respiratory -- exam 1

What is the order for a lung assessment (IPPA)?

Inspection → Palpation → Percussion → Auscultation.

What does pulse oximetry measure?

Hemoglobin oxygen saturation; the lecture lists 95–100% as the usual range.

What does an ABG evaluate?

The effectiveness of gas exchange and acid-base status.

What are normal ABG values?

pH 7.35–7.45, PaCO2 35–45 mm Hg, HCO3 22–26 mEq/L, PaO2 80–100 mm Hg.

What is the first step when interpreting an ABG?

Look at the pH and decide whether it is acidotic or alkalotic.

What does PaCO2 represent in ABG interpretation?

The respiratory component.

What does HCO3 represent in ABG interpretation?

The metabolic component.

What ABG pattern indicates respiratory acidosis?

↓ pH + ↑ PaCO2.

What commonly causes respiratory acidosis?

Hypoventilation with CO2 retention; examples include COPD, oversedation/narcotics, airway obstruction, and respiratory muscle weakness.

What ABG pattern indicates respiratory alkalosis?

↑ pH + ↓ PaCO2.

What commonly causes respiratory alkalosis?

Hyperventilation from anxiety, pain, hypoxia, sepsis, exercise, high altitude, or mechanical ventilation.

What ABG pattern indicates metabolic acidosis?

↓ pH + ↓ HCO3.

What commonly causes metabolic acidosis?

DKA, lactic acidosis, severe diarrhea, renal failure, shock, seizures, and liver failure.

What ABG pattern indicates metabolic alkalosis?

↑ pH + ↑ HCO3.

What commonly causes metabolic alkalosis?

Vomiting, NG suction, diuretics, excess bicarbonate/antacids, and hypokalemia.

What is the main goal with an acute airway obstruction?

Re-establish a patent airway.

What is the greatest risk factor for obstructive sleep apnea (OSA) according to the lecture?

Obesity.

What are classic findings of OSA?

Snoring, witnessed apnea, daytime sleepiness, fatigue, headache, difficulty concentrating, and waking gasping/choking.

What is the diagnostic test for OSA?

Polysomnography (overnight sleep study).

What is an important teaching point for OSA?

Use CPAP as prescribed and avoid alcohol, smoking, and sedatives that can worsen symptoms.

What is the basic pathophysiology of asthma?

Airway inflammation causes bronchospasm and impaired airflow.

What are classic manifestations of asthma?

Wheezing, cough, chest tightness, and dyspnea.

What is the rescue medication for rapid short-term asthma relief?

Albuterol, a short-acting beta agonist.

What is the difference between an asthma controller and rescue medication?

Controller medications are taken regularly to prevent/control symptoms; rescue medications provide rapid short-term relief.

What is status asthmaticus?

Severe, life-threatening airway obstruction that intensifies and does not respond to usual therapy.

What is a dangerous finding in severe asthma that can look like improvement?

Sudden absence of wheezing with low oxygen; this may indicate minimal airflow/complete airway obstruction.

What is pulmonary edema?

A life-threatening buildup of fluid in the lungs.

What are common findings of pulmonary edema?

Severe shortness of breath/gasping, anxiety, confusion/agitation, and possible hypertension with JVD.

What is a pneumothorax?

Air enters the pleural space, causing lung collapse.

What findings suggest a pneumothorax?

Pleuritic chest pain, shortness of breath, decreased/absent breath sounds, decreased tactile fremitus, and hyperresonance.

What findings make a pneumothorax a tension pneumothorax emergency?

Hypotension, marked tachycardia, tracheal deviation, JVD, and cyanosis.

What is a hemothorax?

Blood in the pleural space, often associated with trauma.

What is the purpose of a chest tube?

Remove air or fluid from the pleural space and allow lung re-expansion.

What is important nursing care before chest-tube removal?

Give pain medication 30–60 minutes before removal and prepare the dressing supplies; obtain a CXR after removal per lecture.

What are the three emphasized nursing actions for a tracheostomy?

BAG → SUCTION → OXYGEN.

How long should tracheostomy suctioning last?

No longer than 10–15 seconds per suction pass.

What should be done before tracheostomy suctioning?

Pre-oxygenate with 100% FiO2 for at least 30 seconds.

What should you do if a patient has a penetrating chest object?

Do NOT remove the object.

What is flail chest?

At least 3 ribs fractured in more than 2 places, causing paradoxical chest-wall movement.

What is the classic exam clue for flail chest?

Paradoxical chest-wall movement after blunt chest trauma.

What oxygen device provides a fixed FiO2?

A Venturi mask.

What is the typical flow range for a non-rebreather mask?

10–15 L/min, with about 80–95% FiO2 according to the lecture.

What oxygen target is listed for COPD?

88–92%.