NURS 380 Module 2 Gas Exchange

What are the main respiratory conditions discussed in the lecture?

Influenza, pneumonia, obstructive sleep apnea (OSA), asthma, and chronic obstructive pulmonary disease (COPD).

What is influenza?

A highly contagious upper respiratory infection caused by influenza A, B, or C.

How is influenza transmitted?

Through aerosolization of droplets from coughing or sneezing, and fomites can transfer the virus.

What is the incubation period for influenza?

18 to 72 hours.

What are common risk factors for influenza?

Age (children

What are the systemic symptoms of influenza?

Sudden onset fever, headache, myalgia, malaise, fatigue, and chills.

What is the primary method for diagnosing influenza?

Based on history and physical examination, along with a rapid influenza diagnostic test.

What is the recommended prevention strategy for influenza?

Annual influenza vaccination, ideally given in early fall.

What is the role of antivirals in influenza treatment?

They reduce severity and duration of illness and are indicated for severe symptoms or high-risk patients.

What are key nursing assessments for influenza patients?

Vital signs, O2 saturation, respiratory effort, lung sounds, and general appearance.

What positioning is recommended for patients with influenza?

Semi- to high-Fowler's position to promote lung expansion.

What is pneumonia?

A lower respiratory tract infection causing inflammation of lung parenchyma, impairing gas exchange.

What are the classifications of pneumonia?

Community-acquired pneumonia (CAP), healthcare-associated pneumonia (HAP), and aspiration pneumonia.

What are common risk factors for pneumonia?

Age >65, chronic respiratory illnesses, and immune compromise.

What are the systemic symptoms of pneumonia?

Fever, chills, myalgia, fatigue, diaphoresis, and pallor.

What diagnostic tool is typically used for pneumonia?

Chest x-ray, which shows infiltrates or consolidation.

What are common clinical manifestations of pneumonia?

Cough (productive or nonproductive), dyspnea, tachypnea, and pleuritic chest pain.

What is the significance of early recognition in respiratory conditions?

It allows for timely interventions and can prevent deterioration of the patient's condition.

What are some infection control measures for influenza?

Droplet precautions, including wearing masks and ensuring proper hygiene.

What is the importance of patient teaching in managing influenza?

Educating about vaccination, infection control at home, and recognizing worsening symptoms.

What is the expected outcome for patients recovering from influenza?

Resolution of symptoms, absence of fever, and return to baseline respiratory status.

What are the common complications associated with influenza?

Viral pneumonia and secondary bacterial pneumonia.

What should patients do if they experience worsening symptoms after influenza?

Seek care for worsening shortness of breath or changes in sputum.

What role does hydration play in the management of influenza?

It helps prevent dehydration and supports recovery.

What is the impact of chronic conditions on influenza severity?

Chronic conditions like diabetes and asthma increase the risk of severe complications.

What is the typical duration of viral shedding in influenza?

Viral shedding usually ends 2-5 days after symptom onset, but people remain infectious for about 7-10 days.

What is the significance of proper sampling technique in influenza testing?

It is essential to avoid false negatives in rapid influenza diagnostic tests.

What nursing interventions can help with nutrition in influenza patients?

Encouraging small, protein-rich meals to support healing and decrease aspiration risk.

What does a chest x-ray typically show in pneumonia?

Infiltrates or consolidation.

What laboratory tests are used to guide pneumonia management?

WBC count, ABGs, and sputum culture.

What is the purpose of oxygen therapy in pneumonia management?

To reverse or prevent hypoxia.

Why should oxygen be titrated carefully in patients with chronic lung disease?

To avoid oxygen-induced hypoventilation.

When should antibiotics be started in suspected bacterial pneumonia?

Promptly, often broad spectrum initially.

What are bronchodilators used for in pneumonia treatment?

To relieve bronchospasm and improve airflow.

What supportive care measures are recommended for pneumonia patients?

Fluids, antipyretics, analgesics, and respiratory support.

What complications should be watched for in pneumonia?

Respiratory failure, sepsis, and empyema.

What vital signs should be assessed in pneumonia patients?

Tachypnea, tachycardia, fever, and decreased O2 saturation.

What are common respiratory findings in pneumonia?

Wheezes, crackles, rhonchi, or purulent sputum.

What nursing diagnoses may be relevant for pneumonia patients?

Ineffective breathing pattern, impaired gas exchange, and risk for shock.

What interventions can help improve lung function in pneumonia patients?

Coughing and deep breathing, incentive spirometry, and frequent position changes.

What is the primary pathophysiology of Obstructive Sleep Apnea (OSA)?

Relaxation of soft tissues in the upper airway during sleep leading to airway occlusion.

What are common clinical features of OSA?

Loud snoring, gasping during sleep, and excessive daytime sleepiness.

What screening tool is commonly used for OSA?

STOP-BANG tool.

What does the 'S' in STOP-BANG stand for?

Loud snoring.

What lifestyle changes can help manage OSA?

Weight loss, abstinence from alcohol, and smoking cessation.

What is the primary treatment for OSA?

CPAP therapy.

What is a key nursing intervention for patients on CPAP?

Teach function, mask fitting, and cleaning.

What chronic condition is characterized by inflammation and airway obstruction?

Asthma.

What are common symptoms of asthma?

Wheezing, dyspnea, chest tightness, and cough.

What can long-term uncontrolled asthma lead to?

Airway remodeling and fixed limitation.

What are some risk factors for developing asthma?

Family history, early-life respiratory infections, and exposure to tobacco smoke.

What is a medical emergency sign in asthma patients?

Silent chest (disappearance of wheeze and minimal air movement).

What is the significance of increased sputum production in asthma?

It further obstructs airways.

What is the recommended evaluation for pneumonia recovery?

