The flashcards below were created by user
bhill50
on FreezingBlue Flashcards.
-
s/s of o2 toxicity
dry cough, chest pain, numbness in extremities, nausea
-
staging a tumor
TNM Tumor- #of lymph nodes affected
-
PEEP
positive end expiratory pressure- to keep airways open
-
triggers of asthma
- smoking
- allergens
- infections
- exercise
- sinusitis
- stress
- gerd
- heat
- cold
-
what is the primary clinical symptom of emphysema
wheezing
-
genetic screening is able to detect carriers of this disease...
cystic fibrosis
-
________ o2 masks has 1 or more vents that close on inspiration and open during expiration and delivers 70-100% o2
non-rebreather
-
T/F the purpose of the cilia is to move mucus to back of larynx
true
-
Abnormal distention of air spaces beyond the terminal bronchioles with destruction of the walls of the alveoli. Decreased alveolar surface area causes an increase in "dead space" and impaired o2 diffusion
Emphysema
-
scope thru thoracic cavity is called what?
thorascopy
-
Normal blood ph
7.35-7.45
-
pneumonia can be caused by...
- bacteria
- virus
- fungus
- aspiration
- artificial ventilation
- hypostasis
- chemical (such as mixing solutions and inhaling)
-
the primary stage of tb is usually
asymptomatic
-
severe sustained asthma
hypoxemia worsening
continuous bronchus spasm
resp rate increases
respiratory alkalosis results
status asthmaticus
-
tobacco smoke causes __-__% of COPD cases
80-90
-
what air remains in the lungs after forced respiration; increases with age
residual volume
-
inflammation of both layers of the pleurae- inflamed surfaces rub together with respiration, cause sharp pain, intensified with inspiration
pleurisy
-
____ is the most common cause of death from infection, especially in the elderly
pneumonia
-
compression of the lung tissue
increased permeability of capillaries
pulmonary edema
pulmonary contusion
-
A ___ valve helps trach patients speak
Passy-Muir speaking valve
-
delivery of atmospheric air to gas exchange units
distribution
-
___is a chronic, irreversible dilation of the bronchi and bronchioles- chronic infection- usually secondary to an underlying condition
bronchiectasis- sacs become fibrotic- cilia is impaired
-
you will hear ___ when listening to a pt with acute reap distress syndrome...
crackles
-
-severe form of acute lung injury
-o2 doesnt relieve stress
-decreased bld flow to lungs, platelets clump as an inflammatory response
acute reap distress syndrome
-
T/F the primary o2 admin method for a pt with COPD is a nasal cannula
false- a pt with copd needs precise measurements with a venturi mask
-
holding cough and cough forcefully
deep breathing and coughing
-
___would be used for a pt acutely ill or hx or resp disorders, measures partial pressure (or concentration) of 02, co2, in arterial blood determines if gas exchange is adequate across alveolar membrane.
ABG's
-
the left lung has __ lobes
2; upper and lower
-
accumulation of thick, purulent fluid in pleural space
emphysema: empyema
-
s/s of cystic fibrosis
- this tenacious sputum
- freg resp infections
- finger clubbing
- malabsorption
- fatty, foul smelling stolls
- death from antibiotic-resistant infection
-
obstruction of pulmonary artery or branch by blood clot, air, fat, amniotic fluid, or septic thrombus: most thrombus are blood clots from leg veins
pulmonary emboli
-
shallow rapid breathing causing increased permeability in capillary membranes where fluid can go into the interstitial spaces and alveoli
flail chest
-
reduction of the capillary bed increases pulm vascular resistance and pulmonary artery pressures
-hypoxemia result of these pathologic changes
-increased pulmonary artery pressure may cause right sided heart failure (for pulmonaie)
emphysema
-
contagious bacterial infection that mainly involves the lungs, but may spread to other organs, may be active and become inactive. 5-10% of pts will become ill once theyre infected
pulmonary tuberculosis
-
increased co2 in blood
hypercapnia
-
T/F : Bradypnea is the most common sign for a possible pulmonary embolism
false-tachypnea, sudden onset of dyspnea
-
spontaneous pneumothorax is caused by
weak area on the surface of lungs, could be a cancer pt or copd pt
-
___is for short term and should be moved from one side to the other to avoid damage to tissues or damage to vocal cords
intubation
-
the most critical hours after dx of a flail chest are...
