• provides transport of oxygen in the blood, decrease work of breathing, reduce stress on myocardium
• asses for S/S of hypoxia, ABG results, pulse oximetry

• increase arterial oxygen pressure (PaO2) back to the client's normal baseline, which may vary from 60-95 mmHg

• decrease in arterial oxygen tension (concentration) in the blood measured by PaO2 levels
• S/S - changes in mental status, impaired judgement, agitation, disorientation, confusion, cool extremities

• a decrease in oxygen supply to the tissues and cells, can also because by problems outside the respiratory system

• fatigue, drowsiness, inattentiveness, delayed reaction time

• 1-6L/minute, 23-42% O2 delivery
• advantages: comfortable for the client, continous use with activity and meals
• disadvantages: drying to the nasal mucosa

• simple - 6-8 L/min, 40-60% O2
• partial rebreather - 8-11 L/min, 50-75% O2
• nonrebreather - 12 L/min, 80-100% O2

• 4-8 L/minute, 24-40% O2
• primarily used for COPD clients to provide appropriate levels of oxygen
• advantage: low to high concentrations depending on mask being used
• disadvantage: poorly fitting, must remove to eat

• suppressed respiratory drive and low O2 concentration
• Fire (avoid materials that generate static and electricity)
• Oxygen toxicity (overproduction of free radicals (metabolism cell) can damage cells after long-term use)

• three major antioxidant vitamins: beta-carotene, vitamin C, vitamin E
• contained in fruits and vegetables with blue, purple, red and yellow hues

• apricots, asparagus, beats, carrots, corn, kale, pumpkin, squash, spinach, sweet potatoe, tomatoes, watermelon, collard greens, tangerines

• berries, brococoli, brussel sprouts, grapefruit, kiwi, mangoes, papaya, peppers, peas, strawberries

• carrots, chard, mustard, turnips, nuts, sunflower seeds

• Zinc - found in oysters, red meat, poultry, beans, nuts, seafood, grains, dairy
• Selenium - tuna, beef, poultry, breads

• biggest benefit is to eat the foods raw or lightly steamed; don't overcook or boil

• S/S - dyspnea, restlessness, fatigue, malaise, progressive respiratory difficulty
• use oxygen only as prescribed, minimize durations of high concentrations and reduce as soon as possible

• stimulus for respiration is a decrease in blood oxygen rather than an elevation in CO2 levels
• administration of high concentration of oxygen removes respiratory drive

• False. A patient with hypoxemia will have a decrease in PaO2 levels, not an increase

• administration of oxygen at pressures > 1 atmosphere; amount of oxygen dissolved in plasma is increased which increases in tissues
• client is placed in small cylinder chamber

• treat condition: air embolism, carbon monoxide poisoning, gangrene, diabetic ulcers, slow healing bone fractures
• side effects: ear trauma, CNS disorders, oxygen toxicity, anxiety

• device that encourages patients to inhale slowly and deeply to maximize lung inflatio  and alveoli expansion
• flow type is more commonly used and contains a ball that is pushed up by force of the breath and suspended on inhaling

• True. The patient should be encouraged to use an incentive spirometer approximately 10 breaths per hour between treatments while awake.

• handheld apparatus that disperses a moisturizing agent or medication by mist into the lungs
• take slow deep breaths, hold and expirate; promote coughing to move secretions

• postural drainage, chest percussion and vibration and coughing
• consists of multiple positions to effectively drain different lobes of the lungs
• helps to remove secretions, improve ventilation and increased use of respiratory muscles

• L and M: when the head is down
• U: when the head is up

• exercises and breathing practices achieve a more efficient and controlled ventilation
• used for COPD and patients with dyspnea
• promote alveolar inflation and muscle relaxation which can reduce anxiety, eliminate irregular patterns

• airless condition of alveoli caused by hypoventilation, obstruction to airways or compression
• S/S - cough, sputum production, low-grade fever, respiratory distress, anxiety, hypoxia occurs if large areas of lung is affected

• increased work of breathing and hypoxia
• decreased breath sounds, crackles heard over affected area
• CXR may reveal patchy infiltrates or consolidated areas
• SpO2 <90%

• promote coughing and deep breathing
• change positions frequently to prevent accumulation of secretions
• early mobilization
• incentive spirometry, chest percussion, postural drainage
• suction to remove secretion

• viral, no cases reported since 2004 as per CDC
• first reported in Asia in 2003 and spread to North/South America, Europe
• can cause lung abscesses, TB, PNA

