Medsurg Nursing Respiratory

Front 1

Define Hypoxemia

Back 1

Low level of oxygen in Blood

Front 2

Define Hypoxia

Back 2

Low level of oxygen in Tissue

Front 3

Define Hypercarbia

Back 3

Increased Carbon Dioxide in Blood

Front 4

What drives a healthy person to breathe?

Back 4

Hypercarbic drive

Front 5

What drives a COPD pt to breathe?

Back 5

Hypoxic drive

Front 6

PPY equation

Back 6

PPY= PPD x Years smoked

Front 7

Define Transtracheal Oxygen Therapy

Back 7

2 Holes in Trachea, Oxygen in trachea directly delivered High flow

Front 8

Define Asthma

Back 8

Intermittent reversible airflow obstruction

Front 9

Asthma only affects the ___, not the ___

Back 9

airways, alveoli

Front 10

Name two types of Asthma, and define them

Back 10

Inflammation-obstructs the inner airway

Hyperresponsiveness- twitching, constricting bronchial smooth muscle causing narrowing of airway from outside

Front 11

S/S of Asthma

Back 11

wheezing, diminished breaths, dry and nonproductive cough, increased RR, tachycardia, dyspnea, accessory m. use.

Late s/s: Cyanosis, cant speak, decreased LOC

Chronic s/s: Barrel chest, clubbing

Front 12

Define Status Asthmaticus

Back 12

Severe acute airway obstruction that does not respond to usual treatment

Front 13

What can Status Asthmaticus complicate to?

Back 13

Cor pulmonale, pneumothorax, respiratory/ cardiac arrest

Front 14

How do you Tx Status Asthmaticus?

Back 14

*Magnesium Sulfate (IV systemic bronchodilators most potent), IV fluids, Steroids, epinephrine, Oxygen, possible intubation

Front 15

Emphysema is a ___ problem

Back 15

alveolar

Front 16

Primary cause of Emphysema

Back 16

smoking

Front 17

Emphysema is...

Back 17

Hyperinflation of lungs, causing bullae formation, small airway collapses, airway traps, loss of lung elasticity

Front 18

Emphysema S/S

Back 18

barrel chested, pink puffer, tripod breathing, diminished breaths

Front 19

Define Chronic Bronchitis

Back 19

Airway problem; Inflammation of the bronchi and bronchioles caused by irritants like smoking. Causes vasodilation, congestion, mucosal edema, bronchospasms (Respiratory acidosis)

Front 20

Chronic Bronchitis S/S

Back 20

Blue blower, clubbing by long term hypoxia, crackles, rhonchi, wheezing, productive cough, JVD, corpulmonale

Front 21

COPD pt breathing education includes..

Back 21

diaphragmatic breathing, pursed lip breathing, positioning

Front 22

COPD nutrition education includes..

Back 22

Pt usually thin b/c they rather breathe than eat. So food in high calorie, high protein. Watch Carbs b/c it produces saliva. Easy to chew foods

Front 23

COPD complications

Back 23

INFECTION, hypoxemia, respiratory acidosis, HF, cor pulmonale, cardiac dysrhythmias, respiratory failure

Front 24

Define Sarcoidosis

Back 24

Multi-system granulomatus disorder, autoimmune, stiff lungs, restrictive, thickened lung tissue, affects interstitium of lungs NOT airway

Front 25

Obstructive sleep apnea Define, Name risk factors

Back 25

apnea for 10sec/ 5x per hour; obesity, short neck, smoking, enlarged uvula

Front 26

obstructive sleep apnea S/S

Back 26

daytime sleepiness, waking up tired, irritable, personality change, family/loved one notices change in sleep, polysomnography

Front 27

obstructive sleep apnea Tx

Back 27

weight loss, positive pressure ventilation CPAP, modafinil (manages daytime sleepyness), Surgical ectomy

Front 28

S/S of right sided HF

Back 28

JVD, ascites, peripheral edema, SOB, fatigue, hepatomegaly

Front 29

Define Pulmonary HTN

Back 29

vessel constricion resulting in increased vascular resistance

Front 30

PHTN S/S

Back 30

dyspnea, fatigue, S/S of RHF

Front 31

PHTN Tx

Back 31

med- anticoag, Calcium channel blockers to dilate bld vsl, endothelin-receptor antagonists to dilate bld vsl, flowlan to vasodilate, viagra, digoxin, diuretics, lung transplant

Front 32

Define pneumonia

Back 32

inflammation in interstitial space, alveoli, bronchioles that leads to hypoxemia and edema of lung tissue, movement of fluid into alveoli causing collapsed alveoli and impaired air exchange.

Front 33

Types of Pneumonia

Back 33

infectious/non

community-acquired (common)

nosocomial

Front 34

S/S of pneumonia

Back 34

chills, fever, cough, flushed cheeks, anxious expression, pleuritic pain, tachycardia, dyspnea, increased RR, sputum bld tinged rust colored, labored breathing, accessory m. use, SOB, crackles, wheezing, diminished breath sounds

LATE: hypotensive, orthostatic, rapid, weak pulse, hypoxemia, dehydration

Front 35

TB is...

Back 35

highly communicable, airborne, M.Tuberculosis, secondary TB is dormant (HIV+), Drug resistants- multiple/ extensive

Front 36

TB S/S

Back 36

low grade fever lasting, chest pain, night sweats, lethargy, weight loss, cough w/ bld streaked sputum

Front 37

TB Dx

Back 37

PPD >10mm; sputum for acid-fast bacillus is definitive; bld analysis; CXR for ruling out active disease or old lesions- protocal for postive PPD

Front 38

When is TB no longer contagious?

Back 38

after 3 consecutive negative sputum negatives

Front 39

First line TB drug therapy.. four drugs

Back 39

Isonizaid (INH), Rifampin (RIF), Pyrazinamide (PZA), Ehambutol (EMB)

Front 40

Flu intervention key

Back 40

hand washing

Front 41

Steroids affect WBC and Sugar..how?

Back 41

Increases it

Front 42

Oxygen toxicity

Back 42

>55% for 24hrs destroys tissue

Front 43

Absorption atelectasis

Back 43

Nitrogen makes 75% of air. The imbalance of Carbon dioxide and oxygen causes crackles, decreased breath sounds, lung collapse