Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/87

Click to flip

87 Cards in this Set

  • Front
  • Back
ACID-BASE IMBALANCES of ___ may depress the respiratory system
less than 7.15 or greater than 7.45
What portions of the neuro system deals with respiratory functioning?
The medulla oblongata is the inspiratory and expiratory center of the brain than controls the rate and depth of respiration. The apneustic center of the lower pons may also contribute to inspiration and the pneumotaxic center may assist in expiration.
RESPIRATORY FAILURE is
respiratory system can’t adequately supply the body with the O2 it needs or adequately remove CO
PO2 value of ______ indicates respiratory failure
PO2 less than or equal to 50 mm Hg

PCO2 greater than 50 mm Hg with a pH of less than or equal to 7.25
RESPIRATORY FAILURE may be confirmed by
ABG levels show hypoxemia, acidosis, alkalosis, and hypercapnia.
RESPIRATORY FAILURE tx includes
O2 therapy, intubation, and mechanical ventilation (PEEP)
RESPIRATORY FAILURE interventions include
include early detection of signs of hypoxemia and tx with O2. Provide suctioning, assist with turning, coughing and deep breathing. Maintain bed rest to reduce O2 requirement.
CROUP is
severe inflammation of the upper airway, usually caused by a virus
GROUP s/s are
- bark-like cough, inspiratory stridor and laryngeal obstruction to varying degrees.
GROUP
related to symptoms and can include aerosolized epinephrine, decadron, and application of cool mist. Antipyretics can control fever if present. Frequently affects children up to three years of age
CHRONIC BRONCHITIS is a form of
COPD
COPD results from
results from irritants and infections that increase mucus production, impair airway clearance, and cause irreversible narrowing of the small airways leading to hypoxemia and CO2 retention
CHRONIC BRONCHITIS s/s are
dyspnea, increased sputum production, productive cough, prolonged expiration, rhonchi and wheezes
CHRONIC BRONCHITIS maybe confirmed by which test, what does each test reveal
chest x-ray shows hyperinflation and increased bronchovasicular markings. PFTs may reveal increased residual volume, decreased vital capacity and forced expiratory volumes, and normal static compliance and diffusion capacity.
CHRONIC BRONCHITIS tx includes
increase fluid intake to 3000 ml/day, CPT, IS, increase protein and vitamin C, calories and nitrogen in the diet. Intubate and ventilate if respiratory status deteriorates
What should be noted about FiO2 as it relates to nsg interventions of CHRONIC BRONCHITIS
administer low FiO2 because COPD patients use their hypoxic drive to breathe and increased FiO2 shuts that drive system down, they will stop breathing and become hypercapnic, somnolent and obtunded
LARYNGEAL EDEMA is
edema of the mucous membranes that surround the larynx (voice box
LARYNGEAL EDEMA s/s are
acute anaphylaxis, scarlet fever and severe inflammations of the throat
LARYNGEAL EDEMA tx includes
epinephrine, and an icepack to the throat
Provide a general overview of MUCOID SECRETIONS
Fluid imbalances that result in dehydration can severely impact airway clearance. Thick, sticky, tenacious secretions are harder to remove. Infection can also change the consistency of secretions and make them harder to remove
ASTHMA is
chronic reactive airway disease. Bronchial linings overreact to various intrinsic and extrinsic stimuli, causing episodic spasms and inflammation that can severely restrict the airways
ASTHMA s/s are
chest tightness, dyspnea, wheezing, primarily on expiration, tachypnea, tachycardia, and use of accessory muscle
ASTHMA tx includes
- Increased fluid intake to prevent thickened secretions, beta-adrenergic drugs (serevent), bronchodilators (albuterol, ipratropium bromide), mast cell stabilizer (intal).
Provide an overview of EMPHYSEMA
recurrent pulmonary inflammation damages and eventually destroys alveolar wall, creating large air spaces and reducing the area available to exchange O2 and CO2. Lungs are less able to recoil after expanding, air trapping and overdistention are characteristic of this disorder
EMPHYSEMA s/s are
barrel chest, dyspnea, pursed-lip breathing, increased use of accessory muscles for breathing
EMPHYSEMA maybe confirmed by
chest x-ray reveals a flattened diaphragm, reduced vascular markings, enlarged antero-posterior chest diameter and a vertical heart. PFT’s show increased residual volume, total lung capacity and compliance and decreased vital capacity, diffusing capacity and expiratory volumes
EMPHYSEMA tx includes
bronchodilators, steroids (hydrocortisone, solu-medrol), aerosolized steroids, diaphragmatic and pursed-lip breathing to strengthen respiratory muscles, high-fowler’s position to improve ventilation, smoking cessation, and avoidance of people with respiratory infections.
FLAIL CHEST s/s are
fractured ribs on both the left and right can lead to paradoxical movement of the chest wall. During inspiration a portion of the chest wall deflates instead of expands giving a see-saw appearance to breathing.
FLAIL CHESTunusual treatment maybe
Usual treatment is mechanical ventilation to stabilize the ribs and give them time to heal
What should be noted about Paradoxical movement
movement is not an effective breathing pattern and carries the increased risk of broken rib bones puncturing lung tissue and causing further damage
Provide an overview of DIAPHRAGM PARALYSIS excluding tx
as result of damage to the phrenic nerve. Intercostal and accessory muscles take over the role of breathing and can quickly lead to fatigue and respiratory failure
DIAPHRAGM PARALYSIS tx includes
upright position and frequent use of mechanical ventilation especially at night.
PLEURAL EFFUSION is
excess fluid in the pleural space (between the lung and the protective layer around it. Usually this area contains a small amount of extracellular fluid that lubricates the pleural surfaces. Increased production or inadequate removal of this fluid results in pleural effusion.
PLEURAL EFFUSION s/s are
decreased breath sounds, dyspnea, fever, pleuritic chest
PLEURAL EFFUSION maybe confirmed by
chest x-ray shows radiopaque fluid in dependent regions
PLEURAL EFFUSION tx may include
Thoracentesis to remove fluid and antibiotics according to the sensitivity of causative organism. Use of chest tube to drain fluid from the pleural space.
Explain how altitudes may affect O2 supply
the ambient pressure in high altitude areas is less than at sea level. This decreases the pressure gradient between the lungs and the environment, so that there is less being “pushed” into the lungs.
Living in high altiitudes may result in
in polycythemia to improve oxygen carrying capacity.
Polycythemia is
A condition marked by an abnormally large number of red blood cells in the circulatory system.
Provide an overview of SMOKE INHALATION INJURY
loss of ciliary action, mucosal edema and decrease in surfactant leading to atelectasis, alveolar collapse. Mucosa sloughing can cause expectoration of mucopurulent material and carbon particles. Pt’s should be watched for 24-48 hours to access for extent of edema and risk of problem from exudates in the lung
PERIPHERAL VASCULAR DISEASE IS
chronic inadequate blood flow in the lower extremities
PERIPHERAL VASCULAR DISEASE S/S ARE
moderate edema, burning, itching, prominent superficial veins, ulcers and skin changes
PERIPHERAL VASCULAR DISEASE TX includes
Aimed at vasodilation, pain relief, and maintaining skin integrity. Do NOT use a heating pad to keep extremities warm
PERIPHERAL VASCULAR DISEASE
Encourage walking and other leg exercise, watch for signs of decreased peripheral circulation.

