MED SURG - Respiratory

Most common symptom of pulmonary embolism?

*chest pain that occurs suddenly (MOST COMMON) -dyspnea -increased RR

what assessment findings are common after bronchoscopy?

- dry cough -blood - streaked sputum

When should a pt with asthma v/s worry the RN?

-30+ breaths/min (RR) -120+bpm (pulse) -accessory neck muscles straining to lift chest wall -agitation ( hypoxemia) -hyperresonance ( percussion) -Inspiratory/expiratory wheezing **must stay w/ pt, v/s monitoring,oximetry, ABG's, -PEFR (usually not able to be obtained however in the case it is a number less than 200 L/min indicates severe obstruction),

other asthma triggers

-GERD -Hormones / menses -Stress -extreme emotional expressions ( crying, laughing, anger, fear)

TB sputum culture

-Needed every 2 to 4 weeks once medications are initiated -best done early in the morning and ALWAYS before eating

histoplasmosis

fungal infection of the lungs. S/S: fever, dyspnea, cough, weight loss. Lymph node, liver and spleen enlargement

The nurse is providing immediate postprocedure care to a client who had a thoracentesis to relieve a tension pneumothorax that resulted from rib fractures. The goal is that the client will exhibit normal respiratory functioning, and the nurse provides instructions to assist the client with this goal. Which client statement indicates that further instruction is needed? 1."I will lie on the affected side for an hour." 2."I can expect a chest x-ray exam to be done shortly." 3."I will let you know at once if I have trouble breathing." 4."I will notify you if I feel a crackling sensation in my chest."

1."I will lie on the affected side for an hour." Rationale:After the procedure the client usually is turned onto the unaffected side for 1 hour to facilitate lung expansion. Tachypnea, dyspnea, cyanosis, retractions, or diminished breath sounds, which may indicate pneumothorax, should be reported to the health care provider. A chest x-ray may be performed to evaluate the degree of lung reexpansion or pneumothorax. Subcutaneous emphysema (crepitus) may follow this procedure because air in the pleural cavity leaks into subcutaneous tissues. The involved tissues feel like lumpy paper and crackle when palpated (crepitus). Usually subcutaneous emphysema causes no problems unless it is increasing and constricting vital organs, such as the trachea.

A client with a history of recent upper respiratory infection comes to the urgent care center complaining of chest pain. The nurse determines that the pain is most likely of a respiratory origin if the client makes which statement about the pain? 1."It hurts more when I breathe in." 2."I have never had this pain before." 3."It hurts on the left side of my chest." 4."The pain is about a 6 on a scale of 1 to 10."

1."It hurts more when I breathe in." Rationale:Chest pain is assessed by using the standard pain assessment parameters, such as characteristics, location, intensity, duration, precipitating and alleviating factors, and associated symptoms. Pain of pleuropulmonary (respiratory) origin usually worsens on inspiration.

A health care provider (HCP) writes a prescription to begin to wean the client from the mechanical ventilator by use of intermittent mandatory ventilation/synchronized intermittent mandatory ventilation (IMV/SIMV). The registered nurse determines that the new graduate nurse understands this modality of weaning if which statement is made? 1."The respiratory rate is decreased gradually until the client can assume the work of breathing without ventilatory assistance." 2."A T-piece will be attached to the ventilator and provide supplemental oxygen at a concentration that is 10% higher than the ventilator setting." 3."It will provide pressure support to decrease the workload of breathing and increase the client's ability to initiate spontaneous breathing efforts." 4."It involves removing the ventilator from the client and closely monitoring the client's ability to breathe spontaneously for a predetermined amount of time."

1."The respiratory rate is decreased gradually until the client can assume the work of breathing without ventilatory assistance." Rationale:IMV/SIMV is one of the methods used for weaning. With this method, the respiratory rate is gradually decreased until the client assumes all of the work of breathing on his or her own. This method works exceptionally well in the weaning of clients from short-term mechanical ventilation, such as that used in clients who have undergone surgery. The respiratory rate frequently is decreased in increments on an hourly basis until the client is weaned and is ready for extubation. Therefore, the remaining options are incorrect.

A client has been treated for pleural effusion with a thoracentesis. The nurse determines that this procedure has been effective if the nurse notes which assessment finding? 1.Absence of dyspnea 2.Increased severity of cough 3.Dull percussion notes over lung tissue 4.Decreased tactile fremitus over lung tissue

1.Absence of dyspnea Rationale:The client who has undergone thoracentesis should experience relief of the signs and symptoms experienced before the procedure. Typical signs and symptoms of pleural effusion include dry, nonproductive cough; dyspnea (usually on exertion); decreased or absent tactile fremitus; and dull or flat percussion notes on respiratory assessment.

The nurse is preparing a list of home care instructions for a client who has been hospitalized and treated for tuberculosis. Which instructions should the nurse include on the list? Select all that apply. 1.Activities should be resumed gradually. 2.Avoid contact with other individuals, except family members, for at least 6 months. 3.A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4.Respiratory isolation is not necessary because family members already have been exposed. 5.Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags. 6.When 1 sputum culture is negative, the client is no longer considered infectious and usually can return to former employment.

1.Activities should be resumed gradually. 3.A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4.Respiratory isolation is not necessary because family members already have been exposed. 5.Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags. Rationale:The nurse should provide the client and family with information about tuberculosis and allay concerns about the contagious aspect of the infection. The client needs to follow the medication regimen exactly as prescribed and always have a supply of the medication on hand. Side and adverse effects of the medication and ways of minimizing them to ensure compliance should be explained. After 2 to 3 weeks of medication therapy, it is unlikely that the client will infect anyone. Activities should be resumed gradually and a well-balanced diet that is rich in iron, protein, and vitamin C to promote healing and prevent recurrence of infection should be consumed. Respiratory isolation is not necessary because family members already have been exposed. Instruct the client about thorough hand washing, to cover the mouth and nose when coughing or sneezing, and to put used tissues into plastic bags. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. When the results of 3 sputum cultures are negative, the client is no longer considered infectious and can usually return to former employment.

The nurse is caring for the client who is suspected of having lung cancer. The nurse should assess the client for which most frequent early symptom of lung cancer? 1.Cough 2.Hoarseness 3.Hemoptysis 4.Pleuritic pain

1.Cough Rationale:Cough is the most frequent early symptom of lung cancer, which begins as nonproductive and hacking and progresses to productive. In the smoker who already has a cough, a change in the character and frequency of cough usually occurs. Hoarseness indicates that the affected tissue is in the upper airway. Wheezing and blood-streaked sputum (hemoptysis) are later signs of lung cancer. Pain is a very late sign and is usually pleuritic in nature.