• acute inflammation of the mucous membranes of the trachea and bronchial tree
• inflammed mucosa of the bronchi produces mucopurulent sputum in response to infection
• S/S - dry cough, scant amount of sputum, fever/chills, night sweats, general malaise, SOB, purulent sputum

• inflammation of the lungs caused my microorganisms (bacteria, fungi, viruses)
• most common causes of death from infectious diseases in US

• occurs in the community setting or within the first 48 hours after being hospitalized or institutionalized
• frequently affects older adults, or those with comorbid conditions

• develops within 48 hours or more after admission
• does not appear to be incubating at time of admission

• ventilator associated pneumonia
• thought to be a type of HAP pneumonia
• usually presents in patients who have been mechanically intubred with ventilator support for at least 48 hours

• multi-drug resistant pathogens can cause HCAP, typically several of them and distinction is hard
• must be identified immediately so that antibiotic treatment is not delayed

• occurs with the use of corticosteroids or other immunosuppressive agents
• typically seen in chemotherapy, nutritional depletion, AIDS, long-term advanced life support

• affects both ventilation and diffusion by inflamming the alveoli and exudate is produced
• interferes with diffusion of O2 and CO2
• WBC's migrate to alveoli and can cause edema in bronchi and cause occlusion
• cells become poorly oxygenated

• varies depending on type of pneumonia
• onset of chills, rapidly rising fever 101-105F, chest pain, coughing, tachypenia, SOB, bradycardia
• sputum is often purulent, but rusty colored from blood

• sputum samples are obtained from coughing deeply into a container and expectorating sputum
• physical exam, blood culture and sputum examination

• one time vaccination recommended for all clients 65+ and those with chronic diseases
• those vaccinated at 65+ or older only one dose is required regardless of medical condition

• hypotension
• septic shock, respiratory failure
• pleural effusion occurs in 30% of cases of bacterial pneumonia

• thick, purulent fluid accumulating in the pleural space
• develops where the infection is located may occur as one of the stages of parapneumonic effusion
• chest tube may be inserted to drain the empyema and antibiotic treatment 4-6 weeks

• improve airway patency
• increase activity and fluid intake (2-3L/day)
• adequate nutritional diet
• patient education for prevention of further complications

• seizure and brain injury, drug or alcohol intoxication
• excess sedation r/t anesthesia
• stroke, cardiac arrest
• can cause pneumonia

• necrosis of lung tissue caused by microbial infection generally caused by aspiration of anaerobic bacteria
• drainage can be achieved by postural drainage
• IV antibiotic therapy for 3-5 days, followed by oral antibiotics 4-12 weeks
• diet high in protein to facilitate healing

• infectious disease primarily affects the lungs and can be transmitted to other parts of the body
• usually caused by mycobacterium tuberculosis

• usually seen with a low-grade fever, cough, night sweats, fatigue and weight loss
• cough is usually nonproductive
• spreads from person to person by airborne transmission

• initial therapy is administered once a day for 8 weeks; lasts for addition 4-7 months
• prophylactic INH treatments involved daily doses for 6-12 months
• sputum cultures for AFB are sent to labs to evaluate effectiveness of treatments

• client placed in private room with negative pressure room and door is kept closed
• anyone entering the room must wear N-95 mask and have it fit snugly
• medications must be taken on empty stomach, one hour before meals

• inflammation of both layers of pleurae
• inflamed surfaces rub together with each respiration causing sharp pain intensified by inspiration

• fluid collection in pleural space usually secondary to pneumonia
• large effusions impair lung expansion, causing dyspnea

• can develop in conjunction with PNA, URI, TB, trauma, cancer
• S/S - pain upon take a deep breath, coughing and sneezing worsens the pain, can radiate to the shoulder or abdomen

• a collection of fluid in the pleural space, normally 5-15 mL of fluid that lubricates the pleural space allowing the surfaces to move without friction
• most common cause: bronchogenic carcinoma

• exudative - inflammation by bacterial products or tumors involving the pleural surfaces
• Transudate - usually pleural membranes are not diseased and form from imbalances of hydrostatic pressure

• abnormal accumulation of fluid in the lung tissue, the alveolar space or both
• severe, life threatening
• occurs due to damage of the capillary bed lining; may be due to injury of the lungs

• O2 therapy and IV furosemide
• provide psychological support, change client's position to decrease venous return (ie. dangle feet over the bed)

• severe form of acute lung injury
• sudden, progressive pulmonary edema with increasing bilateral lung infilatrates
• S/S - rapid onset of dyspnea, hypoxemia does not respond to supplemental oxygen therapy

