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110 Cards in this Set

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diaphragm contracts, chest cavity expands, intrathoracic pressure becomes less than atmospheric pressure
inspiration
passive movement of air out of the lungs
expiration
active process of moving air into the lungs
inspiration
movement of air in and out of the lungs
ventilation
state of CO2 deficit caused by hyperventilation
respiratory alkalosis
PCO2 less than 35 mm Hg
respiratory alkalosis
causes of hyperventilation
anxiety, hypoxia, fever, salicylate toxicity
first symptoms of respiratory depression
slow/shallow respirations, restlessness, anxiety, confusion
late symptoms of respiratory depression
lethargy, cyanosis
trapping air in the alveoli
COPD
collapse of the alveoli
atelectasis
disorders that decrease diameter of the airway, thus increasing resistance to airflow and decreasing ventilation
laryngeal edema, croup, asthma, FB, tenacious secretions
a medical emergency that results in swelling of the larynx/throat
laryngeal edema
decreased supply of oxygen to the tissues
hypoxia
decreased oxygen in the blood
hypoxemia
increased CO2 in the blood
hypercapnia
a result of decreased availability of O2 d/t hypoventilation
hypoxia and hypoxemia
a result of the inability of ventilation to remove CO2 from the body's system
hypercapnia
high PaCO2 and low PaO2 (carbonic acid excess)
respiratory acidosis
nurse must monitor patients receiving narcotic pain medication for
sedation and overdose
nursing interventions for preventing hypoventilation and respiratory acidosis
TCDB, O2 as ordered
respiratory acidosis can lead to
respiratory failure
nursing intervention to promote adequate lung expansion in a patient recovering from fractured ribs by firmly holding a pillow while taking deep breaths
splinting
guarding behavior or failure to fully inhale or exhale d/t conditions causing the pt pain such as surgery/fractured ribs/pleurisy
splinting
a condition that occurs when CO2 binds to hemoglobin in the bloodstream and displaces the O2
smoke inhalation
a ratio of blood passing the lungs vs gases exchange
V/Q
condition where blood flows through the lungs but ventilation is not adequate to support gas exchange
shunting
condition where ventilation is adequate for gas exchange, but not enough blood is available to support the exchange
dead space
condition where either ventilation or perfusion is inadequate or nonexistent
silent unit
an example of a silent unit
Pneumothorax
a bleeding disorder that causes alteration in clotting factors that leads to hemorrhage
DIC(Disseminated Intravascular Coagulation)
destruction of platelets leading to hemorrhage
thrombocytopenia purpura
which gender has a higher physiological susceptibility to atherosclerotic plaque?
female (heart smaller, less mass, smaller coronary arteries; post menopausal women have decreased levels of estrogen which is thought to aid in preventing CAD)
most of the incidences of cardiovascular disease in the U.S. are related to
atherosclerosis
normal aging development of arterial vessels
gradually thicken and lose elasticity
normal aging development of heart valves
thickening d/t lipid accumulation and calcification: decreased SA node pacemaker cells
symptoms of age related changes of the heart valves
bradycardia/murmur
normal physiological changes in lung tissue
loss of elasticity in lung recoil and chest excursion
normal physiological changes in upper respiratory tract
decreased ciliary function/ weakened cough
the normal decrease in arterial blood oxygen levels (PaO2) in the elderly is due to
the gradual decrease in number of alveoli
a patient with CHF should avoid eating foods high in
sodium (to promote the removal of fluid from the cells)
how does difficulty breathing affect a person's nutritional status?
diff. breathing can cause fatigue which makes it difficult for the patient to physically eat and ingest enough calories to meet their body's requirements
a rapid weight gain in a patient with cardiovascular conditions may indicate what
fluid retention
common complications associated with diabetic patients
CAD, PVD
how does a person's chronic respiratory disease affect his/her nutritional status?
