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58 Cards in this Set
- Front
- Back
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Elevation of the patients clavicles during inspiration can indicate what? |
Ventilatory fatigue, air hunger, or decreased lung expansion.
Can occur in patients with COPD, especially emphysema. |
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Which side of the long bifurcates before the other? |
The right side – aspiration usually ends up in the right upper lobe. |
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Eupnea |
Normal respirations. The actim of breathing |
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Tachypnea |
Fast respirations- >24 breaths/min |
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Bradypnea |
Slow respirations- <12 breaths/min |
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Apnea |
Absence of respirations |
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Orthopnea |
Inability to breathe while lying down |
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Dyspnea |
Shortness of Breath (SOB) |
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Cheyene-Stokes respirations |
Breaths near the end of life, periods of rapid breathing interspersed with periods of apnea. |
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What significant assessment indicator will you find with emphysema? |
Barrel chest |
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Nursing Measures to aide with COPD pts: |
-Maintain a patient airway -Improve comfort and ease of breathing (Semi-Fowlers position to expand lungs) -Maintain or improve pulmonary ventilation and oxygenation -Improve ability to participate in physical activities |
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Risks associated with oxygenation problems: |
-skin/tissue breakdown -syncope -acid-base balances -feelings of hopelessness and social isolation |
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Chronic Bronchitis |
-causes inflammation and irritation of the airways -bronchial tubes become red/inflamed -excess thick mucus forms -associated with smoking-inhaled fumes, asbestos, coal workers and COPD-ers -irreversible-symptoms can get better for periods of time but will ultimately continues to progress |
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Symptoms of chronic bronchitis: |
-Dyspnea -frequent clearing of throat -edema and weight gain (often due to meds or lack of exercise due to SOB of excercised induced SOB |
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Nursing Measures to aide with COPD pts: |
-Maintain a patient airway -Improve comfort and ease of breathing (Semi-Fowlers position to expand lungs) -Maintain or improve pulmonary ventilation and oxygenation -Improve ability to participate in physical activities |
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Risks associated with oxygenation problems: |
-skin/tissue breakdown -syncope -acid-base balances -feelings of hopelessness and social isolation |
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Chronic Bronchitis |
-causes inflammation and irritation of the airways -bronchial tubes become red/inflamed -excess thick mucus forms -associated with smoking-inhaled fumes, asbestos, coal workers and COPD-ers -irreversible-symptoms can get better for periods of time but will ultimately continues to progress |
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Symptoms of chronic bronchitis: |
-Dyspnea -frequent clearing of throat -edema and weight gain (often due to meds or lack of exercise due to SOB of excercised induced SOB |
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Risk factors for Chronic Bronchitis |
Smoking, second hand smoke, lung irritants(professional and lifestyle), dust, pollution, chronic lung infections, genetics (rarely) |
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Emphysema |
-Long term progressive disease -alveolar walls are destroyed along with capillary blood vessels in them -limits total area of lung where blood and air come together -loss of elasticity in lung tissue -Bullae (air filled sacs that have no function) can form |
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Emphysema |
-Long term progressive disease -alveolar walls are destroyed along with capillary blood vessels in them -limits total area of lung where blood and air come together -loss of elasticity in lung tissue -Bullae (air filled sacs that have no function) can form |
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Bullae |
Air filled sacs that can develops in lungs of pts with emphysema that have no function
Purse lipped breathing can help release the trapped air |
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Emphysema assessment |
-cough -excessive mucus production -wheezing -Dyspnea -chest tightness -barrel chest-caused by air trapping |
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Emphysema assessment |
-cough -excessive mucus production -wheezing -Dyspnea -chest tightness -barrel chest-caused by air trapping |
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Management of emphysema |
-improve airflow/ventilation -assist with anxiety-give medications -prevent complications -flu/pneumonia shot -STOP SMOKING IMMEDIATELY -increase fluids -O2 for Dyspnea or comfort -teach to cough and deep breathe -purse lipped breathing -small frequent meals -blood tinged sputum -RED FLAG |
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Emphysema assessment |
