Respiratory

Front 1

______ 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.

Back 1

Fremitus

Front 2

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.

Back 2

Crepitus

Front 3

When performing respiratory __________, a unilateral decrease or delay in expansion may indicate disease.

Back 3

Respiratory expansion

Front 4

When percussing the thorax, a normal sound would be _______, or a long low pitched hollow sound. _________ or _______ would indicate a disease process is occuring.

Back 4

resonance
hyperresonance, dullness

Front 5

_______ 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.

Back 5

Ventilation
Perfusion
Ventilation-Perfusion VQ

Front 6

Normal tidal volume is _____ ml, which is the amount of air inhaled and exhaled with each breath.

Back 6

500ml or 5-10ml/kg

Front 7

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 __:__.

Back 7

1:1

Front 8

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 ________.

Back 8

Shunting
Obstructions

Front 9

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.

Back 9

dead space

Front 10

In the absence of ventilation and perfusion, or with limited ventilation and perfusion, a condition known as ______ _____ occurs.

Back 10

silent unit

Front 11

A nurse expects a patient's chest with advanced emphysema to become _____ shaped.

Back 11

barrel

Front 12

breath sounds that originate in the smaller bronchi and bronchioles and are high pitched sibilant, and musical are called _________.

Back 12

wheezes

Front 13

What are the 8 major symptoms of respiratory disease?

Back 13

dyspnea, cough, sputum production, chest pain, wheezing, clubbing of the fingers, hemoptysis, and cyanosis

Front 14

Blood spit up from the respiratory tract is called ______.

Back 14

hemoptysis

Front 15

_____ ______ respirations are associated with heart failure and damage to the respiratory center. They are characterized by episodes of apnea and periods of deep breathing.

Back 15

cheyne stokes respirations

Front 16

________ is the ability of the lungs and thorax to stretch and distend with ventilation.

Back 16

Compliance

Front 17

Signs and symptoms of the flu include what?

Back 17

abrupt onset, fever and chills, malaise, muscle aches, headaches, profuse watery discharge, non-productive cough, and sore throat.

Front 18

The most common complication of the flu is ________.

Back 18

Pneumonia

Front 19

The collapse of the alveoli caused by hypoventilation, obstruction to the airways, or compression is called _______.

Back 19

Atelectasis

Front 20

________ 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.

Back 20

Atelectasis

Front 21

In order to prevent Atelectasis, what should the nurse do?

Back 21

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

Front 22

An acute infection of lung parenchyma including alveolar space and interstial space is called _________.

Back 22

Pneumonia

Front 23

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.

Back 23

48
Streptococcus

Front 24

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.

Back 24

48

Front 25

_____ colored sputum is a common clinical manifestation of pneumonia. What are the other clinical manifestations.

Back 25

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

Front 26

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.

Back 26

5000
10,000

Front 27

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.

Back 27

patchy to unclear
95
sputum

Front 28

_______ 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.

Back 28

Pneumovax
5
influenza vaccine

Front 29

Mycobacterium tuberculus is spread by ______ droplet. It is a gram_____ acid fast bacillus.

Back 29

airborne
positive

Front 30

The clinical manifestations of TB include what?

Back 30

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.

Front 31

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.

Back 31

Mantoux
5

Front 32

______ is a combination drug used to treat TB. It is a combination of INH (___mg) and Rifampin (___mg).

Back 32

Rifamate
150
300

Front 33

_______ 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.

Back 33

INH (Isoniazid)
hepato and neuro

Front 34

When a person has active TB, a four drug approach is used for __-__ months and includes what four drugs?

Back 34

6-9
Isoniazid (INH)
Rifampin (RIF)
Pyrazinamide (PZA)
Either Ethambutol(EMB)or Streptomycin (SM)

Front 35

________ _________ constitutes 90-95% of all lung cancers. It is aggressive, locally invasive, and widely metastatic.

Back 35

Bronchogenic Carcinoma

Front 36

________ is the only lung cancer that is known for causing lung cancer in non-smokers. It also occurs more often in women.

Back 36

Adenocarcinoma.

Front 37

A person's risk for getting lung cancer is determine by ____-___ history. To get this number you multiply ______x_______

Back 37

pack per year
packs/day x # of years

Front 38

When chest tubes are placed, the highest tube removes ___ and the lower one removes ___.

Back 38

air
blood

Front 39

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.

Back 39

negative
air
fluid

Front 40

______ is a reversible airflow obstruction. When auscultating you should hear wheezing if this disease process is going on.

Back 40

Asthma

Front 41

_______ is characterized by irreversible bronchoconstriction and includes emphysema and chronic bronchitis.

Back 41

COPD

Front 42

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.

Back 42

alveoli
10

Front 43

The most common symptoms of asthma include ___, ____, and _____.

Back 43

Cough, dyspnea, wheezing

Front 44

In order to prevent asthmatic episodes before exercise, pre-medication may be necessary. ________ or ______ cell stabilizers may be used to prevent an episode.

Back 44

B adrenergic agonists (bronchodilators)
mast cell stabilizer

Front 45

Inhaled B adrenergic agonists are bronchodilators that are used to treat asthma, examples include what?

Back 45

Alupent, Proventil, Xopenex, Maxair, Albuterol, Metaproterenol

Front 46

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.

Back 46

IGE
Cromolyn
Nedocromil

Front 47

Long acting beta blockers such as _______ and ______ can be used to treat moderate persistant asthma.