24-72hrs after dx
-
those at high risk for atelectasis are
postoperative pts
-
cilliary function is damaged, alveoli damaged and macrophage function diminished in which disease?
COPD
-
once youve treated for TB to be considered not a carrier you must have
3 consecutive sputum cultures that read negative (takes 2-10 weeks to develop an immune response)
-
females are at higher risk for which disorder
arterial hypertension
-
___is used as a dx test or therapeutic, needle into the pleural space to aspirate fluid
thoracentisis
-
respiratory acidosis causes:
hypoventillation- retain too much co2
-
you should always wait for __ to return after a bronchoscopy before eating and check for reap distress
gag reflex
-
__ is a sterile swab and tongue blade, a swab at the back of throat
throat culture, make sure pt is aware of gag reflex, no antiseptic mouth wash prior to swabbing.
-
lung cancer that originates in the bronchi, metastasizes late, prognosis is better, associated with smoking
squamous cell carcinoma
-
pathophysiology of __ - inflammation of visceral and parietal pleura (parietal- pain receptors)- friction betwn pleurae (no pain receptors) on inspiration
pleurisy
-
pathophysiology of ___ AFB implant on bronchioles or alveoli, tubercle formed, immune system keeps in check, may activate with impaired immunity
tuberculosis
-
normal lab values for PaCo2
35-45 mm hg
-
collection of fluid in pleural space usually secondary to another disease process- large effusions impair lung expansion, cause dyspnea
pleural effusion- usually fluid is overproduced
-
amnt of air that can be exhaled from maximum resp
vital capacity
-
before a pulmonary function test you should withhold ___ as they can affect the test results
bronchodilaters
-
research shows a deficiency in vitamins _,_ and_ may contribute to lung cancer
a,c,e
-
____measure % of hemoglobin
pulse oximetry
-
max amnt of inhaled air at begining of a normal expiration distending lungs to the maximum
inspiratory capacity
-
sinusitis can spread and cause _____
menigitis
-
_____- continuous positive airway pressure, prevents airway from collapsing, positive pressure on inspiration and expiration
CPAP
-
what history would you need when assesing respiratory
upper and lower reap symptoms, exposures/ smoking, current treatments, family history
-
___can be used to dx pulmonary disease and to assess medicine effectiveness
pulmonary function test
-
inflammation of the lymphoid tissue on each side of the oropharynx
tonsilitis
-
risk factors of COPD
- tobacco smoke
- passive smoking
- occupational exposure
- ambient air pollution
- genetic abnormalities such as Alpha-1:antitrypsin deficieny
-
mouth care for a pt with intubation should be offered at least every _-_ hrs
2-4
-
amnt of air in and out of lungs during normal breathing
tidal volume
-
____ is caused by
airway obstruction
diffuse airway injury
pulmonary infections and obstruction of the bronchus or complications of long term pulmonary infections
genetic disorders such as cystic fibrosis
ideopathic causes
bronchiectasis
-
the most common chronic disease of childhood, can occur at any age and allergy is the strongest predisposing factor of ___
asthma
-
s/s of tb
- cough
- blood tinged sputum
- night sweats
- anorexia and weight loss
- low- grade fever
- dyspnea, chest pain (late)
-
____is when secretions settle in the base of the lungs causing pneumonia
hypostasis
-
after surgery it is important to increase ____ to flush dye out
fluid intake
-
in COPD ___ become permanently distended and air becomes trapped in them
alveoli
-
s/s of sinusitis
pain over affected sinus, fever, nasal discharge
-
a __ indicates obstruction and heard with or without a stethoscope and sounds like a high pitched crowing sound
stridor
-
s/s of atelectasis
insidious, include cough, sputum production, low-grader fever. reap distress, anxiety, symptoms of hypoxia occur if large areas of the lungs are affected
-
___is a more accurate reading for hemoglobin
ABG- arterial blood gas analysis
-
atelectasis is often secondary to____
infection
-
____ is the filling of the pulmonary capillaries w/blood
perfusion
-
a normal pulse ox reading is
95-100%
-
__lung cancer grows rapidly, anywhere and matastizes quickly- poor prognosis
large cell carcinoma- NSCLC
-
tramatic pneumothroax
trauma such as a knife/ gunshot wound
-
___ can help reduce the risk of pulmonary emboli
ambulation
-
syndrome characterized by sudden, progressive pulmonary edema, increasing bilateral lung infiltrates on CXR, hypoxemia refractory to o2 therapy, decreased lung compliance
acute resp distress syndrome
-
DX tests for pneumonia may include...
