Term
| this class is used for emergencies such as acute asthmatic bronchospasm or anapylaxis- causing bronchodilation through epinephrine action. |
|
Definition
|
|
Term
| ______ is a short acting BETA 2 SELECTIVE AGONIST used for severe asthma |
|
Definition
|
|
Term
| Aminophylline and Theodur are examples of this class |
|
Definition
|
|
Term
| side effects of this class of asthma med include Hand tremors, anxiety, insomnia, nervousness, tachycardia ,hypotension, nausea, vomit , & diarrhea. & Pt can't smoke |
|
Definition
|
|
Term
* Act in the CNS
* Decrease airway reactivity
* Smooth muscle relaxant
* Relax pulmonary blood vessels |
|
Definition
|
|
Term
| 5 corticosteroids used to treat asthma |
|
Definition
PREDNISONE
AZMACORT
VANCERIL
DECADRON
SOLUMEDROL |
|
|
Term
| prophylactic asthma medication class which includes Singulair |
|
Definition
|
|
Term
| Mast cell stabilizers such as ___ works by inhibiting the release of histamines (prophylaxis only) |
|
Definition
|
|
Term
| name 3 COMBO asthma drugs: BETA 2 AGONIST + CORTICOIDS |
|
Definition
|
|
Term
BRONCHODILATORS(B2 AGONISTS)
SYSTEMIC THEOPHILLINES
CORTICOSTEROIDS
EXPECTORANTS
MILD SEDATIVES |
|
Definition
|
|
Term
|
Definition
Asthma
Emphysema
Chronic Bronchitis |
|
|
Term
| reversible, obstructive lung condition |
|
Definition
|
|
Term
| 3 pathphysiologic changes in asthma |
|
Definition
1. trigger- bronchospasm
2. inflammation of airway lining
3. great mucus production further obstructs airway |
|
|
Term
| type of asthma- reacts to allergens, usual type for those under age 35 |
|
Definition
|
|
Term
| type of asthma more common in adults with triggers such as smoking, infections, cold air, stress |
|
Definition
|
|
Term
| wht does bobbing the head with each breath indicate |
|
Definition
| increased respiratory effort- asthma attack |
|
|
Term
|
Definition
| decrease the number of attacks to minimize the long-term side effects |
|
|
Term
| 5 things the PFT measures |
|
Definition
TIDAL VOLUME
RESIDUAL VOLUME
VITAL CAPACITY
FORCED EXPIRATORY VOLUME (FEV 1)
PEAK EXPIRATORY FLOW RATE |
|
|
Term
| expected PFT results in asthma |
|
Definition
|
|
Term
| THERAPEUTIC RANGE FOR XANTHINES, USUAL IV DOSAGE |
|
Definition
|
|
Term
| CLASS OF MED THAT IS IN AN EPI-PEN |
|
Definition
|
|
Term
| TYPES OF ASTHMA MEDS FOR ACUTE ATTACK |
|
Definition
BETA 2 agonist
SYMPATHOMIMETICS |
|
|
Term
| 3 TYPES OF ASTHMA MEDS FOR PRPHYLAXIS |
|
Definition
CORTICOSTEROIDS
LEUKOTRINE MODIFIERS
MAST CELL STABILIZERS
(COMBOS ALSO NOT FOR ACUTE ATTACK) |
|
|
Term
| NAME 1 LEUKOTRINE MODIFIER AND 2 MAST CELL STABILIZERS |
|
Definition
|
|
Term
| COMMONLY USED BETA 2 SELECTIVE AGONIST |
|
Definition
|
|
Term
| ADVANTAGE OF BETA 2SELECTIVE AGONIST OVER SYPATHOMIMETICS |
|
Definition
| BETA 2 HAS LITTLE EFFECT ON BP (SYMPATHS RAISE BP SIGNIFICANTLY) |
|
|
Term
| process that maintains oxygen level necessary for survival of cells |
|
Definition
|
|
Term
| 3 primary functions of respiratory system |
|
Definition
ventilate lung alveoli
exchange gases in/out of blood
perfuse the lungs |
|
|
Term
| function of nasopharynx and oropharynx |
|
Definition
humidify air
warm air
filter air |
|
|
Term
|
Definition
* keeps airway open
* prevents food from entering trachea
* voice production |
|
|
Term
| structures of the respiratory passages: conducting airways |
|
Definition
| oropharynx , nasopharynx, larynx, trachea, pulmonary bronchi, bronchioles |
|
|
Term
| chemical that acts to reduce the surface tension of solvents such as water by decreasing the attraction among solvent molecules |
|
Definition
|
|
Term
|
Definition
| internal intercoastals and abdominals |
|
|
Term
|
Definition