A client is suspected of having a pulmonary embolus. The nurse assesses the client, knowing that which is a common clinical manifestation of pulmonary embolism? 1.Dyspnea 2.Bradypnea 3.Bradycardia 4.Decreased respirations

1.Dyspnea Rationale:The common clinical manifestations of pulmonary embolism are tachypnea, tachycardia, dyspnea, and chest pain.

What should you teach your pt about asthma?

RN teaching to pt -intermittent nature of asthma and need for long term tx -identify poss. triggers and prevention methods -management of medication and proper admin. -correct use of peak flowmeter -Developing an asthma action plan w/ primary HCP, what to do for acute asthma attack.

The nurse is preparing to assist a client with a cuffed tracheostomy tube to eat. What intervention is the priority before the client is permitted to drink or eat? 1.Inflate the cuff on the tracheostomy tube. 2.Deflate the cuff on the tracheostomy tube. 3.Maintain the head of the bed in low Fowler's position. 4.Place the tray in a comfortable position in front of the client.

1.Inflate the cuff on the tracheostomy tube. Rationale:Tracheostomy tubes are available in many sizes and are made of plastic or metal. The tubes may be reusable; however, most tubes are disposable. A tracheostomy tube may or may not have a cuff. It also may have an inner cannula. For clients receiving mechanical ventilation, a cuffed tube is used. A noncuffed tube may be used when mechanical ventilation is not required. If a client with a tracheostomy is allowed to eat and the tracheostomy has a cuff, the nurse should inflate the cuff to prevent aspiration of food or fluids. The cuff would not be deflated because of the risk of aspiration. Although the nurse would ensure that the meal tray is in a comfortable position for the client, this would not be the priority intervention. The head of the bed should always be elevated; low Fowler's position could lead to aspiration.

The nurse is taking the history of a client with occupational lung disease (silicosis). The nurse should assess whether the client wears which item during periods of exposure to silica particles? 1.Mask 2.Gown 3.Gloves 4.Eye protection

1.Mask Rationale:Silicosis results from chronic, excessive inhalation of particles of free crystalline silica dust. The client should wear a mask to limit inhalation of this substance, which can cause restrictive lung disease after years of exposure. Options 2, 3, and 4 are not necessary.

A client who is human immunodeficiency virus (HIV)-positive has had a tuberculin skin test (TST). The nurse notes a 7-mm area of induration at the site of the skin test and interprets the result as which finding? 1.Positive 2.Negative 3.Inconclusive 4.Need for repeat testing

1.Positive Rationale:The client with HIV infection is considered to have positive results on tuberculin skin testing with an area of induration larger than 5 mm. The client without HIV is positive with an induration larger than 10 mm. The client with HIV is immunosuppressed, making a smaller area of induration positive for this type of client. It is possible for the client infected with HIV to have false-negative readings because of the immunosuppression factor. Options 2, 3, and 4 are incorrect interpretations.

The nurse is teaching a client with emphysema about positions that help breathing during dyspneic episodes. The nurse instructs the client that which positions alleviate dyspnea? Select all that apply. 1.Sitting up and leaning on a table 2.Standing and leaning against a wall 3.Lying supine with the feet elevated 4.Sitting up with the elbows resting on knees 5.Lying on the back in a low Fowler's position

1.Sitting up and leaning on a table 2.Standing and leaning against a wall 4.Sitting up with the elbows resting on knees Rationale:The client should use the positions outlined in options 1, 2, and 4. These allow for maximal chest expansion. The client should not lie on the back because it reduces movement of a large area of the client's chest wall. Sitting is better than standing, whenever possible. If no chair is available, leaning against a wall while standing allows accessory muscles to be used for breathing and not posture control.

The nurse is assisting in caring for a client after removal of an endotracheal tube. Which finding should be reported to the health care health care provider (HCP) immediately? 1.Stridor 2.Lung congestion 3.Occasional pink-tinged sputum 4.Respiratory rate of 26 breaths/min

1.Stridor Rationale:The nurse reports the presence of stridor to the HCP immediately. This is a high-pitched coarse sound that is heard with the stethoscope over the trachea. It indicates airway edema and places the client at risk for airway obstruction. Lung congestion and a respiratory rate of 26 breaths/min are abnormal, but additional data are needed to determine whether these pose a serious problem at this time. Occasional pink-tinged sputum may be expected at this time.

The nurse is caring for a client with a tracheostomy tube attached to a ventilator. The high-pressure alarm sounds on the ventilator. The nurse should plan to perform which action? 1.Suction the client. 2.Evaluate the cuff for a leak. 3.Assess for a disconnection. 4.Notify the respiratory therapist.

1.Suction the client. Rationale:When the high-pressure alarm sounds on a ventilator, it is most likely because of an obstruction. The obstruction can be caused by the client's biting on the tube, kinking of the tubing, or mucus plugging requiring suctioning. A cuff leak and disconnection would cause the low-pressure alarm to sound, so options 2 and 3 can be eliminated. Notifying the respiratory therapist delays necessary treatment.

The nurse is caring for a client with a dry suction chest drainage system. During assessment of the drainage system, what should the nurse expect to find? Select all that apply. 1.The dry suction control regulation set to the prescribed amount 2.The water filled suction control chamber filled to the prescribed amount 3.Increased intermittent bubbling in the water seal chamber when the system is to gravity 4.Continuous bubbling in the water seal chamber when the system is connected to suction 5.The drainage in the collection chamber marked each shift to monitor the amount of drainage

1.The dry suction control regulation set to the prescribed amount 5.The drainage in the collection chamber marked each shift to monitor the amount of drainage Rationale:There are 2 types of chest drainage systems: the wet drainage system and the dry drainage system. On routine assessment of the system, the nurse should look at the different chambers. For a dry drainage system, the nurse should check the dry suction control regulation and make sure it is set to the prescribed amount. The nurse should also look for the orange floater ball to appear in the window; this indicates that the suction is being applied correctly. Tidaling should be noted in the water seal chamber. The nurse should also check the water seal chamber; if the system is connected to suction (as opposed to gravity), tidaling may not be seen and the suction should be turned off to check for tidaling. If continuous bubbling is noted or the bubbling increases, an air leak may be present and the connections should be checked. In a dry drainage system, water is not added to the suction control chamber; this is done with a wet drainage system. The drainage collection chamber should be monitored and marked each shift to monitor the amount of drainage, if any.