- x-ray: showing pulmonary infultrates
- ABGS- show hypoxemia
- blood cultures- looking for the source
-
t/f a pt with hyposemia will have an increase in the PaCo2 level
false
-
most common fatal autosomal recessive disease among caucasion population.
a mutation of a gene causes changes in chloride transport which leads to thick, viscous secretions in lungs, pancreas, liver, intestines and reproductive tract. pulmonary problems are the leading cause of morbidity and mortality
normally dx in infants
cystic fibrosis
-
___ cancer accounts for approx 1/2 of all head and neck cancers
cancer of the larynx
-
risk factors of ____
-venous stasis
-hypercoagulability
-certain disease states: heart disease, trauma, postoperative/postpartum, DM, COPD.
-other conditions: pregnancy, obesity, oral contraceptive use, consrictive clothing
pulmonary emboli
-
those at risk for pneumonia include
ery young, elderly, smokers, those hospitalized, intubated, and those who are immunocompromised
-
____defused medicine in lungs
nebulizer
-
tension pneumothorax
buildup of pressure pushing on lungs- closed- causing mediastinal shift
-
therapeutic positioning- respiratory distress
- -fowlers
- -semi-fowlers
- 0good lung down
-
x-ray of pulmonary vessels, radiopaque dye is used. check for allergies to dye. dye is injected up thru a femoral artery up into the heart
angiography
-
in emphysema ___ secretion increases, alveoli become large and burst. there is a residual volume increase causing ____
bronchioles, barrel chest
-
s/s of acute respiratory distress syndrome
- rigid onset of severe dyspnea
- hypoxemia that does not respond to supplemental o2
-
during crackles the fine sound is from
alveoli popping open on inspiration
-
pus-infection of the lungs
impynea
-
referring to actual bloodflow within pulmonary circulation
perfusion
-
clinical manifestations of bronchiectais
- chronic cough
- purulent sputum in copious amnts
- clubbing of fingers from chronic hypoxemia
-
___ can be described as course or fine, course is a moist bubbly sound
crackles
-
the 4th leading cause of death and 12th leading cause of disability is
COPD
-
decreased o2 in blood can lead to
hypoxemia
-
it is more likely that someone will aspirate into the ___ bronchus because its wider and shorter
right
-
resp center includes (in brain)
medulla and pons
-
pt cant blow out on expiration, levels of co2 increase
emphysema
-
expiration is a ___process and causes ___ pressure
passive, positive
-
amnt of air remaining in lungs afer normal expiration
functional residual capacity
-
what is the primary symp of chronic bronchitis
productive cough and sputum
-
the exchange of gases betwn air in alveoli and bld in pulmonary caps
external respiration
-
s/s of ___ -hoarseness of more that 2 weeks-persistant cough-sore throat or pain, burning in throat-lump in neck- later symptoms: dysphagia, dyspnea, unilateral nasal obstruction, persistant hoarseness, persistent ulceration, foul breath
generalized symp: weight loss, debilitation, lymphadenopathy, radiation of pain to ear
cancer of the larynx
-
collapse or airless condition of alveoli caused by hypoventilation, obstruction to airways or compression
atelectasis
-
___ mask gives a precise measurement of o2 to be delivered- doesnt allow for humidity
venturi mask
-
pulmonary emboli obstructed complications`
- obstructed area has diminished or absent blood flow, altho area is ventilated, no gas exchange occurs
- -inflammatory process causes regional bld vessels, bronchioles to constrict, further increasing pulmonary vascular resistance, pulmonary arterial pressure, right ventricular workload
- -ventilation-perfusion imbalance, right ventricular failure, shock occur
-