excessive sputum production can affect taste and appetite; medications that treat these disorders can cause anorexia or other GI symptoms
normal ratio of inspiration to expiration
1:2
ratio of inspiration to expiration of a patient suffering from emphysema
2:1 (barrel chest makes AP diameter d/t hyperinflation)
slow deep respirations regular in rhythm. indication of respiratory depression
bradypnea
rapid, shallow respirations regular or irregular occurring in the presence of anxiety, fever, or infection
tachypnea
deep regular rapid respirations caused by metabolic acidosis (bicarbonate defecit or increased acid)
kussmaul's respirations
condition in which the respiratory system attempts to compensate for the body's state of acidosis by increasing the RR to increase CO2 elimination (decreasing acidosis)
ketoacidosis
rhythmic increasing then decreasing dept of respirations followed by apnea
Cheyne-Stokes respiratiosn
cessation of breathing for a period of time
apnea
frequent breathing pattern of patients suffering from heart failure or respiratory center damage
cheyne-stokes respirations
breath sounds heard in all lung fields except the major bronchi
vesicular breath sounds
breath sounds heard over the 1st and 2nd ICS near the sternum and between the clavicals
bronchovesicular breath sounds
breath sounds heard over the trachea
bronchial breath sounds
quiet, soft, low pitched breath sounds
vesicular breath sounds
loud and high pitched breath sounds
bronchial
medium pitch and intensity breath sounds
bronchovesicular breath sounds
fine high pitched breath sounds heard on inspiration
crackles
low pitched sounds heard upon expiration
rhonchi
high pitched musical sounds heard on both inspiration and expiration
wheezes
breath sounds indicative of large airway fluid obstruction commonly present in COPDers and Pneumonia
rhonchi
breath sounds indicating that air is moving through narrowed airways present in asthmatics, FB, and COPDers
wheezes
harsh, grating, rubbing sounds heard on inspiration and expiration
pleural friction rub
absent breath sounds indicate
air is not moving freely through the lungs
causes of absent or diminished breath sounds
atelectasis, pneumothorax, fluid or secretion consolidation
clubbing of the fingernails indicates
chronic hypoxia
patients with increased carbon dioxide levels d/t CO2 retention may have a _________ complexion
ruddy (red)
pursed-lip breathing is used by the patient to achieve
a prolonged expiratory phase of respiration
retraction of intercostal muscles and the use of accessory muscles to breathe is indicative of
acute respiratory distress
the position of comfort for a patient in respiratory distress or having an asthma attack is
the orthopneic position
acute tracheal deviation indicates what emergency situation
tension pneumothorax
if a patient presents to the ED with tracheal deviation to the R side, which side does the pneumothorax lie?
Left
a gradual deviation of the trachea may indicate what disease process
tumor growth
sharp chest pain that increases upon respiration
pleuritic pain/pleurisy
crushing chest pain that radiates to the neck
cardiac chest pain
normal male HGB
13.5-17.5
normal female HGB
11.5-15.5
normal male HCT
40-52%
normal female HCT
36-48%
the nurse should collect the sputum for TB (acid-smear) analysis at what time
am
Theophylline blood levels of 10-20 mcg/ml indicate what
normal level
endoscopic procedure used to biopsy a tumor of the throat
laryngoscopy
the nurse needs to monitor the patient post procedure endoscopy for
bleeding, gag reflex, pneumothorax, laryngeal spasm, respiratory distress, hypotension, hypoxia, hemoptysis
the position of comfort for a patient is post procedure endoscopy is
lateral side lying or Semi-Fowler's
the nurse must be aware that a patient having a thoracoscopy may need what type of cares upon returning to the unit?
chest tube cares, NPO, IV cares
the correct position for the nurse to place the patient for a thoracentesis is
sitting leaning over the bedside table with elbows and head supported
the doctor will order a routine chest xray following a thoracentesis in order to
r/o pneumothorax
side effects of Allegra (fexofenadine)
drowsiness, fatigue, GI distress (nausea)
the antihistamine most likely to cause sedation
Benadryl (diphenhydramine)
medicine used to suppress the cough reflex
antitussives
antitussives should not be administered to patients who suffer from
emphysema or asthma
the drug class or bronchodilators commonly used in acute situations is
beta-2 agonists (adrenergic agents)
a patient taking theophylline is has hypotension, and is convulsing. what can you expect his serum theophylline levels to be? what serious life threatening condition can this lead to?
subnormal (below 10mcg/ml); circulatory failure
a patient asks you what he should do if he misses his morning dose of theophylline
do not double dose: report side effects
side effects of albuterol
tachycardia, hypertension, decreased renal /gi blood flow
prototype decongestant
Sudafed (pseudoephedrine)
symptoms of O2 toxicity are
dyspnea/restlessness, lethargy paresthesia, substernal chest pain, respiratory discomfort
the maximum flow rate of O2 per nasal cannula is
6L/minute
the nurse knows that the chest tube system suction is working at an appropriate level if the water in the control chamber _________
bubbles slowly and steadily
who should be notified if a postsurgical patient has bright red drainage in his chest tube unit or the drainage reaches 200 cc/hr?
the surgeon (hemorrhage)
the nurse can expect the amount of serous drainage to decrease gradually during the first ____ hours following the surgery
24
what do you do if you think the chest tubing is obstructed?
gently squeeze the tubing as you stabilize it with one hand
tidaling occurs during the patient's repsirations. if tidaling stops, the nurse knows that
the lung has reexpanded or there is an obstruction
continuous bubbling in the water seal compartment indicates
an air leak
how often should the nurse check the a patient receiving mechanical ventilation?
at least qhour
before a conscious patient is placed on a mechanical ventilator, it is important to establish ___________
a method of communication such as a writing board
what lab values will be monitored closely when weaning a patient off a mechanical ventilator?
ABGs