Respiratory exam psych-085

What is the care for an oxygen clinder?

Keep upright

Keep away from heat

No smoking near tank or while turned on.

What is the care for an oxygen stroller?

Usually carried in a bag and is kept upright. The oxygen is more concentrated due to be more dense and liquid

What is the function of the epiglottis?

to cover the passage to the airway and prevent food from entering the lungs

What is an oxygen cilnder?

An oxygen tank that can produce 1-6 LPM

Large oxygen tank is used for patients that require extended periods of time

Small oxygen tank is used for transportation

What is an oxygen concentrator?

An electronic device that administers 1-5 lpm (up-to-date is 1-10 LPM)

requires maintainance but does not require refills.

Compressess room air and extracts oxygen.

Nasula Cannula

1-6 LPM

delivers 24-40% oxygen

does not interfere with eating or talking

use caution with those with irregular breathing patterns

Simple oxygen mask

minimum of 6 LPM

can deliver up to 10 LPM

gives up to 40% - 60%

Partial Rebreathing Mask

will have have 60-90% oxygen

Start with 12-15 LPM then lower as needed.

Usually administers 8-11 LPM. NEVER below 6 LPM

bag must remain 1/3 inflated

will have bag but no valves

low flow

Non-rebreathing mask

has bag and valves

has 60-80% oxygen delivery

suggested 12 LPM

must remain 1/3 inflated

NEEDS CONSTANT MONITORING due to poential suffocation from improper fitting

low flow

Venturi mask

*most reliable and consistent oxygen rich delivery system

mixes low flow oxygen with high flow room air

ranges between 4, 6 to 8 LPM

24-60% oxygen range

Caution with venturi mask

Do not use humidifier due to possible back pressure triggering the safety pressure valve, causing it to burst

Intermittent Positive Pressure Breathing (IPPB)

Usually ordered for children or elderly who have chronic lung conditions

*mostly used for those with CYSTIC FIBROSIS

helps by liquifying mucous

Mini-Nebulizer

aerosol mist that administers medication

treatment is done when the mist stops

ambu bag/ BVM (bag valve mask)

used when client is unable to breathe on their own

100% knowledge and adminstration of oxygen is needed

endotracheal intubation (E-Tube)

plastic flexible tube used for intubation

oral care is performed every 2hrs to prevent VAP (ventilator associated PNA)

What is the normal percentage of oxygen in the air?

21% oxygen and 4% carbon dioxide

What is the purpose of the sputum specimen?

Helps detect the presence of organisms or blood in specimen

What is the average breaths per minute for adults?

12-20 resp.

What is the major regulator of respiration?

Carbon dioxide

Chemoreceptors in the medulla stimulate the muscles of respirations in response to changes in carbon dioxide levels

What is the normal oximetry range levels?

95-100% Most MDs will accepts 92 and above

Those with COPD usually have 88% and above

What is the PPD (purified protein derivative) tuberculin test and its time frame?

Its a test that indicates whether or not a person has been exposed to tubercille bacillus

the test is performed with a syringe, creating a wheal, and the site is then examined 48-72 hours after the injection.

What is pneumothorax, and how do you assess for it?

It is a rare and serious complication where there is an accumulation of air in the plueral space

What is the purpose of a throat culture?

Specimen is obtained by using a cotton tipped applicator from the back of the patient's throat and placed in a specimen tube

Helps determine drug sensitivity

Usually used for Group A streptoccoci, which produces fast results

What can a CXR (Chest X-Ray) determine?

It can determine heart and lung abnormalities such as:

Lung tumors and

Lung abscesses

Pulmonary tuberculosis

Pneumonia

foreign objects

enlarged heart

What does LPM stand for?

Liters per minute

What education should be provided when a bronchoscopy is performed?

No food or fluids 6-8 hours before procedure

no food or fluids after procedure until gag reflex has recovered

Medication administer usually numbs throat so patient has to remain side-lying position to prevent aspiration

What are some complications/ concerns for those who receive thoracentesis?

It is a sterile procedure.

Patient must be monitored for any signs of leakage or infection

Must be aware of possible pneumothorax contraction

Watch for respiratory depresion when administering analagesics for pain

What are some complications/concerns for those who receive paracentesis

Performed to relieve excess fluid or air. Helps with breathing difficulties

If a large amount is drained (>1000ml), vasodilation or hypovolemia can occur

*Syncope and shock can also occur

What is the purpose of chest suctioning a client?

It can restore negative pressure within the cavity and reinflate the lungs

or

It can prevent loss of negative pressure within the cavity and keep the lungs inflated

What are some complications of chest suctioning?

Report any dyspnea or severe pain

***If a bottle or connection breaks, the closed system will be disrupted, and this is considered an emergency.

Clamp the chest tubes immediately and summon help.

What are some reasons for a postural drainage (chest tube)?

Pnuemothorax: Air in the top of the lung

Hemothorax: Blood collects in the lower part of the plueral cavity

Plueral effusion: Fluid buildup between the lungs and chest

Pyothorax (Empyema): Collection of purulent exudate in plueral cavity

What is the care after chest surgery

Deep breathing techniques

ROM excercises

record vitals frequently

turn, cough, deep breath every 2-4 hrs

Use of incentive spirometer

encourage excercise soon after surgery

observe any signs of shock, dyspnea, pain in chest, rapid increase in drainage,

hemothrax and pneumothorax

What are some signs and symptoms of hypoxia?

SOB (shortness of breath) on exertion, restlessness, apprehension, anxious facial expression, panic, fatigue, impaired coordination

What is postural drainage?

uses gravitity by having head in downward position

How do you treat hypoxia?

administer oxygen

What does incentive spirometer prevent?

atelectasis

What is the orthopneic position?