Back 47

Salmeterol, formoterol

Front 48

_______ modifiers like Singulair prevent allergic responses that can cause an asthma attack.

Back 48

Leukotrienes

Front 49

Inhaled corticosteroids, inhaled or oral B adrenergic agonists and ______ can be used to treat Severe persistent asthma. because they are very potent vasodilator.

Back 49

Theophylline (Aminophyllin)

Front 50

________ is a potent vasodilator used to treat asthma that is similar to caffeine. It has many adverse effects such as _____ and ____.

Back 50

Theophylline
insomnia
irritability

Front 51

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 _____ _____.

Back 51

Albuterol, metaproterenol
rebound bronchospasm.

Front 52

In _______ there is destruction within the walls of the alveoli and people with this condition are usually called _____ _____.

Back 52

Emphysema
Pink Puffers

Front 53

In emphysema, the cough is _____, with no sputum. They normally have a _____ chest and _____ lip breathing. They are normally called _____ ____ and are thin.

Back 53

absent
barrel
Pursed
pink puffers

Front 54

In Chronic Bronchitis, patients are called _____ ____ and are usually heavy. They have a _____ cough and ______ sputum. Upon auscultation you can hear ____ and _____.

Back 54

blue bloaters
persistent
copious
crackles, wheezes

Front 55

Patients called ____ _____ due to having emphysema have a ____ posture. There O2 is normal to low and they have respiratory _____ due to hyperventilation.

Back 55

Pink puffer
tripod
alkalosis

Front 56

People with COPD show a ______ sign, or a flattened diaphragm when looking on an x-ray.

Back 56

Hoovers

Front 57

People with chronic bronchitis are called ____ _____. They have _____, or too much CO2 in the blood, hypoxemia, and respiratory _______.

Back 57

Blue bloaters
hypercapnia
acidosis

Front 58

The total volume in lungs after maximum inspiration is the ______ ______ ______.

Back 58

Total lung Capacity

Front 59

The total volume in lungs after maximum inspiration is the ______ ______ ______.

Back 59

Total lung Capacity

Front 60

A normal total lung capacity is _____ ml. To get the normal total lung capacity, what components should you add.

Back 60

6000
Tidal volume, Inspiratory Reserve Volume, Expiratory Reserve Volume, Residual volume

Front 61

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.

Back 61

500
5-10

Front 62

A normal inspiratory reserve volume is ______ ml.

Back 62

3000

Front 63

A normal expiratory reserve volume is ______ ml.

Back 63

1000

Front 64

A patient's total lung capacity may be decreased due to ______ diseases such as atelactasis or pneumonia and ______ in COPD patients.

Back 64

compliance, increased.

Front 65

A persons residual volume should be about _____ ml but it may be increased due to obstructive diseases.

Back 65

1200

Front 66

Vital capacity performed with maximally forced expiratory effort is called ______ _____ _____. It is often reduced in patients with ______.

Back 66

Forced vital capacity
COPD

Front 67

______ ______ is measured by having someone take in a maximal breath and exhale fully through a spirometer.

Back 67

Vital capacity

Front 68

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 ____.

Back 68

Forced Vital Capacity
FEV1 (Forced Expiratory Volume 1)

Front 69

If a patients Forced Vital Capacity and FEV1 are both significantly reduced than what does that indicate?

Back 69

lung expansion is restricted.

Front 70

IF the reduction in FEV1 is greatly exceeds the reduction in forced vital capacity, what does this mean?

Back 70

There maybe some degree of airway obstruction in that patient.

Front 71

_______ _________ 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.

Back 71

Malignant Hyperthermia.

Front 72

In malignant hyperthermia, what are the early symptoms?

Back 72

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.

Front 73

To find the flow rate of peripheral blood flow divide _________ by_____.

Back 73

Pressure difference/resistance

Front 74

______ ______ is a muscular cramp like pain in your legs when you are exercising (similar to stable angina) that goes away when you rest.

Back 74

Intermittent claudication

Front 75

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.

Back 75

tracheostomy
cough

Front 76

Normal PaCO2 is _____. It is the arterial CO2 tension that indicates the adequacy of alveolar ventilation.

Back 76

35-45mmHg

Front 77

Normal blood gas level of oxygen is PaO2 _ -__mmHg

Back 77

80-100

Front 78

______ is a sudden constriction in the muscular walls of bronchioles.

Back 78

Bronchospasm

Front 79

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

Back 79

Pulmonary emboli

Front 80

For a diagnosis of chronic bronchitis, a cough with sputum must be present for at least __ months for __ consecutive years.

Back 80

3, 2

Front 81

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

Back 81

bacterial
viral

Front 82

Pink tinged mucoid sputum usually indicate there is a ____ ______.

Back 82

lung tumor

Front 83

Profuse, frothy, pink sputum usually indicates _____ _____.

Back 83

Pulmonary edema

Front 84

COPD patients should be taught pursed lip breathing because it _______ expiration, helps the patient control ____ and _____ of breathing, and relax.

Back 84

slows
rate, depth

Front 85

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.

Back 85

diaphragmatic

Front 86

O2 at room air is ___%.

Back 86

21

Front 87

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.

Back 87

kidneys
(tells if the kidneys are reabsorbing or excreting bicarb ions to maintain normal ph)

Front 88

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.

Back 88

tyramine & histamine

Front 89

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?

Back 89

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.