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89 Cards in this Set

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______ is the palpable vibration on the chest wall when the patient says "99". The sounds are strongest over the trachea and diminish over the bronchi. Absent or decreased fremetis may indicate disease.
Fremitus
When palpating a person's chest, a sound called ______, or a crunching feeling under the skin caused by air leading into the subcutaneous tissue, may be felt from disease.
Crepitus
When performing respiratory __________, a unilateral decrease or delay in expansion may indicate disease.
Respiratory expansion
When percussing the thorax, a normal sound would be _______, or a long low pitched hollow sound. _________ or _______ would indicate a disease process is occuring.
resonance
hyperresonance, dullness
_______ is the flow of gas in and out of the lungs. ________ is the filling of the pulmonary capillaries with blood. A ________-______ imbalance occurs from poor ventilation, poor perfusion or both.
Ventilation
Perfusion
Ventilation-Perfusion VQ
Normal tidal volume is _____ ml, which is the amount of air inhaled and exhaled with each breath.
500ml or 5-10ml/kg
In the healthy lung, a given amount of blood passes through an alveolus and is matched with an equal amount of gas. A normal ventilation perfusion is __:__.
1:1
In low ventilation-perfusion states, blood bypasses the alveoli without gas exchange occurring. This is why it is sometimes called ________. This could be due to pneumonia, atelaectasis, a tumor, or mucus plug. All of which are ________.
Shunting
Obstructions
When there is a high ventilation perfusion ratio, ventilation exceeds perfusion causing ______ ______ to occur. The alveoli do not have enough blood supply for gas exchange to occur.
dead space
In the absence of ventilation and perfusion, or with limited ventilation and perfusion, a condition known as ______ _____ occurs.
silent unit
A nurse expects a patient's chest with advanced emphysema to become _____ shaped.
barrel
breath sounds that originate in the smaller bronchi and bronchioles and are high pitched sibilant, and musical are called _________.
wheezes
What are the 8 major symptoms of respiratory disease?
dyspnea, cough, sputum production, chest pain, wheezing, clubbing of the fingers, hemoptysis, and cyanosis
Blood spit up from the respiratory tract is called ______.
hemoptysis
_____ ______ respirations are associated with heart failure and damage to the respiratory center. They are characterized by episodes of apnea and periods of deep breathing.
cheyne stokes respirations
________ is the ability of the lungs and thorax to stretch and distend with ventilation.
Compliance
Signs and symptoms of the flu include what?
abrupt onset, fever and chills, malaise, muscle aches, headaches, profuse watery discharge, non-productive cough, and sore throat.
The most common complication of the flu is ________.
Pneumonia
The collapse of the alveoli caused by hypoventilation, obstruction to the airways, or compression is called _______.
Atelectasis
________ is cause by Bronchial obstruction by secretions due to impaired cough mechanism or
Conditions that restrict normal lung expansion on inspiration.
Postoperative patients are at high risk.
Atelectasis
In order to prevent Atelectasis, what should the nurse do?
1. Frequently turn patient and encourage early ambulation.
2. Deep breathing exercises should be done at least every 2 hours using incentive spirometry.
3. To remove secretions, suctioning, aerosol therapy, and chest physiotherapy can be done. 4. Judicious use of opioids/narcotics and sedatives
An acute infection of lung parenchyma including alveolar space and interstial space is called _________.
Pneumonia
Community acquired pneumonia occurs in the community or __ hours after being admitted to the hospital. It is most commonly caused by ________ pneumoniae, which is naturally occuring in the throat.
48
Streptococcus
A hospital acquired Pneumonia infection occurs ___ hours after the admission to the hospital. It can be caused by Pseudomonas, Staph, Klebsiella, PCP, Asperilligus, TB or ecoli.
48
_____ colored sputum is a common clinical manifestation of pneumonia. What are the other clinical manifestations.
Rust, Pleuritic pain, anxious expression, myalgia(muscle pain), headache, chills, fever, crackles, wheezes, hypoxemia, hypotensive, tachycardia, dyspnea, tachypnea, use of accessory muscles, rapid weak pulse, dehydration, impending shock
When diagnosing pneumonia, lab values include WBC levels being less than _____ if it is a viral infection and a above ______ if it is a bacterial infection.
5000
10,000
If a person is diagnosed with pneumonia, WBC should be monitored. Also a chest x-ray would reveal ____ to _____ infiltrates. The pulse oximeter would show a reading of less than _____ and _____ cultures should be done before giving an antibiotic so as not to skew results.
patchy to unclear
95
sputum
_______ is the vaccine for pneumonia. It is recommended for people over 65 and at high risk. Revaccination should occur after __ years in immunosuppressed patients. The _____ shot is highly recommended to prevent pneumonia.
