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128 Cards in this Set
- Front
- Back
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O2 and CO2 Exchange |
Diffusion |
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Blood flow through lungs |
Perfusion |
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Perfusion exceeds ventilation. (Shunt) Seeing an obstruction such as pneumonia tumor mucus plug or atelectasis |
Low ventilation perfusion ratio |
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Ventilation exceeds perfusion, Dead Space results. Examples are pulmonary emboli, pulmonary infarction, cardiogenic shock |
High ventilation perfusion ratio |
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Absence of ventilation and perfusion. Seen in pneumothorax and severe acute respiratory distress syndrome |
Silent unit |
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Gerontologic considerations for Respiratory function |
Smoking history, muscle atrophy, impaired cilia, decrease surface area, decrease cough and gag reflex, decreased elasticity, and decreased capacity |
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Health history assessment for Respiratory function |
Surgeries on lung such as pneumothorax or chest tube, illnesses such as influenza and pneumonia, allergies, medications, immunizations up to date the pneumococcal and influenza, exposure to second-hand smoke |
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Risk factors for respiratory disease |
Smoking, personal / family history, genetics, obesity, vitamin D deficiency |
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Manifestations of respiratory disease |
Unexplained restlessness is the first sign, dyspnea, cough, sputum with blood green or yellow, wheezing(high-pitched mucosal sounds), orthopnea (COPD), hemoptysis (expectoration of blood) |
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Physical assessment for Respiratory function or disease |
Clubbing, examine Airway, breathing pattern, percussion, auscultation, cyanosis |
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Purpose of pulmonary function test |
Aid diagnosis, assess respiratory function, assess response to therapy |
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Test that assesses tidal volume. You breathe through your mouth and wear a nose-clip |
Pulmonary function test |
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Test that aids in assessing the ability of the lungs to provide adequate oxygen and remove carbon dioxide |
Arterial blood gas studies |
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What interferes with pulse oximeter |
Nail polish, carbon monoxide, Tremor, decreased temp |
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Diagnostic cultures for respiratory disease |
Throat, nasal, nasopharyngeal. Looking for a specific bacteria |
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Diagnostic sputum studies for respiratory disease |
Obtained early in the morning and sent to the lab right away |
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Imaging studies for respiratory disease |
Chest x-ray, CT scan, MRI, fluoroscopy, pulmonary angiography, lung scan, PET scan |
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Chest needle biopsy, usually a PICC line |
Fluoroscopy |
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Injecting dye, insert catheter through groin area |
Pulmonary angiography |
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Allergy for pulmonary angiography |
Shellfish |
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Puncture site in Pulmonary angiography |
Make sure clots, apply pressure for approximately 5 minutes, gauze and tape for 24 hours |
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Guidelines for pulmonary angiography |
Consent, coagulation studies, renal function because of contrast, and NPO usually at midnight, pre-procedure medication such as anti-anxiety and dilaudid, Vital Signs, level of Consciousness and O2 saturation |
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Scan where infection create a hotspot |
PET scan |
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Guidelines before bronchoscopy |
Consent, and Patio, pre-procedure medications such as Conscious Sedation, suppress cough reflex(anesthetize back of throat), Vital Signs, level of Consciousness, O2 saturation |
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Guidelines after a bronchoscopy |
NPO until cough reflex returns, Vital Signs, what level of Consciousness, O2 saturation. Blood in sputum is not normal |
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Complications after a bronchoscopy |
Respiratory difficulty, bleeding, pneumothorax, perforation, severe pain, increased temperature, expectorate blood |
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Inspection of the pleural cavity |
Thoracoscopy |
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risks with thoracoscopy |
Risk for collapsed lung. Procedure is done under general anesthesia and chest tube to suction |
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Removal of fluid from the pleural space often done at the bedside |
Thoracentesis |
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Guidelines before for thoracentesis |
Consent, Baseline assessment, positioning over bedside table, limit movement, local anesthetic |
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Preparation for thoracentesis |
Tray that needs to get ready, sterile gloves for duck, glass bottle |
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Normal fluid removed from thoracentesis |
Light yellow, clear |
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Post-procedure guidelines for thoracentesis |
Monitor, chest x-ray |
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When a patient needs 02 |
Decreased O2 saturation, anxious, Restless, confusion |
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Order for oxygen use |
Do you need a doctor order but in emergency use judgement and then tell doctor |
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Diagnoses that use oxygen |
Hypoxemia and hypoxia |
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Complications with oxygen use |
Toxicity(more than 50% for more than 48 hours, wean off, monitor O2), suppression of ventilation, fire, bacterial cross-infection |
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Type of hypoxia that occurs when a toxic substance interferes with the ability of tissues to use available oxygen |
Histotoxic hypoxia |
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Type of hypoxia that results because of decreased effective hemoglobin concentration |
