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Questions and Answers
What is the primary requirement for oxygen therapy?
What is the primary requirement for oxygen therapy?
What is the oxygen flow rate range for a nasal canula?
What is the oxygen flow rate range for a nasal canula?
What is a complication of oxygen therapy?
What is a complication of oxygen therapy?
What is the primary goal when administering oxygen therapy?
What is the primary goal when administering oxygen therapy?
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What is the indication for tracheostomy management in oxygen therapy?
What is the indication for tracheostomy management in oxygen therapy?
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What is a late sign of hypoxia?
What is a late sign of hypoxia?
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What is the purpose of a Venturi mask in oxygen therapy?
What is the purpose of a Venturi mask in oxygen therapy?
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What is an early sign of hypoxia?
What is an early sign of hypoxia?
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What is the primary cause of chronic bronchitis?
What is the primary cause of chronic bronchitis?
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What is the name of the breathing technique used to help patients with chronic bronchitis?
What is the name of the breathing technique used to help patients with chronic bronchitis?
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What is the name of the test used to diagnose cystic fibrosis?
What is the name of the test used to diagnose cystic fibrosis?
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What is the primary complication of cystic fibrosis?
What is the primary complication of cystic fibrosis?
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What is the purpose of chest physiotherapy in the treatment of cystic fibrosis?
What is the purpose of chest physiotherapy in the treatment of cystic fibrosis?
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What is the abnormal result of the ABG test in lung cancer?
What is the abnormal result of the ABG test in lung cancer?
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What is the symptom of chronic bronchitis characterized by a bluish discoloration of the skin?
What is the symptom of chronic bronchitis characterized by a bluish discoloration of the skin?
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What is the purpose of administering oxygen therapy in chronic bronchitis?
What is the purpose of administering oxygen therapy in chronic bronchitis?
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What is the primary difference between hypoxemia and hypoxia?
What is the primary difference between hypoxemia and hypoxia?
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What is the primary goal of incentive spirometry?
What is the primary goal of incentive spirometry?
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What is a common symptom of influenza?
What is a common symptom of influenza?
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What is the primary cause of pneumonia?
What is the primary cause of pneumonia?
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What is the primary goal of chest physiotherapy?
What is the primary goal of chest physiotherapy?
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What is a common symptom of tuberculosis?
What is a common symptom of tuberculosis?
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What is the primary treatment for asthma?
What is the primary treatment for asthma?
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What is the primary difference between COPD and asthma?
What is the primary difference between COPD and asthma?
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What is the primary goal of nursing interventions for patients with pneumonia?
What is the primary goal of nursing interventions for patients with pneumonia?
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What is the primary risk factor for obstructive sleep apnea?
What is the primary risk factor for obstructive sleep apnea?
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Study Notes
Respiratory Assessments
- Assessments include history of present illness, physical assessment, and laboratory tests
- Physical assessment includes:
- Clubbing of fingernails
- Mucous membranes
- Position of trachea (is it midline?)
- Breathing (are they using accessory muscles? Is their breathing even?)
- Vital signs
- Sputum
- ESR & CRP
- Chest x-ray
- CBC & CMP
Oxygen Therapy Management
- Oxygen therapy requires a doctor's order and is considered a medication
- Noninvasive oxygen delivery methods:
- Nasal Canula (1-6L, can titrate)
- Simple Mask (6-10L, can titrate)
- Venturi Mask (0-55% O2, "titrate" varies on the valve used)
- Non-Rebreather (100%, no titration)
- Continuous positive airway pressure (CPAP)
- Bi-level positive airway pressure (BIPAP)
- Tracheostomy (indicated if mechanical ventilation is required, max 2 weeks)
- Complications of oxygen therapy:
