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Questions and Answers
Which of the following are main components of asthma?
What are common signs and symptoms of COPD?
What does cyanosis indicate in a patient with respiratory issues?
What is a common feature seen during respiratory distress?
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Which of the following describes a potential complication of pneumonia?
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Which of the following conditions can lead to lung stiffness and swelling of lung tissue?
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What are crackles, wheezing, and stridor examples of?
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What purpose does a peak flow meter serve?
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What is one benefit of using an MDI with a spacer?
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What is postural drainage used for?
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Which of the following describes low flow oxygen delivery systems?
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Which symptom indicates increased airway resistance due to airway obstruction?
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What is one recommended practice for promoting lung expansion and drainage?
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What is the main purpose of a non-rebreather mask in oxygen therapy?
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Which oxygen delivery device is indicated for patients needing high humidity?
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What is the recommended flow rate for a partial rebreather mask?
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Which of the following interventions is NOT appropriate during suctioning of a tracheostomy?
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What is the primary purpose of using a Venturi mask?
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During airway management, which of the following signs indicates the need for suctioning?
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What is the typical oxygen concentration range delivered by a nasal cannula?
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Which of the following artificial airways is specifically used for long-term airway management?
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What is a characteristic feature of COPD that distinguishes it from asthma?
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Which symptom is associated with both respiratory distress and restricted lung movement?
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In a patient with pneumonia, what underlying condition contributes to lung collapse?
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What is the significance of clubbing in a respiratory assessment?
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Which of the following describes a potential nursing intervention for a patient experiencing shortness of breath?
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What is the main outcome of airway obstruction?
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Which intervention is primarily used to facilitate the removal of lung secretions?
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What does a peak flow meter primarily measure?
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What benefit does the use of a spacer with an MDI provide?
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Which of the following types of oxygen delivery systems can meet the complete ventilatory demand of a patient?
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What is a primary purpose of nebulization treatments?
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Which method is NOT a component of chest physiotherapy (CPT)?
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What is the recommended fluid intake for patients with respiratory issues?
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What is the primary function of a high flow nasal cannula?
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Which statement accurately describes the flow rates for the non-rebreather mask?
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In which scenario is suctioning indicated for airway management?
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Which device can deliver variable concentrations of oxygen based on flow rate?
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What is the correct technique for suctioning through a tracheostomy tube?
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What is the typical oxygen concentration delivered by a simple face mask?
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Which type of airway management device is primarily used for short-term intubation?
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What is the maximum number of suctioning passes recommended during one session?
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Study Notes
Respiratory Conditions
- Asthma: An obstructive lung disease, primarily affecting exhalation. Bronchoconstriction, inflammation, and mucous production are its hallmarks.
- COPD: Characterized by inflamed and thickened airways and impaired oxygen exchange caused by airway obstruction, resistance, decreased gas exchange, and CO2 retention. Worsens over time, with symptoms including shortness of breath, coughing with mucous production, fatigue, frequent lung infections, and fatigue. Emphysema and bronchitis are subtypes.
- Pneumonia: A respiratory illness where fluids obstruct the airway, causing lung collapse.
- Altered Respiratory Function: Characterized by abnormal breath sounds, accessory muscle use (leaning forward, see between the ribs, straining neck and shoulders), cyanosis (bluish-grey skin discoloration), and clubbing (associated with chronic tissue hypoxia).
Respiratory Assessment & Interventions
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Increased Breathing Work: Occurs due to restricted lung movement, airway obstruction, and other factors.
- Restricted Lung Movement: Caused by decreased lung expansion, volume, and capacity. Examples include pneumonia, atelectasis, aspiration, exposure to toxins, neuromuscular disease, and skeletal conditions.
- Airway Obstruction: Any process that narrows the airway causes increased airway resistance.
- Breath Sounds: Crackles, wheezing, and stridor are abnormal breath sounds.
- Nebulization Treatments: Deliver liquid droplets of medication (albuterol, Xopenex, antibiotics) directly into the lungs.
- Peak Flow Meter: Measures peak expiratory flow rate, reflecting airway diameter. Green, yellow, and red zones indicate airflow levels.
