NUR 308 Respiratory Nursing Flashcards

Comprehensive vocabulary practice flashcards for NUR 308 covering Tuberculosis, Obstructive Sleep Apnea, Asthma, and COPD.

Mycobacterium tuberculosis

The bacterium responsible for causing tuberculosis, a potentially life-threatening respiratory infection transmitted via aerosolized droplets.

Latent TB

A tuberculosis classification in patients with an intact immune system who have no symptoms, are not contagious, and form a calcified granuloma that walls off the bacteria; can reactivate if immunocompromised or with aging.

Primary TB

A tuberculosis classification characterized by a weakened immune system, no symptoms, non-contagiousness, positive sputum cultures, and a granuloma formed by the body that cannot calcify.

Symptomatic TB Infection

Also known as Primary Progressive TB Infection, a classification where the patient has active TB infection, exhibits clinical symptoms, and is contagious.

Drug Resistant TB

A tuberculosis strain resistant to one or more first-line medications, acquired either through direct transmission from an infected individual or as a result of ineffective TB treatment.

Purified Protein Derivative (PPD) / Mantoux Test

An intradermal injection test read $48-72\,\text{hours}$ later to evaluate TB exposure by measuring induration ($5\,\text{mm}$ for high risk, $10\,\text{mm}$ for moderate risk, and $15\,\text{mm}$ for no risk factors).

Bacille Calmette-Guerin (BCG) Vaccine

A vaccine administered in countries where TB is common to prevent severe disease; it can produce false-positive PPD test results within $10\,\text{years}$ of administration.

Isoniazid

An antitubercular drug taken on an empty stomach alongside Vitamin $B_6$ to prevent neurotoxicity; requires monthly liver function test (LFT) monitoring due to hepatotoxicity risks.

Rifampin

An antitubercular medication that carries a risk of hepatotoxicity, turns urine and body secretions orange, and reduces the efficacy of oral contraceptives.

Pyrazinamide

An antitubercular medication associated with hepatotoxicity and gout; requires checking patient history for gout and promoting increased fluid intake.

Ethambutol

An antitubercular agent associated with ocular toxicity, requiring baseline and monthly visual acuity testing as well as color discrimination checks.

Bronchopleural Fistula

A complication of tuberculosis characterized by the formation of an abnormal fistula pathway between a bronchus and the pleural space.

Miliary TB

A severe, disseminated form of tuberculosis occurring when bacteria enter the bloodstream and spread to multiple organs.

Obstructive Sleep Apnea (OSA)

An upper airway disorder causing narrowing and intermittent breathing disruption during sleep, diagnosed when $\ge 15$ obstructive sleep events occur per hour.

Polysomnography

A diagnostic sleep study conducted in a lab or home setting to record brain activity, airflow, muscle movements, and breathing parameters.

CPAP (Continuous Positive Airway Pressure)

A device that delivers constant positive airflow through a mask during sleep to maintain upper airway patency in OSA patients.

Mandibular Advancement Device

An oral appliance used for sleep apnea that repositionally advances the lower jaw and tongue forward to open the airway.

Asthma

A chronic airway disorder characterized by intermittent and reversible airflow obstruction of the bronchioles due to inflammation or airway hyperresponsiveness.

Mild Intermittent Asthma

An asthma classification defined by symptoms occurring less than twice a week.

Mild Persistent Asthma

An asthma classification defined by symptoms occurring more than twice weekly but not daily.

Moderate Persistent Asthma

An asthma classification defined by daily symptoms with exacerbations occurring twice a week.

Severe Persistent Asthma

An asthma classification defined by continual, non-stop symptoms.

Forced Vital Capacity (FVC)

A pulmonary function test parameter measuring the maximum volume of air forcibly exhaled following a maximum inhalation.

Forced Expiratory Volume in the First Second ($\text{FEV}_1$)

The volume of air forcibly exhaled during the first second of an FVC test; an improvement of $12\%$ post-bronchodilator is diagnostic for asthma.

Peak Expiratory Flow Rate (PEFR)

The fastest airflow speed achieved during exhalation, measured using a peak flow meter by recording the highest of three attempts.

Asthma Action Plan

An individualized, traffic-light color-coded plan directing daily controller medication, quick-relief usage based on peak flow zones, and emergency action triggers.

Short-Acting Beta 2 Agonists (Albuterol)

Fast-acting inhaled bronchodilators used for immediate symptom reversal and prevention of exercise-induced asthma; side effects include tremors and tachycardia.