Avoid temperature extremes, prolonged standing, constrictive clothing or crossing the legs at the knee when seated.
PERIPHERAL VASCULAR DISEASE Complications include
include gangrene, and pressure sores

Increased incidence of peripheral vascular disease in older adults.
Nsg interventions for PERIPHERAL VASCULAR DISEASE
Provide instruction about foot care and exercise programs. Develop a plan for smoking cessation
PULMONARY EMBOLISM is
fat, air or thrombus in the pulmonary vessels that obstructs blood flow. Obstruction may result in pulmonary hypertension and possible infarction
PULMONARY EMBOLISM includes
surgery, flat, long bone fractures, obesity, oral contraceptive use, pregnancy, prolonged bed rest, venous stasis
PULMONARY EMBOLISM s/s are
sudden onset of dyspnea, tachypnea, crackles, chest pain, cough, hemoptysis, tachycardia, anxiety
PULMONARY EMBOLISM dx confirmed by
ABG shows respiratory alkalosis and hypoxemia and elevated A-a gradient. Lung scan shows V/Q mismatch
PULMONARY EMBOLISM tx is
bed rest, anticoagulants (heparin), diuretics (lasix), fibrinolytics (streptokinase), and in recurrent cases the insertion of a vena cava filter.
PULMONARY HYPERTENSION is
when the blood pressure in the pulmonary arteries (the vessels that carry blood from the heart to the lungs) becomes higher than normal. This puts strain on the right side of the heart
PULMONARY HYPERTENSION maybe classified by
When the cause of pulmonary hypertension isn't known, the disorder is called "primary" pulmonary hypertension