Sitting or semi-sitting position with pillows for back support which helps with easier breathing

What could suctioning cause?

Dysrhythmia (irregular heartbeat) and desaturation (loss of oxygenation)

limit suctioning to 5 to 10 seconds

What is the reason for using an incentive spirometer?

It's a breathing exercise that helps build up the respiratory capacity

What causes Influenza?

One of several strains of filterable viruses: types A, B, C, D and others

usually direct and indirect transmission

What are some signs and symptoms of influenza?

Sudden illness, muscle pains, fever, headache, sensitivity to light, burning eyes, chills, sneezing, coughing nasal discharge, sore throat and vomiting

Could potentially causes:

heart disease, pneumonia, encephalitis

What is the treatment for inflenza?

Bed rest, use of mild analgesics, cough syrup, large quantity of fluids. Watch for signs of chest pains, purulent or rose colored sputum, or increase of pulse rate

What is the prevention of influenza?

vaccination

What are special considerations of clients who smoke and have chronic laryngitis?

Receive an examination for cancer

What is the common cold?

Acute rhinitis, which is the inflammation of the nasal mucous membranes. Includes watery eyes, sneezing, nasal discharge, congestion, headache, sore throat, general malaise

Treated by bed rest, plenty of fluids,

Best prevention method is hand washing.

What can cause Pneumonia?

Can be caused by bacterial, viral, chemical, fungal or due to aspiration of a foreign object/fluids

community acquired, hospital acquired, healthcare acquired, asipration. Usually occurs as a complication of another condition

What is the treatment of Pneumonia?

Antibiotics, observing respiratory status, oxygen, adequate fluid intake and nutrition, postioning, deep breathing, I&O records, frequent mouth care

What is the relationship between the elderly and those with lower body temp in regards to PNA?

They are a more susceptible population to this bacterial Pneumonia (mycoplasma pneumonia)

What is an example of a fungal Pneumonia?

Pneumocystis carnii Pneumonia

This is a common opportunistic disease associated with HIV/AIDS infection

treated with co-trimoxazole

Signs of Pneumonia

Severe, sharp pain in the chest and chills followed by high fever

Signs of pleurisy

Inflammation of the lung lining sharp pain when breathing as fluid forms, pain is replaced by dry cough SOB, exhaustion

Treatment for pluerisy

bed rest, restriction of activity, anti-inflammatory agents

Treatment of tuberculosis

medication administration

diet is high protein, vitamin A and C

What is the treatment of snoring?

Palatopharyngoplasty removes extra material from the upper throat

or applying a tape strip to nasal bridge

elevate head of bed or use special pillow

What is CPAP?

continuous positive airway pressure

What is COPD?

chronic obstructive pulmonary disease and is associated with bronchial asthma, bronchiectasis, chronic bronchitis, pulmonary emphysema

It is irreversible and is generally associated with dyspnea on exertion

Care for client with COPD

Oxygen must be administered with caution, amount should not exceed 3 LPM

fluid intake is important

pursed-lip breathing during periods of dyspnea

avoid rapid or forceful exhalation- terminal bronchioles may collapse

keep active but limited to whatever heart and lungs can tolerate

What is a positive skin reaction test for TB?

Where signs of redness or inflammation around injection site show up between the initial time of administration and 72 hrs afterwards.

What can trigger Bronchial asthma attacks?

Sudden change in temperature, extreme physical exertion, contact with animal dander, overeating, emotional stress, exposure to antigens

What are some medications to be taken during an asthma attack?

Short acting beta-agonists such as

albuterol

levalbuterol

ventolin

proventil

asmavent

always rinse inhaler pieces daily

What are some asthma medications that are leukotriene antagonists?

Patient education for bronchial asthma

Poorly managed asthma can lead to frequent attacks as well as emphysema

use anti-inflammatory as front-line therapy

inhale steriods

What is pulmmomary emphysema?

Abnormal, permanent enlargement of alveoli and aveolar ducts. Destruction of alveolar walls results in lack of elasticity. Lungs become distended and less elastic due to lack of oxygen.

Heart must work harder to pump blood through the body

What can Pulmonary emphysema lead to?

Congestive heart failure or right heart failure

What can lead to pulmonary emphysema?

Frequent asthma attacks, cigarette smoking and deficiency of a1- antitrypsin

What are signs and symptoms of pulmonary emphysema?

Difficulty in breathing after exertion

wheezing, chronic cough

pale, drawn and afraid of choking

uses abdominal muscles and other muscles to aid in breathing

afraid to lie down, leans forward and contracts the neck muscles with every breath

What is aspiration?

the inhalation of food, fluid, or foreign material into the lungs

What is hyperventilation?

increased rate and depth of breathing

What is bradypnea?

slow breathing

What is dyspnea?

difficult or labored breathing

What is eupnea?

normal breathing

How do you perform a skin test injection for TB?

Approx. 0.1 mL tuberculin serum (PPD) injected intradermally, with a syringe and needle

What is the care after nasal surgery?

Beware of signs of hemorrhage

teach normal respirations

give frequent oral hygiene, elavate HOB

observe for signs of choking and signs of respiratory distress

at regular intervals, examine back of throat for draining of blood.

What are some characteristics of a benign lung tumor?

Smooth edges and sharply defined margins on x-ray films

What is the function of the medulla?

Controls the rate and depth of respirations

What are the goals of oxygen therapy?

reverses hypoxemia,

decreases the work of the respiratory system,

decreases the heart's work in pumping blood

What is oxygen toxicity?

too much oxygen in the muscle and tissues

What are some concerns in regards to administration of oxygen to newborns?

They have vision difficulties

What is IgG?

The only antibody transfered from mother to fetus across the placenta; protects fetus against antitoxins, viruses, and bacteria. Protects the newborn for the first few months of life

What is