Anticholinergics (Ipratropium)

Inhaled bronchodilators that reduce pulmonary secretions; associated with anticholinergic effects summary: urinary retention, dry mouth, constipation, and blurred vision.

Methylxanthines (Theophylline)

Oral or intravenous bronchodilator agents requiring serum concentration monitoring to avoid toxicity; adverse reactions include tachycardia, nausea, and diarrhea.

Salmeterol

A Long-Acting Beta 2 Agonist (LABA) bronchodilator utilized for long-term daily asthma prevention.

Omalizumab (Xolair)

A monoclonal antibody biologic treatment that targets immune proteins to diminish inflammation; requires observation due to risk of anaphylaxis.

Anaphylaxis

A life-threatening systemic allergic reaction characterized by airway constriction, cutaneous signs, gastrointestinal symptoms, and hypotension; treated with intramuscular epinephrine.

Status Asthmaticus

An acute, life-threatening asthma exacerbation that does not respond to standard therapeutic interventions.

5-Lead ECG Placement Mnemonics

Mnemonics for telemetry electrode placement: White on Right (RA), Clouds over Grass (White/RA over Green/RL), Smoke over Fire (Black/LA over Red/LL), and Brown by heart (V1).

Alpha 1 Antitrypsin Deficiency

A genetic deficiency in a liver-synthesized protective enzyme, leading to unregulated pulmonary destruction and predisposing patients to COPD.

Emphysema

A disease under COPD characterized by destruction of alveoli, hyperinflation, loss of lung elasticity, impaired gas exchange, and carbon dioxide retention.

Chronic Bronchitis

An inflammatory disease under COPD causing bronchial hypersecretion and airway narrowing, defined clinically as a productive cough for at least $3\,\text{months}$ for $2\,\text{consecutive years}$.

Pink Puffer

A clinical phenotype for emphysema characterized by a thin build, barrel chest, exertional dyspnea, purse-lip puffing, and hyperresonance on chest percussion.

Blue Bloater

A clinical phenotype for chronic bronchitis characterized by obesity, hypoxemia, cyanosis, excessive mucus production, and peripheral edema.

Cor Pulmonale

Right-sided heart failure and enlargement of the right ventricle resulting from chronic pulmonary hypertension caused by underlying lung disease.

Spontaneous Pneumothorax

A medical emergency in which air enters the pleural space without traumatic injury, causing partial or total lung collapse.

Positive Expiratory Pressure (PEP) Device

An airway clearance device (such as Flutter or Aerobika) that utilizes expiratory resistance and vibrations to loosen and mobilize retained secretions.

Mycobacterium tuberculosis Transmission

An aerosolized droplet respiratory pathogen transmitted when infected individuals cough, speak, or sneeze; particles can remain suspended in the air for several hours.

Latent TB

A tuberculosis state in patients with intact immune systems who display no symptoms, feel healthy, are non-contagious, and wall off bacteria inside calcified granulomas that can reactivate with aging or immunosuppression.

Primary TB

A tuberculosis state occurring in individuals with weakened immune systems who have no clinical symptoms and are non-contagious, but present positive sputum cultures and uncalcified granulomas.

Symptomatic TB Infection (Primary Progressive TB)

An active tuberculosis infection characterized by clinical symptoms, positive sputum cultures, and high contagiousness.

Drug Resistant TB

A strain of tuberculosis resistant to one or more primary first-line medications, contracted either through primary exposure to a resistant strain or due to non-compliant/ineffective treatment.

TB Screening Guidelines

Health promotion protocols recommending annual testing for individuals residing in high-risk areas, routine testing for exposed family members, and prompt evaluation for anyone exhibiting suspicious symptoms.

TB Key Risk Factors

Close contact with an untreated individual, lower socioeconomic status, experiencing homelessness, immunocompromised status, poorly ventilated crowded settings, travel to endemic areas, substance abuse, and high-risk healthcare occupations.

TB Classical Clinical Manifestations

Persistent cough lasting longer than $3\,\text{weeks}$, rust-colored or blood-streaked sputum, fatigue, weight loss, night sweats, and late-stage dyspnea or rales.

Nucleic Acid Amplification Testing (NAAT)

The fastest and most accurate diagnostic test for tuberculosis, which detects bacterial genetic material directly in respiratory secretions.

Acid-Fast Bacilli (AFB) Smear and Culture

A diagnostic laboratory procedure performed on respiratory secretions where a positive acid-fast stain strongly indicates active tuberculosis infection.