The nurse is caring for a client who is mechanically ventilated, and the high-pressure ventilator alarm is sounding. The nurse understands that which complications may cause this alarm? Select all that apply. 1.Water or a kink in the tubing 2.Biting on the endotracheal tube 3.Increased secretions in the airway 4.Disconnection or leak in the system 5.The client ceasing spontaneous breathing

1.Water or a kink in the tubing 2.Biting on the endotracheal tube 3.Increased secretions in the airway Rationale:Causes of high-pressure ventilator alarms include water or a kink in the tubing, biting on the endotracheal tube, increased secretions in the airway, wheezing or bronchospasm, displacement of the endotracheal tube, or the client fighting the ventilator. A disconnection or leak in the system and the client ceasing to spontaneously breathe are causes of a low-pressure ventilator alarm.

A registered nurse who is orienting a new nursing graduate to the hospital emergency department instructs the new graduate to monitor a client for one-sided chest movement on the right side while the client is being intubated by the health care provider (HCP). Which statement made by the new nursing graduate indicates understanding of the importance of this observation? 1."It will enter the left main bronchus if inserted too far." 2."It will enter the right main bronchus if inserted too far." 3."It may enter the left main bronchus if not inserted far enough." 4."It may enter the right main bronchus if not inserted far enough."

2."It will enter the right main bronchus if inserted too far." Rationale:If the endotracheal tube is inserted too far into the client's trachea, the tube will enter the right main bronchus. This occurs because the right bronchus is shorter and wider than the left and extends downward in a more vertical plane. If the tube is not inserted far enough, no chest expansion at all will occur. The other options are incorrect.

The nurse is preparing to suction a client via a tracheostomy tube. The nurse should plan to limit the suctioning time to a maximum of which time period? 1.5 seconds 2.10 seconds 3.30 seconds 4.60 seconds

2.10 seconds Rationale:Hypoxemia can be caused by prolonged suctioning, which stimulates the pacemaker cells in the heart. A vasovagal response may occur, causing bradycardia. The nurse must preoxygenate the client before suctioning and limit the suctioning pass to 10 seconds.

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings would the nurse expect to note on assessment of this client? Select all that apply. 1.A low arterial PCo2 level 2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen saturation with mild exercise 4.A widened diaphragm noted on the chest x-ray 5.Pulmonary function tests that demonstrate increased vital capacity

2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen saturation with mild exercise Rationale:Clinical manifestations of chronic obstructive pulmonary disease (COPD) include hypoxemia, hypercapnia, dyspnea on exertion and at rest, oxygen desaturation with exercise, and the use of accessory muscles of respiration. Chest x-rays reveal a hyperinflated chest and a flattened diaphragm if the disease is advanced. Pulmonary function tests will demonstrate decreased vital capacity.

The nurse caring for a client with a pneumothorax and who has had a chest tube inserted notes continuous gentle bubbling in the water seal chamber. What action is most appropriate? 1.Do nothing, because this is an expected finding. 2.Check for an air leak, because the bubbling should be intermittent. 3.Increase the suction pressure so that the bubbling becomes vigorous. 4.Clamp the chest tube and notify the health care provider immediately.

2.Check for an air leak, because the bubbling should be intermittent. Rationale:Fluctuation with inspiration and expiration, not continuous bubbling, should be noted in the water seal chamber. Intermittent bubbling may be noted if the client has a known pneumothorax, but this should decrease as time goes on and as the pneumothorax begins to resolve. Therefore, the nurse should check for an air leak. If a wet chest drainage system is used, bubbling would be continuous in the suction control chamber and not intermittent. In a dry system, there is no bubbling. Increasing the suction pressure only increases the rate of evaporation of water in the drainage system; in addition, increasing the suction can be harmful and is not done without a specific prescription to do so if using a wet system. Dry systems will allow for only a certain amount of suction to be applied; an orange bellow will appear in the suction window, indicating that the proper amount of suction has been applied. Chest tubes should be clamped only with a health care provider's prescription.

The nurse is monitoring the chest tube drainage system in a client with a chest tube. The nurse notes intermittent bubbling in the water seal chamber. Which is the most appropriate nursing action? 1.Check for an air leak. 2.Document the findings. 3.Notify the health care provider. 4.Change the chest tube drainage system.

2.Document the findings Rationale:Bubbling in the water seal chamber is caused by air passing out of the pleural space into the fluid in the chamber. Intermittent (not constant) bubbling is normal. It indicates that the system is accomplishing one of its purposes, removing air from the pleural space. Continuous bubbling during inspiration and expiration indicates that an air leak exists. If this occurs, it must be corrected. Notifying the health care provider and changing the chest tube drainage system are not indicated at this time.

The nurse is reading the report for a chest x-ray study in a client who has just been intubated. The report states that the tip of the endotracheal tube lies 1 cm above the carina. How does the nurse correctly interpret these findings? 1.It is at the first tracheal cartilaginous ring. 2.It is at the bifurcation of the right and left main bronchi. 3.It is at the point at which the larynx connects to the trachea. 4.It is at the area connecting the oropharynx to the laryngopharynx.

2.It is at the bifurcation of the right and left main bronchi. Rationale:The carina is a cartilaginous ridge that separates the openings of the two main (right and left) bronchi. If an endotracheal tube is inserted past the carina, the tube will enter the right main bronchus as a result of the natural curvature of the airway. This is hazardous because then only the right lung will be ventilated. Incorrect tube placement is easily detected because only the right lung will have breath sounds and rise and fall with ventilation. Options 1, 3, and 4 are incorrect interpretations.

A client with a tracheostomy tube who is on a ventilator is at risk for impaired gas exchange. The nurse should assess for which finding as the best indicator of adequate ongoing respiratory status? 1.Oxygen saturation of 89% 2.Respiratory rate of 16 breaths/minute 3.Moderate amounts of tracheobronchial secretions 4.Small to moderate amounts of frank blood suctioned from the tube

2.Respiratory rate of 16 breaths/minute Rationale:Impaired gas exchange could occur after tracheostomy because of excessive secretions, bleeding into the trachea, restricted lung expansion because of immobility, or concurrent respiratory conditions. An oxygen saturation of 89% is less than optimal. A respiratory rate of 16 breaths/minute is in the normal range.

The nurse is monitoring a client who has a closed chest tube drainage system. The nurse notes fluctuation of the fluid level in the water seal chamber during inspiration and expiration. On the basis of this finding, the nurse should make which interpretation? 1.There is a leak in the system. 2.The chest tube is functioning as expected. 3.The amount of suction needs to be decreased. 4.The occlusive dressing at the insertion site needs reinforcement.

