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214 Cards in this Set
- Front
- Back
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A patient with a low oxygen saturation may develop:
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dyspnea
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This may develop if air leaks into tissues from a chest tube site
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crepitus
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May be necessary for severe pleural effusion
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thoracentesis
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the patient with air trapping may develop a:
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barrel chest
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the nurse can measure this to check chest expansion
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respiratory excursion
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cracles are an example of this type of sound
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adeventitious
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a patient who is choking may need an emergency:
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tracheotomy
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In the water seal chamber, this shows that a chest tube is intact
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tidaling
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the absence of respirations
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apnea
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a patient is taught to remove the inner cannula of this every 8 hours for cleaning
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tracheostomy tube
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The order in which the air flows through these breathing structures:
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Nose, Nasal cavities, nasopharynx, oropharynx, laryngopharynx, larynx, trachea, primary bronchi, secondary bronchi, bronchioles, alveoli
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Velcro being torn apart
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Fine crackles
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Faint lung sounds
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diminished
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leather rubbing together
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pleural friction rub
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loud crowing noise
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stridor
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moist bubbling
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course crackles
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high pitched violins
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wheezes
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Proper sequence of breathing:
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Medulla generates motor impulses, they travel along the phrenic and intercostal nerves, the diaphragm and external intercostal muscles contract, the chest cavity is enlarged, the parietal pleura expands which expands the visceral pleura and then the lungs, the intrapulmonic pressure decreases and air enters the lungs until the pressure equalizes
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Structure that covers the larynx during swallowing
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epiglottis
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the respiratory centers in the brain
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medulla and pons
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purpose of serous fluid between the pleural membranes
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prevent friction
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substance that decreases surface tension and inflation within the alveoli
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surfactant
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function of nasal mucosa
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warm and moisten incoming air
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decteriorating cilia in the respiraotyr tract predisopose the elderly to:
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respiratory infection
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adventitious lung sound that is "violin llike"
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wheezes
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purpose of pursed lip breathing
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carbon dioxide excretion
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position that helps increase oxygen saturation in the patient w/ lung disease
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good lung down
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Standard care provided to a patient with a transtracheal catheter
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assist w/ cleaning 2-3 times p/day
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purpose of chest physiotherapy (CPT)
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help expectorate secretions
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If the suction control chamber on the chest drainage system is bubbling vigorously, what is the correct intervention?
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check tubing and reduce the level of wall suction
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the patient who has had his or her larynx removed
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lanyngectomee
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a nosebleed is called:
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epitaxis
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the term used to describe drainage or pus
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exudate
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another term for "nose job"
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rhinoplasty
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difficulty swallowing
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dysphagia
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correct term for a runny nose
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rhinitis
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A patient postop swallows repeatedly in their sleep. This may indicate:
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swallowing blood: check vitals, examine throat, position semifowlers
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Why is aspirin contraindicated in a surgical postop for nasal surgery?
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increases risk of bleeding (as do ibuprofen)
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Type of illness where antibiotics are prescribed
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bacterial infection
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Why are antibiotics contraindicated for the flu?
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it is a virus, not a bacteria
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Two reasons why fluids should be encouraged in flu patients
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hydration (fever and illness increase risk of dehydration) and helps thin secretions
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severe headache, fever and facial tenderness may indicate
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sinus infection (sinusitis)
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semi fowlers position, room humidifier, hot moist packs and antibiotics may all be prescribed during
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sinusitis
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Dysphagia or hoarseness are early indications of:
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cancer of the larynx
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A special valve that diverts air into the esophagus, a picture board, and esophageal speech are all optional communication methods for this postop condition
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laryngectomy
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Why are narcotics ordered in low doses to the laryngectomy patient
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depress respiratory rate and cough reflex
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Which position is recommended for the patient with epitaxis?
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sitting up leaning slightly forward
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What would be prescribed topically to constrict vessels and slow down bleeding?
