Respiratory

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Author:
hanlin
ID:
166604
Filename:
Respiratory
Updated:
2012-08-19 20:58:47
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Nursing Respiratory
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Nursing 210
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  1. Hypoxemia
    A PaO2 less than 60 mm Hg
  2. Mucociliary action
    Anesthesia slows the mucociliary transport rate
  3. Hypoxia
    Low oxygen levels at the tissue level
  4. Assessment for Hypoxemia
    Respiratory rate and rhythm may be normal in hypoxemia
  5. What occurs in subacute hypoxemia
    Oxygen saturation falls to consistently loer but noncritical level
  6. Which interventions may help decrease metabolic demand
    Sedation, analgesia and antipyretics
  7. Oxygen dissolved in the plasma is defined as
    PaO2
  8. What occurs in episodic hypoxemia
    Oxygen saturation may fall quickly and unexpectedly
  9. Imparied oxygen diffusion may cause?
    Hypoxemia
  10. Inadequate lung ventilation can be caused by?
    Neurologic disease
  11. Hyperventilation is likely to cause
    Increase pH from CO2 depletion
  12. After use of incentivie spirometer u note increase in percentage of pulse ox this is related to?
    The increased oxygen diffusion from alveoli to capillaries
  13. After GI surgery hat breath sounds would lead you to call physician immediately?
    Expiratory wheezes througout
  14. If acidosis results from a slow, shallow respiratory rate you'd expect the following change in acid/base balance
    pH decrease and PaCO2 increase
  15. During inspiration air enters the thoracic cavity because of
    decrease in intrathoracic pressure relative to pressure at the airway
  16. The ability of the lungs to adequately oxygenate the arterial blood is determined by examination of the
    Arterial oxygen tension (PaO2)
