Term
| sputum indication: purulent (2) |
|
Definition
clear colored
sign of bronchitis |
|
|
Term
| sputum indication: blood tinged (2) |
|
Definition
|
|
Term
| sputum indication: Foul smelling (3) |
|
Definition
infection
bronchiecsatis
acute respiratory infection |
|
|
Term
| sputum indication: brassy (2) |
|
Definition
aortic aneurysm
golden/bronze colored |
|
|
Term
| sputum indication: frothy (3) |
|
Definition
pink or yellow
light and bubbly
sign of CHF |
|
|
Term
| sputum indication: hemoptysis (2) |
|
Definition
coughing up blood
pulmonary bloeed |
|
|
Term
| a good determinant of regional ventilation |
|
Definition
|
|
Term
| vibration of the voice or from secretions or movement of air in the lungs |
|
Definition
|
|
Term
| what could hyporesonant fremitus be caused by (5) |
|
Definition
COPD
fluid
collapse
hyperinflation
can't get air in |
|
|
Term
| why could hyperresonant fremitus be caused by (2) |
|
Definition
echo of air moving in lung
consolidated pneumonia |
|
|
Term
| flat mediate percussion sound (2) |
|
Definition
| over viscera/organ, hyporesonant |
|
|
Term
| dull mediate percussion sound (2) |
|
Definition
muffled/filtered d/t increased density
hyporesonant |
|
|
Term
| hyperresonant mediate percussion sound |
|
Definition
| amplified, echoes, means that there is air under there. can be d/t overinflation, lung is completely open, or there is air in teh open space |
|
|
Term
| how should the pt breathe during auscultations |
|
Definition
| through their mouth not their nose |
|
|
Term
| fremitus vs percussion: hyporesonance with air/overinflation |
|
Definition
|
|
Term
| fremitus vs percussion: hyperresonance with air/overinflation |
|
Definition
|
|
Term
| fremitus vs percussion: hyporesonance with fluid |
|
Definition
|
|
Term
| fremitus vs percussion: hyperesonance with incresaed density |
|
Definition
|
|
Term
| fremitus vs percussion: hyporesonance with decreased intensity |
|
Definition
|
|
Term
| adventitia sounds: discontinuous sounds like short bursts of poppping |
|
Definition
|
|
Term
| adventitia sounds: fine crackles heard at end of inspiration suggests suddening opening of small airways like in what conditiosn (3) |
|
Definition
CHF
Pulmonary fibrosis
Atelacstasis |
|
|
Term
| adventitia sounds: high pitched moist crackles occuring throughout breathing suggest fluid like in what (3) conditions |
|
Definition
respiratory infection
infiltrates
pneumonia |
|
|
Term
| adventitia sounds: musical continous notes which may hrard during any phase of the breathing cycle |
|
Definition
|
|
Term
| adventitia sounds: wheezes are indicative of what |
|
Definition
| airway obstruction d/t either mucous or bronchoconstriction |
|
|
Term
| adventitia sounds: wheezes are indicative of what |
|
Definition
| airway obstruction d/t either mucous or bronchoconstriction |
|
|
Term
| adventitia sounds: wheezes could mean what (5) |
|
Definition
lesion/mass
foreign body
compression of airway (enlarged node or other)
inflammation/edema
increased secretions |
|
|
Term
| adventitia sounds: phonation is is indicative of what |
|
Definition
|
|
Term
| adventitia sounds: 2 parts of phonation |
|
Definition
|
|
Term
| adventitia sounds: what is egophoy |
|
Definition
| E comes out sounding like A |
|
|
Term
| adventitia sounds: what is bronchophony |
|
Definition
|
|
Term
| 4 types of ventilator support |
|
Definition
control mode
assist control mode
assist
ventilator support mode |
|
|
Term
| ventilator mode in which the ventilator maintains all of the respiratory functions without patient participation |
|
Definition
|
|
Term
| what does control mode of the ventilator control |
|
Definition
|
|
Term
| condition of the pt if they are on a ventilator control mode |
|
Definition
| sedate or pharmacologically paralyzed |
|
|
Term
| 2 modes of assist control modes |
|
Definition
IMV - Intermittent Mandatory
SIMV - Synchronized Intermittent Mandatory Ventilation |
|
|
Term
| Benefit of assist control modes over control modes |
|
Definition
| machine has a set rate but is also responsibe to patient initiation |
|
|
Term
| Assist Control Mode: Allows for what |
|
Definition
| the pt to breathe with voluntary control but with a set rate |
|
|
Term
| Assist Control Mode: also provides what |
|
Definition
|
|
Term
| Assist Control Mode: IMV mode: regardless of pt's spontaneous efforts what is delivered |