| External intercostals and Diaphragm |
|
|
Term
| condition where the pleural lining is inflamed causing sharp pain on cough or deep breath |
|
Definition
|
|
Term
| movement of air to/from atmosphere into/out of lungs |
|
Definition
|
|
Term
| where is the respiratory center in the brain |
|
Definition
| mainly medulla (some pons) |
|
|
Term
| respiratory pathway (4 points) |
|
Definition
| medulla to phrenic nerve to diagram to intercostals |
|
|
Term
| neurologic ctrl of respirations- what do central chemo receptors sense? |
|
Definition
| pH of spinal fluid (how much C02) |
|
|
Term
| what do peripheral chemoreceptors sense (Neuro-respiration) |
|
Definition
|
|
Term
| if central chemo receptors sense high pH what will happen to respirations |
|
Definition
| respirations will decrease |
|
|
Term
| what muscles should COPD patients be encouraged to exercise to help with expirations |
|
Definition
|
|
Term
| tendency of the elastin fibers to return to their original position away from the chest wall after being stretched. |
|
Definition
|
|
Term
| the lung ability to stretch, and measure of force required to inflate lung |
|
Definition
|
|
Term
| when the lung has __ compliance muscles are stiff and it takes more effort to bring air IN to lung |
|
Definition
|
|
Term
| ___ compliance lungs are overstretched and there is inadequate elasticity |
|
Definition
|
|
Term
| inflate a balloon and then let the air out. the balloon returns to its original shape- what lung property is this like? |
|
Definition
|
|
Term
| compliance and elasticity have this type of relationship |
|
Definition
|
|
Term
| ____ is the ability to stretch and __ is the ability to snap back into shape |
|
Definition
|
|
Term
| air-trapping occurs in ____ airway disease (restrictive or obstructive) causing higher than normal lung volumes |
|
Definition
|
|
Term
| what do mast cells bring to and release at the cite of an allergic reaction |
|
Definition
|
|
Term
| FEV1/FEV should be > _____ |
|
Definition
|
|
Term
|
Definition
| forced expiratory volume in 1 second |
|
|
Term
| when lung beta 2 receptors are stimulated what effect does it have on bronchi |
|
Definition
|
|
Term
| pink frothy sputum indicates _____ |
|
Definition
|
|
Term
| what is the genus of bacteria that causes TB called |
|
Definition
|
|
Term
| A person has been on 60% oxygen for the past few days and is complaining of mild chest pain and is restless- what's happening |
|
Definition
|
|
Term
| a simple face mask is a low-flow device that delivers __-__% O2 in __-__L |
|
Definition
|
|
Term
| a nasal cannula is a low-flow device that delivers __-__% O2 in __-__L |
|
Definition
|
|
Term
| a venturi mask is a high-flow device that delivers __-__% O2 in __-__L |
|
Definition
|
|
Term
| what differentiates latent from active TB infection |
|
Definition
| in active the bacteria are multiplying and immune system can't keep up |
|
|
Term
| a non-rebreather mask is a high-flow device that delivers __-__% O2 in __-__L |
|
Definition
|
|
Term
| 2 things a patient should not do before a PFT |
|
Definition
bronchodilators (4-6 hrs prior)
smoking (6-8 hrs prior) |
|
|
Term
| when can a pt eat/drink after a bronchoscopy? |
|
Definition
| when gag reflex returns (usually around 2 hours) |
|
|
Term
| what should the nurse do if post-bronchoscopy patient's sputum is blood tinged? |
|
Definition
| nothing- that is expected. |
|
|
Term
|
Definition
| pre-bronchoscopy throat spray |
|
|
Term
| what is the function of cuff on trach |
|
Definition
| provides seal between upper and lower airway |
|
|
Term
| what is the non-cuffed trach used for (2 uses) |
|
Definition