Pneumovax
5
influenza vaccine
Mycobacterium tuberculus is spread by ______ droplet. It is a gram_____ acid fast bacillus.
airborne
positive
The clinical manifestations of TB include what?
Progressive fatigue, Low grade fever, Weigt loss (patient has anorexia and waste away), night sweats, irregular menses, cough with mucopurulent drainage that is yellow or green, hemoptysis, and dull aching chest pain.
A ______ test is done to test for exposure to TB. An intradermal PPD injection is given and causes a local inflammatory response. A firm, bleb __ mm or more after 48 to 72 hours indicates a positive test.
Mantoux
5
______ is a combination drug used to treat TB. It is a combination of INH (___mg) and Rifampin (___mg).
Rifamate
150
300
_______ is a drug that is used prophylactically daily for 4-7 months. It is never given alone to treat active TB. Major side effects are _____ and ____ toxicity.
INH (Isoniazid)
hepato and neuro
When a person has active TB, a four drug approach is used for __-__ months and includes what four drugs?
6-9
Isoniazid (INH)
Rifampin (RIF)
Pyrazinamide (PZA)
Either Ethambutol(EMB)or Streptomycin (SM)
________ _________ constitutes 90-95% of all lung cancers. It is aggressive, locally invasive, and widely metastatic.
Bronchogenic Carcinoma
________ is the only lung cancer that is known for causing lung cancer in non-smokers. It also occurs more often in women.
Adenocarcinoma.
A person's risk for getting lung cancer is determine by ____-___ history. To get this number you multiply ______x_______
pack per year
packs/day x # of years
When chest tubes are placed, the highest tube removes ___ and the lower one removes ___.
air
blood
The purpose of a chest tube is to restore intrapleural ______ pressure. It allows the lungs to re-expand and removes ____ and ____ from the pleural space.
negative
air
fluid
______ is a reversible airflow obstruction. When auscultating you should hear wheezing if this disease process is going on.
Asthma
_______ is characterized by irreversible bronchoconstriction and includes emphysema and chronic bronchitis.
COPD
Asthma affects only the airways, not the ______. Half of cases occur in children under __, but most of these cases go into remission by adult hood.
alveoli
10
The most common symptoms of asthma include ___, ____, and _____.
Cough, dyspnea, wheezing
In order to prevent asthmatic episodes before exercise, pre-medication may be necessary. ________ or ______ cell stabilizers may be used to prevent an episode.
B adrenergic agonists (bronchodilators)
mast cell stabilizer
Inhaled B adrenergic agonists are bronchodilators that are used to treat asthma, examples include what?
Alupent, Proventil, Xopenex, Maxair, Albuterol, Metaproterenol
Mast cell stabilizers are used to treat asthma because reactions can be triggered by ___ receptors. Examples include, ______ and _____ . These can not used for an emergency because they take two weeks to work.
IGE
Cromolyn
Nedocromil
Long acting beta blockers such as _______ and ______ can be used to treat moderate persistant asthma.
Salmeterol, formoterol
_______ modifiers like Singulair prevent allergic responses that can cause an asthma attack.
Leukotrienes
Inhaled corticosteroids, inhaled or oral B adrenergic agonists and ______ can be used to treat Severe persistent asthma. because they are very potent vasodilator.
Theophylline (Aminophyllin)
________ is a potent vasodilator used to treat asthma that is similar to caffeine. It has many adverse effects such as _____ and ____.
Theophylline
insomnia
irritability
B-adrenergic agonists such as _______ and ________ have a fast onset of action and last 4-8 hours. They provide short-term relief of bronchoconstriction, but overuse can cause _____ _____.
Albuterol, metaproterenol
rebound bronchospasm.
In _______ there is destruction within the walls of the alveoli and people with this condition are usually called _____ _____.
Emphysema
Pink Puffers
In emphysema, the cough is _____, with no sputum. They normally have a _____ chest and _____ lip breathing. They are normally called _____ ____ and are thin.
absent
barrel
Pursed
pink puffers
In Chronic Bronchitis, patients are called _____ ____ and are usually heavy. They have a _____ cough and ______ sputum. Upon auscultation you can hear ____ and _____.
blue bloaters
persistent
copious
crackles, wheezes
Patients called ____ _____ due to having emphysema have a ____ posture. There O2 is normal to low and they have respiratory _____ due to hyperventilation.
Pink puffer
tripod
alkalosis
People with COPD show a ______ sign, or a flattened diaphragm when looking on an x-ray.
Hoovers
People with chronic bronchitis are called ____ _____. They have _____, or too much CO2 in the blood, hypoxemia, and respiratory _______.
