Term
| 3 causes of extrapulmonary respiratory failure |
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Definition
loss of CNS control: i.e., injury at C4
obstruction: i.e., a tumor
or chest wall restriction: which is why we no longer use straight jackets |
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|
Term
| 3 causes of intrapulmonary respiratory failure |
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Definition
lung tissue damage (COPD, emphysema, etc.)
alveolar-capillary damage
pulmonary embolism |
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Term
| special assessment for those with a chest tube |
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Definition
| palpate for crepitus around the opening (that would indicate subQ emphysema, which is bad) |
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Term
| respiratory signs of acute respiratory failure |
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Definition
sudden changes in structure of airway/lungs
altered breathing patterns (SOBOE, paradoxical chest wall movement, tachypnea)
& cyanosis |
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Term
| non-respiratory signs of acute respiratory failure |
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Definition
LOC
cardiac dysrhythmias
abnormal skin temperature |
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Term
| special consideration for giving suction |
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Definition
| only give it 3x, after this ICP can increase dangerously |
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Term
| special consideration for sedated patients |
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Definition
| assess for orientation and SpO2 often due to increased risk for aspiration |
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Term
| at what point should you discontinue nasal-canula on your patient, and to what should you switch them? |
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Definition
| only give O2 NC up to 6L, then switch them to a non-rebreather |
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Term
| Respiratory considerations for morphine administrations |
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Definition
| RR must be above 7 r/min before next dose of morphine can be given |
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Term
| what are the 5 conditions on the V/Q mismatch continuum (from no ventilation to no perfusion) |
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Definition
Shunt (as from oversecretion): no ventilation
partial shunt (as from mucus plug): compromised ventilation
Normal ventilation
Clot: compromised perfusion
Deadspace: complete vascular obstruction |
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Term
Acute or Chronic Respiratory failure?
pH: 7.3, PaCO2 70, Bicarb 27 |
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Definition
Acute
PaCO2 and Bicarb are both high indicating respiratory acidosis, but the pH is basic, meaning it hasn't had time to compensate |
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Term
If a patient has COPD, which of these is the most cause for concern:
RR: 34
SpO2: 87
1-2 spoken words at a time |
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Definition
1-2 spoken words--> indicative of severe shortness of breath
RR will be high in COPD patients
SpO2 above 85% is acceptable in COPD patients |
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Term
| coarse crackles upon auscultation of the lungs indicates what kind of intervention? |
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Definition
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|
Term
|
Definition
continuous positive airway pressure vs. dual positive airway pressure
forces air in vs. forces air in & out |
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|
Term
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Definition
| acute respiratory distress syndrome: a systemic inflammatory acute lung injury with low incidence, but high mortality rates |
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|
Term
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Definition
| anything that can cause an allergic reaction in the airway (aspiration, pneumonia, burns, etc.) or an immune reaction in the blood (sepsis, pancreatitis, blood transfusion, etc.) |
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|
Term
| acute bronchitis vs pneumonia |
|
Definition
inflammation of bronchi vs. entirety of lungs
normal CXR vs. consolidation
heavy coughing vs. crackles
SOB, malaise vs. flu-like symptoms |
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Term
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Definition
| hospital acquired pneumonia can be a result of ventilator use, and can lead to opportunistic infection (like TB) and aspiration |
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Term
| 3 most common "reasons" for not getting vaccinated |
|
Definition
lack of knowledge
chemotherapy
and fear of side effects |
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Term
| reason for sputum culture and gram stain of pneumonia-patient sputum |
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Definition
| need to know type and strain of pathogen to treat properly |
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|
Term
| Supportive care for Pneumonia |
|
Definition
These are FOR NED, he has pneumonia:
Fluids (3L)
Oxygen PRN
Rest
Nutrition
Education (prevention, treatment)
Drugs (bronchodilators, antipyretics, and analgesics) |
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|
Term
| what group of people would be the most likely to contract TB |
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Definition
| those poor, racial minority prisoners living in underserved areas with HIV |
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|
Term
|
Definition
frequent cough with white frothy sputum
night sweats
sanguinous sputum--> poor prognosis |
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|
Term
| Once you've tested positive in the Mantoux test, you'll always test positive whether you have TB or not. How can you tell after this point? |
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Definition
| CXR: infiltrates. Not diagnostic, but good for screening |
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Term
| babies born in high-prevalence region for this disease get that vaccine at birth |
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Definition
This: TB
That: BCG vaccine (afterward, you test positive Mantoux test) |
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|
Term
| if treated in the hospital, TB patients need... |
|
Definition
| ...negative air flow and airborne isolation |
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|
Term
| How to tell if someone with TB is infectious |
|
Definition
| sputum culture: if negative, non-infectious and vice versa |
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|
Term
|
Definition
| pl. Bullae, a fluid-filled internal blister--often from the lung as a result of COPD |
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|
Term
| What does the location of a chest tube tell you? |
|
Definition
high: removing air
low: removing fluid |
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Term
| 2 causes of high negative pressure in a chest tube |
|
Definition
deep breathing (SOB) (may need suctioning)
chest drain "stripping" |
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|
Term
| When should a chest tube be clamped |
|
Definition
1. when disconnected/open
2. when assessing for a leak
3. when there's risk for tension pneumothorax |
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|
Term
| when should a chest tube NOT be clamped |
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Definition
1. when there may be a leak at the chest tube site
2. during transport
3. after the need for clamping has passed (never LEAVE it clamped) |
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Term
| three early signs of lung cancer |
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Definition
| fever/chills, cough, and dyspnea |
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|
Term
| 5 late signs of lung cancer |
|
Definition
SCaN FWd
sanguinous sputum, chest pain, N/V, fatigue, and weight loss |
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Term
|
Definition
| removal of a small wedge of pulmonary tissue |
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|
Term
|
Definition
| removal of a lobe of one lung |
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Term
|
Definition
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Term
|
Definition
| removal of a segment of a lobe of a lung |
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Term
| 3 important (nursing) interventions post-lung surgery, and their rationale |
|
Definition
incentive spirometry to prevent atelectasis
sleep on your non-operated side to avoid opening stitches
get up and moving quickly to avoid PE and pneumonia |
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