Secondary" pulmonary hypertension has a known cause. Common causes are emphysema and chronic bronchitis (breathing problems).
PULMONARY HYPERTENSION maybe treated by
medicines called calcium-channel blockers, breathing oxygen from a tank, or a blood-thinning medicine may help. In primary pulmonary hypertension, a medicine that is given through a vein, called prostacyclin (brand name: Flolan), may lower the blood pressure in your pulmonary arteries.
TUBERCULOSIS is
Airborne, infectious, communicable disease. Alveoli become infected from inhaled droplets containing tubercle bacilli
TUBERCULOSIS s/s are
fever, night sweats, cough with yellow mucoid sputum, anorexia, weight loss
TUBERCULOSIS maybe confirmed by
mantoux skin test is positive. Sputum study is positive for acid-fast bacillus and M. tuberculosis.
TUBERCULOSIS tx includes
standard/airborne precautions, antituberculars (isoniazid, rifamping),
TUBERCULOSIS nsg interventions include
Instruct the patient to cover nose and mouth when sneezing to reduce transmission by droplet.
ADULT RESPIRATORY DISTRESS SYNDROME is
Assault to the pulmonary system (aspiration, decreased surfactant production, fat emboli, fluid overload, neurologic injuries O2 toxicity, respiratory infection, sepsis, shock, trauma). Respiratory distress. Decreased lung compliance. Severe respiratory failure
ADULT RESPIRATORY DISTRESS SYNDROME s/s are
Anxiety, restlessness, crackles, rhonchi, decreased breath sounds, dyspnea, tachypnea
ADULT RESPIRATORY DISTRESS SYNDROME maybe confirmed by
ABG shows respiratory acidosis, metabolic acidosis and hypoxemia that doesn’t respond to increased O2. Chest x-ray shows bilateral infiltrates and lung fields with a ground-glass appearance
ADULT RESPIRATORY DISTRESS SYNDROME tx includes
intubation and mechanical ventilation, O2 therapy, analgesics (morphine), antibiotic ( according to infectious organism sensitivity), diuretics, neuromuscular blocking agents (Norcuron), and steroids.
ADULT RESPIRATORY DISTRESS SYNDROME nsg interventions include
turning and CPT to promote drainage and keep airways clear. Position in high-fowler’s to promote chest expansion. Maintain bed rest to promote oxygenation.
PULMONARY EDEMA is
complication of L sided heart failure. Increased pressure in the capillaries of the lungs causes acute transudation of fluid. Creates impaired oxygenation and hypoxia.
PULMONARY EDEMA s/s are
dyspnea, orthopnea, tachypnea, blood-tinged, frothy sputum, agitation, restlessness, intense fear
PNEUMOTHORAX is
loss of negative intrapleural pressure results in collapse of the lung. The surface area of gas exchange is reduced, resulting in hypoxia and hypercapnia
PULMONARY EDEMA maybe confirmed by
hemodynamic monitoring shows increased PAP, PAWP, and CVP. Decreased cardiac output
PULMONARY EDEMA nsg interventions are
assessing cardiovascular status, etc to detect changes in fluid blance, tachycardia, S3 heart sound, hypotension, increased respiratory rate and crackles which can indicate increases fluid volume.

Keep the head of the bed in high fowler’s if tolerated to reduce venous return to the heart and promote chest expansion
PNEUMOTHORAX causes are
blunt chest trauma, penetrating chest injuries, rupture of a bleb, and thoracic surgeries
PNEUMOTHORAX s/s are
diminished or absent breath sounds, dyspnea, tachypnea, subcutaneous emphysema, cough, sharp pain that increases with exertion
PNEUMOTHORAX maybe confirmed by
chest x-ray
PNEUMOTHORAX tx includes
chest tube to water-seal drainage
Black lung diease is
condition of the lungs caused by inhalation of coal dust
Provide an overview of CHEST TUBES are assessed by
Assess by palpating chest around the tube for subcutaneous emphysema, notify dr. of any increase. Assess function of chest tube. Bubbling in the water seal chamber should decrease as the pneumothorax is resolved. Constant bubbling may indicate a loose connection, promptly correct any loose connections. If the tube becomes dislodged, cover the opening immediately with petroleum gauze and apply pressure. Call the doctor and continue to keep the opening closed, prepare to reinsert chest tube. If the tubing becomes cracked insert the distal end into sterile water and call the doctor.
PNEUMONIA is
bacterial, viral, parasitic, or fungal infection that causes inflammation of the alveolar spaces. Droplet inhalation causes inflammation and an increase in alveolar fluid, secretions thicken making ventilation more difficult
PNEUMONIA s/s are
chills, fever, crackles, rhonchi, pleural friction rub on auscultation, SOB, dyspnea, tachypnea, used of accessory muscles, sputum production
PNEUMONIA maybe confirmed
chest x-ray shows pulmonary infiltrates, sputum study to identify specific organism
PNEUMONIA tx includes
symptomatic and antibiotics
PNEUMONIA nsg interventions are
monitoring for dehydration due to insensible water loss secondary to fever, monitor respiratory status to detect early signs of compromise
ATELECTASIS is
localized alveolar collapse that reduces the gas exchange surface of the lungs.
ATELECTASIS is caused by
include mucous plugs, decreased expansion due to pain, and anesthesia
ATELECTASIS s/s are
diminished or bronchial breath sounds, dyspnea, anxiety, cyanosis, diaphoresis, tachycardia, substernal or intercostal retraction
ATELECTASIS tx is
bronchodilators, deep breathing and coughing, administer adequate analgesics.
COPD s/s are
Exertional dyspnea, weakness, fatigue and chronic, productive cough
COPD tx may inclue
correcting hypoxemia and administration of digitalis, antibiotics, vasodilators, anticoagulants and oxygen
COPD maybe confirmed by
increased pulmonary artery pressure measurements