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SOPN Test 7
SOPN Respitory Dysfunction Test 7 (3 of 3)
| Question | Answer |
|---|---|
| What is Diapphragmatic Breathing? | Breathing, avoid using ribcage, instead use diaphragm of upper adomen |
| What is procedure using gravity to drain lungs? | Postural Drainage, should not be done after meals, do not use with pts with ICP, careful with hypertension and pts with orthopnea. |
| Do not perform Chest Physical Therapy with what conditions? | Hemoptyis, Rib Fractures, Pulmonary Embolism, TB, Operable Lung Cancer, never on bare skin. |
| Vibration Physcial Therapy | Patient takes a deep breath, while exhaling wall is vibrated and patient asked to cough. |
| What conditions require Oxygen Therapy? | Hypoxemia, pneumonia, ARDS, COPD, Lung Cancer MI, shock, CNS depression of respirtory center. |
| How is flow rate of Oxygen measured? | Liters per minute. |
| 02 Transtracheal: | Use with long term home 02 delivery. Small catheter is directly inserted into the trachea and held by a flange. No ADL interference. |
| Complication of Transtracheal | Accidental Pneumothorax. |
| Why would you use an Endotracheal Tube for 02 delivery? | Mechanical respiration due to respiratory failure, or respiratory arrest. |
| What should be major concern with Endotracheal Tube? | ***Endo and tracheal cuff pressure should not exceed 20mm Hgb. If greater than 20mm Hgb can cause a stensis and or necrosis***** |
| How to remove Endotracheal 02 Tube? | Upright position, hyperoxygenated and suctioned, cuff deflated, pt takes deep breath, remove, and oxygen via face mask or shovel mask. |
| NI after removal of Endo or Trach 02 tube? | Larygeal edema, spasm, hemmorage, RR, 02 sat, ABG's, stridor, pallor, cyanosis, change in mental status. |
| What is an artificial opening in the trachea may be temporary or permenent? | Trachestomy, to provide long term patent airway. |
| What has a removable inner cannula, held in place by a twill tape or velcro strap? | Trachestomy. |
| Allows for air exchange via small hole and allows pt to speake when the tube is plugged or being weaned off ventilator? | Fenestrated Trach Tube. |
| NI for Fenestrated Trach Tube? | RR, O2, breath sounds, check pressure cuff for leakage with stethoscope over site, help with nonverbal communication, change dressing, asses for fever for infection. |
| More NI for Fenestrated Trach Tube? | replacement tube with obturator is available, call bell in reach, trach care, hold tube in stoma or may dislodge, dressing under flange to protect skin. |
| Removal of Fenestrated Trach Tube procedure? | Hyperoxygenate, suction, deflate cuff, suction again, remove tube, would closes after five days. |
| Mechanical Ventilator Pressure Cycled: | Uses pressure, used for short term RR |
| Mechanical Ventilator Volume Cycled: | Delivers a constant volume of air regarless of pressure needed to attain volume, pressure alarm when pt needs suctioning or pt is coughing. |
| Mechanical Ventilator Assist Only: | Pts own repiratory effortr triggers machine, if apneic no breaths will be delivered. |
| Mechanical Ventilator Assist Control: | Pt will tirgger won breaths as well as set control rate for back up. If apenic will have a back up set rate. |
| Synchronized intermittent mandatory ventilations (SIMV) | Pt intiates breaths with preset pressure, but also delivers a mandatory synchronized ventilation, used to WEAN PTS OFF VENTILATORS. |
| Continous Positive Pressure (CPAP): | No breaths pt breathing on own, with each breath a small amount of pressure to help keep airways open on inspiration, PEEP postive end expriatroy pressure, keeps aveoli open from collapse. |
| BiPAP = Continous Positive Airway Pressure | Positive inspiratory as well as psitive expiratory used for SLEEP APNEA. |
| How many times does a healthy person sigh in an hour? | 6 - 10 times. |
| A sigh on a ventilator prevents what? | Micro-atelectasis |
| Nursing Care Patients on Ventilation Machines? | Never shut off alarm, RR beause not recorded by machine, just 02sat and breath sounds, watch for symmetric lung expansion, boserve for respiratory distress & hypoxia. |
| Symptoms of Respirtory Distress: | Anxiety, restlessness, tachycardia, increase RR, confusion, cyanosis. Always have suction equipment and AMBU bag at all times. |
| How do you wean pt off ventilators? | Gradually, # of breaths descrese then put on CPAP, High Folwers, Pulmonary Function Test, 02 sats, RR, Lung sounds, VS, mental status. |