| maintenence or transition to d/c trach |
|
|
Term
|
Definition
outer cannula
inner cannula
obdurator |
|
|
Term
| ideal placement of tracheostomy |
|
Definition
| 3-4 cartilage ring of trachea |
|
|
Term
| pt position during tracheotomy procedure |
|
Definition
| laying flat with neck hyperextended |
|
|
Term
| tracheotomy procedure, obdurator function |
|
Definition
| protects tracheal lining by blocking the distal opening of the cannula with a smooth surface that facilitates the inserting of the tracheostomy |
|
|
Term
| what type of trach allows the pt to speak |
|
Definition
|
|
Term
| 2 immediate actions after tracheotomy procedure |
|
Definition
* xray to confirm proper placement
* assess for pneumothorax |
|
|
Term
| most common complictation of tracheostomy |
|
Definition
| obstruction (secretions, prolapse) |
|
|
Term
| when is trach dislodgement an emergeny |
|
Definition
| within 72 hours after insertion- the stoma may close |
|
|
Term
| what should be kept at bedside in case of accidental decannulation of trachea |
|
Definition
| with 72 hours is emergency, keep tracheostomy obturator and spare at bedside, hyperextend the neck. obturator inserted into tube, replace the tube and remove the obturator |
|
|
Term
| what should you do if there is an accidental decannulation |
|
Definition
| put on a glove and open the hole use ambo bag to give O2 through stoma |
|
|
Term
| how much bleeding after tracheotomy would warrant a call to Dr? |
|
Definition
| 100cc per hour or greater, also intermitent bleeding not reducing |
|
|
Term
| what is a major complication of over-inflation of trach cuff |
|
Definition
| may reduce blood flow to tissues>necrosis> fistula |
|
|
Term
| necrosis caused hole from one cavity to another |
|
Definition
|
|
Term
| fistula may develop from ___ to ___ from trach |
|
Definition
|
|
Term
| maximum amount of pressure a trach cuff should be inflated to |
|
Definition
|
|
Term
| how often should trach cuff pressure be checked |
|
Definition
|
|
Term
| how is trach fistula dxed |
|
Definition
| feed pt blue dye- if it appears in suctioned secretions- +result |
|
|
Term
| what nerve might you hit while suctioning trach and what happens |
|
Definition
| vagus, bp drops rapidly (~80/40) |
|
|
Term
| what is a swallowing technique to teach trach patients when eating |
|
Definition
|
|
Term
| cuff hypo/hyper-inflation issues |
|
Definition
| underinflated cuff increases patient’s risk for aspiration. over- inflation may cause ischemia or necrosis of tracheal tissue. |
|
|
Term
| What should wall suction be set at prior to suctioning a trach? |
|
Definition
|
|
Term
| true or false: Use the lowest level of oxygen necessary to maintain an adequate SaO2 |
|
Definition
| TRUE (prevents oxygen toxicity) |
|
|
Term
|
Definition
| constant pressure which forces air into the lungs when you inhale with a set pressure. this pressure helps the lungs expand and keeps the airways open |
|
|
Term
| Examples of Noninvasic Positive Pressure Ventilation (NIPPV) |
|
Definition
|
|
Term
| The use of various positions to allow secretions to drain by gravity |
|
Definition
|
|
Term
a set of techniques that include percussion, vibration, postural drainage with
gravity, and positioning to loosen respiratory secretions and move them into the central
airways where they can be removed by coughing or suctioning |
|
Definition
|
|
Term
| how often oral care with trach |
|
Definition
|
|
Term
| action important when changing trach ties to prevent dislodgement |
|
Definition
Secure the new ties before
removing the soiled ones to prevent accidental decannulation |
|
|
Term
