Diagnostic Studies: Pulmonary Function Test

<p>Fastest-Immediate Reaction • Primary Regulator • Neutralize Acids • Respiratory and Renal systems must have adequate function</p> Signup and view all the answers

<p>respiratory Excrete CO2 and H2O • Respiratory Regulation in Medulla//////Renal system Normal Acid elimination • Absorb HCO3 increasing blood PH and decreasing urine acidity</p> Signup and view all the answers

<p>Fix respirations- Bronchodilators -Respiratory stimulants- Drug antagonists -Oxygen- Vent support</p> Signup and view all the answers

<p>hypoventilation hypoxia, rapid shallow respirations, decreased BP, ski/mucosa pale to cyanotic, headaches, cant catch there breaths, hyperkalmeia, dysrhythmias, drowsiness dizziness disorientation, Muscle weakness hyperreflexia</p> Signup and view all the answers

<p>respiratory depression, anesthesia, overdose, airway obstruction, alveolar capillary diffusion(pneumonia,COPD,ARDS,PE</p> Signup and view all the answers

<p>Treat underlying cause,Raise plasma pH &gt; 7.20 ,Treat underlying cause ,Sodium Bicarb, Follow ABGs ,Continuously monitor patient.</p> Signup and view all the answers

<p>Vomiting  NG suctioning  Diuretic therapy  Hypokalemia  Excess bicarb intake</p> Signup and view all the answers

<p>Hyperventilation  Hypoxemia  Pneumonia  Pulmonary Embolus  Pregnancy (normal finding)  Ventilatory settings too high or too fast  High altitudes  Liver failure  Septicemia (fever)  Stroke  Overdose of salicylates or progesterone</p> Signup and view all the answers

<p>seizures, deep rapid breathing, hyperventilation, tachycardia, low or normal BP, lethary confusion, light headedness, naseua vomitting</p> Signup and view all the answers

<p>Respiratory Alkalosis</p> Signup and view all the answers

<p>hyperventilation, anxiety, PE, FEar, mechanical ventilation</p> Signup and view all the answers

<p>Treat underlying cause, Decrease tidal volume or resp rate ,Pain control/sedation, Breathe into paper bag ,Antidepressants ,Correct Co2 slowly</p> Signup and view all the answers

<p>Diabetic ketoacidosis --Lactic acidosis --Starvation --Diarrhea --Renal tubular acidosis -Renal failure -GI fistulas- Shock- Ileostomy</p> Signup and view all the answers

<p>headache, decreased bp, hyperkalemia, muscle twicthing, warm flushed skin, nasea vomitting diarrhea, changes in LOC, KUSSMAUL RESPIRATIONS(compensatory hyperventilation)</p> Signup and view all the answers

<p>Treat underlying cause,, Stop K+ wasting diuretics,, Spironolactone ,,Acetazolamide IV fluids Sodium chloride, Replace K+ ,Monitor Resp rate, Monitor HR ,Seizure precautions</p> Signup and view all the answers

<p>Raise plasma pH &gt; 7.20 Treat underlying cause Sodium Bicarb Follow ABGs Continuously monitor patient.</p> Signup and view all the answers

<p>Hyperkalemia</p> Signup and view all the answers

<p>Use solutions from non-sterile containers Will require a sterile field  Will require use of solutions from non-sterile containers  Will require oxygen and suction</p> Signup and view all the answers

<p>Assess when patient last ate, schedule care at least 3 hours after meal to decrease risk of vomiting or aspirating stomach contents</p> Signup and view all the answers

<p>Assess trach site for drainage, redness or swelling (indications of infection)Assess patient’s respiratory status prior to care, during, &amp; after. • Respiratory rate, depth, rhythm, breath sounds, color, pulse oximetry (determines whether patient can tolerate trach care</p> Signup and view all the answers

<p>Delegation: established trachs may delegate to unlicensed personnel, but new fresh trachs, RN’s must perform the care and assess</p> Signup and view all the answers

<p>To avoid possible aspiration of fibers(Use only sterile manufacture precut dressings or folded 4X4, never use cotton-filled gauze sponge  EBP: patient may aspirate cotton or gauze fibers</p> Signup and view all the answers

<p>Adults 100-150 mm Hg  Children: 100-120 mm Hg  Infants: 50-95 mm Hg</p> Signup and view all the answers

<p>Semi-fowler position,• Suction only when necessary • Use suction catheter no more than ½ size of internal diameter of airway tube • Adjust suction regulator per policy, lowest possible setting to accomplish suction</p> Signup and view all the answers

