med surg

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Author:
cassiekay10
ID:
222326
Filename:
med surg
Updated:
2013-06-04 01:04:52
Tags:
resp
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resp
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  1. resp are controlled in the
    MEDULLA
  2. rate/depth controlled by the
    pons
  3. Normal values for pH
    7.35-7.45
  4. Normal values PaO2
    75-100 mmHg
  5. PaCO2 normal
    35-45 mm Hg
  6. HCO3- normally
    22-26`
  7. O2 sat normals
    95-100%
  8. Coarse Crackles (Rales)
    • fluid in airways
    • moist bubbling sound
    • pulm edema, bronchitis, pneumonia
  9. fine crackles
    • alveoili popping open on inspiration
    • velcro tearing- end of resp
    • heart failure, atelactasis
  10. Wheezes
    • narrowed airways
    • fine high pitched violins on expiration
    • asthma
  11. stridor
    • airway obstruction
    • loud crowing
    • obstruction from tumor or foreign body
  12. pleural friction rub
    • inflamed pleura rubbing together
    • leather rubbing/grating sound
    • pleurisy, lung CA, pneum, pleural irrtation
  13. diminished
    • decreased air movement
    • faint sounds
    • emphysema, hypovent, obesity, musc chest wall
  14. absent
    • no air movement
    • no sounds
    • pneumothorax, pneumectomy
  15. rbc count normal for male and female
    • male - 4.5-6.2 m cells/mm3 venous blood
    • female - 4.2-5.4 m cells/mm3 venous blood
  16. RBCs and Hemoglobin increased in
    chronic lung disease and dehydration
  17. RBCs and Hemoglobin decreased in
    anemia, hemorrhage, overhydration w IVs
  18. WBC normal values
    5000-10000 cells/mm3 venous blood
  19. WBCs increased in
    infection
  20. type of pressure inside pleural cavity
    negative
  21. stimulus in healthy person to breathe
    CO2
  22. stimulus to breathe with emphysema
    low O2
  23. likely site of aspirated object
    R bronchi
  24. Pulmonary function tests rate
    degree of pulmonary capillaries
  25. persed lip breathing gives person a
    sense of control
  26. meds by inhalation special function
    sends throughout the resp tract
  27. immediate post-op airway intervention
    npo
  28. what is looked for in TB tests
    raised area on the 2nd day (>5mL)
  29. First thing to do for COPD pt whom can't tolerate too much O2 and loses consciousness
    take it off!
  30. pt with COPD and freq. infections teach
    • good handwashing
    • vaccinations
  31. what med discolors tears and secretions
    Rifampin
  32. what lab values to monitor for Rifampin
    ALS and ALT
  33. cause of COPD drive from low O2
    increased carbon dioxide = med not sensitive, they rely on peripheral receptors
  34. nurse is responsible for ____ for trach on ventilator
    • monitor settings
    • trach care
  35. space between the folds of vocal cords
    glottis
  36. bronchi passageway
    • trach to primary bronchi L and R
    • divide into secondary bronchi
    • divide into smaller tertiary bronchi
    • divide into bronchioles
    • to tiny sacs called of air called alveoli
  37. exchange of o2 and co2 take place in
    alveoli
  38. how many lobes in each lung
    3 on R, 2 on L
  39. each lung is covered by a membrane called
    pleura
  40. the pleura is
    a sac containing a small amount of fluid that acts as a lube for lungs to expand and contract
  41. normal breathing pattern is
    12-20
  42. tachypnea
    • regular and even
    • faster than 20
  43. bradypnea
    • reg and even
    • slower than 12
  44. sighing respirations
    • reg and uneven
    • periodic deep breaths
    • more than 3 sighs per minute
    • 12-20
  45. cheyne-stokes apnea
    progressively deeper, then become more shallow, followed by apnea
  46. kussmaul resp w hyperventilation
    • reg and deep
    • faster than 20
  47. biots respirations apnea
    • irregular pattern
    • varied depth
    • periods of apnea
  48. obstructive breathing
    gradual rise in end-expiratory level w ea successive breath
  49. apnea
    temp interruption in normal breathing pattern in which no air movement occurs
  50. dyspnea
    shortness of breath
  51. orthopnea
    difficulty w breathing in a lying position
  52. pack years calculated by
    multiplying number of years smoked by packs ea day
  53. hypoxia
    rapid or slow and tachycardia
  54. trach not in midline is
    deviated
  55. rhonchus
    dry, rattling sound caused by partial bronchial obstruction
  56. a pt in resp distress usually has
    tachycardia
  57. THROAT
    PHARYNX
  58. VOICE BOX
    LARYNX
  59. WINDPIPE
    TRACHEA
  60. tachycardia caused by
    fever, pain, and anxiety
  61. bradypnea caused by
    sedatives, opiods, alcohol, brain/metabolic/resp disorders
  62. resp stimulated by
    changing levels of co2 and o2 in arterial blood
  63. external respiration
    breathing, exchange of gases bw persons lungs and the environment. accomplished by muscular activity and negative thoracic pressure
  64. internal respiration
    exchange of gases at the cellular level, bw the bloodstream and individual cells. accomplised through diffusion
  65. sub data
    • past health hx
    • medications
    • surgery or other tx
    • functional health assessment
    • symptoms
  66. obj data
    • physical exam:
    • vitals, pulse, nose, mouth and phar, neck, thorax and lungs (inspection, palpation, percussion, auscultation), diagnostic tests
  67. chest xray
    • size & location of heart and pulm structures
    • ids presence of lesions/foreign bodies/fluid
  68. ct scan
    • diagnose lesions
    • id lesions and early stages of disease
  69. pet scan
    • benign vs malignant nodules
    • iv injection radioisotope w short half life
    • npo 4-8 h
  70. ventilation/perfusion v/q
    • id areas of lung not recieving air flow (ventilation) or blood flow (perfusion)
    • injection of radioisotope and inhalation of radioactive gas (xenon)
  71. ventilation wo perfusion suggests
    pulmonary embolus
  72. fluoroscopy
    • observes form and motions of deep structures by xray
    • between xray and fluorecent screen
    • shadow images
    • actions observed
  73. pulmonary function test
    • evaluate lung function
    • spirometer diagrams air movement as pt does maneuvers
    • measures lung vol and airflow

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