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Respitory function

nur 305 respitory

QuestionAnswer
Pulmonary Function Test is used for 1.Evaluation of lungs and pulmonary reserve. 2.Evaluation to response to bronchodilator therapy. 3.Differentiation between restrictive and obstructive forms of chronic pulmonary disease. 4.Screening tool.
Pulmonary test contraindications 1.pt is in pain unable to cooperate 2.pts unable to cooperative b/c of age or mental status
Pulmonary test preparation 1.Explain to pt about the procedure. 2.Assure the pt can sit up and cooperative with test. 3.No smoking for 6 hrs-vasconstriciton 4.Do not use inhalers- want a true representation
Post procedure of pulmonary function test 1.patient is usually tire 2.assess lung sounds 3.assess resp rate, rhythm, effort
Relief measures for dyspnea High fowlers position and O2
Cough significance 1.description of the cough 2.coughing at pm- L-sided hrt failure or asthma coughing in the am w/ sputum- bronchitis cough worsen supine-sinusitis
Cough relief measures 1.Cough suppressants w/ ccaution 2.Drinking warm beverages
Sputum relief measures 1.hydration 2.aerosolized solutions 3.smoking cessation 4.oral hygiene and wise selection of food(citrus juices)
chest pain significance 1.pleuritic pain- sharp on inspiration 2.pt are more comfortable lying on the affected side
chest pain relief measures analgesic and NSAIDS
Wheezing airway narrowing on expiration
Clubbing 1.found in chronic hypoxia conditions 2.lung diseases
Hemoptysis 1.spitting up blood 2.amount is not always proportional to the 3.seriousness of the situation
Cyanosis 1.5g/dl of deoxgenated hgb 2.anemina doesnt always mean you have it 3.Polycythemia person can be cyanotic 4.not a reliable indicator of hypoxia 5.central cyanosis is reliable method
Rate and depths of resp 1.eupnea- normal 12-18 2.bradypnea- <10 3.Tacyonea- >24
Atelectasis 1.tactile fremitus- absent 2.percussion- flat 3.decrease to absent breath sounds
Pneumothorax 1.tactile fremitus- decrease to absent sounds 2.percussion- hyperresonant 3.absent breath sounds
Consolidation 1.tactile fremitus- increased 2.percussion- dull 3.bronchial breath sounds and crackle
bronchitis 1.tactile fremitus- normal 2.percussion-resonant 3.normal to decrease breath sounds, weezing
emphysema 1.tactile fremitus- decrease 2.percussion- hyperresonant 3.decrease intensity of breath sounds and prolong expirations
Asthma 1.tactile fremitus- normal to decrease 2.percussion- resonant to hyperresonant 3.wheezes
Sputum studies 1.clear the nose and throat, rinse the mouth, take deep breaths, cough using diaphragm 2.specimen should be taken to the lab within 2 hrs
Bronchoscopy is use for 1.direct inspection and examination 2.collect specimen and location of pathologic process 3.dx bleeding sites 4.remove foreign body 5.remove secretions
bronchoscopy complications 1.infection 2.aspiration 3.broncospasm 4.hypoxemia 5.pneumothorax 6.bleeding 7.perforation
bronchoscopy nursing management 1.signed consent 2.NPO 6hr pre procedure 3.Remove dentures 4. administer sedation as ordered 5.topical anesthetic-so they wont gag 6.post procedure NPO intil cough reflex 7.after cough reflex returns, ice chips and liquids afte
Broncochoscopy interventions monitoring resp status, breath sounds ans assessments
Thoracoscopy is use for evaluation of pleural effusins, pleural disease and tumor staging
Thoracoscopy intervention post procedure is to monitor for SOB,air hunger, hypoxia, chest drainage system
Rhinitis manifestations rhinorrhea, common nasal symptoms
Rhinitis 1.infectious/inflammatory 2.acute/chronic 3.alllergic/non 4.trement depends on cause
nursing management of rhinitis 1.allergic rhinitis avoid exposure to allergens 2.pt edu about OTC-read labels cautiously 3.pt edu about environmental control 4.pt edu about nasal sprays 5.handwashing
common cold manifestations common nasal symptoms, sore throat,asso w/ herpes symplex
common cold management 1.fluids 2.rest 3.prevent chilling 4. salt water 5.NSAID-for pain 6.decongestants-caution
acute/chronic sinusitis s&s facial pain, pressure over sinuses, sore throat,eyelid edema,fatigue,headache earache,dental pain
acute/chronic sinusitis risk factors exposure environmental hazards
acute/chronic sinusitis complications meninigitis and lung abscess
upper respitory nursing interventions include? 1.maintain patent airway-control secretions 2.promote comfort-cool/warm compressor 3.promote communication-in writing 4.fluid intake-2-3L 5.patient teaching-stop smoking
OSA risk factors 1.obesity 2.older age 3.smoking