|
Definition
| mandatory breath is delivered at a preset rate |
|
|
Term
| Assist Control Mode: which mode does the pt have more control IMV or SIMV |
|
Definition
|
|
Term
| Assist Control Mode: difference between the mandatory breath between IMV and SIMV |
|
Definition
IMV does not count spontaneous effort to RR
SIMV counts spontaneous effort to RR |
|
|
Term
| Assist Control Mode: if the pt breathes with the SIMV, what does this mode also ensure |
|
Definition
| that the pt is getting enough volume during their inspiration |
|
|
Term
| Difference between assist mode and assist control mode |
|
Definition
|
|
Term
|
Definition
| PSV mode - Pressure Support Ventilation |
|
|
Term
| Assist mode: what is the role of PSV |
|
Definition
| pt initiates breath, ventilator makes sure they are getting enough volume. pt generated = 10 mL, volume requirement = 25, ventilator will provide 15 ml |
|
|
Term
| 4 Ventilator Support Modes |
|
Definition
PEEP- Positive End-Expiratory Pressure
IPPB - Intermittent Positive Pressure Breathing
Inspiratory Hold
CPAP - Continuous Positive Airway Pressure |
|
|
Term
|
Definition
| increase pressure to maintain open airways so that greater gas exchange can occur and ensure the air can get out. timed with expiration |
|
|
Term
| PEEP is good for what lung pathology category |
|
Definition
|
|
Term
|
Definition
| intermittently interjects postitive pressure into the tubing to provide sligh increase in time for gas exchange |
|
|
Term
| purpose of inspiratory hold |
|
Definition
| triggers a hold at end of inspiration to maintain ventilation and gas exchnage and even ventilation |
|
|
Term
|
Definition
| maintian slightly higher than atmospheric pressure to prevent early airway closure |
|
|
Term
| CPAP is good for what specific pathology |
|
Definition
|
|
Term
| purpose of an incentive spirometer |
|
Definition
visual feedback to assist in deep breathing exercises
give quantitative goal for increasing inspiration |
|
|
Term
| how can O2 be delivered (2) |
|
Definition
|
|
Term
| types of masks include (3) |
|
Definition
aerosol
venturi/veni/VM
Face tent |
|
|
Term
| O2 mask which receives meds with O2 a few tiems a day |
|
Definition
|
|
Term
| O2 mask that is most common |
|
Definition
|
|
Term
| pt populations for a face tent (4) |
|
Definition
very sick pt's
negative pressure system
pediatric pts
mask won't stay on otherwise |
|
|
Term
|
Definition
| to maximize high concentration O2 |
|
|
Term
| what needs to be added when supplemental O2 is being used |
|
Definition
|
|
Term
| importance of humidifyig O2 masks |
|
Definition
| lack of moisture prevents body from absorbing O2 as well |
|
|
Term
| percentage of O2 to be considered high flow |
|
Definition
|
|
Term
|
Definition
|
|
Term
| use of high flow O2 is considered for what individuals |
|
Definition
| acute respiratory distress |
|
|
Term
| how is high flow O2 delivered |
|
Definition
| through intubation when other assist is anticipated or required |
|
|
Term
| What should TV be for use of Low flow O2 |
|
Definition
|
|
Term
| What should the RR be for use of low flow O2 |
|
Definition
|
|
Term
| Low flow rates are <= to what |
|
Definition
|
|
Term
| Low flow rate O2 if L/Min = 1 |
|
Definition
|
|
Term
| Low flow rate O2 if L/Min = 2 |
|
Definition
|
|
Term
| Low flow rate O2 if L/Min = 3 |
|
Definition
|
|
Term
| Low flow rate O2 if L/Min = 4 |
|
Definition
|
|
Term
| nasal cannula are used to deliver what volume of O2 |
|
Definition
|
|
Term
| ventrui/venti mask (VM) is used for what percnetage of O2 |
|
Definition
|
|
Term
| ventilators used for pt's with sleep apnea (2) |
|
Definition
|
|
Term
| ventilator used with chronic ventialroy dependent pt's |
|
Definition
|
|
Term
| a tracheostomy collar would be used to deliver what % of O2 |
|
Definition
|
|
Term
| when is a re-breather mask used |
|
Definition
|
|
Term
| purpose of the re-breather mask |
|
Definition
| pt exhales into a bag so that the new air and bag air is rebreathed and the pt is inhaling both O2 and CO2 to prevent a respiratory alkolytic state |
|
|
Term
| why are pt's with COPD a relative contraindicaiton for high flow O2 |
|
Definition
| pt is overinflated already, will overinflate more, will throw off gas distribution |
|
|
Term