-cough -excessive mucus production -wheezing -Dyspnea -chest tightness -barrel chest-caused by air trapping |
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Management of emphysema |
-improve airflow/ventilation -assist with anxiety-give medications -prevent complications -flu/pneumonia shot -STOP SMOKING IMMEDIATELY -increase fluids -O2 for Dyspnea or comfort -teach to cough and deep breathe -purse lipped breathing -small frequent meals -blood tinged sputum -RED FLAG |
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Hemoptysis |
Blood tinged sputum |
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Medical management of emphysema |
Antibiotics Steroids Bronchodilators Stop smoking |
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Medical management of emphysema |
Antibiotics Steroids Bronchodilators Stop smoking |
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Asthma |
Chronic disease that inflames and narrows airways
Causes wheezing, chest tightness, SOB, cough |
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Medical management of emphysema |
Antibiotics Steroids Bronchodilators Stop smoking |
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Asthma |
Chronic disease that inflames and narrows airways
Causes wheezing, chest tightness, SOB, cough |
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What is the hallmark sign of asthma |
Nighttime cough |
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Is asthma reversible? |
Yes, with the use of inhalers. However there is no cure, asthma can occur at anytime. |
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Singulair for asthma-method of action: |
Blocks inflammation/mucus producing leukotrienes from attaching to receptor site |
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Singulair for asthma-method of action: |
Blocks inflammation/mucus producing leukotrienes from attaching to receptor site |
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Treatments of embolus |
CT scan/MRI of chest O2 HOB up at least 30 degrees Anticoagulants Fibrinolytic medications |
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Singulair for asthma-method of action: |
Blocks inflammation/mucus producing leukotrienes from attaching to receptor site |
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Treatments of embolus |
CT scan/MRI of chest O2 HOB up at least 30 degrees Anticoagulants Fibrinolytic medications |
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Pulmonary edema |
Accumulation of fluid in interstitial tissues and alveoli |
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Symptoms of pulmonary edema: |
SOB, cyanosis Tachypnea/cardia Restlessness/agitation Blood tinged/frothy sputum Wheezing, sudden weight gain |
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Management of pulmonary edema |
Monitor O2 Administer medications STRICT I&O, daily weights Low Na diet, fluid restriction Possible mechanical ventilation Emotional support for pt/family
Comfort and safety are priority |
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Pulmonary embolism (PE) |
Foreign substance in pulmonary artery
Could be blood or fat clot, air or amniotic fluid |
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Nursing observations of pt with embolus |
Pt looks SCARED suddenly Chest pain Elevated temp Hemoptysis SOB Rapid respirations (Tachypnea) |
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Valves on right side of heart |
Tricuspid (S1) and pulmonary valve (S2) |
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Valves on left side of heart |
Mitral (S1) and aortic (S2) |
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Systole |
When the heart is pumping blood to the lungs for oxygenation and to the body (S1 or 'lub' sound)
This sound is the closing of the tricuspid and mitral valves |
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Systole |
When the heart is pumping blood to the lungs for oxygenation and to the body (S1 or 'lub' sound)
This sound is the closing of the tricuspid and mitral valves |
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Diastole |
When the ventricles are filling with blood from the atria (S2 or 'dub' sound)
This sound is the closing of the aortic and pulmonic valves
Longer than systole to allow the ventricles to fill with blood |
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What is known as the widow maker? |
Left coronary artery occlusion |
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Angina |
Heart or chest pain |
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Angina |
Heart or chest pain |
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Conditions that affect cardiac output |
CHF, MI, angina, structural heart conditions |
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Medications used with CHF |
Lasix, beta-blockers are drugs of choice
ACE and ARBS are 2nd line for CHF |
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Right sided heart failure |
Results and crying it we gain, distended neck veins, enlarged liver and spleen, and edema of the lower extremities |
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Left sided heart failure |
Causes shortness of breath especially upon exertion, crackles on auscultation, cough, and nighttime dyspnea |
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What is known as the 'pacemaker' of the heart? |
The SA or sinoatrial node |