Anemic hypoxia |
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Hypoxia resulting from inadequate capillary circulation |
Circulatory hypoxia |
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Hypoxia because of decreased oxygen level in the blood resulting in decreased oxygen diffusion into the tissues |
Hypoxemic hypoxia |
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Low-flow oxygen Administration systems |
Nasal cannula, oropharyngeal catheter, simple mask, partial rebreathing mask, and nonrebreathing mask |
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High-flow oxygen Administration systems |
Transtracheal catheter, Venturi mask, aerosol mask, face tent |
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Oxygen Administration that only delivers oxygen and breathing in |
O2 conserving device |
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Safety with oxygen Administration |
No smoking, keep staying away from drug sunlight, he sources, cold, replace tubing every couple weeks |
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Home Care checklist for oxygen |
When to use a humidifier, no smoke, 5c from TV radio, how and when to place order, signs and symptoms that need to be reported, precautions and safety measures |
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For postural drainage. Do chest percussion and vibration before meals. |
chest physiotherapy |
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Breathing exercises |
Diaphragmatic, pursed - lip. In 3 through nose, out 7 through mouth |
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Removal of entire lung |
Pnemonectomy- turned from back to operated side every hour |
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Remove lobe of lung |
Lobectomy - turned to either side after |
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Single segments removed from ant lobe of lung |
Segmentectomy |
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Biopsy of small nodules |
Wedge resection |
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1 lobar Broncos excised |
Bronco plastic resection |
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Removal of 20 to 30% of lung |
Lung volume reduction |
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Positioning after thoracic surgery |
Semi Fowler's |
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Breathing techniques for after a thoracic surgery |
Pursed lip breathing and diaphragm breathing |
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Positioning to improve gas exchange after thoracic surgery |
Out of bed as soon as possible |
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Purpose of arm and shoulder exercises after thoracic surgery |
Prevent complications. |
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Complications after thoracic surgery |
Respiratory distress, dysrhythmias, pneumothorax, Hemorrhage, shock |
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Most common cause of non-allergic rhinitis |
Common cold |
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Inflammation and irritation of mucous membranes of the nose |
Rhinitis |
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Causes of rhinitis |
Common allergens such as perfume mold dust dander and pollen |
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Manifestations of rhinitis |
Rhinorrhea, nasal congestion, sneezing, pruritus, headache, nasal discharge |
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Treatment for rhinitis |
Antihistamines and corticosteroids and trying to avoid allergens |
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Self-care with rhinitis |
No clothes outside in the clothes lion, keep windows closed, better with no carpet |
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Viral rhinitis |
Common cold. Highly contagious, May last one to two weeks |
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Manifestations of viral rhinitis |
Low grade fever, nasal congestion, rhinorrhea, nasal discharge, sneezing, watery eyes, sore throat, malaise, chills, headache, muscle aches |
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Management of viral rhinitis |
Symptom therapy antihistamines expectorants NSAIDs antivirals nasal decongestants increase fluids and rest |
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Transmission of viral rhinitis |
Sneezing coughing and talking |
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Herpes labialis |
Cold sore |
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Cause of herpes labialis |
Herpes simplex virus type-1, highly contagious, 7 to 10 days to heal, always have it in you |
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Triggers for herpes labialis |
Over exposure to sunlight / wind, cold, influenza, have you alcohol use, physical and emotional stress |
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Manifestations of herpes labialis |
Burning or tingling sensation, painful blisters that rupture and crust over |
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Treatment for herpes labialis |
Antivirals analgesics that decrease symptoms and duration |
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Causes of acute rhinosinusitis |
Viral upper respiratory infection, unresolved bacterial infection, exacerbation of allergic rhinitis |
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Manifestations of acute rhinosinusitis |
Purulent nasal drainage Facial Pain or pressure fever if bacterial infection |
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Management of acute rhinosinusitis |
Antibiotics, no sprays to shrink nasal mucosa, heat to relieve pain |
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Body becomes dependent on medication to keep nasal passages open and congestion returns even worse when medication is stopped |
Rebound congestion |
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Amount of days to use nasal spray |
No more than 3 to 4 days in a row |
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12 weeks of two or more of the following: mucopurulent drainage, nasal obstruction, facial Pain or pressure, hyposmia(decreased smell) |
Chronic rhinosinusitis |
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Management of chronic rhinosinusitis |
Hydration, nasal sprays, analgesics, decongestant, correct structural deformities, balloon sinuplasty |
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Balloon sinuplasty |
Open up sinuses with balloon catheter |
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Pharyngitis |
Sore throat. Viral or bacterial |
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Manifestations of pharyngitis |