<p>15 seconds---------------• Do NOT force catheter • Do NOT apply suction as you enter the airway • Rotate the suction catheter when withdrawing it • Apply suction as you remove the catheter but no longer than 15 seconds • Avoid saline lavage during suctioning • Repeat suction as needed allowing 30 second intervals hyper oxygenate between passing catheter</p> Signup and view all the answers

<p>Advance no further than carina trachea</p> Signup and view all the answers

<p>To improve oxygen saturation levels before suctioning---• Dominant hand sterile, non- dominant hand unsterile • Sterile hand controls suction tube • Place patient in semi-fowler position • Hyperoxygenate patient prior to suction • Insert catheter gently without applying suction (closing suction opening with thumb) • Advance suction catheter no further than carina trachea</p> Signup and view all the answers

<p>01 Date and time suction was performed 02 Note suction techniques and catheter size used 03 Note color, consistency, and odor of secretions 04 Document patient’s respiratory status before and after the procedure 05 Document patient’s tolerance of procedure and any complications encountered 06 Document any interventions performed to address complications.</p> Signup and view all the answers

<p>Catheter size used</p> Signup and view all the answers

<p>Consistency and odor 3</p> Signup and view all the answers

<p>04 Document patient’s respiratory status before and after</p> Signup and view all the answers

<p>• When suctioning is completed, provide oxygen source • Provide oral care • Reposition patient • Provide for safety</p> Signup and view all the answers

<p>Sit upright and lean forward and tilt head forwards, pinch tip of nose with two fingers for 15-20 minutes--if bleeding continues use nasal spray</p> Signup and view all the answers

<p>topical nasal sprays</p> Signup and view all the answers

<p>Dry cracked mucous membranes Trauma</p> Signup and view all the answers

<p>Sit upright leaning forward-Educate not to blow nose x 48 hrs, avoid nose picking, avoid bending over--Monitor Vitals--Monitor Bleeding--Pack with petroleum or iodoform gauze, Rapid Rhino / small foley cath / nasal tampons-ice packs and pressure</p> Signup and view all the answers

<p>nasal saline--antibiotics--silver nitrate for clotting--phenylephrine for clotting---also monitor HGB</p> Signup and view all the answers

<p>Bacteria/virus/fungus/--allergies-inflammation of sinus membranes--NG TUBE</p> Signup and view all the answers

<p>Culture for nasal discharge--CT scan, MRI, X-ray, Nasal endoscopy, signs and symtoms to diagnose</p> Signup and view all the answers

<p>prulent nasal discharge, fever, generalized fatigue, swelling inflammation and pain</p> Signup and view all the answers

<p>Corticosteroids (Flonase) other meds used are (AFRIN) adrenergic nasal spray--analgesics(acetaminophen/ibuprofen)--nasal irrigation</p> Signup and view all the answers

<p>8-10 glasses of water humidifier--warm moist packs--semi fowler position--educate to only use for up to 3 days nasal sprays</p> Signup and view all the answers

<p>inflammation of nasal membranes--Virus-rhinovirus</p> Signup and view all the answers

<p>decongestants-analgesics(acetaminophen,Ibuprofen)</p> Signup and view all the answers

<p>localized itching-nasal discharge-sneezing-nasal congestion-fever-sore throat-malaise</p> Signup and view all the answers

<p>fluids, educate why antibiotics are not used--rest</p> Signup and view all the answers

<p>throat culture or rapid flu test--S/sx to diagnose</p> Signup and view all the answers

<p>inflammation of pharnyx-virus-bacteria-beta hemoltic streptococci--highest incidence in ages 4-7</p> Signup and view all the answers

<p>dysphagia-sore throat that is red and swollen--exudate--generalized malaise-fever and chills</p> Signup and view all the answers

<p>Rapid Strep Test-throat culture and sensitivity</p> Signup and view all the answers

<p>saltwater gargles--rest--fluids</p> Signup and view all the answers

<p>Antibiotics (e.g., Penicillin)--acetaminophen--throat lozenges</p> Signup and view all the answers

<p>Virus--bacteriahighest in ages 4-7</p> Signup and view all the answers

<p>Red &amp; Swollen Tonsils with exudate--myalgia--malaise--fever and chills--pain while swallowing--HA sore throat</p> Signup and view all the answers

<p>throat culture and sensitivity--WBC with differential</p> Signup and view all the answers