- MDI: Metered Dose Inhalers provide measured doses of medication.
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CPT: Chest Physiotherapy: Techniques for removing secretions.
- Vibration: Helps loosen secretions using a flutter valve, acapella, or vest.
- Postural Drainage: Positioning for drainage of secretions.
- Percussion: Clapping on the chest to dislodge secretions.
- Spacer: Attaches to MDI to improve medication delivery to the lungs.
- Pulse Oximeter: Measures the percentage of hemoglobin saturated with oxygen.
- Positioning: Upright postures (sitting, standing) promote lung expansion. Frequent position changes are beneficial.
- Fluids: Encourage fluid intake, water is preferred.
- Ambulation: Upright and OOB activity promotes better lung function.
Oxygen Delivery Systems
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Low Flow vs. High Flow:
- Low Flow: Mixes with room air, not enough to meet full inspiratory demand.
- High Flow: Delivers pre-mixed oxygen to meet full inspiratory demand. Used for patients with low O2 levels, those requiring humidification, and COPD patients.
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Partial Rebreather vs. Non-Rebreather:
- Partial Rebreather: 30-60% oxygen delivery, 10-15 L/min.
- Non-Rebreather: 55-90% oxygen delivery, 10-15 L/min.
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Devices:
- Venturi Mask: 24-60% oxygen delivery with color-coded valves for setting flow rate.
- Simple Face Mask: 40-60% oxygen delivery at more than 5 L/min.
- Nasal Cannula: 24-60%, 1-6 L/min.
- High-Flow Nasal Cannula: Reduces dead space, increases oxygen concentration, delivers up to 60 L/min flow.
- Trach Collar: 28-98% oxygen delivery with high humidity.
- Oxygen Hood: Delivers high oxygen concentration (more than 60%) with high humidity.
Artificial Airways
- Oral or Nasal Pharyngeal Airways: Temporary airways placed in the mouth or nose.
- Endotracheal Tubes: Inserted through the mouth or nose into the trachea.
- Tracheostomy Tubes: Inserted surgically into the trachea, providing a long-term airway.
Airway Management
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Suctioning: Removing secretions from airways through a tube placed in a surgical opening.
- Indications for Suctioning: Audible airway noises, adventitious breath sounds, cyanosis, decreased PaO2 or pulse oximetry, agitation, increased work of breathing, retractions, nasal flaring, and shortness of breath.
- Suctioning Technique: Suction only on the way out of the airway, rotate the catheter, limit suctioning time to 10-15 seconds, hyperoxygenate the patient before and after suctioning.
- Tracheostomy Suctioning: Suction to the end of the tracheostomy tube.
- Hyperoxygenate: Provide extra oxygen to the patient before and after suctioning.
Respiratory Conditions
- Asthma is an obstructive lung disease characterized by bronchoconstriction, inflammation, and mucous production, making it difficult to exhale air.
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Chronic Obstructive Pulmonary Disease (COPD) involves inflammation and thickening of the airways, tissue damage responsible for oxygen exchange, and symptoms such as shortness of breath, cough with mucous production, and fatigue.
- Emphysema and bronchitis contribute to COPD.
- Barrel chest and tripod position are often seen in COPD.
- Pneumonia occurs when secretions obstruct the airways, leading to lung collapse. Excess mucous fluid buildup is a common symptom.
- Cyanosis is a bluish-grey discoloration of the skin due to low oxygen saturation in the blood.
- Clubbing is a deformity of the fingertips caused by chronic tissue hypoxia, often seen in respiratory or cardiac disease.
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Common symptoms of respiratory conditions include:
- Cough - a reflex response to irritation in the airways.
- Sputum Production - mucus from the nose, throat, and lungs, potentially containing blood.
- Shortness of Breath (Dyspnea) - difficulty breathing.
- Altered Respiratory Rate - tachypnea (increased) or bradypnea (decreased) or irregular rhythms like Cheyne-Stokes.
Respiratory Assessment & Interventions
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Increased Breathing Work:
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Restricted Lung Movement: Decreased lung expansion, volume, and capacity due to lung stiffness, tissue swelling, or airway narrowing.