Purified Protein Derivative (PPD) / Mantoux Test Interpretation

An intradermal test evaluated $48-72\,\text{hours}$ post-injection, where induration thresholds are positive at $\ge 5\,\text{mm}$ for high-risk patients, $\ge 10\,\text{mm}$ for moderate-risk patients, and $\ge 15\,\text{mm}$ for individuals without risk factors.

Bacille Calmette-Guerin (BCG) Vaccine Nursing Considerations

A vaccine administered in high-TB-prevalence countries that can cause false-positive PPD skin tests within $10\,\text{years}$ of administration, requiring followup via QuantiFERON-TB Gold blood test or chest X-ray.

Sputum Collection Protocol for TB Diagnosis

A diagnostic protocol requiring the collection of three consecutive early-morning sputum samples while maintaining airborne precautions and proper personal protective equipment.

Isoniazid (INH) Nursing Considerations

An antitubercular medication taken on an empty stomach concurrently with Vitamin $B_6$ (pyridoxine) to prevent neurotoxicity; requires baseline and monthly liver function test (LFT) monitoring and strict alcohol avoidance.

Rifampin

An antitubercular agent that causes harmless orange discoloration of body fluids (urine, tears, sweat), carries hepatotoxicity risks, and significantly decreases the effectiveness of oral contraceptives.

Pyrazinamide Nursing Considerations

An antitubercular drug associated with hepatotoxicity and hyperuricemia/gout; requires screening for gout history and advising high fluid intake.

Ethambutol Nursing Considerations

An antitubercular medication that causes ocular toxicity, requiring baseline and monthly testing for visual acuity and red-green color discrimination.

Tuberculosis Major Complications

Acute respiratory failure, bronchopleural fistula (abnormal tract between bronchus and pleural space), pleural effusions, and miliary TB (hematogenous dissemination to multiple organs).

Obstructive Sleep Apnea (OSA)

Intermittent breathing disruptions during sleep caused by repetitive upper airway narrowing or collapse.

OSA Major Risk Factors

Obesity, male sex, age $40-65\,\text{years}$, smoking, alcohol use, atrial fibrillation, nocturnal dysrhythmias, Type 2 diabetes mellitus, and craniofacial or soft tissue upper airway abnormalities.

OSA Primary Clinical Manifestations

Loud snoring, snorting, witnessed apneic episodes, gasping during sleep, choking, recurrent waking, nocturnal restlessness, and daytime fatigue.

OSA Diagnostic Criteria and Polysomnography

A diagnosis confirmed by overnight sleep study (polysomnography) recording $\ge 15$ obstructive sleep events per hour.

OSA Non-Surgical Interventions

Continuous Positive Airway Pressure (CPAP), weight loss, side-sleeping (non-supine position), mandibular advancement oral devices, smoking cessation, and avoiding alcohol or sedatives prior to sleep.

OSA Systemic Complications

Severe nocturnal hypoxemia leading to cardiovascular conditions including cardiac ischemia, myocardial infarction, stroke, atrial fibrillation, heart failure, erectile dysfunction, and sudden cardiac death.

Asthma Pathophysiology

A chronic airway disorder marked by intermittent, reversible airflow limitation and bronchiole inflammation or airway hyperresponsiveness.

Asthma Severity Classifications

Classification based on symptom frequency: Mild Intermittent ($< 2\text{ times/week}$), Mild Persistent ($> 2\text{ times/week}$, but not daily), Moderate Persistent (daily symptoms with exacerbations $2\text{ times/week}$), and Severe Persistent (continual, non-stop symptoms).

Asthma Key Risk Factors

Family history of asthma, environmental allergen/pollutant exposure, cigarette smoke exposure, chemical irritants, allergies, and Gastroesophageal Reflux Disease (GERD).

Asthma Clinical Manifestations

Dyspnea, audible wheezing, persistent cough, increased sputum, tachycardia, tachypnea, chest tightness, anxiety, barrel chest, reduced oxygen saturation, and inability to speak in full sentences.

Pulmonary Function Testing in Asthma

Evaluation of lung mechanics where an improvement in Forced Expiratory Volume in 1 Second ($\text{FEV}_1$) of $\ge 12\%$ following administration of an inhaled bronchodilator confirms an asthma diagnosis.

Peak Expiratory Flow Meter Technique

A self-monitoring procedure performed sitting upright: take a maximum inhalation, blow out as hard and fast as possible, repeat 3 times, and record the single highest reading (not the average).

Asthma Action Plan

An individualized, color-coded self-management plan based on peak flow zones that guides daily controller therapy, quick-relief medication dosing, and emergency action steps.