<p>saltwater gargles--tonsilectomy--semi fowlers--monitor for bleeding--keep suction equipment readily available-rest and fluids</p> Signup and view all the answers

<p>Indicate generalized body pain and discomfort--common meds are acetaminophen and antibiotics</p> Signup and view all the answers

<p>Throat swab viral throat culture, rapid flu test because of infection</p> Signup and view all the answers

<p>virus--transmitted droplets--transmitted physical contact--avoid aspirin</p> Signup and view all the answers

<p>malaise-HA-sore throat-myalgia-cough</p> Signup and view all the answers

<p>Tamiflu--flu vaccines--acetaminophen--</p> Signup and view all the answers

<p>vitals and lung sounds q4h--assess allergies and educate-hand hygiene-preventative measures-fluids--monitor for dehydration--rest</p> Signup and view all the answers

<p>Indicates caution and triggers asthma--usually 50% to 80% of personal best</p> Signup and view all the answers

<p>lbuterol • Side Effects: Tremors, anxiety, tachycardia, palpitations and nausea</p> Signup and view all the answers

<p>Xolair • Reduces sensitivity to allergens • Used when high doses of corticosteroids does not work • Not a rescue med • SubQ Q2-4 weeks</p> Signup and view all the answers

<p>Bronchodilator • Therapeutic ranges • &gt;20 = toxic • Toxicity s/sx: N/V, rapid HR, seizures, dysrhythmias</p> Signup and view all the answers

<p>Leukotriene Receptor Antagonists (LTRAs)</p> Signup and view all the answers

<p>eak flow results  Red Zone  50% or less of personal best  Indicates serious problem  Definitive action must be taken with health care provider</p> Signup and view all the answers

<p>Usually 80% to 100% of personal best  Remain on medications</p> Signup and view all the answers

<p>Measures the maximum speed of expiration Results are higher when well lower when airflow is constricted Expected value depends on the patients sex, age, and heigh</p> Signup and view all the answers

<p>secondary to chronic respiratory disorder--dilation of bronchi airways--secretions of pool in dilated areas</p> Signup and view all the answers

<p>bloody sputum--inflamed airways--dyspnea--cough--recurrent lower LRI-fever during active infection--copious purulent sputum</p> Signup and view all the answers

<p>bronchoscopy--chest x-ray-- ct scan-- sputum cultures</p> Signup and view all the answers

<p>oxygen--prevent infection--CPT--FLUIDS</p> Signup and view all the answers

<p>bronchodilators--corticosteroids/leukotrine--ntibiotics--flu and pneumonia vaccines--azithromycin--mucolytic</p> Signup and view all the answers

<p>chronic inflammation of airways--asthma triggers-bronchospams</p> Signup and view all the answers

<p>prolonged expiration--air trapping--dyspnea--cough--chest tightness--wheezing--increased RR--accessory muscle use</p> Signup and view all the answers

<p>PEFR-spirometry--allergy skin testing</p> Signup and view all the answers

<p>Gas Exchange</p> Signup and view all the answers

<p>Bronchodilator--inhaled corticosteroids long acting beta agonist</p> Signup and view all the answers

<p>smoking air pollution industrial chemicals--chronic bronchitis--emphysema-blocked airways</p> Signup and view all the answers

<p>High protein, high fat, low carb--smoking cessation--tripod postion-- breathing exercises</p> Signup and view all the answers

<p>diminhsed breathe sounds crackles and wheezes--inflammation mucus-barrel chest-chronic hypoxemia</p> Signup and view all the answers

<p>spirometry--ABGS</p> Signup and view all the answers

<p>adrenergic and anti cholinergic--corticosteroids--oxygen</p> Signup and view all the answers

<p>Chest x-ray, CT Scan, bronchoscopy, ABGs, Spirometry</p> Signup and view all the answers

<p>Nintedanib--flu vaccines-oxygen</p> Signup and view all the answers

<p>clubbing--inspiratory crackles--fatigue--SOB--cough--flu like symptoms--</p> Signup and view all the answers

<p>smoking cessation</p> Signup and view all the answers

<p>Scarring and fibrosis of lung tissue.---injury to alveoli = chronic inflammation</p> Signup and view all the answers

<p>Overproduction of mucus</p> Signup and view all the answers

<p>Respiratory system</p> Signup and view all the answers

<p>Autosomal recessive</p> Signup and view all the answers

<p>Hypokalemia and hypocalcemia</p> Signup and view all the answers

<p>Air trapping</p> Signup and view all the answers