| why would a pt who is alert and in need of ventilatory assistance tolerate SIMV best |
|
Definition
| allows them to breathe on their own while only getting support from the SIMV |
|
|
Term
| why is an occasional sign programmed into most control mode protocols |
|
Definition
| increases the thoracic mobility, gives a nice break to the gas diffusion rates, allow more CO2 out |
|
|
Term
| why would ventilatory support which increases O2 delivery pressures and PEEP be therapeutic for a pt with long standing COPD complicated by a respiratory infection and CHF |
|
Definition
| more fluid d/t infeciton/CHF so bad O2 exchange. there is time for CO2/O2 exchanges, reestablishes pressures from CO2 and O2 |
|
|
Term
| emphysema: inspection findings (3) |
|
Definition
increased anteroposterior diamter
use of accessory mm
thin individual |
|
|
Term
| emphysema: palpation/fremitus |
|
Definition
| decreased tactile fremitus |
|
|
Term
| emphysema: percussion findings (2) |
|
Definition
increased resonance
decreased excursion of diaphragm |
|
|
Term
| emphysema: auscultatoin findings (2) |
|
Definition
decreased lung sounds
decreased vocal fremitus |
|
|
Term
| chronic bronchitis: inspection findgins (2) |
|
Definition
possible cyanosis
short, stocky individual |
|
|
Term
| chronic bronchitis: palpation |
|
Definition
|
|
Term
| chronic bronchitis: percussion |
|
Definition
|
|
Term
| chronic bronchitis: auscultation |
|
Definition
|
|
Term
| pneumonia: inspection findings |
|
Definition
|
|
Term
| pulmonary embolism: inspection findings (2) |
|
Definition
sudden onset of dyspnea
chest pain |
|
|
Term
| pneumothorax: inspection findings |
|
Definition
|
|
Term
| pleural effusion: inspection findings |
|
Definition
| may be no outward clinical sign |
|
|
Term
| atelectasis: inspection findings |
|
Definition
| often no outward clinical signs |
|
|
Term
| penumonia palpation findigns (2) |
|
Definition
increased tactile fremitus
splinting on affected side |
|
|
Term
|
Definition
|
|
Term
| pneumonia auscultations (2) |
|
Definition
late crackles
bronchial breath sounds |
|
|
Term
| pulmonary embolism palpation |
|
Definition
|
|
Term
| pulmonary embolism percussion |
|
Definition
|
|
Term
| pulmonary embolism auscultation |
|
Definition
|
|
Term
|
Definition
|
|
Term
| pneumothorax: palpation (3) |
|
Definition
absent fremitus
trachea may be shifted to other side
may have decreased chest wall excursion on affected side |
|
|
Term
|
Definition
|
|
Term
| pneumothorax: auscultation |
|
Definition
|
|
Term
| pleural effusion: palpation (3) |
|
Definition
decreased fremitus
trachea shifted to other side
decreased chest wall excursion on affected side |
|
|
Term
| pleural effusion: percussion |
|
Definition
|
|
Term
| pleural effusion: auscultation |
|
Definition
|
|
Term
| atelectasis: palpation (3) |
|
Definition
decreased fremitus
trachea shifted to same side
decreased chest wall excursion on affected side |
|
|
Term
|
Definition
|
|
Term
| atelectasis: auscultation |
|
Definition
|
|
Term
| issues to be addressed in the SCI acute phase (3) |
|
Definition
wean off ventilator
improve/maintain respiratory status
improve inspiratory capacity |
|
|
Term
| Intervention during SCI acute phase: maintain |
|
Definition
| chest mobility and compliance as the pt may not be moving and breathing as deep as they used to |
|
|
Term
| Intervention during SCI acute phase: strengthen |
|
Definition
| accessory mm and diaphragm as much as possible |
|
|
Term
| Intervention during SCI acute phase: re-train |
|
Definition
diaphragm
anything above mid-thoracic level will affect the diaphragm |
|
|
Term
| 2 most common reasons for death in SCI pt's |
|
Definition
lung infections
wound infections |
|
|
Term
| Intervention during SCI acute phase: 4 other options |
|
Definition
corset/pneumobelt if needed
postural drainage with percussion and vibration
assisted coughing
education |
|
|
Term
| SCI Subacute/Outptphase: issues to be addressed (3) |
|
Definition
continue to strengthen accessory mm and diaphragm
improve ventilatory capacity as much as possible
posture and balance control |
|
|
Term
| SCI Subacute/Outptphase interventions: exercises for what (2) |
|
Definition
|
|
Term
| SCI Subacute/Outptphase interventions: strengthen |
|
Definition
accessory mm
trunk/core mm |
|
|
Term
| SCI Subacute/Outptphase interventions: how to strengthen the accessory mm (3) |
