| What prevents food from falling into the trachea? | Epiglottis |
| What lines the lung surface? | Visceral pleura |
| Internal Respiration | Process by which oxygen is transferred from the blood to body cells and carbon dioxide is passed from the body cells to the blood to be eliminated from the body |
| External Respiration | (Ventilation) consist of the movement of oxygen into the lungs (inhalation) and the removal of carbon dioxide from the lungs (exhalation) |
| What pattern does inhaled air follow? | Nose, Pharynx, Trachea, Bronchi, Alveoli |
| What is dyspnea? | Period of difficulty breathing |
| What position would someone experiencing dyspnea be most comfortable in? | Sitting upright |
| Define Cheyne stokes respirations. | Pattern of respiration in which shallow, rapid, breathing is followed by a period of apnea. (Usually occurs before someone dies) |
| Define tachypnea | Increased rate of breathing. Usually over 20 breaths per minute. |
| If you have a patient that isn't getting adequate O2 exchange what is an appropriate nursing diagnosis? | Impaired airway clearance |
| Where does the oxygen/carbon dioxide change take place? | Alveoli capillary membrane |
| Define Perfusion | The flow of blood within the circulatory system |
| What kind of blood does the pulmonary vein carry from the lungs? | oxygenated |
| What could happen if there is an abnormal contour of the chest like with scoliosis? | Could result in incomplete or restricted lung expansion |
| In what position would a patient have maximum lung capacity and volume? | Standing |
| Describe crackles. | Results from delayed opening of deflated airways. Sounds like static or strands of hair being rubbed together. May be from inflammation or congestion. Can be cleared with coughing |
| Your patient has an ABG ordered. What areas might you see this lab test be drawn from? | radial, brachial, or femoral arteries |
| What would be a normal pH? | 7.35-7.45 |
| What controls the ratio of bicarbonate changing the carbonic acid? | Kidneys |
| What would be a treatment for Respiratory alkalosis? | Measures to slow respiratory rate, breathing into a paper bag, sedation |
| What type of information is given by a pulse oximetry? | Oxygen content in hemoglobin |
| What does a positive Mantoux skin test indicate? | infection or exposure of Mycobacterium tuberculosis |
| What might be determined by a sputum and c&s? | What antibiotics should be used for that particular infection. Also diagnosis cancer cells and diagnosis TB(which takes 3 tests) |
| Why would you always get a c/s specimen prior to administering antibiotics? | It might make it difficult to get an accurate c/s |
| What is viewed during a fluoroscopy? | The thoracic cavity with all it's contents in motion |
| Your patient is scheduled for a procedure where radioactive contrast medium will be used. What allergies do you need to assess for? | Iodine or shellfish allergies |
| Your patient is scheduled for a bronchoscopy. What do you tell them about food/fluid intake? | NPO for 6 hours prior to the procedure |
| What are some complications of bronchoscopy? | Hypotension, Bracycardia, Bronchospasms, Pneumothorax, Aspiration, Hypoxemia, Bleeding, Dysrythmias |
| What are the postop care instructions for a patient that had a bronchoscopy? | NPO until gag reflex is back, Semi fowler's position, Monitor v/s, Watch for hemoptysis, swelling of the face & neck, stridor, decreased or asymmetric chest movement, diminished lung sounds, Tell pt there may be blood in sputum cause of throat irritation |
| The pt has undergone a thoracentesis and they become dyspnic, tachypenic, and hypertensive. These are s/s of: | Lung has been punctured |
| What is the primary nursing prevention that prevents ateletasis? | Deep breathing and coughing which are done to aid in lung expansion and expectoration of respiratory secretions |
| What does pursed lip breathing promote? | Promotes carbon dioxide elimination. It inhibits airway collapse and decrease dyspnea in patients with chronic lung disease |
| What might you see postop to prevent atelectasis? | Incentive spirometer |
| What can you have patients do to help liquefy respiratory secretions? | Aerosol Therapy |
| If you have a patient that is on 3L of O2 and they become lethargic and are experiencing bradypneia what could this be a sign of? | Oxygen toxicity |
| You have a patient with COPD and emphysema. Why would you never administer O2 over 3L? | They have become used to high CO2 levels. If O2 levels increase it will stop the hypoxic drive(bodies urge for oxygen) |