cloudy-gunky fluid containing WBC in fluid associated with pneumonia, TB or CA
exudative
-
pathophysiology of ___ ____ injury to alveoli
-scarring, fibrosis
-impaired gas exchange
pulmonary fibrosis
-
___ test shows if any bacteria will grow and which antibiotic will destroy the bacteria
C&S
-
____+____ work together to maintain homestasis
lungs and kidneys
-
lung cancer that occurs more frequently in women tha men, peripheral fields, slow growing, usually not DX until its metastasized elsewhere. linked with smoking, prognosis=better
adenocarcinoma (NSCLC)
-
the right lung has ___ lobes
3- upper, middle, and lower
-
pathophysiology- air in the interpleural space (air btwn the visceral pleura)
pneumothorax
-
SCLC usually from smoking has a poor prognosis and the survival time is usually
9-10 months
-
normal breath sounds
- -vesivular
- -brochovesicular
- -bronchial
-
causative factors for pulmonary disease
- cig smoking
- air pollution
- can be hereditary
- virus that hits lungs
- toxic inhalhent
- immune dysfunction- RA, lupus
-
respiratory alkalosis causes:
hyperventillation- blowing off too much quickly
-
epistaxis may be a serious problem if ____
there is significant bld lose or an airway compromise
-
inspiration is ___ of the respiratory cycle
1/3
-
___ is a bi-lobed positive airway for people who are alert and can breath on their own for periods of time without excessive secretions
Bi-pap- always check for skin breakdown and anxiety
-
___ shows soft tissue damage, no metal can be on pt
MRI
-
___ accounts for more than 10% of all hospital admissions
pneumonia
-
max amnt of exhaled air in excess of norm tidal vol
expiratory reserve vol.
-
-
___ test shows fibrin products and will show bld clots
d-dimer
-
watery fluid fill capillaries, associated w/heart failure, liver or kidney disease
transudative
-
inflammation of the mucous membrane lining larynx
laryngitis
-
a simple o2 mask gives __-__% of o2
40-60%
-
factors that affect lung vol.
- sex
- height
- smoking/non
- athletes/non
- living in higher or lower altitudes
-
asymetrical chest movt, crackles, diminshed breath sounds, rise in vitals or lowered bp may be a sign of
atelectasis
-
____ sound is pleura rubbing together, sounds like leather rubbing together
friction rub
-
lung cacner that usually grows rapidly, orginates in major bronchi, metastasizes quickly to bone, liver, and brain
small cell lung cancer (SCLC)- oat cell 13%
-
shunting of bld occurs if there is an imbalance of V/Q and results in ___
hypoxia
-
the movemnt of air in and out of lungs is
ventilation
-
therapeutic measures for breathing-breathing in nose and out through mouth
pursed-lip breathing
-
cystic fibrosis is a dysfunction of __ glands
exocrine
-
the main cause of TB
mycobacterium TB- spread by droplets
-
inflammation of the sinus mucosa, may be bacterial or allergic
sinusitis
-
etiology of secondary pulmonary arterial hypertension
CAD, valve disease
-
movnt of air to and from alveoli
ventilation
-
gas exchange takes place in the
alveoli
-
decreased air mount- decreased lung sounds
diminshed breath sounds
-
ceptal cells (type 2) in alveoli secrete
surfacant
-
___ bond is formed in lungs
iron
-
o2 is carried by ___portion of RBC
iron
-
air must reach the ___ to be availible for gas exchange
alveoli
-
pathophysiology of _____
-acute lung infection
-inflammation and alveolar damage
-alveoli filled with exudate
-reduced surface area for gas exchange
pneumonia
-
normal inspiratory pressure is approx___ cm
100
-
_____procedures asses lung function and gas exchange
radioisotope procedures
-
those at risk for influenza are _____
elderly and children
-
scar tissue and narrowing occurs in the airways.
substances activated by chronic inflammation damage the parenchyma.