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epinephrine
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Also called "white lung"
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ARDS
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Chest collapses during inspiration during this type of respiration
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paradoxical
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bloody sputum is also called
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hemoptysis
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abbreviation for inhaler
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MDI
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Respiratory membrane secretion
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mucous
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incision into the chest
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thoracotomy
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abbreviation for inhaled nebulized medication
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NMT (nebulized mist treatment)
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treatment for repeat pneumothorax
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pleurodesis
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blister on lung
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bleb
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abbreviation for tuberculosis
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TB
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abbreviation for "front to back" when referring to the chest
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apnea
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term used to describe hormones produced by tumors
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ectopic
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medication that relieves coughing
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antitussive
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treatment in addition to standard therapy
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adjuvant
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abbreviation for laboratory tests done to measure respiratory status
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ABG
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unable to react, as in skin testing
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anergy
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continuous asthma is called
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status asthamticus
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drainage on infected tonsils
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exudate
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blood in the chest
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hemothorax
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rapid respirations
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tachypnea
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firm raised area in positive tuberculosis skin test
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induration
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MEDICATION: expectorant
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Guaifenesin (Humibid)
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MEDICATION: potent anti-inflammatory
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prednisone
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MEDICATION: Leukotriene inhibitor (reduces inflammation in asthma)
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Zafirlukast (Accolate)
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MEDICATION: Beta-adrenergic bronchodilator
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Albuterol (Ventolin)
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MEDICATION: Anticholinergic bronchodilator
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Tiotropium (Spiriva)
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MEDICATION: Mast cell stabilizer to prevent asthma
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Cromolyn sodium (Intal)
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MEDICATION: antitussive
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Codeine
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Formula for figuring out "pack year" data
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packs a day times years smoked
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Disease that causes destruction of alveolar membranes and adjacent capillaries, reducing the surface area available for gas exhange, resulting in hypoxia and dyspnea
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Emphysema
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Lung sounds normally heard with emphysema
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diminished
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What is the oxygen protocol for patient with Emphysema?
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no more than 2L p/ minute due to reduction of her stimulus to breathe
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Emphysema increases the risk of bullae and blebs, which can cause this if they rupture
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pneumothorax
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Proceedure in which physician places a small tube through the nose or motuh and into the bronchi to look at your airways
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bronchoscopy
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Rules regarding NPO post bronchoscopy
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gag reflex returns prior to going PO
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Smoking, exposure to passive smoke, air pollution, and a diet low in fruits and veggies increase your chance of:
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lung cancer
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Radiation is this type of treatment for lung cancer
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pallative
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With this disease, airways are inflamed and spastic
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asthma
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In this disease, lungs have lost some of their elasticity and air gets trapped
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emphysema
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What is the purpose of corticosteriod treatment in lung disease:
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reduce airway inflammation
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MEDICATION: Solu-Medrol is what type of medication?
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corticosteriod (methylprednisolone)
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Which medication can be used to quickly reduce SOB in a crisis situation for a patient w/ end stage respiratory disease?
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IV Morphine
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Chest drainage system should be held at what level from patient?
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below
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Effectiveness of therapy for the patient w/ pneumothorax and a chest drainage system can be determined best by:
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auscultating lung sounds
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Risk factor that presents the greatest threat for respiratory disease
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smoking
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Correct sequence of blood flow through the heart:
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right atrium, tricuspid valve, right ventricle, pulmonic valve, pulmonary artery, lungs, pulmonary veins, left atrium, mitral valve, left ventricle, aortic valve, aorta, body, superior and inferior caval veins
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The aging of blood vessels, esp arteries, begins in:
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childhood
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Average resting blood pressure tends to ____________ with age
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increases risk of bleeding (as do ibuprofen)
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Average resting blood pressure may contribute to
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stroke or left sided heart failure
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causes the left ventricle to work harder and may hypertrophy
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hypertension
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Its function is to carry oxygen and nutrients to the tissues and remove waste products
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cardiovascular system
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Its function is to pump blood
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heart
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Composed of arteries, veins, capillaries and lymph vessels
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peripheral vascular system
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With aging the walls of the blood vessels:
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stiffen
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This heart sound occurs at the beginning of systole when the atrioventricular valves close
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lubb
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This sound occurs at the start of diastole when the semilunar valves close
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dupp
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Levels of pulse quality
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absent (0), normal (2+), bounding (3+)
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X ray, electrocardiogram (ECG), stress tests, echocardiogram, thallium scan, dipyridamole thallium scan, multiple gated acquisition (MUGA), serum troponin I, creatine kinase-myoglobin (CK-MB), lactate dehydrogenase (LDH) myoglobin, cardiac catheterization and angiography all test:
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cardiac function
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Pain, pulselessness, pallor, poikilothermia, paresthesia and paralysis are the 6 Ps of:
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peripheral vascular disease
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Plethysmography, Doppler ultrasound, pressuremeasurement, stress testing, venography and arteriography test for:
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peripheral vascular disease
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assessed before medication administration, test dyes
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allergies
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modifiable risk factor for cardiovascular disorders (a habit)
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smoking
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location: chest, calf; radiation; arms, jaw, neck
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pain
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sign resulting from right sided heart failure
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weight gain
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lung sounds with left sided heart failure
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crackles
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symptom of dysrhythmias
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dizziness
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effect of decreased cardiac output
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fatigue
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classic symptom of acute heart failure
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pink tinged sputum
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Place where each normal heartbeat is initiated
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sinoatrial node in the wall of the right atrium
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which contracts first? Atria or ventricles?
