w/use of acessery muscle for breathing
What are the nursing implications for dyspnea
position, O2 (low flow)
bluish discoloration of the skin
what are the S&S of cyanosis
peripheral- nail beds clubbing and lack of color, central- bluish coloring of lips (more serious)
What are the nursing implications for cyanosis
postion, O2
deficiency of oxygen at the cellular level <90%
What are the S&S of hypoxia
air hunger, dyspnea, and restlessness, H/A disoriented/confusion, tachycardia, tachypnea, cyanosis
What are the nursing implicaitions for hypoxia
assess RR, ABG's, O2 sat, pulse oximetry, H&H, position & O2
crackles (Rales) sounds
smaller airways, increase of inspirations
sonourous wheezing (Rhonchi)
usually in large airways, continuous snoring sounds (thick, tenacious)
Sibilant wheezes
air rushes through narrowed airways
Frictional Rubs
crackling, grating sound, hard with inspiration and expiration
What are the ways to prevent respiratory disease
avoid irritants, vaccinations, avoid crowds, hygienic measures, hydration, healthy living
What are the diagnositic tests for respiratory problems ... 8
ABG, pulmonary function, imaging, bronchoscopy, mediastinoscopy, thoracentesis, sputum specimen, pulse oximetry
What is ABG
measures the pH and content of O2 and CO2 in arterial blood
retained CO2, increase in H2CO3
What are the S&S of acidosis
Increase of P and RR, drowsiness, confusion, H/A
What is the treatment of acidosis
treat cause, medicated nebulizer
too much Co2 blown off
What are the S&S of alkalosis
Dizziness, diaphoresis, numbness & tingling , muscle spasm
What is the treatment of alkalosis
rebreathe air i.e. with paper bag, slow RR, meds
Pulmonary Function test
use a spirometer to measure lung volumes
Tidal volume
volume of air inhaled and exhaled with a normal breath
(quiet breathing)500mL
Vital capacity
maximum amount of air that can be expired after maximal inspiration 3-4L
Imaging studies
Chest X-ray- see consolidation or masses

Cat scan- see cross section of lung feild
direct visulization of the bronchial tubes with a lighted scope
What is the purpose of a Bronchoscopy
C&S, Biopsy tumor, bronchogram via dye to visualize bronchi
What needs to be prepared for a bronchoscopy
NPO, explain procedure, surgical permit, local or general anesthesia
What is the nursing care for bronchoscopy
Check return of gag reflex, humidify air/face mask, oral fluids slowly, maitain airway
scope inserted into the mediastinal space to view or biopsy and inspect lymph node
needle inserted into the pleural space to take sample of fluid (8th-9th intrercostal space)
What is the purpose of a thoracentesis
What needs to be prepared for a thoracentesis
permit, explination of procedure, collect equipment
What is the nursing care of a pt. w/thoracentesis
observe pt VS q15 minutes; watch for pneumothorax, care of specimen, position of unaffected side
Sputum specimen
analyze for C&S to identify microorganism and effective antibiotic
When is the best time to gather a sputum specimen
in the A.M
Pulse oximetry
noninvasive determination of O2 sat, or amount of oxygen carried in the blood stream
What are the nursing implications for C/DB
Position for maximum expansion/relaxation, breathe thru the nose, hold then out thru pursed lips, and dispose of secretions
Incentive spirometry
device to encouarge deep breathing
What are the nursing implicaiton for incentive spirometry
proper use, set goals, use q1-2h, and watch for signs of hyperventilaiton
Oxygen therapy
administer oxygen enriched environment to relieve hypoxia or dyspnea
What are the devices use to admin O2
Cannula (spectox)
How much low flow O2 at rest
How much low flow O2 w/activity
What are the nursing implications for oxygen therapy
Check liter flow and tubing connections, avoid smoking, check electrical devices for shorts, check for effectiveness, O2 sign
moistureize air pt. breathes to liquefy secretions/soothing/decrese swelling
What are the types of humidification
Heated nebulizer, room humidifier
What are the nursing implications for humidification
use sterile distilled water
Postural drainage and percussion
help facilitate drainage of sputum from lungs
Postural drainage
pt. placed in various positions to help facilitate drainage of sputum from lungs via gravity
tapping on the chest to loosen up mucus
What are the nursing implications for postural drainage and percussion
perform a.c. not on full stomach, disposal, watch kidney/spinal cord areas, use other respiratory treatments, oral hygiene