inflammatory response causes change in pulmonary vasculature
COPD
-
s/s of ____ _____
- dyspnea
- pain
- cough
- tachypnea
- diminshed lung sounds
-
inflammation of the nasal mucous membranes (common-cold- release of histamine)
Rhinitis
-
____ ____ is caused by 3 or more rib fractures, in 2 or more places- part of the chest collapses, from severe trauma
flail chest
-
s/s of tonsilititis
sore throat, fever, chills, malaise. pain on swallowing,malgasia
-
high concentrations of o2 can become toxic. after __-___ hrs of being on high o2 youre at risk for o2 toxicity
-
acute pharyngitis can lead to
staph or kidney damage
-
decreased co2 in blood
hypocapnia
-
the at risk group for TB are
the elderly, infants, immunosupressed pts (aids, chemo) those with anti rejection drugs from an organ transplant, those with crowded living spaces and those with poor nutrition
-
causes of atelectasis
bronchial obstruction by secretions due to impaired cough mechanism or conditions that restrict normal lung expansion on inspiration
-
____ is a chronic inflammatory disease of the airways that causes hyper responsiveness, mucosal edema, and mucous production-inflammation leads to cough, chest tightness, wheezing and dyspnea
asthma
-
intraplural pressure
in plueral space
-
sum of all lung vols- total amnt of air the lungs can hold
total lung capacity
-
inspiratory or expiratory sound caused by narrowed airways is _____
wheezing
-
death usually occurs ____ after DX of primary arterial HTN
2-5 years
-
expiration accounts for ___% of reap cycle
2/3
-
smokers are ___% more likely to develop lung cancer
13
-
the cause of primary pulmonary arterial hypertension is
unknown-primary shows a genetic link
-
Q's to ask about reap disease
- where is it
- how does it feel
- aggravating or alleviating factors
- timing
- severity
- pt pain
- patients perception
-
emphysema comes from the greek term meaning
over inflated
-
inflammation of the pharynx- bacterial or viral
pharyngitis (sore throat)
-
____ is usually secondary to pneumonia, TB, CA, PE (cancer, pulmonary embolism)
pleurisy
-
Respiratory muscles ___during respiration causing ___ pressure
contract, causing neg pressure
-
abnormal breath sounds
crackles, wheezes, friction rubs
-
t/f? an early sign of cancer of the larynx is the glottic area is enlarged cervical nodes
false- effects voice sounds
-
risk factors for aspiration
- brain injury
- cognitive status
- seizures
- consciousness
- drug and alcohol intoxification
- excessive sedation
- high residual vol
- stroke
- cardiac arrest
-
s/s: harsh, hoarse cough, thick sputum- worse in morning, wheezes and crackles for more than 10 days
COPD
-
tension pneumothroas s/s
- tracheal deviation- will move trach to the side-emergency
- bradycardia
- cyanosis
- shock and death if untreated
-
entrinsic asthma
not caused by allergies, usually environmental, related to recurrent respiratory infections
-
what is gas exchange btwn the lungs and blood, btwen the bld and tissues?
respiration
-
the bacteria that normally causes pneumonia is______
-
normal lab values for PaCo2
80-100mm Hg
-
pneumonia s/s
- chest pain
- fever, chills
- cough, dyspnea
- yellow, rusty or blood tinged sputum
- crackles, wheezes
- malaise (tired)
-
_____ test shows RBS, hemoglobin, o2 carrying capacity- WBC for infection
CBC
-
___ rate effects maximal expiratory flow and is freq done by pts using a home spirometer
peak flow
-
before a ____ test you should drink plenty of h2o so you can liquify secretions
sputum tests, secretions that are liquified are easier to cough up.