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atria first then ventricles
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detects changes in blood pressure
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pressoreceptors in the carotid and aortic sinuses
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Why does epinephrine incrase blood pressure?
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increases heart rate and force of cardiac contraction
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When BP decreases, kidneys help raise it by secreting
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renin
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prevents backflow of blood in veins
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valves
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The usual difference between bp readings in the arm and leg
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10mm Hg higher
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If the nurse gets a lower bp reading in the left arm than the right, she should use which arm going forward?
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right
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Normally when a patient stands, the bp can drop by which amt?
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up to 15 mm Hg
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Normally when a patient stands, the heart rate can incrase by:
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up to 20 beats per minute
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Legs with bilateral decreased hair distribution, thick brittle nails, shiny taught dry skin can indicate:
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decreased arterial blood flow
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What medication would be given to a patient for a thallium stress test to increase blood flow that occurs with exercise?
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a coronary vasodilator, dipyridamole (Persantine)
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Types of dysrhythmias that may require a permanent pacemaker
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third degree heart block and symptomatic bradycardia
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Most common form of arteriosclerosis, in which fats are deposited on arterial walls
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atherosclerosis
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amount of blood the heart pumps out each minute
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cardiac output
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amount of pressure exerted on the wall of the arteries when the ventricles are at rest; the bottom number in a blood pressure reading
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diastolic blood pressure
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abnormally elevated blood pressure
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hypertension
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systolic pressure is 140 mm Hg or more, but the diastolic pressure is less than 90 mm Hg
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isolated systolic hypertension
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normal blood pressure
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normotensive
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opposition to blood flow through the vessels
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peripheral vascular resistance
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deposit of fatty material in the artery
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plaque
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abnormally elevated blood pressure, the cause of which is unknown; also called essential hypertension
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primary hypertension
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high blood pressure that is a symptom of a specific cause, such as a kidney abnormality
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secondary hypertension
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maximal pressure exerted on the arteries during contraction of the left ventricle of the heart; top number of a blood pressure reading
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systolic blood pressure
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What type of diuretic is: Spironolactone (Aldacotone)
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potassium sparing
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What type of diuretic is: Bumetanide (Bumex)
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loop
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What type of diuretic is: Chlorothiazide (Diuril)
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Thiazide or thiazidelike
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What type of diuretic is: Triamterene (Dyrenium)
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potassium sparing
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What type of diuretic is: Furosemide (Lasix)
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Loop
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What type of diuretic is: Amiloride (Midamor)
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potassium sparing
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What type of diuretic is: Metolazone (Zaroxolyn)
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Thiazide or thiazidelike
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What type of diuretic is: Hydrochlorothiazide (HydroDIURIL, HCTZ)
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Thiazide or thiazidelike
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What type of diuretic is: Torsemide (Demadex)
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Loop
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T/F: Constant stress can cause hypertension
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FALSE
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T/F: There is a link between a high fat diet, obesity, and hypertension
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TRUE
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T/F: high calcium, potassium, and magnesium levels are important risk factors for the development of hypertension
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FALSE
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T/F: People who are not active on a regular basis are at an increased risk of developing hypertension
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TRUE
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T/F: a diet high in salt is also high in vitamins and minerals
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FALSE
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The reccomended follow up for a systolic bp of 120-139 is in:
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1 year
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The reccomended follow up for a systolic bp of less than 120 is in:
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2 years
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The reccomended follow up for a systolic bp more than 180 is in:
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NOW
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The reccomended follow up for a systolic bp of 160-179 is in
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1 month
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The reccomended follow up for a systolic by of 140-159 is in:
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2 months
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The reccomended follow up for a diastolic bp of 90-99 is in:
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2 months
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The reccomended follow up for a diastolic bp of 110 is in:
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NOW
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The reccomended follow up for a diastolic bp of 100-109 is in:
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1 month
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The recommended follow up for a diastolic bp of less than 80 is in:
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2 years
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The reccomended follow up for a diastolic bp of 80-89 is in:
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1 year
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List the modifiable risk factors for hypertension
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high cholesterol, cigarette smoking, sedentary lifestyle
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Type of hypertension where Systolic is high and diastolic is normal
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isolated systolic hypertension
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Criteria for hypertension (other than the numbers)
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higher than normal on two separate occasions
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The effect of smoking on blood pressure
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associated w/ stage 1 and 2 hypertension
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Side effect of Adalat (Procardia)
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headache
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Category of hypertension for patient w/ 164/102 and 176/100 bp readings
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stage 2
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Common side effect of metolazone (Zaroxolyn)
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muscle weakness
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The purpose of enalapril maleate (Vasotec)
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decrease levels of angiotensin II
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Most likely side effect for patients on enalapril maleate (Vasotec)
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cough
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The purpose of propranolol (Inderal)
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decrease cardiac output
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Important instruction regarding propranolol (Inderal)
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do not stop abruptly
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Nursing Diagnosis that is the focus of care for pt w/ hypertension
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deficient knowledge
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A patient diagnosed with LTBI has:
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a TB infection but not active disease, so as long as their immune system stays strong, they can keep the infection from making them sick
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What assessment finding does the nurse expect w/ a patient with emphysema
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diminished breath sounds
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Most conclusive diagnostic test for lung cancer?