• intubation, mechanical ventilation to keep alveoli open
• prone position is best for oxygenation, frequent positioning
• nutritional support, enteral feedsing preferred

• characterized by elevated pulmonary arterial pressure and RSHF
• S/S are often not often visible until late progression

• dyspnea - happens on exertion as disease progresses and is present at rest

• goal is to usualy treat the underlying condition
• Rx with Calcium Channel Blockers (indicated for small % of clients), or Flolan (epoprostenol), treprostinil (Remodulin) that relax the smooth muscle and are mostly given in the ICU

• obstruction of pulmonary artery or branch by blood clot, amniotic fluid, or septic thrombus
• inflammatory process obstructs the area and results in diminished or absent blood flow
• bronchioles constrict which further increases pulmonary vascular resistance

• symptom - dyspnea
• sign - tachypnea
• chest pain, anxiety, fever, cough, syncope

• death usually occurs within one hour after the onset of symptoms
• VQ scan is used to diagnose PE: IV administration of a contrast agent, allows comparison of different areas of the lung

• prevention - antiembolism stockings, avoid crossed legs, sitting for long periods, drink fluids, exercise to avoid stasis
• treatment - IVC filter inserted into inferior vena cava, anticoagulation, thrombolyric therapy

• interstitial lung disease; tumor or growth from a disease of unknown etiology
• usually presents between 20-40 years of age
• more common in African Americans
• lungs most commonly affected; S/S - dyspnea, cough, congestion

• common cold is the most common cause of URI
• some last days others last weaks
• affects nasal cavity, air cells, sinuses, pharynx, larynx and trachea
• clients are rarely hospitalized for URIs

• GERD; sleep with HOB elevated
• thinning of mucous membranes and loss of muscle mass can cause structural changes in the larynx

• disorder characterized by inflammation and irritation of mucous membranes of the nose
• often coexist with other respiratory disorders
• affects 10-30% of the population worldwide
• can be acute or chronic, nonallergic or allergic

• excessive nasal drainage aka "runny nose"

• acute upper respiratory infection caused by a virus
• S/S - fever, nasal congestion, sneezing, watery eyes, sore throat, chills, muscle ache; last 1-2 weeks
• management - fluids, rest, expectorants, salt water gargles, NSAIDS

• chronic, progressive and permanent disease
• airflow limitation
• has characteristics similar to bronchitis and emphysema

• smoking - 80-90% of cases
• second hank smoking
• occupational exposure
• air pollution
• genetics

• ongoing injury and repair process with an inflammatory response of the lungs to noxious particles or gases leads to changes in respiratory system

• by the use of spirometry

• this is the total amount of air (measured in litera) that can forcibly be blow out after inspiration

• Amount of air measured in liters that can be forcibly blown out in one second

• mild airflow limitation
• indivudual usually unaware that lung function is abnormal
• FEV1 = 80%

Stage II - Moderate COPD

• worsening airflow limitation
• start to seek medical attention R/T chronic respiratory symptoms
• FEV1 = 80%

• further worsening of airflow, fatigue, reduced exercise
• repeated exacerbation that impacts quality of life
• FEV1 = 50%

• severe airflow limitation
• exarcerbations can be life threatening
• FEV1 = 30%>

• chronic productive cough for 3 months in two successive years when all causes have been excluded

• permanent enlargement of the air spaces over time that causes alveolar destruction
• can cause dead space, impaired O2 exchange, impaired elimination of CO2

• due to the back up of blood in the venous system, you will see edema, distended neck veins and pain in the liver region

• relax the smooth muscle of the respiratory tract thereby opening bronchial passages

• Albuterol
• Levalbuterol

• Salmeterol
• Formoterol

• Ipratropium

• Tiotropium

• reduce inflammation in the airway walls
• frequently used if airway obstruction cannot be kept under control with bronchodilators

• drugs that help dissolve mucus and reduce thickness of respiratory tract fluid
• can be given PO or INH
• ex: acetylcysteine, guaifenesin

• short acting beta-agonist PRN

• short acting beta-agonist PRN
• add regular treatment with one or more long acting beta-agonist

• short acting beta-agonist
• regular treatment with one or more long acting beta-agonist
• add inhaled corticosteroid

• short acting beta-agonist PRN
• long acting beta-agonist
• inhaled corticosteroid
• oxygen therapy if needed

• manifest with three factors: increased sputum, more purulent sputum, worsening dyspnea