Term
|
Definition
Inflammation of the bronchi
Typically follows a URI |
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Term
| Acute bronchitis is a/an _____ response |
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Definition
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Term
| Acute bronchitis causes increased mucous production which stimulates what |
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Definition
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Term
| With acute bronchitis, the two stages of cough are |
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Definition
| First is non-productive which leads to uncontrollable bursts |
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Term
| Manifestations of acute bronchits |
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Definition
| Chest pain, fever, malaise |
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Term
| What diagnostic test do we use for acute bronchitis and why |
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Definition
| X-ray to look for swelling and inflammation |
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Term
| Treatment for acute bronchitis |
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Definition
| Adequate rest, increased fluid intake, mild analgesics, antibiotics, expectorant cough medications for day, cough suppressant for night |
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Term
| What is the primary nursing care for acute bronchitis |
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Definition
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Term
|
Definition
| Inflammation of respiratory bronchioles and alveoli |
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Term
| Two classifications of pneumonia |
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Definition
1) Infectious - bacteria, viruses, fungi, protozoa, or other microbes
2) Non-infectious - aspiration |
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Term
| Define the pathophysiology of acute bacterial pneumonia |
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Definition
1) bacteria invades the lungs
2) Alveoli-edematous fluid filled
3) blood cells and bacteria collect in the alveoli
4) leads to solidification of lung tissue
5) microphanges remove fluid, bacteria, and damaged cells (mucous) |
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Term
| Manifestions of acute bacterial pneumonia |
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Definition
| Fever, chills, cough, sharp stabbing chest pain, dyspnea, diminished breath sounds, crackles |
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Term
| Complications of acute bacterial pneumonia |
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Definition
| Pleurisy (painful inflammation of adjacent pleura), lung damage, empyema (pus in pleural cavity) |
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Term
| Discuss pneumocystis jiroveci pneumonia |
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Definition
1) opportunistic-AIDS
2) parasitic pneumonia
3) Alveoli thicken and become filled with fluid
4) Gas exchange is severely impaired |
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Term
| Discuss atypical pneumonia |
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Definition
1) also called walking pneumonia
2) caused by mycoplasma pneumoniae
3) typically mild |
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Term
| Manifestations and complication of atypical pneumonia |
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Definition
1) Fever, headache, muscle ache, malaise, dry hacky non-productive cough
@) complication is death |
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Term
| Define aspiration pneumonia |
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Definition
| A chemical or bacterial pneumonia caused from gastric contents/foreign object entering lungs |
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Term
| List diagnostic tests for pneumonia |
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Definition
1) Sputum culture and sensitivity
2) CBC with WBC differential
3) ABG
4) pulse oximetry
5) Chest Xray
6) bronchoscopy |
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Term
| Nursing care for post-bronchoscopy |
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Definition
1) Monitor VS, respirations, and status
2) NPO until gag reflex returns
3) May have blood tinged sputum for several hours
4) sore throat/hoarseness
5) wheezing stridor is not normal |
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Term
| Two types of pneumonia vaccines |
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Definition
1) Pneummococcal vaccine
2) Influenza vaccine |
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Term
| List types of medications used to treat pneumonia |
|
Definition
1) Antibiotics (fights bacteria)
2) Bronchodilators (nebulizers)
3) Mucolytics (breaks it up)
4) Cough syrup (expectorant) |
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Term
| Oxygen therapy for pneumonia |
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Definition
1) nasal cannula - up to 6L
2) simple face mask - 5-8L
3) Partial non-rebreather 6-10L
4) Non-rebreather 10-15L
5) Venturi - precise regulation |
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Term
| Other therapies for pneumonia |
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Definition
1) Increase fluid intake 2500-3000ml