OSA alerts 1.excessive daytime sleeping 2.noctural awakening 3.insomnia 4.loud snoring 5.morning headaches- alter co2 o2 6. intellectual deterioration 7. peronality changes 8.impotence 9. systemic/ pulmonary hypertension 10. dysrhythemia-vtacy 11.enuresis
OSA management 1. avoid sleeping on the back-sleep on side 2.avoid alcohol and meds- depresss the resp sys 3.CAP or BIPAP 4.surgical procedure asso with tracheostomy
atelectasis manifestations 1.common in the post op pt and immobilize pt 2.low grade fever is a common sign
atelectasis assessment 1.increase breathing 2.decreased breath sounds-crackles 3.hypoxemia and low o2 sat
atelectasis prevention 1.frequent turning-2hrs 2.early mobilization 3.deep breathing exercise-incentive spirometers 4.coughing
atelectasis treatment 1.MDI for meds 2.suction and chest PT 3.thoracentesis-pleural effusion compression the lung tissue
What is HAP 1.onset of symptoms more than 48 hrs post adm 2.most lethal nosocomial infection
what is CAP occurs within community or within 48 hrs of hospitalization
pneumonia risk factors 1.obstruction and interference of lung drainage 2.immunosuppressed 3.smoking 4.immobility 5.depressed cough reflex 6.NG tube 7.alcohol intoxication 8.general anesthesia
pneumonia in immunocompromised greatest in AIDS, chemotherapy and organ transplant patients
pneumonia signs and symptoms 1.fever 2.pleurtic pain 3.chest pain 4.SOB 5.myalgia 6.orthopnea 7.fatigue 8.diaphoresis
pneumonia interventions 1.hydration 2.humidification 3.coughing 4.deep breathing 5.incentive spirometry 6.chest physical therapy 7.promote rest and conserve energy 8.fluid intake 9.maintain nutrition 10. prevent complications
tb risk factors 1.close contact 2.immuniocompromised status 3.subtance abuse 4.medical condition 5.inadequate health 6.emigration from countries with high prevalence 7.jail 8.high risk procedures 9.immunosuppressed
ppd test 1.intradermal layer-inner forearm 2.4" below the elbow 3.test read in 48-72hr- beyond that may not be accurate.
ppd interpetation: size of duration 1.0-4 not sig-unless immunocompromise 2.>5 sig 3.>10 sig 4. sig means exposure to the M.TB or BCG 5.>5 HIV= +
ppd results 1.+ reaction doesn't always mean you have TB 2.- does not alway exclude one from the infection(immunosuppressed pt can not develop immune response that can produce a + test)
spread of tb 1.military tb 2. late reactivation of a dormant in the lung or elsewhere 3. assess pt contacts
tb classification 1.class 0-no exposure/no infection 2.class-exposure/no evidence of infection 3.class 2-latent- + ppd but no evidence of tb 4.class 3-disease clinically active 5.class 4-disease not clinical active 6.class 5-dx is pending
tb assessment includes fever,anorexia,weight loss,night sweats,fatigue cough and sputum production
tb complications include malnutrition, side effects of meds, multidrug resistance, spread of tb
tb pharmacolgy therapy 1.person considered noninfectious after 2-3 wks of continous med therapy-stay home 2.vitB12 administer with INH- to prevent peripheral neuropathy 3.meds taken on empty stomach or 1hr after meals 4.INH- avoid foods with tyramine
nursing management of tb include 1. - pressure rooms 2.special masks 3. pt edu- cover mouth when coughing and proper disposal of tissues and handwashing
tb nursing intervention 1.promote airway clearance 2.advocate adherence to treatment regimen 3.promote activity and nutrition 4.monitor for complications 5.bld work monitoring of LFT,BUN and creatine
what is asthma 1.intermittent,reversible airflow obstruction affecting the airway 2.inflammation resulting in a narrow airway 3.hyperresponsiveness
asthma physical findings 1. mild to moderate asthma- no symptoms 2.wheeze on expiration 3. increase resp rate and coughing 4. accessory muscles 5. muscle retraction at sternum,suprasternal notch and between ribs 6.severe asthma- barrel chest
asthma lab results 1.increase in ERS and IgE 2.alter ABG 3.decrease of FEV/PEF(15-20%) during an attack
PEF 1.measures the amount of airflow during a forced expiration 2. daily monitoring is recommend for moderate-severe cases. 3. PEF can drop hrs or days before asthma symptoms occur- teach pt to monitor
asthma treatment goals decrease inflammation and improve air flow
asthma client education 1.avoid trigger-NSAIDS 2.bronchodilators before exercise 3.rest 4.reduce stress and anxiety 5.monitor PEF 6.seek emergency care
COPD 1.airflow limitation and not fully reversible 2.emphysema or chronic bronchitis
COPD risk factors 1.smoking-passive or active 2.AAT-modify the environment 3.air polluntant