-
A pt w/ __is usually acutley ill, fluid, fibrin development, loculation impair lung expansion. resolution is a prolonged process
empyema
-
changes in arteries in the heart and in the lung become narrowed and hardened and cannot expand like b4 building pressure- this happens in which disease
pulmonary arterial HTN
-
a DX test for sinusitis would be___
xray- showing a cloudy result, but may require a CT scan
-
aspiration prevention:
- elevate HOB
- turn pt to side when vomiting
- prevention of stimulation of gag reflex with suctioning or other procedures
- assessment, proper admin of tube feeding
- rehabilitation therapy for swallowing
-
wheezes are considered an adventious breath sound? T/F
True
-
s/s of lung cancer
- none until late
- productive cough
- recurrent infection
- dyspnea
- hemoptysis
- anorexia and weight loss
- pain
- wheezing/stridor
-
____test shows blood o2 sat
pulse oximetry (SaO2)
-
___ will eventually make alveoli non functional with scarring, losing ability to expand and contract
pulmonary fibrosis
-
with an angioplasty the pt should be NPO for ___hrs and lying flat on their back for ___-___ hrs after with a sand bag over site
8 hrs, 3-8hrs
-
____ _____ test asses resp function and determine extent of the dysfunction
pulmonary function tests
-
prevention for aspiration
- keep HOB elevated during and after tube feedings
- check gastric residual when admin tube feedings
- use of thickened liquids
- dont use straws
-
epistaxis
hemorrhage from the nose, nosebleed. most common site- anterior septum
-
antitripsin deficiency- hereditary- associated with which disease
emphysema
-
a pt with COPD should receive no more than __L of o2
2 more could knock out breathing
-
ausculating breathing- check for
- normal breath sounds
- adventious sounds
- compare bilaterally
-
s/s of ___ -sharp pain on inspiration (knife-like) shallow breating
fever, elevated WBC
friction rub
pleurisy
-
mechanical ventiallation uses __pressure to push o2 thru the tube
positive
-
grading a tumor
by size and tissue involvement
-
max amnt of inhaled air on excess of normal tidal vol
inspiratory reserve vol.
-
etiology of pulmonary fibrosis
- hereditary
- virus
- env/ occupational exposure
- immune dysfunction
- idiopathic
-
elevated pressure in pulmonary arteries and rght ventricualr failure-pathophysiology of ___
pulmonary arterial hypertension
-
s/s of arterial HTN
JVD, peripheral edema
-
using a nebulizer helps decrease
side effects, delivering directly to lungs instead of whole body
-
exchange of o2 and co2
diffusion
-
decreased o2 in inspired air can lead to
hypoxia
-
influenza spreads by ___and lasts for approx ___ days
droplets, 10 days
-
s/s of infection in elderly
- new-onset
- confusion
- lethargy
- fever
- dyspnea
-
for a flail chest you should monitor ___they may need a ___ or a ___
ABG's, chest tube or ventilator
-
DX test for pleurisy
- chest x-ray
- sputum culture
- CBC
-
___o2 mask has vents on sides to allow room air to mix in with o2 gives up to 50% of o2
partial rebreather
-
airflow limitation is progressive and is associated with abnormal inflammatory response of the lungs to noxious agents. inflammatory response occurs throughtout the airways, lung parenchyma and pulm vasculature
COPD
-
scope into mouth or nose to remove objects-rigid or flexible to view
bronchoscopy
-
A____ measures vols of air exhaled and is used to assess lung capacitys
spirometer
-
intrathoracic pressure
in thoracic cavity
-
pathophysiology of acute respiratory distress
- alveolocapillary membrane damage
- pulmonary edema
- alveolar collapse
- lungs stiff and noncompliant
- lungs may hemorrhage
- can lead to atelectasis
- pt will become hypoxic
-
exchange of gases btwn bld in body cells is____
internal respiration
-
what will the EKG show for arterial HTN
Rght hypertrophy-enlarged heart, could be caused by COPD
-
T/F: for pts with chronic bronchitis, the nurse expects to see the major clinical sym's of tachypnea and tachycardia
false- sputum and productive cough
-
ANA titer shows
immune response
-
when inspecting you should check for
- symmetry
- dyspnea
- use of accessory muscles
- color-cyanosis
- resp rate and rythm
- chest shape
-
atmospheric pressure has the ___ pressure
most
-
during crackle the coarse sound is from
fluid in airways
-
extrensic asthma
allergies usually cause this- kids normally outgrow this
-
intropulmonary pressure
pressure in airways
-
force of less than ___ cm usually requires a ventilator
25
-
there are approx ___ alveoli in the adult lung
300 million
-
exhale deely, deep breath in and use abdominal muscles to cough
huff coughing
|
|