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70 Cards in this Set
- Front
- Back
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Why do we breath?
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supply oxygen and remove CO2, maintain acid base balance of blood
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what are the mechanics of respiration
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elastic recoil and compliance, diffusion of o2 and co2
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When you breathe in, O2 is higher or lower in the alveoli
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higher
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collapsed alveoli is called
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atelectasis
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Right lung has how many lobes? Left has?
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3 and 2
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hypoxia is
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decreased oxygen
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hypercapnia is
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increase co2
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the body responds to what changes first where respiration is concerned?
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hypoxia, lack of o2
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What is the Hering Breuer felex?
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its affect is strech sensors in the alveoli, if the lungs are sterched too much, they stop breathing
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pro receptors in the body respond to ___ to increase ___
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exercise to increase respiration
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Hemoptysis is
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cough
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subjective assessment for respirations include
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cough, dyspnea, chest pain, smoking history, enviromental exposure, meds, past med/surg
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kyphosis is
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convex back
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barrel chest is
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enlarged chest area, rigid
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5 p's of circulatory checks
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pulse
pain paralysis paresthesia-numbness pallor |
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what laboratory diagnostic tests would you do for pneumonia
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C & S of sputum, gram stain,
ABG, Hg, Hct |
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abnormal clubbing of the finger tips would be found r/t
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chronis hypoxia
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a really good sign for pulmonary edema is
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crackles or rales, usually hear at the end of respiration
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adventitious sounds are
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crackles, wheezing, rhonchi, stridor
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where do you ausculate for crackles or rales
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over the lung filds, heard in the lung bases first with pumonary edema, caused by interstitial lungs water and deflated alveoli popping open
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where is the best place to ausculate for rhonchi?
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over the large airways, timing-inspiration and exhalation more pornounced on exhalation, caused by narrow airways from mucuous secretions, sounds like intermitent rumbling
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where is the best place to ausculate for wheezing
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over the lung fields and airways occurs on inhale and exhale from narrowed airways, high pitched shisling
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Chest pain is very common for a pulmonary ____.
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embolism
have decreased breath sounds |
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This describes what? apprehension, tachypnea, chest pain, confusion, dyspnea, cough heoptysis, pallor, fever, decreased breath sounds-rales and friction rub over affected areas
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pulmonary embolus
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this describes what? tachypnea, cough, intercostal retraction, flaring of nare, dyspnea, apprehension, use of accessory muscles, inhalation and exhalation wheezing, diminished breath sounds
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asthma
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this describes what? tachypnea, used of accessory mucles, incread expiratory time, intercostal retraction, increase AP diameter of chest, rales, shochi, wheezed, decreased intensity of breath sounds
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bronchitis
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this describes what? tachypnea, cyanosis, trachea deviated to the side of pneumothorax, decreased movement of the ches on the side of the pneumothorax, decrease breath sounds
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pneumothorax
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describes what? tachypnea, cough fever, decrease diaphragm movement, occasiona rhonchi, fine medium rales increased tactile fremitius
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pneumonia
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describes what? tachypnea, tachycardia, trachea deviated to the side of the affected area, decrease chest expansion on affeted dside, occasional rales
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atelectasis
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describes what? occasional tachpnea, trahcea deviated from side of effusion, decreased breath sounds over area, occasional rales
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pleural effusion
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describes what? tachpnea, apprehension, use of accessory muscles, frothy putum, distended neck veins, tachycardia, pmi displaces, initally fine rales progress to coarse, wheezing may be present
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pulmonary edema
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Collapsed section of alveoli or an entire lung due to 1. Obstruction, 2. Compression, 3. Lack of surfactant
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Atelectasis—
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Infection in lung that leaves alveolar membrane edematous and porous, allowing RBC and WBC’s to pass from blood to alveoli. Alveoli fill up with bacteria, debris, fluid and blood cells replacing alveolar air
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lobular pneumonia
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This Assessment might indicate what?