  17. Most important respiratory defense mechanism ddistal to the respiratory bronchioles is the
    Alveolar macraphages
  18. A rightard shift of the oxygen-hemoglobin dissocation curve
    facilitates release of oxygen at the tissue level
  19. Signs and Symptoms of inadequate oxygenation include all of the following except
    increased peripheral perfusion, increased urine output
  20. The left mainstream bronchus is
    more angulated than the right
  21. Respiration is more affected by
    PaCo2
  22. Which of the folloing shift the oxyhemoglobin dissociation curve to the left?
    Decrease temp, increase in pH
  23. During normal quiet relaxed breathing what will the intrapleural pressure be?
    Equal to the atmospheric pressure
  24. Adventitious breath sounds include all the following except
    bronchovesicular sounds
  25. Your patients tidal volume is 1000cc's he is breathing 15 times a min what is his minute volume?
    15,000cc's
  26. Early signs of o2 toxicity include
    numbness in the extremities and dry, hacking cough
  27. Which of the folloing is a high-flow O2 delivery
    Venturi Mask
  28. What is the percent of O2 in normal room air (ambient)
    21%
  29. The bloods O2 carrying capacity can be limited to
    Anemia
  30. What range of O2 concentration does a nasal cannula provide
    Between 24-40 percent
  31. Lower than normal O2 saturation in arterial blood is
    hypoxemia
  32. Oxygen toxicity can occur when a patient receives O2 at?
    50 % or greater for more than 24 hours
  33. A healthy person's respiratory drive depends on?
    PCO2
  34. Venturi mask
    24-55% 4-10L
  35. Non-Rebreather Face Mask
    6-15 L/min  60-100%
  36. Face Mask
    6-10 L/Min 35-60%
  37. Which oxygen mask? Mild dyspnea related to anemia
    Face Mask
  38. Which oxygen mask?
    Order for a specific concentration of O2
    Nasal Cannula
  39. Which mask?
    High dose of O2
    Non-rebreather mask
  40. Which mask?  Someone who is very groggy and requires greater than 50% of oxygen concentration
    Venturi Mask
  41. The bloods O2 carrying capacity can be limited to
    Anemia
  42. Lower than normal O2 saturation in arterial blood is called
    Hypoxemia
  43. A health persons respiratory drive depends on?
    PCO2
  44. Early signs of O2 toxity include:
    Numbness in the extremities and dry hacking cough
  45. Difference between SpO2 and ABG
    pulse ox provides continous monitoring
  46. Which is required to acheive a reliable reading from a pulse oximetry?
    good arterial blood flow
  47. SpO2 values should always be considered in the content of which other value?
    Hemoglobin
  48. Most common cause of inaccurate SpO2 reading is?
    Patient movement
  49. What color of nail polish is most likely to affect SpO2 reading?
    Black
  50. A signal strength indicator and plethysmographic waveform help the nurse to assess?
    Reliability of readings
  51. Pulse ox sensor should NOT be placed on the
    Finger on an arm that has an automatic blood pressure cuff
  52. Normal AP to lateral ration of chest
    1:2
  53. Normal costal angle is no more than
    90 degrees
  54. What sound would you expect to percuss over healthy lung tissue?
    Resonance
  55. Early sign of hypoxia?
    Change in mental status
  56. Breath sound heard of the majority of the posterior lung fields of a health patient
    Bronchovesicular
  57. What occurs at the Alveoli
    Gas exchange
  58. How does the shape of your spine influence the ability to inspire deeply?
    Skeletal deformities may limit thoracic cage excursion, limits lung expansion within the thorax
  59. Purpose of Surfactant?
    Reduced the surface tension of the fluid lining the alveoli and prevents alveolar collapse
  60. Normal breath sounds
    Bronchial, bronchiovesicular, vesicular
  61. What sound predominates over lung fields with percussion?
    Resonance
  62. If pt has a fever how does that affect his oxygenation status?
    Pt has more O2 sat and less CO2
  63. Surfactant is
    a substance secreted by Type II cells that lowers surface tension and prevents alveolar collapse
  64. Respiration is more affected by
    PaCO2
  65. Sputum example is used for diagnosis of
    Cancer of the lung, Pneumonia, turberculosis
  66. If you were blowing out the candles on a birthday cake which lung volume would you be using?
    ERV Expiratory reserve volume
  67. Incentivite Spirometer measures
    Total lung capacity
  68. People who can hold their breath under the water for a  long period of time without passing out are using
    Inspiratory reserve volume IRV
  69. Test gag reflex before giving oral food or fluid after this test
    Bronchoscopy
  70. Ph level
    • 7.35 to 7.45
    • Low is Acidosis, High is Alkalosis
  71. PaCO2 level
    • 35-45
    • low is alkalosis, high is acidosis
  72. HCO3 level
    • 22-26
    • Low is acidosis, High is Alkalosis
  73. Dextromethorphan (Benylin) works by
    Inhibition of the cough center in the Medulla
  74. Dextromethorphan has what type of side effects?
    Few minor adverse side effects
  75. Pseudoephedrine (Sudafed) works by
    Mimicking the action of the sympathetic nervous system
  76. Pseudeophedrine (Sudafed) is indicated for the treatment of?
    Viral Upper Respiratory Infection
  77. Which of the following adverse effects may occur during pseudoephedrine (Sudafed) therapy?
    Tachycardia
  78. How does Afrin(Oxymetazoline) differ from Sudafed?
    Route and decrease incidince of adverse effects
  79. Which nasal spray is a steroid anti-inflammatory drug?
    Dexamethasone sodium phosphate (Turbinaire)
  80. Antihistamines such as Fexofenadine (Allegra) are the treatment choice for
    Allergic Rhinitis
  81. Allegra (Fexofenadine) a second generation anti-histamine differs from first generation anti-histamine suach as diphenhydramine (Benadryl) by