| T or F: optimal trach tie- square knot on side of neck with room to fit 1-2 fingers, between tie and neck |
|
Definition
|
|
Term
| a chest wound that penetrates that pleura or lung, allowing air to be "sucked" into the pleural space upon each inspiration |
|
Definition
| sucking chest wound (results in pneumothorax) |
|
|
Term
|
Definition
| drain blood, fluid, or air from around your lungs. This allows your lungs to fully expand. |
|
|
Term
| T or F: Singulair (montelukast) should be taken every day even if asymptomatic |
|
Definition
| True- this is an asthma prophylactic/maintenance drug |
|
|
Term
| COPD pts should have high ___ and high ___ diets |
|
Definition
|
|
Term
1. pneumonia with 5-30% death rate
2. pneumonia with 50% death rate |
|
Definition
1. legionaires
2. klebsiella |
|
|
Term
| where is the legionella bacteria usually found |
|
Definition
| large water supply systems and AC systems (like in hotels) |
|
|
Term
| how is legionaires contracted |
|
Definition
| breathing in mist/vapor containing legionella bacteria |
|
|
Term
| PCP is caused by a __ called carini-jiroecci and mainly affects ___ patients |
|
Definition
|
|
Term
| Walking pneumonia is caused by _____ |
|
Definition
|
|
Term
| wbcs migrate into alveoli bringing exudation of fluid into alveoli, septum and interstitium |
|
Definition
|
|
Term
| patches of white consolidation on chest x-ray indicates ____ |
|
Definition
|
|
Term
| cause of V/Q mismatch in pneumonia |
|
Definition
inflammatory exudate fills
alveola w/debris and fluid-
ventilation is down, perfusion is normal |
|
|
Term
| inflammation of alveloar memebranes decreases ___ production which causes ____ |
|
Definition
|
|
Term
| Alveolar collapse causes lung compliance to _____ |
|
Definition
| decrease. (lung is stiff and it takes more work to fill lung) |
|
|
Term
| why does intubation increase risk for pneumonia |
|
Definition
| air bypasses early defense structures of mouth, nose, throat. |
|
|
Term
| smoking causes chronic _____ of the _____ of the airway. #1 reason it is risk factory for respiratory problems |
|
Definition
|
|
Term
| smoking can cause paralysis of ___ putting smokers at high risk for infection |
|
Definition
|
|
Term
sputum colors
1. rust
2. green/yellow
3. pink frothy |
|
Definition
1. klebsiella
2. general bacterial
pulmonary edema |
|
|
Term
| classic symptom of late stage TB |
|
Definition
|
|
Term
| what kind of cough accompanies PCP |
|
Definition
|
|
Term
| elderly with pneumonia may lack this classic symptom but have confusion and dehydration instead |
|
Definition
| fever (also respiratory s&s may be absent) |
|
|
Term
| 4 changes seen in chest xray when pneumonia is present |
|
Definition
infiltrations
consolidations
bronchial pneumonia
pleural effusion |
|
|
Term
| best time to get cultures for pt with pneumonia |
|
Definition
|
|
Term
|
Definition
| erythrocyte sedimentation rate: how fast RBC fall to the bottom of a tube. increased during times of inflammation |
|
|
Term
| classic signs and symptoms of hypoxemia |
|
Definition
| restlessness, irritability, confusion |
|
|
Term
| nurse can give ___L oxygen without order |
|
Definition
|
|
Term
| mucoytic that smell like rotten eggs and treat pneumonia, bronchitis, emphysema and CF |
|
Definition
| mucomyst (acetylcysteine) |
|
|
Term
|
Definition
| breaks mucus down for easier removal through coughing |
|
|
Term
|
Definition
SUPERINFECTION
ALLERGY
GI PROBS
HEPATO OR NEPHROTOXIC
RENDERS BIRTH CTRL INEFFECTIVE |
|
|
Term
| ROBITUSSIN, MUCINEX, AND EUCALYPTUS ARE USED AS ____ |
|
Definition
|
|
Term
| ANTITUSSIVES ARE CONTROVERSIAL BECAUSE THEY ____ |
|
Definition
| SUPPRESS COUGH (COUGHING HAS A PURPOSE) |
|
|
Term
|
Definition