2) chest physiotherapy (percussion, vibration, and postural drainage) |
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Term
| Nursing Care for pneumonia |
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Definition
1) assess/monitor respiratory status
2) maintain O2
3) fowler's position
4) Cough, deep breathe, incentive spirometry
5) Adequate fluids/rest |
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Term
|
Definition
| Procedure to remove fluid from the pleura space using needle aspiration |
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Term
|
Definition
| Chronic recurrent infectious disease primarily affecting the lungs |
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Term
|
Definition
| Slow going, slender, rod-shaped acid fast bacilli |
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Term
|
Definition
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Term
| What are the 2 forms of TB? |
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Definition
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Term
| Explain the pathophysiology of TB |
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Definition
| WBC go to site and isolate and seal off the bacilli because they are unable to destroy it. Scar tissue forms around tubercle |
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Term
|
Definition
| A sealed off colony of bacilli |
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Term
|
Definition
1) Fatigue
2) Weight loss/anorexia
3) Afternoon fever/night sweats
4) Dry cough/productive cough |
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Term
| Define extra-pulmonary TB |
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Definition
| The development of TB in other organs |
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Term
| Interdisciplinary care for TB focuses on |
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Definition
1) early detection
2) accurate dx
3) effective tx
4) preventing spread |
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Term
|
Definition
1) Referred to as PPD
2) Also known as the Mantoux skin test
3) Once a person tests positive they will always test positive but it doesn't mean that the TB is active |
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Term
|
Definition
1) Sputum for acid-fast bacilli (AFB)
2) Chest Xray
3) bronchoscopy |
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Term
|
Definition
1) Olsoniazid (INH)
2) Rifampin |
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Term
| List the nursing care steps to lower the risk of infection in TB pts |
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Definition
1) private room, negative airflow
2) Standard precautions
3) Mask client when transporting
4) Special UV lights, special cleaning |
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Term
| Nursing care education for TB pts |
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Definition
1) Disease process
2) Prevention of spread
3) Adequate nutrition/rest/fluid intake
4) Meds every single day
5) Avoid alcohol, Tylenol |
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Term
| Three different types of chest physiotherapy; what assessment is important prior to doing any of these procedures? |
|
Definition
1) Percussion
2) Vibration
3) Postural drainage
Auscultate to find where it is in the lungs...increase fluids |
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Term
| A common nursing dx for pts with respiratory dysfunction is activity intolerance. Identify goals and interventions for these clients |
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Definition
1) dyspnea or cyanosis with activty - may indicate limited activity tolerance
2) assist with self-care activities - reduces pt's energy demands
3) schedule activities b/w rest periods - minimizes fatigue and improves activity intolerance
4) provide assistive devices - helps reduce the energy required to move and change positions
5) enlist support people to help minimize stress and anxiety - stress and anxiety increases metabolic demands and can decrease activity intolerance
6) provide emotional support and reassurance that strength and activity will return to normal when pneumonia has resolved - pt may be concerned that this will continue |
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Term
| Classifications of common medications used in respiratory conditions |
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Definition
1) Antibiotics - get rid of causative organisms
2) Bronchodilators - relieves bronchoconstriction and airflow obstruction |
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Term
|
Definition
| Pus in the pleural cavity |
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Term
| What does a positive PPD/Mantoux test mean? |
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Definition
| Indicates the pt has developed an immune response to the bacillus, it does NOT mean the pt has active TB or is currently infectious |
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Term
| When does a TB test have to be read |
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Definition
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Term
| Medications used in the treatment of TB. Be aware of both active TB tx and preventative tx. |
|
Definition
1) antituberculosis drugs - prevents and treats
2) active TB is treated with at least 2 antibacterial meds; 4 antitubercular drugs may be used for the first 2 months.