Fiery red sore throat, fever, malaise, enlarged lymph nodes |
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Test for pharyngitis that takes 10 to 15 minutes |
Rapid antigen detection test |
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Management of pharyngitis |
Antibiotics- penicillin, analgesics, ice collar, bed rest |
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Nutrition with pharyngitis |
Liquid or soft foods, cool beverages, ice cream |
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Nursing diagnosis for client with upper Airway infection |
Ineffective Airway clearance and acute pain |
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Interventions to maintain a pay in Airway with an upper Airway infection |
Cough and deep breathe, suction, prop up, increase liquids |
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Interventions to promote comfort with an upper Airway infection |
Bronchodilator, NSAIDs, fluids, ice |
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Interventions to promote communication with an upper Airway infection |
Texting and writing |
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Risk factors for obstructive sleep apnea |
Obesity, male, postmenopausal, Advanced age, alcohol, meds |
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Obstructive sleep apnea |
Stop breathing for a minimum of 10 seconds 5 times an hour |
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Manifestations of obstructive sleep apnea |
Snoring with periods of apnea, three s's snoring sleeplessness s/o |
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Management of obstructive sleep apnea |
Weight loss, CPAP, tonsillectomy, correct deformity, provigil and triptil |
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Epistaxis |
Nosebleed |
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Risk factors for epistaxis |
Infection, dry nasal membranes, trauma, hypertension, tumor |
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Management of epistaxis |
Direct pressure, vasoconstrictors, cotton tampons |
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Nursing interventions for epistaxis |
Mantra Vital Signs, assist in controlling bleeding, sure client, education |
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manifestations of a nasal fracture |
Pain, bleeding, swelling, periorbital ecchymosis, deformity |
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Diagnostics for a nasal fracture |
Test clear nasal drainage. Check for cerebrospinal fluid(glucose present in CSF) |
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Management of nasal fracture |
Packing, cold compress, Elevate head, analgesics, reduce fracture |
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Risk factors for laryngeal cancer |
Smoking, alcohol, chronic laryngitis |
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Manifestations for laryngeal cancer |
Hoarseness for more than 2 weeks, persistent cough, sore throat, pain or burning in throat, lump |
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Areas affected by laryngeal cancer |
Supraglottic, glottic, subglottic |
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Management of laryngeal cancer |
Radiation and chemotherapy |
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Surgical management for laryngeal cancer |
Vocal cord stripping, cordectomy, laser, partial laryngectomy, total laryngectomy |
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Removal of portion of Lennox, one vocal cord, and tumor |
Partial laryngectomy. Still have voice but maybe changed |
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Remove laryngeal structures that results in permanent loss of voice and permanent tracheostomy |
Total laryngectomy |
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Speech that compresses air into esophagus and expel it |
Esophageal speech |
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Communication that uses a battery powered device and projects sound into oral cavity |
Artificial larynx |
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Communication marrow valve is placed in tracheal stoma to divert air into the esophagus and out the mouth |
Tracheoesophageal puncture |
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Pre-op teaching for a laryngectomy |
Reduce anxiety, education |
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Complications with a laryngectomy |
Respiratory distress, Hemorrhage, aspiration |
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Collapse of the alveoli |
Atelectasis |
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Causes of atelectasis |
Surgery, and Mobility, retain situations such as in a coma |
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Prevention of atelectasis |
Cough and deep breathe, incentive spirometry, ambulation, reposition |
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Manifestations of atelectasis |
Dyspnea, cough, sputum, decreased O2 saturation |
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Management of atelectasis |
Improve ventilation, remove secretions, cough and deep breathe, incentive spirometer, ambulant, peep, bronchoscopy |
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Pneumonia occurring in the community or less than 48 hours of Hospital admission |
Community-acquired pneumonia |
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Pneumonia occurring in a non hospitalized client with extensive Healthcare contact |
Healthcare-associated pneumonia |
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Pneumonia occurring more than 40 hours after a hospital admission |
Hospital-acquired pneumonia |
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Pneumonia that developed more than 48 hours after endotracheal intubation |
Ventilator-associated pneumonia |
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Immunocompromised host for pneumonia |
Immunosuppressive agents, chemo, poor nutrition, AIDS, immune disorders, long-term vent |
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Risk factors for pneumonia |
Smoking, COPD, respiratory impairment, older adults, tube feeding, stroke patients, unconscious patients, bed rest patients |
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Prevention of pneumonia |
Stop smoking, improve nutrition, reposition, ambulate |
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Manifestations of pneumonia |
Chills, rapidly Rising fever, chest pain, dyspnea, headache, low grade fever, myalgia, pharyngitis, poor appetite |
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Management of pneumonia |
Antibiotic therapy and symptom management |