2.The chest tube is functioning as expected. Rationale:The presence of fluctuation of the fluid level in the water seal chamber indicates a patent drainage system. With normal breathing, the water level rises with inspiration and falls with expiration. Fluctuation stops if the tube is obstructed, if the suction is not working properly, or if the lung has reexpanded. Options 1, 3, and 4 are incorrect interpretations of the finding. An air leak may cause excessive bubbling in the water seal chamber. Excessive and vigorous bubbling in the suction control chamber may indicate that the amount of suction needs to be decreased. The status of the dressing is not specifically related to the presence of fluctuation of the fluid level in the water seal chamber.

An oxygen delivery system is prescribed for a client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which oxygen delivery system would the nurse prepare for the client? 1.Face tent 2.Venturi mask 3.Aerosol mask 4.Tracheostomy collar

2.Venturi mask Rationale:The Venturi mask delivers the most accurate oxygen concentration. It is the best oxygen delivery system for the client with chronic airflow limitation such as chronic obstructive pulmonary disease, because it delivers a precise oxygen concentration. The face tent, aerosol mask, and tracheostomy collar are also high-flow oxygen delivery systems but most often are used to administer high humidity.

Tuberculosis (TB)

infectious bacterial disease, most commonly spread by inhalation of small particles and usually affecting the lungs; may spread to other organs CXR shows consolidation

The nurse is caring for a group of clients on the clinical nursing unit. The nurse interprets that which of these clients is at most risk for the development of pulmonary embolism? 1.A 25-year-old woman with diabetic ketoacidosis 2.A 65-year-old man out of bed 1 day after prostate resection 3.A 73-year-old woman who has just had pinning of a hip fracture 4.A 38-year-old man with pulmonary contusion sustained in an automobile crash

3.A 73-year-old woman who has just had pinning of a hip fracture Rationale:Clients frequently at risk for pulmonary embolism include those who are immobilized. This is especially true in the immobilized postoperative client. Other causes include those with conditions that are characterized by hypercoagulability, endothelial disease, or advancing age.

The nurse is caring for a client who is mechanically ventilated and is monitoring for complications of mechanical ventilation. Which assessment finding, if noted by the nurse, indicates the need for follow-up? 1.Muscle weakness in the arms and legs 2.A temperature of 98.6°F (37°C), decreased from 99.0°F (37.2°C) 3.A blood pressure of 90/60 mm Hg, decreased from 112/78 mm Hg 4.A heart rate of 80 beats/minute, decreased from 85 beats/minute

3.A blood pressure of 90/60 mm Hg, decreased from 112/78 mm Hg Rationale:Complications of mechanical ventilation include the following: hypotension caused by application of positive pressure, which increases intrathoracic pressure and inhibits blood return to the heart; pneumothorax or subcutaneous emphysema as a result of positive pressure; gastrointestinal alterations such as stress ulcers; malnutrition if nutrition is not maintained; infections; muscular deconditioning; and ventilator dependence or inability to wean. Some muscle weakness is expected. Options 1, 2, and 4 present normal assessment findings.

The nurse working on a medical respiratory nursing unit is caring for several clients with respiratory disorders. The nurse should determine that which client on the nursing unit is at the lowest risk for infection with tuberculosis? 1.An uninsured man who is homeless 2.A newly immigrated woman from Korea 3.A man who is an inspector for the U.S. Postal Service 4.An older woman admitted from a long-term care facility

3.A man who is an inspector for the U.S. Postal Service Rationale:Clients at high risk for acquiring tuberculosis include immigrants from Asia, Africa, Latin America, and Oceania; medically underserved populations (ethnic minorities, homeless); those with human immunodeficiency virus infection or other immunosuppressive disorders; residents in group settings (long-term care, correctional facilities); and health care workers.

The nurse is caring for a client on a mechanical ventilator. The high-pressure alarm on the ventilator sounds. The nurse suspects that the most likely cause of the alarm is which finding? 1.A disconnection of the ventilator tubing 2.An exaggerated client inspiratory effort 3.Accumulation of respiratory secretions 4.Generation of extreme negative pressure by the client

3.Accumulation of respiratory secretions Rationale:The high-pressure alarm sounds when the preset peak inspiratory pressure limit is reached by the ventilator before it has delivered a set tidal volume. Causes include tubing obstruction or kinks, breathing "out of phase" or "bucking the ventilator," accumulation of secretions, condensation of water in the ventilator tubing, coughing or Valsalva maneuvers, increased airway resistance, bronchospasms, decreased pulmonary compliance, and pneumothorax. The remaining options identify causes for triggering the low-pressure alarm.

A client with chronic obstructive pulmonary disease (COPD) who is beginning oxygen therapy asks the nurse how to manage the amount of oxygen given. How should the nurse instruct the client? 1.Do not exceed 1 L/min. 2.Do not exceed 2 L/min. 3.Adjust the oxygen depending on SpO2. 4.Adjust the oxygen depending on respiratory rate.

3.Adjust the oxygen depending on SpO2. Rationale:The client with COPD is often dependent on oxygen. The oxygen should be adjusted depending on the SpO2, which should be 88% to 92%. All other options are incorrect.

The nurse is caring for a dyspneic client with decreased breath sounds. The nurse should carry out which intervention to decrease the client's work of breathing? 1.Instruct the client to limit fluid intake. 2.Place the client in low Fowler's position. 3.Administer the prescribed bronchodilator. 4.Place a continuous pulse oximeter on the client.

3.Administer the prescribed bronchodilator. Rationale:Administering the prescribed bronchodilator will help to decrease airway resistance, which decreases the work of breathing and should ease the client's dyspnea. The client should be placed in high Fowler's position to maximize chest expansion. Clients with increased mucus production have increased airway resistance, which increases the work of breathing. Thus, fluids should be increased to help liquefy secretions. Placing a continuous pulse oximeter will assist with monitoring the client's condition but will have no effect on the client's work of breathing.

The nurse who is participating in a client care conference with other members of the health care team is discussing the condition of a client with acute respiratory distress syndrome (ARDS). The health care provider (HCP) states that as a result of fluid in the alveoli, surfactant production is falling. What does the nurse anticipate as a physiological consequence? 1.Atelectasis and viral infection 2.Bronchoconstriction and stridor 3.Collapse of alveoli and decreased compliance 4.Decreased ciliary action and retained secretions

3.Collapse of alveoli and decreased compliance Rationale:Surfactant is a phospholipid produced in the lungs that decreases surface tension in the lungs. This prevents the alveoli from sticking together and collapsing at the end of exhalation. When alveoli collapse, the lungs become "stiff" because of decreased compliance. Common causes of decreased surfactant production are ARDS and atelectasis. The remaining options are incorrect.