Meds may cause undesired effects; most are toxic to the liver; compliance with the regimen is sometimes problematic |
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Term
| Common medications used for asthma |
|
Definition
Long term -
anti-inflammatory agents
long-acting bronchodilators
leukotriene modifiers
Quick relief -
rapid-acting bronchodilators
anticholinergic drugs
methylxanthines |
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Term
| What are the primary symptoms of asthma |
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Definition
| wheezing, breathlessness, chest tightness, coughing, tachypnea/cardia, anxiety |
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Term
| Why does the asthma pt experience wheezing? |
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Definition
| They are trying to push air out of very narrow airways |
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Term
| Signs and symptoms of COPD |
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Definition
| Chronic cough, fatigue, distended jugular vein, club fingers |
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Term
| Medications used for COPD |
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Definition
| Antibiotics, bronchodilators, corticosteroids, immunizations (flu and pneumonia) |
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Term
| Nursing care considerations or nursing diagnosis important for the COPD pt |
|
Definition
1) Maintain a clear airway
2) Advise of smoking cessation
3) Encourage nutrition
4) Psychosocial issues due to decreased quality of life as the disease progresses |
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Term
|
Definition
| inhale through nose with mouth closed, exhale slowly through pursed lips twice as long as inhalation |
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Term
| What is Diaphragmatic/abdominal breathing |
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Definition
| place one hand on abdomen and the other on the chest, inhale (concentrating on pushing the abdominal hand outward while the chest remains still) |
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Term
| Controlled cough technique |
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Definition
| After using a bronchodilator inhale deeply and hold breath briefly, cough twice (first to loosen the mucous, then to expel secretions) inhale by sniffing to prevent mucous from moving back into deep airways...rest |
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Term
|
Definition
| Inhale deeply while leaning forward, exhale sharply with a "huff" sound...helps keep the airways open while mobilizing secretions |
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Term
| Why might a COPD pt be on low O2 concentration |
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Definition
| The drive to breathe may be inhibited, leading to respiratory arrest |
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Term
| What blood gas results might you see in a COPD pt |
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Definition
| Low PO2 (hypoxia), high PCO2 (hypercapnia) and low PH (respiratory acidosis) |
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Term
| What are the early indicators of hypoxemia |
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Definition
| Airflow is reduced and the work of breathing increases; low O2 output |
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Term
| What drugs are avoided in pts with lower respiratory disorders? |
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Definition
| Meds that interfere with normal respiratory defenses - beta blockers, sedatives |
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Term
| What are some of the S/S of all respiratory disorders |
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Definition
| Cough, excess mucus, dyspnea, hemoptysis (coughing up of blood), chest pain, fever, anorexia, cyanosis, edema, clubbing |
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Term
| Importance of vaccinations in the elderly |
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Definition
| Due to compromised immune function, people over age 65 should be immunized (flu and pneumonia) |
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Term
|
Definition
| A total or partial collapse of the lung and airlessness |
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Term
| What care is provided post-operatively to prevent atelectasis? |
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Definition
| Frequent respiratory assessment is important; position pt on the unaffected side with involved side up to promote drainage. Move pt frequently, encourage coughing and deep breathing, encourage fluids to thin secretions |
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Term
| Discuss the diagnostic test "Chest X-ray" for pts with respiratory conditions |
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Definition
Purpose: detect masses, abscesses, and lung disorders
Information obtained: identify size and location of structures
Nursing care: Make sure pt is not pregnant |
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Term
| Discuss the diagnostic test "Chest CT" for pts with respiratory conditions |
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Definition
Purpose: Provides more detailed images than xrays
Diagnostic info obtained: identify size and location of structures
Nursing care: Ask about allergies to iodine and seafood; make sure pt is well hydrated |
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Term
| Discuss the diagnostic test "Bronchoscopy" for pts with respiratory conditions |
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Definition