used when a pt. is unable to cough or handle own secretions, clear airway
Where are the nursing implications for suctioning
Suction only when withdrawing suction catheter, no longer than 10-15 seconds per pass, use O2 between suctioning
tracheotomy and tracheostomy
creation of new opening in trachea to facilitate breathing
What are the types of tracheotomy
plastic/disposable tube with cuff

larygectomy tube has short, larger lumen
What are the nursing implications for tracheotomy and tracheostomy
dressing changes/inspection, humidification, trach tapes to hold in place, cuff care, communication
What are the different types of thoracic surgery
Thoracotomy, Wedge Resection, Lobectomy, Pneumonectomy
open chest cavity between 4,5,6,or 7th rib
Wedge resection
removal of well circumscribed area of the lung
resection of one lobe
resection of the entire lung
What is the purpose of chest tubes
placed in pleural space to remove air/fluid and re-expand lung
What are the nursing implications for chest tubes
do not raise above chest level, C&DB, medicate, if gets disconnected- clean and reconnect
What are the nursing implications for the removal of a chest tube
x-ray before and after, watch for pneumothorax, inclusive dressing
What is the activity for a pt. w/thoracic surgery
up as soon as fully awake, pre-medicate
What is the discharge teaching for a pt. w/throacic surgery
Activity level at own speed but as much as possable, care for stitch pain, numbness around incision, C/DB
What are the S&S of fractured ribs
sharp pain over fracture site, dyspnea, limited respiratory excursion
What is the treatment and nursing care for a pt. w/fractured ribs
rib belt or ace wrap, semi-fowlers to fowlers position, mild sedation, C/DB
Flail chest
loss of stability of chest was with subsequent respiratory impairment due to multiple rib fractures
What are some S&S of flail chest
paradoxal breathing, respiratory distress, cyanosis, hypoxia
air in the pleural space form injury or ruptured bleb
What are the S&S of pneumothroax
sudden sharp chest pain, dyspnea and anxiety, hypoxia, cyanosis
What is the treatment and nursing care for pneumothroax
chest tube and drainage, siting position w/progressive ambulaiton, surgery to stop bleeding
Acute coryza
the common cold
Acute pharyngitis
(sore throat)inflamation of the mucous membranes of the pharynx, usually w/acute rhinitis or sinusitis
Acute laryngitis
inflamaition of the mucus membranes lining the larynx inflam of vocal cords. w/upper resp infection. 3weeks becomes chronic
Influenza (Flu)
epidermic viral infectionof the respiratory tract- fever joint pain, chills
inflammation of visceral and parietal plura
What are the causes of pleurisy
pneumonia, TB, Chest trama, lung cancer
What are the risk factors for cancer of the larynx
smoking, chronic laryngitis, chronic voice strain, heavy air pollution
What are the S&S of Cancer of the larynx
hoarseness, lump when swallowing, pain is late, respiratory S&S
What are the treatments of larynx cancer
partial or total laryngectomy, radiation
What is the preop nursing care for a pt. getting/laryngectomy r/t cancer of larynx
explain procedure, prepare for voice loss, emotional support
What is the postop nursing care for a pt. w/laryngectomy r/t cancer of the larynx
ventilation, nutrition, incision, stoma care, communication
What is ventilation care r/t laryngectomy
trach care and position HOB at 45 degrees
What is nutrition care r/t laryngectomy
N/G tube, tube feeding
What is stoma care r/t a laryngectomy
learn suctioning/care of stoma, humidification, safty, medi-alert tag
What is communication r/t a laryngectomy
laryngeal speech, artificial larynx, laryngeal prosthesis
What are the risk factors for lung cancer
smoking, air pollution, chemical dust, second hand smoke
What are the S&S of lung cancer
nagging cough, hemoptysis, dyspnea
What are the methods of dx lung cancer
chest x-ray, bronchoscopy, sputum specimen, open lung biopsy
What are the types of surgerys for lung cancer
lobectomy and pneumonectomy
What is the nursing care for a pt. w/lung cancer
chest tubes, position/activity, ventilation, emotional support
collapse of alveoli
What are the causes for atelectasis
mucous plug in bronchioles post anesthesia, pneumonia, ventilators, debilitated pt., tumors
What are the S&S of atelectasis
increase T, P, RR, dyspnea, orthopnea, crackles, decreased breath sounds
What is the treatment for atelectasis