The nurse is monitoring the respiratory status of a client after creation of a tracheostomy. Which co-existing condition in the client may cause an inaccurate pulse oximetry reading? 1.Fever 2.Epilepsy 3.Hypotension 4.Respiratory failure

3.Hypotension Rationale:Hypotension, shock, or the use of peripheral vasoconstricting medications may result in inaccurate pulse oximetry readings as a result of impaired peripheral perfusion. Fever and epilepsy would not affect the accuracy of measurement. Respiratory failure also would not affect the accuracy of measurement, although the readings may be abnormally low.

A nursing student is developing a plan of care for a client with a chest tube that is attached to a chest drainage system. Which intervention in the care plan indicates the need for further teaching for the student? 1.Position the client in semi Fowler's position. 2.Add water to the suction chamber as it evaporates. 3.Instruct the client to avoid coughing and deep breathing. 4.Tape the connection sites between the chest tube and the drainage system.

3.Instruct the client to avoid coughing and deep breathing. Rationale:It is important to encourage the client to cough and deep breathe when a chest tube drainage system is in place. This will assist in facilitating appropriate lung reexpansion. The client is positioned in semi Fowler's position to facilitate ease in breathing. Water is added to the suction chamber as it evaporates to maintain the full suction level prescribed. Connections between the chest tube and the drainage system are taped to prevent accidental disconnection.

The nurse is providing an educational session to community members regarding histoplasmosis. The nurse should provide which information about this disease? 1.It is caused by a tick bite. 2.It is caused by contamination from cat feces. 3.It can be caused by the inhalation of spores from bird droppings. 4.It can be contagious by respiratory contact with an infected person.

3.It can be caused by the inhalation of spores from bird droppings. Rationale:Histoplasmosis is caused by the inhalation of spores from bat or bird droppings. This disease cannot be transmitted from one person to another. Lyme disease is a multisystem infection that results from a bite by a tick that is usually carried by several species of deer. Toxoplasmosis is caused by the ingestion of cysts from contaminated cat feces.

The nurse is teaching a client with emphysema about positions that help breathing during dyspneic episodes. The nurse instructs the client to avoid which position, which would aggravate breathing? 1.Sitting up and leaning on a table 2.Standing and leaning against a wall 3.Lying on the back in a low Fowler's position 4.Sitting up with the elbows resting on the knees

3.Lying on the back in a low Fowler's position Rationale:The client should not lie on the back because this reduces movement of a large area of the client's chest wall. The client should use positions that allow for maximal chest expansion. Sitting, if possible, is better than standing. If no chair is available, leaning against a wall while standing allows accessory muscles to be used for breathing and not for posture control.

The nurse is reinforcing instructions to a client about the use of an incentive spirometer. The nurse tells the client to sustain the inhaled breath for 3 seconds. When the client asks the nurse about the rationale for this action, the nurse explains that which is the primary benefit? 1.Dilate the major bronchi. 2.Increase surfactant production. 3.Maintain inflation of the alveoli. 4.Enhance ciliary action in the tracheobronchial tree.

3.Maintain inflation of the alveoli. Rationale:Sustained inhalation when using an incentive spirometer helps maintain inflation of the terminal bronchioles and alveoli, thereby promoting better gas exchange. Routine use of devices such as an incentive spirometer can help prevent atelectasis and pneumonia in clients at risk. The remaining options are not benefits for sustained inhalation.

The nurse is providing instructions to a client about diaphragmatic breathing. The nurse tells the client that this technique is helpful because in normal respiration, as the diaphragm contracts, it takes which action? 1.Aids in exhalation 2.Moves up and inward 3.Moves downward and out 4.Makes the thoracic cage smaller

3.Moves downward and out Rationale:As the diaphragm contracts, it moves downward and out, becoming flatter and expanding the thoracic cage, to promote lung expansion. This process occurs during the inspiratory phase of the respiratory cycle. The incorrect options occur with exhalation and relaxation of the diaphragm.

The nurse is assisting a radiologist to facilitate a thoracentesis. The nurse assists the client to a position that widens the spaces between the ribs to help drain which area? 1.Alveoli 2.Trachea 3.Pleural space 4.Main bronchi

3.Pleural space Rationale:Thoracentesis is the needle aspiration of fluid or air from the pleural space for diagnostic or management purposes. Thoracentesis may be done at the bedside and is often done with imaging for guidance. The other options are incorrect.

The nurse monitors the respiratory status of the client being treated for acute exacerbation of chronic obstructive pulmonary disease (COPD). Which assessment finding would indicate deterioration in ventilation? 1.Cyanosis 2.Hyperinflated chest 3.Rapid, shallow respirations 4.Coarse crackles auscultated bilaterally

3.Rapid, shallow respirations Rationale:An increase in the rate of respirations and a decrease in the depth of respirations together indicate deterioration in ventilation. Cyanosis is not a good indicator of oxygenation in the client with COPD. Cyanosis may be present in some but not all clients. A hyperinflated chest (barrel chest) and hypertrophy of the accessory muscles of the upper chest and neck are common features of chronic COPD. During an exacerbation, coarse crackles are expected to be heard bilaterally throughout the lungs but do not indicate deterioration in ventilation.

The nurse is caring for a client who has just returned from the postanesthesia care unit after radical neck dissection. The nurse should assess for which characteristic of wound drainage expected in the immediate postoperative period? 1.Serous 2.Grossly bloody 3.Serosanguineous 4.Serous with sputum

3.Serosanguineous Rationale:Immediately after radical neck dissection, the client will have a wound drain in the neck attached to portable suction that drains serosanguineous fluid. In the first 24 hours after surgery, the drainage may total 80 to 120 mL. The remaining options are not expected findings.

The nurse is discharging a client with chronic obstructive pulmonary disease (COPD) and reviewing specific instructional points about COPD. What comment by the client indicates that further teaching is needed? 1."I need to avoid alcohol and sedative medications." 2."I have to cut down on the percentage of carbohydrates in my diet." 3."Besides smoking, I can't be around second- or thirdhand smoke." 4."I have to keep my nasal cannula oxygen levels between 4 and 6 L/minute."