| Nasal Decongestants: | Reduce swelling of the nasal mucosa and usually OTC. Stimulate Alpha adrenergic adreanalinepinephrine receoptors, release epinephrine = vasocontriciton, shriking of nasal membranes. |
| Side Effects of Nasal Decongestants? | Irritability, rebound congestion with repeat use & Hypertension. |
| What kind of drug is epedrine? | Nasal Decongestant |
| What do Antihistamines do? | Relieve sneezing, and itching of allergies BENADRYL. Side effects: Sleepy |
| What are Antitussives? | Cough suppressants, use caution, cough is a protective mechanism. Inhibits cough center in the medulla. |
| Non Opiods Antitussive? | Codine, side effects decreased RR = hypotension. |
| What kind of drug is Dextromethorpan? | Antitussive watch for hyperacivity, increases with alcohol. |
| What do Mucolytics do? | Loosens Mucous to expectorate. Example: Mucomyst *antidote fore Tylenol* |
| What does Hypertonic Saline do? | Lossens Mucous to expectorate administered via inhalation. |
| What do Bronchodilators do? | Relax constricted airways, dilate bronchi. |
| Albuteral, Proventil, Ventolin, Metaproternol, Isporternol are all what? | Bronchodilators. Warn pt not to exceed does wait one minute between inhalation puffs. |
| What are Xanthines? | Bronchodilators, example: aminophylline, theophylline, side effects: angina, palpations, anorexia, H/A, insomnia, tachycardi. |
| What do Anticholinergic Drugs Do? | Inhibits cholinergic receptors in smooth bronchial muscle. Resulting in brochodilation. |
| What kind of drug is Atrovent (ipratropium) | Anticholinergic: bronchodilation. |
| Chest tube Drainage what is the importance of the Apparatus? | Uses a water seal to prevent backup of air into chest tube with or without suction |
| Chest Tube for Drainage: | One way catheter apparatus to collect air and fluid. |
| Chambers of Chest Drainage: | Water seal with 2cm H20 pressure oscillates when pt inhales & exhales. Water seal allows air to move from the plaural space into the drainage system but not back into chest. |
| What is wrong if 1st chamber: Water Seal in chamber is bubbling? | Air is leaking from the lung or bronchus. |
| Collection Chamber of Chest Drainage? | Collects fluid DIRECTLY from chest to chest tube is the 2nd chamber. Mark drainage on every shift. |
| 3rd chamber of Chest Drainage? | (-) pressure chamber is to provide suction and negative pressure to reestablish negative in th chest |
| Chest Tube Insertion: | Done at bedside or OR, Local anethesia, small incision tube inserted confirmed with CXR. |
| NI Chest Tube Insertion: | Absent lung sounds may mena pneumothorax, observe for distress, all vitals. KEEP DRAINAGE SYSTEM BELOW pt chest level and free of kinks. Record drainage. |
| When observing water seal of Chest Tube what should you look for? | *Observe water seal, should be fluctulate/tidaling with each breath. Bubbles present air leak, fluctuation may stop when lung is reinflated.* |
| How should patient lie with Chest Tube? | Not on the tube! Encourage TCDB every two hours. |
| What should you never do with a Chest Tube? | Never CLAMP, except momentarily to empty a full drainage, otherwise traps air in lungs causing pneumothorax = air cannot escape. |
| Never Milk what? | A Chest Tube. |
| What should you do if Chest Tube is accidentlly removed? | Cover with a petroleum gauze dressing. |
| Procedure for removal of Chest Tube? | Give pain med to pt, sutures are cut, pt takes a deep breath, and hold it, tube removed, petroleum gauze dressing is applied to wound. |
| What is a Heimlich Valve? | A one way valve that may be used instead of water seal drainage. Valve allows for air and fluid or blood clots to be removed fro the chest, can be attached to Chest Tube. Advantage is mobility for pt. |
| Pre Op Throaic Surgery: | Tell pt to stop smoking, CXR, lung scans, AGB's for baseline, Labs. |
| Complications of Thoracic Surgery: | Air Leaks, when lung tissue fails to cose, = bubbling in water seal chambers. |
| What is Subcutaneous Emphysema with Thoracic Surgery: | Presence of air under the skin freulting from its excape from the respiratory tract, rice crispys under the skin, can be from AIR LEAK, or Blocked Chest Tube! S/S puffy around the skin, cellophane pops in skin. |
Created by:
keldog09
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