| What is CPAP and what does it maintain? | Continuous Positive Airway Pressure - maintains positive pressure in the airway during sleep, thereby avoiding periods of apnea |
| Key points about oxygen: | Check liter flow against MAR Monitor pt response O2 sats and ABG If humidification used, use sterile water Replace & clean equipment to prevent infection No petroleum products NO SMOKING! |
| The common cold is known by what other name? | Rhinitis or Coryza |
| What type of meds might you see a patient with rhinitis place on? | Analgesics, Decongestants, Antihistamines, Antitussives, Saline gargle NO ANTIBIOTICS, ANTIVIRALS, OR ANTIBACTERIALS |
| Your patient has hypertension and rhinitis. What medication if ordered might you question? | Antihistamines and decongestants |
| What would you tell a patient with rhinitis about rest and sleep? | adequate rest and sleep is the best prevention of rhinitis |
| Why would you monitor the patient for vision changes after sinus surgery? | may indicate damage to the optic nerve |
| Your patient has had sinus surgery what would be included in their postop teaching? | No blowing nose no lifting>10 lbs Avoid the valsava maneuver (grunt or strain) Avoid smoky environments Remain in warm environment |
| What can pharyngitis lead to? | Endocarditis and rheumatic fever (cardiac and renal complications) |
| Your patient has had an I&D for a periotonsillar abscess. What post procedure nursing care will you see administered? | place in semi fowlers position to prevent aspiration, ice collar to reduce swelling and pain, encourage fluids, observes signs respiratory obstruction or excessive bleeding. |
| Define aphonia | complete loss of voice |
| What is epistaxis and what is the most common cause in children? | nosebleed, caused by trauma to the nose in children |
| What is rhinoplasty? | reconstruction of the nose "nose job" |
| What are nasal polyps? | grape-like swellings that arise from nasal mucous membranes, result from chronic irritation R/T infection or allergic rhinitis, they obstruct nasal breathing and sinus drainage, lead to sinusitis. |
| What is the most important thing to monitor following nasal surgery? | bleeding, ask pt to report excessive swallowing which can indicate bleeding. |
| You have a patient come in that has had some facial trauma with a broken nose. They are having some clear nasal drainage. Why might you see a dextrostix test done on the drainage? | to determine presence of glucose, which is diagnostic for cerebrospinal fluid |
| What are some things that increase the patients risk for sleep apnea? | Smoking, Neuromuscular disease, sedatives, hypnotics, heavy alcohol |
| What is one of the first symptoms of laryngeal cancer? | persistent hoarseness |
| How might the diagnosis of laryngeal cancer be made? | laryngoscopy, biopsy, observation of the mobility of the vocal cords, CT, and chest xray |
| What type of surgery might be done if the cancer has spread beyond the larynx? | Radical neck dissection ( removal of the lymph nodes, muscles, and adjacent tissues) |
| Your patient is a postop tonsillectomy patient. You note that they are swallowing excessively. What might this be a sign of? | bleeding at suture site |
| What position would you place a tonsillectomy patient in to prevent aspiration? | Semi Fowlers |
| What are the 2 major problems for the postop tonsillectomy patient? | hemorrhage and respiratory distress |
| Why might a patient start bleeding as long as 7 days post tonsillectomy? | This is when the scabs fall off |
| What is the difference from a tracheotomy and a tracheostomy? | Tracheotomy is the surgical procedure that makes an opening into the trachea Tracheostomy is a surgical opening into the trachea into which a tracheotomy or laryngectomy tube is inserted. |
| What would be the goal of suctioning? | to improve gas exchange in the lungs by removing excessive mucous secretions with a suctioning catheter |
| Is suctioning of a trach a clean or sterile procedure? | Sterile |
| How long would you apply a suction to a trach patient? | No more than 10 seconds |
| How would you determine the effectiveness of suctioning? | Listening to breath sounds before and after suctioning |
| What are some complications of ET tubes? | ulceration and stricture to the trachea or larynx, atelectasis, and pneumonia |
| Why is a patient on a ventilator at risk for aspiration? | absence of cough and swallowing reflexes and the secretions are often thick |
| What is the body holding onto in Respiratory acidosis? | CO2 |
| You have a patient that is consuming baking soda for indigestion. They are at risk for ____? | metabolic alkalosis |