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biopsy
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Priority intervention 1 hr pre-op for a pneumothorax
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prn analgesic
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assessment findings in a patient w/ pneumonia that most indicates a need to remind the patient to cough and deep breathe?
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wheezes and crackles
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Priority intervention for a patient w/ SOB, increasing confusion and combativeness
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assess the patient, check to make sure they are getting enough oxygen
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Why is an influenza patient not prescribed an antibiotic?
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antibiotics are for bacteria, influenza is caused by a virus
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priority assessment after a laryngectomy?
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airway patency
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Reason why an antiviral drug may not be given for the flu
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only work if you start them w/in 48 hrs after symptoms start
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position recommended for a patient w/ a nosebleed
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sitting up leaning slightly forward
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Ways to avoid passing influenza
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wash hands, cover nose and mouth during coughing/sneezing, avoid sharing eating utensils
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Communication method that will not work with a patient with a laryngectomy
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placing a finger over the stoma
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Proper way to use a metered dose inhaler
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exhale, place canister in mouth, depress canister and inhale at the same time
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Normal value for O2 sat
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more than 95%
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Violin-like sound heard on chest auscultation
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wheezes
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deteriorating cilia in the respiratory tract predispose the elderly to:
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respiratory infection
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During inhalation, which muscle contractions take place to enlarge the chest cavity from top to bottom
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diaphragm moves down
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What is the cause of primary hypertension?
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there is no known cause
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Most important lifestyle modification for the hypertensive patient (if applicable)
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lose weight
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Often the only sign of hypertension
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elevated blood pressure
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How long should a patient go before a follow up dr visit with a 138/84 bp reading?
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1 year
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If a patient comes in to an outpatient clinic w/ a 210/120 mmHg bp how do you proceed?
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patient rests quietly while the nurses call 911 and request an ambulance
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expected findings in a patient experiencing the complication of heart failure from hypertension
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distended jugular veins in semi fowler position
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A patient receiving a diuretic should? (nursing instructions)
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change positions slowly
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Criteria that determines BP therapy for hypertension is successful
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bp less than 120/80 mmHg
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The mitral and tricuspid valves prevent backflow of blood from where?
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ventricles to atria when the ventricles contract
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The purpose of the endocardium of the heart
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lines the chambers of the heart and prevents abnormal clotting
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Function of the coronary blood vessels
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bring oxygenated blood to the myocardium
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Location of the cardiac centers in the nervous system
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medulla
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Function of angiotensin II
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increase vasoconstriction and aldosterone secretion
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Increase of resting bp w/ age may contribute to:
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left sided heart failure
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Modifiable cardiovascular risk factor
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tobacco use
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If it takes longer than 3 seconds for the color to return when assessing capillary refill it may indicate:
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decreased arterial flow to the extremity
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An important safety intervention that should be used while assessing a patient for orthostatic hypotension
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gait belt
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area of the body to assess a patient on bedrest for edema
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sacrum
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Should be included in patient teaching for coronary angiography w/ femoral catheter insertion site
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dye injection causes hot flushing sensation, ambulation is not possible immediately after proceedure, allergies assessed prior to testing
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Why is a high fiber diet reccomended for cardiac patients?
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reduce cardiac workload
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A patient is taking digoxin (Lanoxin), furosemide (Lasix), potassium, warfarin (Coumadin) and famotidine (Pepcid). Which may be stopped several days before surgery?
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Warfarin (Coumadin)
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