- Oxygen toxicity: symptoms include nonproductive cough, nasal congestion, substernal pain, headache, N/V, fatigue, sore throat, dry mucous membranes, infection
- Hypoxia: early signs include restlessness, irritability, use of accessory muscles, nasal flaring, tachycardia, tachypnea, hypertension; late signs include decrease in level of consciousness, increase in lactic acid, dysthymias, bradypnea, bradycardia, hypotension, cyanosis
- Hypoxemia: insufficient oxygen in the arterial blood
Infectious Respiratory Disorders
- Influenza:
- Highly contagious acute viral respiratory infection
- Symptoms: fever, chills, malaise, muscle aches, HA, rhinorrhea, cough, sore throat
- Diagnosis: rapid flu test
- Treatment: saltwater gargles, increase fluids, Tamiflu (first 48 hours), analgesics
- Nursing interventions: handwashing, vaccinations, avoiding close contact with infected people
- Pneumonia:
- Excess fluid in the lungs due to inflammation
- Symptoms: fever, SOB, chest pain, cough, dyspnea, crackles/wheezes
- Laboratory tests: increased WBC, decreased O2/increased CO2
- Diagnosis: chest x-ray (consolidation)
- Treatment: antibiotics, bronchodilators, oxygen therapy, Guaifenesin (Mucinex)
- Nursing interventions: high fowlers, oxygen therapy, cough and deep breath, incentive spirometer, increase fluid intake
- Tuberculosis:
- Upper airway disorders:
- Rhinitis/Rhinosinusitis:
- Nasal inflammation/sinus inflammation (allergies)
- Symptoms: nasal itching, runny nose
- Treatment: nasal spray, decongestants, antihistamine
- Nursing interventions: medication compliance, avoiding triggers
- Obstructive sleep apnea:
- Breathing disruption that occurs during sleep
- Causes: upper airway blockage
- Risk factors: overweight, birth defects, smoking
- Symptoms: persistent daytime sleepiness, irritability
- Treatment: C-pap, smoking cessation, weight loss
- Laryngitis:
- Inflammation of the larynx
- Laryngeal cancer:
- Cancerous growth on the vocal cords
- Symptoms: hoarseness, persistent sore throat, pain with swallowing, SOB
- Diagnosis: barium swallow, MRI, PET scan
- Treatment: chemotherapy, radiation, surgery, trach
- Laryngeal trauma:
Lower Airway Disorders
- Asthma:
- Chronic inflammation disorder of the airway
- Intermittent and reversible
- Triggered by allergen
- Symptoms: dyspnea, wheezing, chest tightness, coughing, tachypnea, prolonged expiration, increased sputum
- Diagnosis: pulmonary function test, ABG's
- Treatment: bronchodilators (can cause an increase in HR)
- Albuterol: short-acting bronchodilator for acute asthma attacks (reliever drug)
- Solumedrol (control therapy)
- Corticosteroids
- Nursing interventions: avoid triggers, pursed lip breathing, smoking cessation, track asthma with a peak flow meter (3 times and record the highest number)
- Status Asthmaticus:
- Life-threatening asthma attack
- Airway obstruction that is unresponsive to usual therapy
- Symptoms: extremely labored breathing, gasping, decreased level of consciousness, cyanosis, neck vein distention, pulsus paradoxes
- Treatment: bronchodilators, epinephrine, corticosteroids
- Nursing interventions: administer oxygen to the patient, prepare for emergency intubation and mechanical ventilation
Chronic Obstructive Pulmonary Disease (COPD)
- Combination of emphysema and chronic bronchitis
- Airway obstruction irreversible
- Emphysema:
- Destruction of the alveoli
- Decreases lung elasticity
- Hyperinflation and air trapping in the lungs
- Chronic bronchitis:
- Inflammation of the airways
- Hypersecretions of mucous
- Risk factors: smoking, air pollution, occupational
- Symptoms: cough, excess sputum, crackles/wheezes, barrel chest, red/blue skin, clubbing of nails, cyanosis, increased work of breathing, tripod position, SOB
- Laboratory tests:
- Decreased SpO2 (less than 90)
- ABG: 50/50 club
- PFT
- Chest x-ray
- Treatment: bronchodilators, corticosteroids, anticholinergics, oxygen therapy
- Nursing interventions: place patient in upright position, administer oxygen, monitor for R-sided HF, smoking cessation, pursed lip breathing, incentive spirometer, increase fluid and protein intake
Cystic Fibrosis
- Genetic disorder (autosomal recessive disorder)
- Severely impairs lung function and other organ functions
- Abnormally thick sticky mucous (plugs organ ducts)
- Can lead to organ failure
- Symptoms:
- Respiratory: wheezing, coughing, dyspnea, mucous plugs, cyanosis, clubbing, barrel chest, chronic respiratory infection
- Gastrointestinal: steatorrhea (fatty, malodorous stool), delayed growth, ADEK deficiencies
- Integumentary: abnormally high NaCl in sweat, saliva, tears
- Diagnosis: sweat Cl test, PFT, DNA testing, stool analysis
- Treatment: bronchodilators, anticholinergics, antibiotics, pancreatic enzymes
- Nursing interventions: chest physiotherapy, administer oxygen as ordered, increase fluid, protein, and calorie intake, supplement fat-soluble vitamins
Lung Cancer
- No specific notes provided in the text
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Description
Assess respiratory function through physical examination, laboratory tests, and oxygen therapy management. Learn about vital signs, chest x-ray, and more.