Pain in chest with breathing Increased RR, HR Guarding Fever Productive cough Crackles |
lobular pneumonia
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Common after surgery, use incentive spirometer
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Atelectasis
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Barrel chest, use of accessory muscles. Shortness of breath. Tachypnea. Pursed lip breathing
Decreased breath sounds, prolonged expiration. Muffled heart sounds from over distention of lungs |
emphysema
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Reaction to allergen causing bronchospasm, inflammation, bronchiole edema and mucous in the airways
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asthma
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Effusion-Collection of excess fluid in intrapleural space.
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pleural effusion
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Assessment
Dyspnea, possible pain Increased respirations, dry cough, tachycardia, cyanosis, abdominal distention. Tracheal shift away from affected side Decreased or absent breath sounds |
pleural effusion
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Pneumothorax-Free air in pleural space causing lung collapse; spontaneous, traumatic, tension
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pneumothorax
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Assessment
Dyspnea Unequal chest expansion. If large, tachypnea, cyanosis, tracheal shift to unaffected side, apprehension Breath sounds decreased or absent on affected side. |
pneumothorax
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Thrombus, fat or air bubble lodge in right heart and occlude pulmonary vessels
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Pulmonary Embolism-
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Increased permeability of pulmonary capillaries and alveolar epithelium
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Acute Respiratory Distress Syndrome
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Assessment
Dyspnea, apprehensive Restless, disoriented, cough, thin frothy sputum, retractions, decreased PaO2-alkalosis Crackles, rhonchi |
Acute Respiratory Distress Syndrome
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Is it possible to determine the type of pneumonia by clinical manifestations
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no
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sputum color in pneumonia would indicate what?
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Sputum production rust colored for Klebsiella and strep and staphylococal
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pneumonia (community acauired)
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legionella
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Most common forms of bacterial pneumonia are
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Streptococcal pneumonia, Staphylococcus aureus, Klebsiella, Pseudomonas aeurginosa, Legionella
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Most common forms of viral pneumonia are
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Influenza, parainfluenza, Respiratory Syncytial virus (RSV), adenovirus
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this pneumonia smells really bad and is thick green
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Pseudomonas aeruginosa
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If a person has a community acquired pneumonia they would
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dvelop within 48 hours of admit or prior to admit
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HAP, hospital acquired pneumonia happens how
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compromised host defenses impaired, reaches lower resp tract and overwhelms, e coli, influenza, MRSA
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empyema
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pus in pleural cavity
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A general term applied to a symptom complex involving the epiglottis, glottis and larynx characterized by hoarseness and a barking cough, and inspiratory stridor as a result of edema of larynx and airway obstruction. May have fever. Generally occurs at night
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croup most common in 1-3 yo, after 3 often bacterial, starts as URI
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Use of accessory muscles marked by retraction on inspiration. Implies blockage of branch of respiratory tree
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retractions
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Inspiratory stridor is generally from obstruction
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above the glottis-foreign body
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Expiratory stridor is generally from obstruction
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below the trachea
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irreversible lung distention and ABG imbalance is what
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COPD
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Primary symptoms of COPD are
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cough, sputum production and dyspnea
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for a child with croup do not use
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Drooling, forward position, stridor and retractions DO NOT depress tongue- may cause laryngeal spasm and complete tracheal obstruction in event of epiglottitis
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to suction a trach limit suction to
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2-3 times and 10-15 seconds each
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why do you always need a tach kit when cleaning a trach
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incase the pt coughs it out, only replace straps with two nurses, reinsert immeadiately if expelled
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If pt uses a metered dose inhaler teach to use
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1-2" from opening of mouth, if steriod-rinse mouth out after to avoid thrush
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Inflammation and narrowing of bronchial airways
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asthma and bronchitis
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asthma has ___ wheeze
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expiratory
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the presence of air in the pleural space is known as
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pneumothroax
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Salmetrol (Serevent) 2 inhalations every 12 hoursr
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relaxes smooth muscles brochodilatory, reduces broncho spasms in exercise induced or COPD maintenance, use with maintenance meds
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flovent used for
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asthma maintenance, rinse mouth after, decrease inflammation
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therapy for postural drainage with percussion is for
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loosening secretion for coughing or expectant in pneumonia or mucous
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antibiotic used for pneumonia would be based on
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C & S and patients history
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