Normalization of vital signs, improved O2 saturation, and increased energy.

What should patients be instructed to report when recovering from pneumonia?

Worsening chest pain, increasing dyspnea, or signs of respiratory failure.

What does spirometry measure in asthma patients?

Decreased FEV1 and FEV1/FVC ratio; improvement in FEV1 after bronchodilator suggests reversible obstruction.

What is the purpose of the bronchodilator reversibility test?

To measure lung function before and after a short-acting bronchodilator.

What should patients avoid before a spirometry test?

Rescue inhaler for ~48 hours, heavy meals for 2 hours, and smoking for 6-12 hours.

How is peak expiratory flow (PEF) monitored at home?

Measured with a peak flow meter; perform three times and record the highest value using traffic light zones.

What is the role of chest x-ray in asthma diagnosis?

Used to rule out other pulmonary diseases, not to diagnose asthma itself.

What do inhaled corticosteroids do in asthma management?

They are the cornerstone long-term controller therapy that reduces airway inflammation, mucus production, and hyperresponsiveness.

What is the function of short-acting beta2-agonists (SABA)?

Provide rapid bronchodilation for acute symptom relief and are always available as rescue medication.

What distinguishes long-acting beta2-agonists (LABA) from SABAs?

LABAs are daily controllers used in combination with inhaled corticosteroids to maintain open airways.

What is the mechanism of action of anticholinergics in asthma?

They block acetylcholine effects on bronchial smooth muscle and are often combined with beta-agonists.

What do leukotriene modifiers do?

They interrupt leukotriene pathways, preventing airway narrowing and swelling.

What is the role of theophylline in asthma treatment?

It is a secondary add-on therapy reserved for difficult-to-control asthma due to its narrow therapeutic window and risk of toxicity.

Define status asthmaticus.

A severe, sustained asthma exacerbation that does not respond to standard therapies.

What are the signs of severe asthma exacerbation?

Persistent bronchoconstriction, air trapping, hyperinflation, hypoxemia, and hypercapnia.

What are key nursing assessments for asthma patients?

Respiratory rate, O2 saturation, breath sounds, ability to speak, and use of accessory muscles.

What is the goal of patient teaching for asthma management?

To create an asthma action plan, identify triggers, and teach proper inhaler technique.

What lifestyle changes can help manage asthma?

Smoking cessation, regular exercise, hydration, and pre-exercise SABA use if needed.

What defines Chronic Obstructive Pulmonary Disease (COPD)?

A chronic, progressive lung disease with airflow limitation that is not fully reversible.

What are the primary causes of COPD?

Chronic exposure to irritants, primarily cigarette smoke, leading to airway and lung tissue inflammation.

What are the main symptoms of COPD?

Difficulty exhaling completely, air trapping, lung hyperinflation, and chronic dyspnea.

What is the significance of alpha-1 antitrypsin deficiency in COPD?

It increases vulnerability to inflammatory damage and early emphysema, even in nonsmokers.

What characterizes emphysema?

Destruction of alveolar walls, reduced gas exchange surface area, and loss of elastic recoil.

What defines chronic bronchitis?

A chronic productive cough for at least 3 months in 2 consecutive years.

What are the clinical manifestations of COPD?

Progressive dyspnea, chronic cough with sputum, use of accessory muscles, and barrel chest.

How is COPD diagnosed?

Through detailed history of smoking, environmental exposure, and progressive symptom pattern.

What does spirometry reveal in COPD?

Reduced FEV1 and reduced FEV1/FVC ratio that does not fully normalize after bronchodilator administration.

What findings might a chest x-ray show in COPD?

Hyperinflation, flattened diaphragm, and increased AP diameter.

What is the purpose of pulse oximetry and ABGs in COPD management?

To assess oxygenation and CO2 retention.

What are short-acting beta-agonists used for?

Quick relief of acute dyspnea.

What role do long-acting beta-agonists play in COPD treatment?

They provide maintenance therapy for sustained symptom control and reduce exacerbations.

How are inhaled corticosteroids used in COPD?

To reduce airway inflammation and exacerbation frequency in selected patients.

What should be done during an exacerbation of COPD?

Administer short-acting bronchodilators more frequently and consider systemic corticosteroids.

What are common triggers for acute COPD exacerbations?

Respiratory infections or environmental irritants.

What is cor pulmonale in the context of COPD?

Right-sided heart failure due to chronic hypoxia leading to pulmonary hypertension.

What are signs of cor pulmonale?

Peripheral edema, jugular venous distension, and worsening fatigue.

What is the significance of monitoring sputum in COPD patients?

Changes in sputum volume, color, and consistency may signal infection or impending exacerbation.

What is the recommended oxygen saturation target for COPD patients?

Typically between 88-92%.

What is the purpose of noninvasive ventilation like BiPAP?

To reduce work of breathing, support fatigued respiratory muscles, and improve O2 delivery and CO2 clearance.

What is the huff-cough technique?

A method involving a slow deep breath, holding for 2-3 seconds, then exhaling steadily with 3 short 'huff' breaths.

What is the incubation period in infectious diseases?

The time between initial contact with infectious material and the development of symptoms.

What does FEV1 stand for?

Forced expiratory volume in one second; a key measure of expiratory flow.

What does FVC stand for?

Forced vital capacity; the total volume of air exhaled during a forced expiration after full inspiration.

What does V/Q mismatch refer to?

An imbalance between ventilation and perfusion, causing impaired gas exchange.

What is aspiration in a medical context?

The entry of food, fluid, emesis, or saliva from the oral cavity into the trachea and lungs.

What is hypoxia?

Insufficient oxygen at the cellular, tissue, or organ level to meet metabolic demands.

What is hypercapnia?

Elevated carbon dioxide levels in the blood.