COPD complications include? 1.hypoxemia and acidosis 2.RTI 3.cardiac prolems
Chronic bronchitis 1.disease of the airway 2.cough and sputum for 3mos for >2yrs
emphysema 1.distended alveoli resulting in impair gas exchange 2.hypercania 3. cor pumonale is a complication
COPD lab 1.ABG- hypoxemia/hypercarbia 2.respitory acidosis-late sign would be metabolic 3.polycythemia
nursing management for COPD 1.oxygen therapy 2.drug therapy 3. breathing techniques(diaphragmatic, purse lips, position) 4.exercise 5.energy conservation 6.hydration
PE risk factors 1.venous statsis- prolong immobility 2.hypercoagulability 3.venous endothelial disease certain disease state- trauma, post op period, COPD 4.age 5.obesity 6.pregnancy 7.birth control pill 8.DVT 9.constrictive clothing
PE symotoms 1.depends on size and the area being occluded 2.DVT-sudden pain, swelling and warmth in the extremity, skin discolration 3.dyspnea and tacypnea- most common 4.chest pain-sudden pleuritic 5.apprehensive 6.fever, cough, diaphoresis 7.hemoptysis 8.syn
PE prevention 1.active leg exercise 2.early ambulation 3.elastic compression stockings 4.avoid sitting with legs crossed or sitting for long period of time 5.drink fluids 6.SCD 7.anticoagulant therapy 8.thrombolytic therapy
PE surgical management 1.pulmonary embolectomy 2.transvenous catheter embolectomy 3.inferior vena cava umbrella
PE nursing management 1.minimize risk for PE 2.prevent thrombus formation-ambulation,leg exercises, feet should rest on the flr, iv's- dont prolong 3.assess for potential PE 4.monitor thrombolytic therapy- vitals-q2hr, avoid invasive procedure, test INR and PTT 3-4 hr after
PE nursing management part 2 1.mange pain-semilfowler,turning the pt- to improve ventilation perfusion ratio, meds 2.manage o2 therapy-deep breathing, monitoring o2 sat and managing hypoxemia 3.relieving anxiety 4.monitoring for complications 3.
PE assessment findings 1.chest xray- may not show infiltrates,elevated diaphragm on the affected side or pleural effusion 2.ECG-sinnus tacy, pr interval depression 3.ABG- hypoxemia, hypocapnia- also ABG can be normal even if the presence of PE 4.angiography-best dx of PE
Occupational lung disease: silicosis manifestations 1.dyspnea, weight loss, fever, cough 2. progression of the disease is rapid 3.chronic problem with long latency
Occupational lung disease: asbestosis manifestations 1.progressive dyspnea,persistent dry cough, anorexia,malasie,chest pain, anorexia 2. early findings include-end inspiratory crackles 3.advance is cor pulmonale, clubbing, resp failure 4. persons with great expurse or hx of smoking die from lung cancer
Occupational lung disease: black lung disease 1. first sign-chronic cough and sputum production 2.dyspnea 3. sputum production of melanoptysis (smokers) 4. cor pulmonale and resp failure
Pheumothorax: 3 types 1.simple- spontaneous;disfuse intertitual lung disease and severe emphysema 2.tramatic-rib fx's, gun shot, invasive procedure 3.tension- air drawn into pleural space from a lacerated lung- lung collaspes, heart, trachea is shifted to the unaffected side
pheumothorax manifestation 1.sudden pleurtic pain 2.tacypnea 3.air hunger 4.agitation 5.hypoxemia 6.central cyanosis 7.hypotension 8.tacycardia 9. profuse diaphoresi 10.tracheal deviation
pneumothorax assessment findings 1.airway 2.trachial-midline/shifted 3.breath sounds 4.circulation 5.vitals 6.possible cause
pneumothorax interventions 1.maintain patent airway 2.notify the doc 3.needle thoracostomy 4.insertion of chest tuibe 5.chest xray 6.o2 7.monitor vitals 8.assess for shock
lung cancer risk factors 1.smoking-active/passive 2.environmental and occupation exposure-radon have been associated with cancer 3.genetics 4.dietary factors-low intake of fruits and vegetables
adenocarcinoma 1.occurs peripherally and often metastasize 2.least associated with smoking
lung cancer clinical signs 1.cough and chage in cough 2.wheezing 3.dyspnea 4.hemoptysis 5.fever 6.URI 7.chest or shoulder pain 8.hoarseness
lung cancer prevention restrictive advertising
lung cancer treatment 1.sugery 2.radiation 3.chemotherapy 4.palliative therapy
radiation 1.may reduce size of tumor 2.make inoperable tumor operable 3.relieve pressure 4.may help to relieve symptoms of cancer 5.may lead to problems of normal tissue-esophagitis,pneumonitis,lung fibrosis
lung cancer nursing management include? 1.mangae symtoms of treatment 2.relieve breathing problems 3.reduce fatigue
Created by: sm08042n
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