C&DB, medicated and heated neb, suction as last resort
inflammation of the alveoli because of bacteria or virus and exudate secreted as responce, problem w/o2 and co2 exchange
What are the types of pneumonia
bacterial, viral, fungal, nosocomial, legionnaires
Bacterial pneumonia
pneumococcal, nosocomial
viral pneumonia
patchy, diffuse throughout lung field- negitive sputum
legionnaires disease
acute bacterial bronchopneumonia from stagnant H2O
What are the S&S of pneumonia
sudden onset of:
chills and fever, cyanosis, tachycardia, dyspnea/tachypnea
Cough, pain, weak and malaise
How is pneumonia dx
lab- increse of WBC, blood cultures
Chest x-ray
What is the treatment of pneumonia
supportive- clear airway, O2, diet, FF, rest, mild analgesic
fungal infection from eastern/central US, lives in dark moist areas, increse w/chicken bat excrete
Coccidioidomycosis (Valley fever)
found in dry arid soil, Arizona, New Mexico, Texas, w/rodents
What are the S&S of fungal infections
masks as TB, increase temperature, malaise, cough
What is the treatment for fungal infections
antifungal agents (Amphotericin B; Nizoral/Diflucan)
infection of the lung from acid fast bacilli
What are the risk factors for TB
Homeless, malnurtrition, immuno-compromised
What are the S&S of TB
Productive cough, blood in sputum, low grade fever, fatigue, anorexia, chest pain, dyspnea
How is TB dx
Skin test, x-ray, sputum C&S
What is the treatment for TB
Multiple drug therapy
broad clasification, indicates obstructive air flow entering &/or leaving lungs
What disorders are included in COPD
Chronic bronchitis, emphysema, asthma, bronchiectasis
Chronic bronchitis
repeated inflammation/infection of bronchial tree
What are the S&S of chronic bronchitis
excessive mucus production, crackles and wheezes, cyanotic, dyspnea with bronchospasms, polycythemia, Resp acidosis
complex and destructive lung disease of alveoli
What are the causes for emphysemia
Smoking, Air pollution, heredity
What are the S&S of Emphysemia
dyspnea, weakness, barrel chest, chronic nonproductive cough, Increse of CO2, distended neck veins, thin
What are the treatments for emphysemia
avoid irritants, stop smoking, avoid cold air,
What are some treatments for emphysemia
Liquefy secretions, Low flow O2, decrease bronchospasms
What are the medications for emphysemia
Glucocorticoids- anti-inflam action and bronchodilators
What are teaching/discharge points for emphysemia
Breathing retraining, graded exercise, adequate rest, home equipment, diet- small meals
Intermittent airway obstruction, reaction that narrows airways
What are the different types of asthma
Allergy (extrinsic) antigen/antibody reaction

Non-allergic (intrinsic)
reaction to infections/cold weather/stress- ideopathic
What are the S&S of Asthma
Paroxysmal wheezing, tightness of chest, hypoxia, cyanosis, mild resp. alkalosis from tachypnea, cough,
What are the treatments for asthma
Medications, O2, cool environment, liquefy secretions, decrease anxiety, allergy shots
What are the medications for asthma
bronchodilators, Glucocorticoids, antibiotics
What are the important pt. teaching points for asthma
air conditioning/swamp coolers, no smoking, position, relieving stress, FF
Pulmonary embolism
Moving clot that obstructs one or more of pulmonary arteries/arterioles; results as hypoxemia and atelectasis
What are the sources of Pulmonary embolisms
DVTs, and mural thrombi (left ventrical thrombus)
What are the risk factors for Pulmonary Embolis
venous stasis, hypercoagulability, post op pt.
What are the S&S of pulmonary embolism
Chest pain, tachypnea/dyspnea, apprehensive, tachycardia, crackles, hemoptysis
What is the treatment/care for pulmonary embolism
stabilize pt.
bedrest- HOB up, HOB up, VS, IV, ABGs, reduce anxiety, anticoagulant therapy
What are the important teaching points for a pulmonary emolism
prevention, early ambulation, turning, ROM, anticoagulants
Adult respiratory distress syndrome (ARDS)
combination of symptoms that results from injury to lung
What are the causes for (ARDS)
Mssive injuries- trama, head injuries, major surgery, near drowning, infection
What is the pathohysiology of (ARDS)
increase in capillary permeability and lungs become edematous (hypoxemia) alveoli collapse
What are the S&S of (ARDS)
Rapid shallow breathing, dyspnea, hypoxia, cyanosis, crackles, tachycardia
What is the treatment and nursing care for (ARDS)
ICU, Mechanical ventilation, ET tube, observations- VS, electrolyte, ABGs, I/O, quiet relaxed environment