Short-Acting Beta 2 Agonists (Albuterol)

Rapid-acting inhaled bronchodilators used for acute symptom reversal and pre-exercise prophylaxis; potential side effects include skeletal muscle tremors and tachycardia.

Anticholinergic Bronchodilators (Ipratropium)

Inhaled agents that cause bronchodilation and decrease mucous secretions; side effects include dry mouth, urinary retention, constipation, tachycardia, and blurred vision.

Methylxanthines (Theophylline)

Oral or intravenous bronchodilators requiring periodic blood concentration monitoring to prevent toxicity; adverse signs include tachycardia, nausea, and diarrhea.

Long-Acting Beta 2 Agonists (Salmeterol)

Inhaled bronchodilators utilized for daily, long-term asthma prevention and maintenance, never for acute rescue.

Inhaled and Systemic Corticosteroids Nursing Considerations

Anti-inflammatory agents that require taking oral doses with food, performing proper oral hygiene/rinsing to prevent thrush, monitoring for hyperglycemia, weight gain, and fluid retention, reporting black tarry stools, and avoiding abrupt cessation.

Omalizumab (Xolair)

A monoclonal antibody biologic therapy that binds inflammatory proteins to manage moderate-to-severe allergic asthma; requires post-injection observation due to risk of anaphylaxis.

Anaphylaxis Manifestations and Emergency Management

A life-threatening systemic allergic response causing airway constriction, dyspnea, dysphagia, hives, hypotension, and tachycardia; managed immediately with intramuscular epinephrine.

Status Asthmaticus

A severe, life-threatening asthma exacerbation that fails to respond to standard rescue bronchodilators and medical interventions.

5-Lead Telemetry ECG Placement

Lead placement remembered by: White on Right (RA), Clouds over Grass (White/RA over Green/RL), Smoke over Fire (Black/LA over Red/LL), and Brown by Heart (V1 chest lead).

Common Asthma Environmental Triggers

Temperature/humidity changes, air pollution, strong odors, seasonal allergens, stress/emotions, detergent enzymes, household chemicals, and viral respiratory infections.

Chronic Obstructive Pulmonary Disease (COPD) Overview

A progressive, non-reversible airflow limitation disease involving chronic pulmonary inflammation, comprised primarily of emphysema and chronic bronchitis.

Alpha 1 Antitrypsin Deficiency

A genetic deficiency of a liver-synthesized protective enzyme that normally prevents unchecked elastase destruction of lung parenchyma, leading to early-onset emphysema.

Emphysema ('Pink Puffer')

A COPD sub-type characterized by destruction of alveolar walls, loss of pulmonary elasticity, air trapping, and hyperinflation; patients present thin, with a barrel chest, pursed-lip breathing, and hyperresonance on chest percussion.

Chronic Bronchitis ('Blue Bloater')

A COPD sub-type characterized by airway inflammation and mucus hypersecretion; clinically defined as a productive cough lasting at least $3\,\text{months}$ per year for $2\,\text{consecutive years}$, presenting with obesity, hypoxemia, cyanosis, and peripheral edema.

COPD Classical Manifestations

Exertional dyspnea, increased work of breathing, tripod positioning, accessory muscle use, late digital clubbing, cyanosis/pallor, and dependent edema secondary to right heart strain.

Target Oxygen Saturation in COPD

Prescribed oxygen therapy titrated to achieve a target arterial oxygen saturation of $88-92\%$ to maintain hypoxic drive and prevent hypercapnia.

Cor Pulmonale

Right ventricular hypertrophy and failure caused by chronic pulmonary arterial hypertension resulting from underlying lung pathology; manifested by JVD, hepatomegaly, and peripheral edema.

Spontaneous Pneumothorax

A medical emergency in COPD where subpleural blebs rupture without trauma, allowing air into the pleural space and causing partial or complete lung collapse.

Positive Expiratory Pressure (PEP) Device

An airway clearance device (e.g., Flutter or Aerobika) that utilizes expiratory resistance and internal vibrations during deep exhalations to loosen and mobilize retained secretions.

COPD Airway Clearance and Breathing Techniques

Nursing interventions including pursed-lip breathing, diaphragmatic breathing, huff coughing, chest physiotherapy, mucolytic administration, and increasing daily fluid intake to $2-3\,\text{L/day}$.

COPD Exercise Conditioning Protocol

A pulmonary rehabilitation strategy where patients engage in self-paced daily walking until dyspnea occurs, rest, and resume for $20\,\text{minutes}$ per session, $2-3\text{ times/week}$.