4."I have to keep my nasal cannula oxygen levels between 4 and 6 L/minute." Rationale:Clients with COPD have adapted to a high carbon dioxide level, so their carbon dioxide-sensitive chemoreceptors are essentially not functioning. Their stimulus to breathe is a decreased arterial oxygen (PaO2) level, so administration of oxygen greater than 24% to 28% (1 to 3 L/min) prevents the PaO2 from falling to a level (60 mm Hg) that stimulates the peripheral receptors, thus destroying the stimulus to breathe. The resulting hypoventilation causes excessive retention of carbon dioxide, which can lead to respiratory acidosis and respiratory arrest. Therefore, oxygen administration levels for clients with COPD should be kept within the range of 1 to 3 L/min (per health care provider prescription). Also, nutrition for the client with COPD requires a reduction in the percentage of carbohydrates in the diet. Excessive carbohydrate loads increase carbon dioxide production, which the client with COPD may be unable to exhale. In addition to avoiding alcohol and sedative medications, the increased risk for COPD from active smoking, passive smoking (or secondhand smoke), and smoke that clings to hair and clothing (sometimes called "thirdhand" smoke), contributes to upper and lower respiratory problems.

The nurse has conducted discharge teaching with a client diagnosed with tuberculosis who has been receiving medication for 2 weeks. The nurse determines that the client has understood the information if the client makes which statement? 1."I need to continue medication therapy for 1 month." 2."I can't shop at the mall for the next 6 months." 3."I can return to work if a sputum culture comes back negative." 4."I should not be contagious after 2 to 3 weeks of medication therapy."

4."I should not be contagious after 2 to 3 weeks of medication therapy." Rationale:The client is continued on medication therapy for up to 12 months, depending on the situation. The client generally is considered noncontagious after 2 to 3 weeks of medication therapy. The client is instructed to wear a mask if there will be exposure to crowds until the medication is effective in preventing transmission. The client is allowed to return to work when the results of 3 sputum cultures are negative.

The nurse has completed care for a client whose tracheostomy tube has a nondisposable inner cannula. Which action should the nurse perform prior to reinserting the inner cannula? 1.Suction the client's airway. 2.Wipe the inner cannula off with a clean washcloth. 3.Dry the inner cannula thoroughly with sterile gauze. 4.Allow the inner cannula to dry after washing it with sterile water.

4.Allow the inner cannula to dry after washing it with sterile water. Rationale:After washing and rinsing the inner cannula with sterile water (per agency policy), the nurse taps it against a sterile surface to remove excess liquid and allows it to dry. The nurse then inserts the cannula into the tracheostomy tube and turns it clockwise to lock it in place. The nurse would not suction a client without an inner cannula in place. This is a sterile procedure and therefore it is inaccurate to use a clean washcloth. Gauze is not used to dry the cannula because gauze particles can remain on the cannula.

The clinic nurse is providing instructions to a client with a diagnosis of pharyngitis. The nurse provides which instruction to the client? 1.Drink hot tea throughout the day. 2.Drink hot cocoa instead of coffee. 3.Restrict fluid intake to 1000 mL daily. 4.Eat foods that are highly seasoned in moderation.

4.Eat foods that are highly seasoned in moderation. Rationale:Foods that are highly seasoned are irritating to the throat and should be completely avoided. The client with pharyngitis should be instructed to consume cool clear fluids, ice chips, or ice pops to soothe the painful throat. Citrus products should be avoided because they irritate the throat. Milk and milk products are avoided because they tend to increase mucus production. The client should be instructed to eat bland foods and drink 2000 to 3000 mL of fluid daily unless contraindicated.

A client is on continuous mechanical ventilation (CMV) and the high-pressure alarm sounds. Which action should the nurse take to eliminate the problem? 1.Silence the alarm to avoid disturbing the client. 2.Check the ventilator circuit for any disconnections. 3.Inflate the cuff of the endotracheal tube to a pressure of 25 mm Hg. 4.Empty excess accumulated water from the ventilatory circuit tubing.

4.Empty excess accumulated water from the ventilatory circuit tubing. Rationale:High-pressure alarms can be triggered by increased airway resistance caused by excess secretions in the airway, biting the tube, coughing, bronchospasm, a kinked ventilatory circuit, or excess condensation of water in the ventilator tubing. Excess water should be emptied from the tubing. Alarms should never be silenced until the cause has been identified and corrected. In addition, this will not eliminate the problem. The low-pressure alarm would sound with a disconnection. Filling the cuff to 25 mm Hg can result in impaired circulation to the tracheal mucosa.

A client with chronic obstructive pulmonary disease (COPD) has a respiratory rate of 24 breaths per minute, bilateral crackles, and cyanosis and is coughing but unable to expectorate sputum. Which problem is the priority? 1.Low cardiac output secondary to cor pulmonale 2.Gas exchange alteration related to ventilation-perfusion mismatch 3.Altered breathing pattern secondary to increased work of breathing 4.Inability to clear the airway related to inability to expectorate sputum

4.Inability to clear the airway related to inability to expectorate sputum Rationale:COPD is a term that represents the pathology and symptoms that occur with clients experiencing both emphysema and chronic bronchitis. All of the problems listed are potentially appropriate for a client with COPD. For the nurse prioritizing this client's problems, it is important first to maintain circulation, airway, and breathing. At present, the client demonstrates problems with ventilation because of ineffective coughing, so the correct option would be the priority problem. The bilateral crackles would suggest fluid or sputum in the alveoli or airways; however, the client is unable to expectorate this sputum. The client's respiratory rate is only slightly elevated, so option 3, altered breathing pattern, is not as important as airway. The client is cyanotic, but this probably is because of the ineffective clearance of the sputum, causing poor gas exchange. The data in the question do not support low cardiac output as being most important at this time.

Pulmonary sarcoidosis?

Sarcoidosis is basically scar tissue build up, leads to right sided heart failure.. S/S: dry cough, dyspnea (early signs), late signs night sweats, fever weight loss, skin nodules

The nurse is teaching a client with chronic airflow limitation (CAL) about positions that help breathing during dyspneic episodes. Which position, assumed by the client, would indicate that the client needs additional teaching on positioning? 1.Sitting up and leaning on a table .Standing and leaning against a wall 3.Sitting up with elbows resting on knees 4.Lying on the back in a low Fowler's position

4.Lying on the back in a low Fowler's position Rationale:The client should use the positions outlined in options 1, 2, and 3. These allow for maximal chest expansion and decreased use of accessory muscles of respiration. The client should not lie on the back because it reduces movement of a large area of the client's chest wall. Sitting is better than standing, whenever possible. If no chair is available, leaning against a wall while standing allows accessory muscles to be used for breathing rather than posture control.