- Examples: pneumonia, atelectasis, foreign body aspiration, exposure to toxins, neuromuscular disorders, and skeletal conditions.
- Airway Obstruction: Any process that narrows the airway and causes increased airway resistance.
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Restricted Lung Movement: Decreased lung expansion, volume, and capacity due to lung stiffness, tissue swelling, or airway narrowing.
- Breath Sounds: Crackles, wheezing, and stridor
- Nebulization Treatments: Deliver a suspension of liquid droplets into the lungs using air or oxygen. Medications like albuterol, Xopenex, or antibiotics are administered through nebulization.
- Peak Flow Meter: Measures peak expiratory flow rate during a forced exhalation reflecting airway diameter. Zones (green, yellow, red) indicate severity based on personal best readings.
- Metered-Dose Inhaler (MDI): Delivered measured doses of medication.
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Chest Physiotherapy (CPT):
- Vibration: Uses devices like a flutter valve, acapella, or high-frequency pulsator vest to loosen secretions.
- Postural Drainage: Positioning to drain secretions from specific lobes or segments of the lungs.
- Percussion: Clapping to create mechanical waves to remove secretions.
- Spacer: Used with MDIs, it improves medication delivery to the lungs and reduces unpleasant taste in the mouth.
- Pulse Oximeter: Measures the percentage of hemoglobin that is attached to oxygen.
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Positioning:
- Upright Posture: Sitting and standing promote easier lung expansion.
- Frequent Position Changes: To assist with drainage and lung expansion
- Good Side Down: To facilitate drainage.
- Fluids: Encourage fluid intake, preferably water, to thin secretions and avoid caffeine and alcohol.
- Ambulation: Walking and upright activities promote lung drainage and improve oxygenation.
Oxygen Delivery Systems
- Low Flow Systems: Mix oxygen with room air, but do not provide enough flow to meet the patient's inspiratory needs.
- High Flow Systems: Meet the patient's full ventilatory demands.
- Partial Rebreather Mask: Delivers a 30-60% oxygen concentration, with 10-15L/min flow.
- Non-Rebreather Mask: Delivers 55-90% oxygen concentration, with 10-15L/min flow.
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Devices for oxygen delivery:
- Venturi Mask: Delivers 24-60% oxygen concentration; colored valves indicate flow rate and corresponding percentage.
- Simple Face Mask: Delivers 40-60% oxygen concentration at a flow rate of more than 5L/min.
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Nasal Cannula:
- Low flow system delivering 24-60% oxygen at 1-6 L/min.
- High flow nasal cannula (HFNC): a more advanced system providing pre-mixed air/oxygen blend, delivers up to 60L/min flow, heated and humidified.
- Trach Collar: Delivers 28-98% oxygen concentration and provides high humidity.
- Oxygen Hood: Delivers high oxygen concentrations (greater than 60%) and high humidity, often used for infants.
Artificial Airways
- Oral or Nasal Pharyngeal Airways: Used to maintain an open airway for short-term use.
- Endotracheal Tubes: Used for short-term airway management inserted through the mouth or nose.
- Tracheostomy Tubes: Used for long-term airway management, surgically placed in the trachea.
Airway Management
- Suctioning: Removal of secretions through a tube inserted into the airway or surgical opening to maintain a patent airway.
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Reasons for suctioning:
- Audible Upper Airway Noise: Gurgling.
- Adventitious Breath Sounds: Abnormal breath sounds.
- Cyanosis: Blue discoloration of the skin.
- Decreased PaO2 or Pulse Oximetry: Low oxygen levels.
- Restlessness and Agitation: Signs of hypoxia.
- Increased Work of Breathing: Retractions, nasal flaring, shortness of breath.
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Suctioning Technique:
- Insert to the end of the tracheostomy tube.
- Apply suction only on the way out of the airway, intermittently.
- Rotate the catheter while applying suction.
- Limit suction time to 10-15 seconds per pass.
- Hyperoxygenate the patient before and between suctioning passes.
- Limit suctioning to three passes per session.
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Description
Test your knowledge on respiratory conditions such as asthma, COPD, and pneumonia. This quiz covers key characteristics, symptoms, and respiratory assessments. Explore how altered respiratory function impacts overall health.