    Decreased sedation
  82. An expectorant drug such as Guaifenesin (Robitussin) is used to relieve a
    Dry hacking cough
  83. Cromoly sodium (NasalCrom) works by
    Preventing the break down of mast cells
  84. Hydrocodone can cause?
    Constipation
  85. Pts with ___ should avoid Sudafed (Pseudoephedrine) therapy
    Severe Hypertension
  86. What pt should avoid Allegra
    Breast Feeding
  87. Pt receiving Benylin should be told not to..
    Drive until they see how the drug affects them
  88. Tidal Volume
    Volume of air inspired or expired in a single breath during regular breathing
  89. Inspiratory reserve volume
    Maximal volume of air that can be inahled after normal respiration
  90. Inspiratory capacity
    Volume of gas that can be taken in lungs in a full inhalation starting from resting inspiratory position equal to tidal volume and inspiratory reserve volume
  91. Expiratory reserve volume
    max amount of gas that can be exhaled from the resting end expiratory level
  92. Residual capacity
    amount remaining (gas) in the lungs at the end of maximal exhalation
  93. Functional residual capacity
    volume of air present in the lungs at the end of passive expiration
  94. Vital Capacity
    Volume of gas that can be expired from lungs from position of full inspiration ith no limit to duration of imspiration equal to inspirate capacity plus expiratory level
  95. Oxyhemoglobin dissassociation cruve
    Relationship between the partial pressure of O2 and the percent of saturation of O2 (SpO2)
  96. If the PaO2 drops from 100-80 mmHg as a result of lung disease or heart disease the hemoglobin of the arterial blood remain almost max saturated 94% and
    Tissues do not suffer from hypoxia
  97. When arterial blood passes into tissue capillaries and is exposed to the tissue tension of O2 hemoglobin will
    give up large quantities of O2 for the use by the tissues
  98. Reseting respiration
    Phrenic nerve
  99. Rhythm of breathing
    Respiratory centers in the brain
  100. Rate and Depth of Ventilation
    Inspiratory and Expiratory centers in Medulla Oblongata and the pons
  101. Deep prolonged inspirations
    Apneustinc center in lower pons
  102. Control pattern of respirations
    Pneumatoaxic center in upper pons
  103. Anoxia
    Absense or abnormally low amount of O2 in the blood can occur during cardiac arrest, anemia, heart failure
  104. Atelectasis
    Collapsed, airless condition of alveoli
  105. Crackles
    Sound created with closing and snapping opening of alveoli
  106. Emboli
    Undissolved matter in blood stream
  107. Hypercapnia
    Excess Carbon Dioxide in blood
  108. Pneumothorax
    Air within pleural cavity
  109. Oxyhemoglobin
    Combined form of hemoglobin and oxygen
  110. Rhonchi
    Sounds made by fluid in the larger airways most use the term course crackles or wheezes to describe
  111. Wheezes
    Whistling or sighing sound resulting from narrowing of lumen size of bronchi, high pitched musical sound heard mainly on expiration
  112. Hairlike projection of the nasal epithelium are known as
    Cilia
  113. Which bronchi is straigher
    Right
  114. What is the space between the lungs called?
    Mediastinum
  115. Membrane that lines each lung called
    Visceral Pleura
  116. Membrane that lines the inside of the thoracic cavity called
    Parietal Pleura
  117. Space between the visceral and parietal is called
    Pleural space (fluid)