Purpose: to identify tumors or other structures
Nursing care: Remove dentures, mouth care, closely monitor vitals and respiratory status, NPO until gag reflex returns |
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Term
| Discuss the diagnostic test "Sputum Cytology" for pts with respiratory conditions |
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Definition
Purpose: To detect presence of abnormal (cancer) cells
Diagnostic info obtained: Sputum culture analyzed by gram stain or acid-fast bacillus
Nursing care: collect in the early morning, use sterile technique |
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Term
| Discuss the diagnostic test "ABG" for pts with respiratory conditions |
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Definition
Purpose: to assess acid-base balance
Diagnostic info obtained: PH, PaCO2, PaO2, HCO3
Nursing care: Apply pressure to the site at least 5 minutes after arterial puncture, promptly report results when results are abnormal |
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Term
|
Definition
PH 7.35-7.45
HCO3 22-26
CO2 35-45 |
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Term
| How does the nurse assist with a thoracentesis |
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Definition
| Support and assist pt to remain still and remain in position during the procedure; provide psychologic support; monitor respirations, pulse and color |
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Term
| What education will you provide the pt receiving a thoracentesis? |
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Definition
| Symptoms of recurrent effusion - increasing dyspnea, SOB, cough, hemoptysis or pleuritic pain should be reported to the doctor |
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|
Term
| Medical and nursing follow-up care post thoracentesis |
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Definition
| Apply dressing to puncture site; position pt on UNAFFECTED side for one hour; record vitals, breath sounds, cough, and assess for bleeding or crepitus every 15 minutesx4, every 30 minx2 and then every 2-4 hours as indicated |
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Term
| Manifestations of acute rhinitis |
|
Definition
| red, swollen mucosa; clear, water secretions; coryza; sneezing; coughing; low grade fever; headache; muscle aches; malaise |
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|
Term
| Diagnostic tests for acute and chronic rhinitis |
|
Definition
| Pharyngeal and nasal cultures; CBC to check WBC; Chest xray; CT scan |
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Term
| Medications for acute and chronic rhinitis |
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Definition
| Decongestants and antihistamines |
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Term
| Nursing care/teaching for acute and chronic rhinitis |
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Definition
| Monitor respiratory; semi-fowlers to fowlers position |
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Term
| Manifestations of chronic rhinitis |
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Definition
| Pale, swollen mucosa; thin watery nasal discharge; itchy, water eyes; sneezing; headache |
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|
Term
| Pathophysiology of obstructive sleep apnea |
|
Definition
| Temporary absence of breathing during sleep |
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|
Term
| Common causes of obstructive sleep apnea |
|
Definition
1) Obstruction - the pharynx collapses and tongue covers the pharyngeal opening
2) Obesity
3) Large neck
4) Alcohol/sedatives |
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|
Term
| Common symptoms of obstructive sleep apnea |
|
Definition
1) loud snoring
2) frequent night waking
3) daytime sleepiness
4) headache
5) irritability
6) difficulty concentrating
7) memory loss
8) personality changes
9) hypertension
10) cardiac dysrhythmias |
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|
Term
| Treatment of obstructive sleep apnea |
|
Definition
1) weight reduction
2) CPAP/BiPAP
3) surgery
4) avoid alcohol/sedatives |
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Term
|
Definition
| Removal of one-half or more of the larynx; client is able to resume normal speaking, breathing, and swallowing; a trachea is temporarily used |
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Term
|
Definition
| Removal of the entire larynx and the surrounding tissues; speech is lost; you have a permanent trachea |
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|
Term
| How long is a tracheostomy used when a laryngectomy is performed |
|
Definition
Partial laryngectomy - usually removed w/in a week
Total laryngectomy - permanent |
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|
Term
| Speech restoration following a laryngectomy |
|
Definition
1) speech pathology
2) tracheoesophageal puncture - surgical procedure to restore speech
3) speech generator - vibrator held against the nect
4) esophageal speech - use swallowed air and controlled belching to create and form words |
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|
Term
| Nursing care/interventions regarding tracheostomies |
|
Definition
1) No suctioning
2) Cleaning - pt in semi-fowlers or fowlers position; sterile technique; clean incision w/ gauze; remove and soak inner canula in sterile saline; cleanse the collar; clean inner canula with brush, shake off excess liquid; replace canula into trach tube; replace dressings; apply clean ties/holder
3) Emergency prevention/intervention - HOLD OPEN and call for help!! |
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Term