| Codeine, Dextromethorphan |
|
|
Term
| FIRST SYMPTOMS OF LEGIONAIRES DISEASE |
|
Definition
| GI PROBS- NAUSEA, VOMITING, DIARRHEA |
|
|
Term
| pt has fatigue, anorexia, cough, low fever, night sweats. what do you suspect |
|
Definition
| TB (bloody cough will appear in progressed TB) |
|
|
Term
| Pink Puffer and Blue Bloater = ? |
|
Definition
Pink puffer = pure emphysema
Blue bloater= chronic bronchitis |
|
|
Term
| what is #1 thing that puts copd pts at risk for respritory infection |
|
Definition
|
|
Term
| chest tubes: is gentle bubbling in the water seal chamber a normal/expected finding? |
|
Definition
| NO- it is an indication of air leak. |
|
|
Term
| If tidaling is not occurring in water seal chamber what should be suspected |
|
Definition
| patency of the chest tube is compromised |
|
|
Term
| how much water should be in water seal chamber of chest tube collection box |
|
Definition
|
|
Term
| what kind of person is most at risk for Primary spontaneous pneumothorax |
|
Definition
|
|
Term
Clients with chronic obstructive bronchitis are given diuretic therapy because reducing fluid volume
a. reduces oxygen demand
b. improves clients’ mobility
c. reduces sputum production
d. improves respiratory function |
|
Definition
| A- Reducing fluid volume reduces the workload of the heart, which reduces oxygen demand and, in turn, reduces the respiratory rate |
|
|
Term
Which of the following respiratory disorders is most common in the first 24 to 48 hours after surgery?
a. Atelectasis
b. Bronchitis
c. Pneumonia
d. Pneumothorax |
|
Definition
|
|
Term
| Potassium levels tend to rise in ____ and fall in ____. (pH imbalance) |
|
Definition
|
|
Term
chest tightness, SOB, air hunger, tachypnia, decreased LOC are signs of:
a. Asthma attack
b. Pulmonary embolism
c. respiratory failure |
|
Definition
|
|
Term
| are xanthines for acute asthma attack or long term control |
|
Definition
|
|
Term
Which of the following pt statements would cause the nurse to recommend interruption of the drug regime oral streptomycin ?
“My stomach hurts after I take this medication.”
“Lately, I have had some tingling in my toes.”
“Sometimes I get dizzy in the morning.”
“My ears have been ringing lately.” |
|
Definition
| “My ears have been ringing lately.” streptomyacin is an ototoxic and nephrotoxic aminoglycosoid |
|
|
Term
|
Definition
| is the most common 1ST line medication used for the treatment of TB |
|
|
Term
CNS: psychosis, seizures. EENT: visual disturbances. GI: DRUG-INDUCED HEPATITIS , nausea, vomiting. Derm: rashes. Endo: gynecomastia. Hemat: blood dyscrasias. Neuro: peripheral neuropathy . Misc: fever.
WHAT TB DRUG HAS THE ABOVE SIDE EFFECTS |
|
Definition
|
|
Term
Rash, red/orange discoloration of tears, saliva, urine . GI: abdominal pain , diarrhea , flatulence , heartburn , nausea , vomiting , ↑ liver enzymes, hepatotoxic
NAME THIS TB DRUG |
|
Definition
|
|
Term
GI: HEPATOTOXICITY , anorexia, diarrhea, nausea, vomiting. GU: dysuria. Derm: acne, itching, photosensitivity, skin rash. Hemat: anemia, thrombocytopenia. Metab: hyperuricemia . MS: arthralgia, gouty arthrit
WHAT TB DRUG |
|
Definition
|
|
Term
| Major side effects of TB med ETHAMBUTOL |
|
Definition
| optic neuritis, visual disturbance |
|
|
Term
| These 3 2nd-line anti-tb drugs are used in combination with other anti-tb drugs mainly for resistant bacteria or less compliant patients |
|
Definition
Capreomycin (Capastat)
Ethionamide (Trecator-SC)
Cycloserine (Seromycin) |
|
|
Term
| the __ phase of TB treatment includes INH+RIF+EMB |
|
Definition
|
|
Term
| the continuation phase of TB treatment includes __+__ |
|
Definition
| CONTINUATION PHASE= INH +RIF |
|
|