  118. How many lobes of left lung
    2
  119. How many lobes of the right lung
    3
  120. Wher does gas exchange occur
    Alveoli
  121. Primary muscle of inspiration
    Diaphragm
  122. Three accessory muscles that are used for forced inhalation
    • External intercostals
    • Sternocleidomastoid
    • Abdominal
  123. Does the intrathoracic increase or decrease with inspiration?
    Decrease
  124. Where are the neurogenic mechanisms controlling respirations located?
    Medulla and Pons
  125. Dead Space
    • Ventilation normal absense of perfusion
    • Air there blood isn't
  126. Shunting
    • Ventilation absent perfusion normal
    • Blood there air isn't
    • Example Pneumonia, Collapsed Alveoli
  127. Shift to left
    • Increase in pH and Decrease in PaCO2, Holding in CO2, Alkalosis
    • Anything lower than 60 bad body can't compensate organs fail
    • People that are drowning
  128. Shift to right
    Decrease in Ph, Increase PaCO2, Acidosis, People that are sick, Fever,
  129. Pulmonary Lung Function tests measure
    • Ventilation and Perfusion
    • Differentiate beteen obstructive and restrictive lung diseases
  130. Minute volume is
    Volume of air exchanged in one minute
  131. hemoglobin
    10-15
  132. Hematocrit
    40-50%
  133. How many days for Kidneys and Lungs
    3 days for kidnesy and seconds for lungs
  134. BiCarb is produced by the
    Kidney
  135. Upper Airway Infection also known as
    • Common cold
    • Incubation period contagious (2-3 days)
  136. Mucinex
    Expectorant, only works if not dehydrated
  137. Non drowsy formula means
    blocks mast cells from relasing histamine
  138. Opiates as Antitussives when should take?
    Am
  139. Decongestants ...
    • Dry out sinuses, Increase HR, Decrease appetites
    • Don't take before bed
  140. Antitussive
    If interferring with sleep
  141. Histamines should be taking when
    With meals or right after
  142. Antitussive.. take with
    Full glass of water, for non productive, dry cough
  143. When is it unsafe for an antitussive
    Pregnant, alcohol, asthma or emphysema
  144. How do antitussives interact with opiates
    Cause CNS depression if taken together
  145. How much fluid should the patient drink/day when on an expectorant?
    up to 10 glasses to loosen secretions
  146. Antitussives can cause
    Drowsiness, mild dizziness, nausea
  147. Define Decongestants
    Vasoconstricting agent used to shrink engages nasal mucous membranes in mild URI's
  148. Action of decongestants
    Shrink engorged nasal mucous membrane in mild URI and relieves Nasal stuffiness
  149. Decongestants cause
    Increase in BP in HTN pts, Increase dizziness, increase blood glucouse in DM pts, Increase headaches, Increase CNS stimulations or nervousness, Increase Insomnia, Increase restlesness, Increase Irritability
  150. Decongestants interact ith
    • Anticouagulants
    • Increase systemic vascular resistance and decrease renal perfusion
  151. Rhinoplasty avoid
    Anti coagulants such as aspirin for 2 weeks
  152. Trach right after no
    Tape change for 24 hours
  153. Trach pts do not have
    • a sense of smell
    • impacts nutrition
  154. What do opioids and detromethophan have in common
    CNS depressant
  155. Trachs are used to bypass upper or lower resp problem
    Upper
  156. Conditions that predispose pt to OSA
    HTN, Over 50, Men, Overweight, Smoking
  157. What is a CPAP
    • Continous Positive Airway pressure
    • keep alveoli open by keeping pressure so air can be passed
  158. Surgical procedure that helps OSA
    • Uvulopalatopharyngoplasty
    • Tracheostomy
  159. Trach feel bubbly feeling on skin??
    • Misplaced tube or dislodged
    • Spontaneous pneumothorax
  160. Crepitus
    Feeling of popping under skin
  161. An air leak ill be noted by bubbling in
    H2) seal chamber with expiration and or cough
  162. Purpose of Chest Tube
    Reestablish negative pressure
  163. Collection chamber
    Reservoir for fluid coming from pt
  164. Water seal
    Prevent air from going back in pt
  165. Solution
    Create neg pressure promote drainage
  166. Water seal chamber must have water in it because
    it prevents air from going back in the chest
  167. Isotonic
    • NaCL 0.45
    • NS
    • LR
    • D5 1/2
  168. Hypotonic
    • 1/2 NS
    • NACL 0.45%
    • D5W
  169. Hypertonic
    • Dextrose 10 in H2O
    • Dextrose 5% in NaCL 0.9% or D5Normal Saline
    • Dextrose 5% or 10%  in LR
    • D5LR or D10LR
  170. D 5 1/2 is 
    • Isotonic in the bag
    • Hypotonic in the body because..
    • Sugar goes into RBCs
  171. Tension Pneumothroax
    Trachea will be pulled to side

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