| Most common cause of lung cancer |
|
Definition
|
|
Term
| Common symptoms of lung cancer |
|
Definition
1) hoarseness, wheezing, dyspnea
2) coughing, hemoptysis, chest pain
3) anorexia, weight loss |
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|
Term
| Exams to diagnose lung cancer |
|
Definition
1) chest xray
2) suptum cytology (sputum culture - 1st thing in morning)
3) CT scan
4) bronchoscopy w/ biopsy
5) thoracentesis with biopsy |
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|
Term
|
Definition
|
|
Term
| What interventions may be done to cure or slow progression of lung cancer? |
|
Definition
Chemo
Bronchodilators
Analgesics
Antibiotics
Radiation
Thoracentesis
Bronchoscopy (laser resection)
Thoracotomy |
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|
Term
| Nursing interventions for pts post-operative pneumonectomy (general lung surgery care) |
|
Definition
Assess respiratory status
Assist with coughing
Postural drainage
Incentive spirometry
Maintain chest tube drainage
Suction as needed while intubated
Assist to move in bed
Encourage and help with early ambulation |
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Term
|
Definition
| Accumulation of air in the pleural space |
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Term
|
Definition
| Accumulation of blood in the pleural space |
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|
Term
| Common manifestations of pneumo/hemothorax |
|
Definition
| Abrupt onset, pleuritic chest pain, dyspnea, tachypnea, tachycardia, unequal chest movement, decreased breath sounds (on affected side), air movement through open wound, hypotension, shock, trachea deviates toward the unaffected side |
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|
Term
| Discuss necessary emergency interventions for pneumo/hemothorax |
|
Definition
1) thoracentesis to remove air/blood
2) chest tube - prevents air from entering the chest during inspiration and allows air to escape during expiration |
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|
Term
| Assessment for chest tube management |
|
Definition
| Assess system at least every 2 hours |
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|
Term
| Discuss equipment position for chest tube management |
|
Definition
1) secure tube to chest wall
2) prevent kinking of tubing
3) keep drainage system below the level of the chest
4) Keep system closed |
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|
Term
| Emergency care of the chest tube |
|
Definition
| Cover site with occlusive dressing and tape on 3 sides to skin |
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|
Term
| Definition and pathophysiology of pulmonary embolism (PE) |
|
Definition
| Pulmonary artery blockage, disrupts blood flow, impairs gas exchange |
|
|
Term
| Manifestations of pulmonary embolism (PE) - small emboli |
|
Definition
| Asymptomatic, dizziness, syncope, cough, hemoptysis, mild SpO2 decrease, mild PO2 decrease via ABG |
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|
Term
| Manifestations of pulmonary embolism (PE) - large emboli |
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Definition
| Abrupt onset, anxiety, restlessness, dyspnea, chest pain, tachycardia, tachypnea, cyanosis, sever PO2 decrease via ABG |
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|
Term
| Prevention of pulmonary emboli (PE) |
|
Definition
Pneumatic compression devices
elastic stockings (TED hose)
anticoagulant therapy
early ambulation
ROM exercises
avoid crossing legs or behind knee constriction
leg elevation |
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|
Term
| Treatment of pulmonary embolism (PE) |
|
Definition
Medications - fibrinolytic therapy, anticoagulants
Surgery - vena cava filter |
|
|
Term
| Define adult respiratory distress syndrome (ARDS) |
|
Definition
| Pulmonary edema (unrelated to heart failure) or injury to the lung |
|
|
Term
| Manifestations of adult respiratory distress syndrome (ARDS) |
|
Definition
| Dyspnea, tachypnea, clear lung sounds that progress to crackles, refractory hypoxemia, agitation, confusion, lethargy |
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|
Term
| Medical interventions for adult respiratory distress syndrome (ARDS) |
|
Definition
| Bronchodilators, antibiotics, steroids |
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|
Term
| Nursing interventions for adult respiratory distress syndrome (ARDS) |
|
Definition
Maintain airway
Frequent full-body assessments
prevent complications
facilitate weaning process
emotional support |
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|
Term
| How does a nasal decongestant for rhinitis reduce nasal congestion |
|
Definition
|
|
Term
| What patient should not take nasal decongestants |
|
Definition
| Cardiac patients because it can cause tachycardia and restlessness |
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|
Term
| Following a bronchoscopy, the nurse should assess for what? |
|
Definition
|
|
Term
| Why would a chest tube need to be inserted in a pt |
|
Definition
| to reinflate the lung following a pneumo/hemothorax |
|
|
Term
| How do you know if a chest tube is working |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Nursing care for acute epistaxis |
|
Definition
| Have pt lean head forward, hold nose, put packing in nose |
|
|
Term
| What is a serious complication of rib fractures |
|
Definition
|
|
Term
| Why can it be difficult to find lung cancer |
|
Definition
|
|
Term
| What could you say to the pt who doesn't want to leave their CPAP machine on |
|
Definition
Emotional support - "can you try to leave it on for an hour longer?"
Encourage them that they will become more comfortable |
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