The nurse is assessing the respiratory status of a client who has suffered a fractured rib. The nurse should expect to note which finding? 1.Slow, deep respirations 2.Rapid, deep respirations 3.Paradoxical respirations 4.Pain, especially with inspiration

4.Pain, especially with inspiration Rationale:Rib fractures result from a blunt injury or a fall. Typical signs and symptoms include pain and tenderness localized at the fracture site that is exacerbated by inspiration and palpation, shallow respirations, splinting or guarding the chest protectively to minimize chest movement, and possible bruising at the fracture site. Paradoxical respirations are seen with flail chest.

The nurse is monitoring the chest tube drainage system in a client with a chest tube. The nurse notes constant bubbling in the water seal chamber. Which is the most appropriate initial nursing action? 1.Continue to monitor. 2.Document the findings. 3.Change the chest tube drainage system. 4.Perform a focused respiratory assessment.

4.Perform a focused respiratory assessment. Rationale:Bubbling in the water seal chamber is caused by air passing out of the pleural space into the fluid in the chamber. Intermittent (not constant) bubbling is normal. It indicates that the system is accomplishing one of its purposes, removing air from the pleural space. Continuous bubbling during inspiration and expiration indicates that an air leak exists. If this occurs, it must be corrected. A focused respiratory assessment should be done immediately, specifically checking for respiratory difficulty and subcutaneous emphysema. Changing the chest tube drainage system are not indicated at this time. Continuing to monitor delays necessary intervention. Although documenting is necessary, it is not the most appropriate initial action.

The nurse is caring for a client with tuberculosis (TB) who is fearful of the disease and anxious about the prognosis. In planning nursing care, the nurse should incorporate which intervention as the best strategy to assist the client in coping with the illness? 1.Allow the client to deal with the disease in an individual fashion. 2.Ask family members whether they wish a psychiatric consultation. 3.Encourage the client to visit with the pastoral care department's chaplain. 4.Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease.

4.Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease. Rationale:A primary role of the nurse working with a client with TB is to teach the client about medication therapy. An anxious client may not absorb information optimally. The nurse continues to reinforce teaching using a variety of methods (repetition, teaching aids), and teaches the family about the medications as well. The most effective way of coping with the disease is to learn about the therapy that will eradicate it. This gives the client a measure of power over the situation and outcome. Allowing the client to deal with the disease in an individual fashion gives no active assistance to the client. Asking family members whether they wish a psychiatric consultation does not involve the client. Although visiting with the pastoral care department's chaplain may be helpful, it is not the best strategy among the options provided.

A client being mechanically ventilated after experiencing a fat embolism is visibly anxious. What is the best nursing action? 1.Ask a family member to stay with the client at all times. 2.Ask the health care provider for a prescription for succinylcholine. 3.Encourage the client to sleep until arterial blood gas results improve. 4.Provide reassurance to the client and give small doses of morphine sulfate intravenously as prescribed.

4.Provide reassurance to the client and give small doses of morphine sulfate intravenously as prescribed. Rationale:Morphine sulfate often is prescribed for pain and anxiety in the client receiving mechanical ventilation. The nurse should speak to the client calmly and provide reassurance to the anxious client. Family members also are stressed, not just because of the complication but because of the original injury. It is not beneficial to ask the family to take on the burden of remaining with the client at all times. Succinylcholine is a neuromuscular blocker but has no antianxiety properties. Encouraging the client to sleep until arterial blood gas results improve does nothing to reassure or help the client.

A client's baseline vital signs are as follows: temperature 98.8°F (37.1°C) oral, pulse 74 beats/min, respirations 18 breaths/min, and blood pressure 124/76 mm Hg. The client's temperature suddenly spikes to 103°F (39.4°C). Which corresponding respiratory rate should the nurse anticipate in this client as part of the body's response to the change in status? 1.Respiratory rate of 12 breaths/min 2.Respiratory rate of 16 breaths/min 3.Respiratory rate of 18 breaths/min 4.Respiratory rate of 22 breaths/min

4.Respiratory rate of 22 breaths/min Rationale:Elevations in body temperature cause a corresponding increase in respiratory rate. This occurs because the metabolic needs of the body increase with fever, requiring more oxygen. Therefore, the remaining options are incorrect.

A client with long-standing empyema undergoes decortication of the affected lung area. Postoperatively the nurse should place the client in which position? 1.Sims' 2.Supine 3.Side-lying 4.Semi Fowler's

4.Semi Fowler's Rationale:After any procedure involving lung surgery, the nurse should position the client in semi Fowler's position. This position allows for maximal lung expansion and promotes drainage through the chest tube that may be placed during surgery. The positions identified in the remaining options will limit lung expansion.

The nurse is caring for a pt after a bronchoscopy and bx. Which finding, if noted in the pt, should be reported immediately to the HCP? A. Dry cough B. Hematuria C. Bronchospasm D.Blood-streaked sputum

C. Bronchospasm The pt should be assessed for complications like; bronchospasm, cyanosis, dyspnea, stridor, hemoptysis, hypoT, tachycardia, dysrhythmias

The nurse caring for a client who has a pneumothorax notes continuous bubbling in the water seal chamber of the client's closed-chest drainage system. How should the nurse interpret this finding? 1.The drainage chamber is full. 2.The pneumothorax is resolving. 3.The suction chamber system is shut off. 4.There is an air leak somewhere in the system.

4.There is an air leak somewhere in the system. Rationale:Continuous bubbling through both inspiration and expiration indicates that there is air leaking into the system. A resolving pneumothorax or a full drainage chamber would not cause bubbling with respiration in the water seal chamber. Shutting off the suction to the system stops bubbling in the suction control chamber but does not affect the water seal chamber.

PaO2 normal range

80-100 mm Hg

SaO2 (Oxygen Saturation)

95-100%

tension pneumothorax

A life-threatening collection of air within the pleural space; the volume and pressure have both collapsed the involved lung and caused a shift of the mediastinal structures to the opposite side.