|
Definition
P flex
resistive breathing
scoop technique |
|
|
Term
| SCI Subacute/Outptphase interventions: 2 other interventions |
|
Definition
assisted coughing if still needed
pt and family education |
|
|
Term
| How does lung cancer lead to pulmonary edema/pleural effusion |
|
Definition
| as WBC count goes up, other inflammatory agents show up causing inflammation which results in pulmonary edema/effusion |
|
|
Term
| leading cause of death from cancer for men and women |
|
Definition
|
|
Term
| lung cancer will cause these 3 impairemtns |
|
Definition
ventilation
compliance
other inflammation (pulmonary edema/effusion) |
|
|
Term
| Lung cancer interventions (3) |
|
Definition
remove mass/tumor if there is one
surgery or meds to attempt to maintain V/Q
fucking quit smoking |
|
|
Term
| leading cause of lung cancer |
|
Definition
|
|
Term
| how do all cancers impact the cardiopulmonary system |
|
Definition
| increased demand on heart and lungs due to body fighting the disease |
|
|
Term
| how do some cancers affect the circulatory system |
|
Definition
| some cancers affect RBC, plateletes, iron |
|
|
Term
| which cancers will affect the body's metabolic systems (4) |
|
Definition
renal
liver
intestinal
stomach |
|
|
Term
| cancers that affect the body's metabolic system will have what affect on the pulmonary system |
|
Definition
| changes to metabolic system will result in body pH changes which will affect the respiraotry system |
|
|
Term
| what becomes paramount as the cancer becomes terminal? |
|
Definition
| positoning (body can't fight cancer and infection at the same time) |
|
|
Term
| cancer's physical effects from a endurance standpoint |
|
Definition
pt will fatigue quicker
recovery takes longer |
|
|
Term
| circulatory or blood volume changes as a result of cancer to be watched for (2) |
|
Definition
|
|
Term
| cardiac comlications d/t trauma (6) |
|
Definition
cardiac arrest
cardiac ischemia or infarct
cardiac tamponade
pericardial effusion
arrhythmias
cardiac contusion |
|
|
Term
| Pulmonary complications d/t trauma (5) |
|
Definition
pneumothorax (atelectasis if less severe trauma)
pleural effusion
rib fractures/bruised ribs
lung contusion
pulmonary edema (not as common as inflammation is usually surrounding the lung) |
|
|
Term
| Interventions with trauma/multiple trauma |
|
Definition
| keep in mind positioning, breathing, and activity tolerance regardless of what is being tx (integ, ortho, neuro) |
|
|
Term
| post trauma cardiopulmonary complications (4) |
|
Definition
PE
pneumothorax
destabilizing arrhythimas
atelectasis |
|
|
Term
| Mgmt of the geriatric age: pt's ______ vs age |
|
Definition
|
|
Term
| type of exercise that may be more suited to the geriatric population as a whole |
|
Definition
| short bursts of exercise but more frequently throughout the day |
|
|
Term
| pulmonary congenital anomalies (3) |
|
Definition
tracheal atresia
bronchoplumonary atreasia
chest/abdominal wall abnormalities |
|
|
Term
| pulmonary congenital anomalies: what is tracheal atresia |
|
Definition
narrowing or a smaller formation of a structure.
Cartilage isn't formed all the way so the trachea is very soft. Baby will be intubated but trachea may form around the tube and attach to the tube. Once pt becomes stable, the tube becomes smaller and smaller so the trachea doesn't form around the tube |
|
|
Term
| pulmonary congenital anomalies: what is bronchopulmonary atresia |
|
Definition
| seen in premature newborns. need ventilator right away. may or may not be dependent on ventilator for the rest of their life. Lungs didn't have enough tie to develop prior to birth since they are premature |
|
|
Term
| pulmonary congenital anomalies: chest or abdominal wall abnormality examples (3) |
|
Definition
hemidiaphragm abnormality
congenital absence of diaphragm
mild malformations during development |
|
|
Term
| childhood acquired disorders: (4) |
|
Definition
infant RDS
bronchopulmonary dypslasia
asthma
CF |
|
|
Term
| infant RDS is seen in which population and why? |
|
Definition
| premature babies because they lack surfactant |
|
|
Term
| what is bronchopulmonary dysplasia (BPD) |
|
Definition
fibrotic changes, decreased airway clearance
child may develop RSV (respiratory syncytial virus). can be fatal. chronic respiratory problems |
|
|