Blue bloaters
hypercapnia
acidosis
The total volume in lungs after maximum inspiration is the ______ ______ ______.
Total lung Capacity
The total volume in lungs after maximum inspiration is the ______ ______ ______.
Total lung Capacity
A normal total lung capacity is _____ ml. To get the normal total lung capacity, what components should you add.
6000
Tidal volume, Inspiratory Reserve Volume, Expiratory Reserve Volume, Residual volume
A normal tidal volume is _____ ml or ___-__ ml/kg. It may not vary even with severe diseases, but it may vary from breath to breath so it is important to note several and note the average.
500
5-10
A normal inspiratory reserve volume is ______ ml.
3000
A normal expiratory reserve volume is ______ ml.
1000
A patient's total lung capacity may be decreased due to ______ diseases such as atelactasis or pneumonia and ______ in COPD patients.
compliance, increased.
A persons residual volume should be about _____ ml but it may be increased due to obstructive diseases.
1200
Vital capacity performed with maximally forced expiratory effort is called ______ _____ _____. It is often reduced in patients with ______.
Forced vital capacity
COPD
______ ______ is measured by having someone take in a maximal breath and exhale fully through a spirometer.
Vital capacity
When the vital capacity is exhaled at a maximal flow rate, the _____ _______ ______ is measured. Most patients can exhale at least 80% of their vital capacity in one second. This is called ____.
Forced Vital Capacity
FEV1 (Forced Expiratory Volume 1)
If a patients Forced Vital Capacity and FEV1 are both significantly reduced than what does that indicate?
lung expansion is restricted.
IF the reduction in FEV1 is greatly exceeds the reduction in forced vital capacity, what does this mean?
There maybe some degree of airway obstruction in that patient.
_______ _________ is an inherited muscle disorder chemically induced by anesthetic agents. Early identification is necessary for these patients because so many people die post operation from it.
Malignant Hyperthermia.
In malignant hyperthermia, what are the early symptoms?
Tachycardia of 150BPM is often the earliest sign. Ventricular dysrhythmias, decreased cardiac output, hypotension. Calcium abnormalities cause tetanus like symptoms. Temperature increase is actually a late symptom.
To find the flow rate of peripheral blood flow divide _________ by_____.
Pressure difference/resistance
______ ______ is a muscular cramp like pain in your legs when you are exercising (similar to stable angina) that goes away when you rest.
Intermittent claudication
A ______ is used to bypass an upper airway obstruction to allow removal of tracheobronchial secretions, to prevent aspiration, for long term mechanical ventilation, and to replace an endotracheal tube. It is necessary to suction the tube because of decreased effectiveness of the ______ mechanism.
tracheostomy
cough
Normal PaCO2 is _____. It is the arterial CO2 tension that indicates the adequacy of alveolar ventilation.
35-45mmHg
Normal blood gas level of oxygen is PaO2 _ -__mmHg
80-100
______ is a sudden constriction in the muscular walls of bronchioles.
Bronchospasm
A ______ ______ refers to the obstruction of the pulmonary artery of one or more of its branches by a thrombus that originates somewhere in the venous system or on the right side of the heart
Pulmonary emboli
For a diagnosis of chronic bronchitis, a cough with sputum must be present for at least __ months for __ consecutive years.
3, 2
If sputum is profuse and purulent and the colors green,yellow,or rust it indicates there is a ______infection. If the sputum is thin, and mucoid it indicates a _____ infection
bacterial
viral
Pink tinged mucoid sputum usually indicate there is a ____ ______.
lung tumor
Profuse, frothy, pink sputum usually indicates _____ _____.
Pulmonary edema
COPD patients should be taught pursed lip breathing because it _______ expiration, helps the patient control ____ and _____ of breathing, and relax.
slows
rate, depth
In addition to pursed lip breathing, patients with COPD should be taught _______ breathing as opposed to upper chest breathing. This reduces the respiratory rate, increases alveolar ventilation, and can force more air out during expiration.
diaphragmatic
O2 at room air is ___%.
21
ABGs help assess the ability of the lungs to provide adequate O2 and remove CO2. They can also help you assess how well the ______ are working.
kidneys
(tells if the kidneys are reabsorbing or excreting bicarb ions to maintain normal ph)
INH (Isoniazid) is used to treat TB. People on this drug should avoid foods with _______ and ______. For example, tuna, aged cheese, red wine, soy sauce, yeast extracts.
tyramine & histamine
Rifampin is a drug used to treat TB. What is important to tell people who wear contacts? What is an important thing to note about its effects on other drugs?
Rifampin may discolor contact lenses so they may want to wear eye glasses. Rifampin also increases metabolism which reduces the affectiveness of beta blockers, oral contraceptives, quinidine, corticosteroids, and coumadin.