How do microorganisms reach the lungs and cause pneumonia? SATA? A. Aspiration B. Lymphatic spread C. Inhalation of microbes in the air D. Touch contact with the infectious microbes E. Hematogenous spread from infections elsewhere in the body

A. Aspiration C. Inhalation of microbes in the air E. Hematogenous spread from infections elsewhere in the body Microorganisms that cause pneumonia reach the lungs by aspiration from the nasopharynx or oropharynx, inhalation of microbes in the air, and hematogenous spread from infections elsewhere in the body. The other causes of infection elsewhere in the body. The other causes of infection do not contribute to pneumonia

Occupational asthma triggers

Occupational asthma triggers -Farming, agriculture -Plastic/chemical industrial plants -beauticians -laundry detergents -metal salts -paints/solvents -pharmaceutical agents -wood and vegetable dusts -hospital worker -baker

Airborne precautions for TB patients?

Particulate ( N95), gown, gloves

when are patients with TB no longer contagious

Patients should not be contagious after 2-3 weeks of medication therapy

What does an acute asthma attack look like?

Acute asthma attack -wheezing/crackles -breathlessness -Chest tightness -coughing -restlessness -SOB (dyspnea) -Tachycardia

Air pollutant asthma triggers?

Air pollutant asthma triggers -Cigarette -perfumes -exhaust fumes -aerosol sprays -oxidants -sulfur dioxides

Allergen asthma triggers

Allergen Asthma Triggers -animal dander -cockroaches -dust mite -molds -pollens

open pneumothorax

An open or penetrating chest wall wound through which air passes during inspiration and expiration, creating a sucking sound; also referred to as a sucking chest wound. (dressing would be covered on

Short acting medications for Acute Asthma attacks?

Anticholinergics -ipratropium Beta agonists(bronchodilators) - Albuterol, levalbuterol

what is an asthma triad?

Asthma triad -nasal polyps -asthma -sensitivity to ASA, NSAIDS

The microorganisms Pneumocystis jiroveci (PJP) and cytomegalovirus (CMV) are associated with which type of pneumonia? A. Necrotizing pneumonia B. Opportunistic pneumonia C. Hospital-associated pneumonia D. Community-acquired pneumonia

B. Opportunistic pneumonia Ppl @ risk for opportunistic pneu. include those w/ altered immune responses. Pneumocystis jiroveci rarely causes pneu. in healthy individuals but is the most common cause of pneu. in persons with HIV dx. CMV occurs in ppl with an impaired immune response. Necrotizing pneu. is cause by Staph, klebsiella and Strep.

What two medications commonly cause asthmatic episodes in patients? A. Diuretics, anticholinergics B. antiseizure, antiemetic C. Ace inhibitors, Beta blockers D. SSRI, Antacids

C. Ace inhibitors, Beta blockers Use of beta blockers in oral from or topical eye drops (metoprolol, timolol) may trigger asthma because they can cause bronchospasm. Ace inhibitors ( lisinopril) may produce cough in susceptible individuals, thus making asthma symptoms worse.

Why is the classification of pneumonia as community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP) clinically useful? A. Atypical pneumonia syndrome is more likely to occur in HAP B. Diagnostic testing does not have to be used to identify causative agents C. Causative agents can be predicted, and empiric treatment is often effective. D. IV abx therapy is necessary for HAP, but oral therapy is adequate for CAP

C. Causative agents can be predicted, and empiric treatment is often effective. Pneu. that has its onset in the community is usually caused by different microorganisms than pneumonia that develops related to hospitalization and tx can be empiric - based on observations and experience w/o knowing the exact causative organism. Frequently a causative organism cannot be identified from cultures, and tx is based on experience.

occupational lung disease

Constant exposure to inhaled particles causes pulmonary fibrosis and the alveoli lose their elasticity

What is the long acting treatment(medications) for asthma?

Corticosteroids, Leukotrienes, Anti-IgE -fluticasone, prednisone -montelukast -Xolair

Pt presents in the ER with Acute asthma attack, initial assessment indicated wheezing, however 5 minutes later there was an absence of wheeze, and any other breath sounds ( silent chest) should the RN be concerned?

Diminish or absent breath sounds may indicate significant decrease in air movement, pt is struggling to breath, this is a LIFE-THREATENING situation indicating impending respiratory failure and may require mechanical ventilation

During an acute asthma attack, What should the RN do?

During an asthma attack RN should: -Position the pt in high fowler's or sitting to aid in breathing -Admin. oxygen as prescribed -Stay with pt (decreases anxiety) -admin. bronchodilators (albuterol or ipratropium) -Record color, amt, and consistency of sputum, if any -Admin. steroids as prescribed (fluticasone, montelukast, prednisone, Xolair) -Auscultate lung sounds before, during, and after tx

S&S of acute respiratory distress syndrome

Earliest detectable sign is increased respiratory rate, followed by increased dyspnea, air hunger, retraction of accessory muscles and cyanosis.

EIA

Exercise induced asthma -exposure to cold dry air ( skiing)

EIB

Exercise-induced bronchospasm - occurs after vigorous exercise (NOT DURING) *jogging, aerobics, speed walking, stair climbing*

Food additive asthma triggers

Food additive asthma triggers -beer, wine, dried fruit, shrimp, processed potatoes -MSG (monosodium glutamate) -Sulfites (bisulfites and metabisulfite) -Tartrazine

Most people who have asthma also have GERD, why?

GERD may worsen asthma symptoms because reflux may trigger bronchoCONSTRICTION and cause aspiration. -Asthma medications worsen GERD

Medications that are triggers for asthma?

Medication triggers for asthma -Beta blockers ( metoprolol, timolol) -bronchospasm -Ace inhibitors (lisinopril) - can worsen asthma symp. -ASA (wheezing within 2 hours of admin) - NSAIDS ( PROFOUND symptoms; rhinorrhea, congestion, tearing, and angioedema)

Why do you draw ABG samples before suctioning?

The suctioning procedure will deplete the pt's oxygen level, resulting in an inaccurate ABG result.

Primary purpose of pursed lip breathing?

To get rid of Co2

Viral/bacterial infections that can be a trigger for asthma?

Viral infections (asthma triggers) -Sinusitis, allergic rhinitis -Viral upper respiratory tract infections

Chest physiotherapy (CPT)

a series of maneuvers including percussion, vibration, and postural drainage designed to promote clearance of excessive respiratory secretions.

closed pneumothorax

air enters the pleural space through an opening in the pleura that covers the lung. However there is no puncture leading to the outside of the body

pneumothorax

air in pleural space; that causes collapsed lung

hemoptysis

coughing up blood from the respiratory tract

dyspnea

difficult or labored breathing

acute respiratory distress syndrome (ARDS)

respiratory failure as a result of disease or injury, can lead to hypoxia

effective gas exchange depends on ?

the distribution of gas ( ventilation) and blood (perfusion) in all portions of the lungs