| (breathing) the exchange of oxygen and carbon dioxide between the lungs and the environment | external respiration |
| the exchange of oxygen and carbon dioxide on a cellular level | internal respiration |
| inserting a needlelike instrument into the pleural space and removing the fluid | thoracentesis |
| difficulty breathing | dyspnea |
| an abnormal condition in which a person must sit or stand to breathe deeply or comfortably | orthopnea |
| abnormal sounds superimposed on breath sounds, including sibilant wheezes, sonorous wheezes, crackles and pleural friction rubs | adventitious sounds |
| musical, high pitched, squeaking to whistling sounds caused by the rapid movement of air through narrowed bronchioles | sibilant wheezes |
| low-pitched, loud, coarse, snoring sounds, often heard on respiration | sonorous wheezes |
| short, discrete, interrupted crackling or bubbling sounds that are heard most commonly through respiration | crackles |
| low-pitched, grating, or creaking lung sounds that occur when inflamed pleural surfaces rub together during respiration | pleural friction rubs |
| oxygen deficiency in the cellular tissues | hypoxia |
| this is performed by passing a bronchoscope into the trachea and bronchi | bronchoscopy |
| bleeding from the nose | epistaxis |
| acute rhinitis is also called acute ______ | coryza |
| capable of producing disease | virulent |
| pus accumulating in the pleural space | empyema |
| the collapse of the alveoli, preventing the respiratory exchange of carbon dioxide and oxygen | atelectasis |
| the condition in which the amount of air that enters the alveoli and takes part in gas exchange is not adequate for the body’s metabolic needs | hypoventilation |
| an abnormally rapid rate of breathing | tachypnea |
| a collapsed lung due to a collection of air or other gas in the pleural space, causing the lung to collapse | pneumothorax |
| caused by the passage of a foreign substance (blood clot, fat, air, tumor tissue, or amniotic fluid) into the pulmonary artery or its branches, with resulting obstruction of the blood supply to lung tissue and subsequent collapse | pulmonary embolism (PE) |
| COPD can lead to this, an abnormal cardiac condition characterized by hypertrophic of the right ventricle of the heart as a result of hypertension of the pulmonary circulation | cor pulmonale |
| greater than normal amounts of carbon dioxide in the lungs | hypercapnia |
| this type of asthma is caused by external factors, such as environmental allergens (pollen, dust, feathers, animal dander, foods) | extrinsic |
| this type of asthma is from internal causes, not fully understood but often triggered by respiratory tract infection | intrinsic |
| this is responsible for the basic rhythm and depth of respirations | the medulla oblongata and pons |
| adventitious breath sounds: brief, not continuous, interrupted bubbling sounds, common on inspiration, similar to hairs rolled between fingers near the ear | crackling |
| adventitious breath sounds: high-pitched, sibilant crackling at the end of respiration | fine crackles |
| adventitious breath sounds: medium pitched, sonorous, moisture sound, during mid inspiration | medium crackles |
| adventitious breath sounds: loud, bubbly sound, early in inspiration | coarse crackles |
| adventitious breath sounds: deep, running sound (may be continuous) loud, low, coarse sound, (like a snore) heard at any point of inspiration or expiration | sonorous wheezes |
| adventitious breath sounds: high pitched, musical, whistle-like sound heard during inspiration or expiration, may be several notes or one, and may vary | sibilant wheezes |
| adventitious breath sounds: dry, crackling, grating, low-pitched sound with machine like quality during inspiration or expirations, loudest over anterior chest | pleural friction rub |
| nursing interventions for bronchoscopy | NPO until gag reflex returns (usually 2hrs), semi-fowler’s |
| what is thoracentesis | aspirating fluid from the pleural space for examining the fluid for gravity wbc rbc and pathogens |
| nursing interventions for thoracentesis | obtain written consent, relieve of anxiety, unaffected side head of bed elevated 30 degrees, monitor VS general appearance, fluid removal limited to 1300ml |
| Guidelines for Interpreting Arterial Blood Gas Values: each value | pH, PaCO2, PaO2, HCO3, SaO2 |
| Guidelines for Interpreting Arterial Blood Gas Values: pH normal value | 7.35-7.45 |
| Guidelines for Interpreting Arterial Blood Gas Values: PaCO2 normal value | 35-45 mm Hg |
| Guidelines for Interpreting Arterial Blood Gas Values: PaO2 normal value | 80-100 mm Hg |
| Guidelines for Interpreting Arterial Blood Gas Values: HCO3 normal value | 21-28 mEq/L |
| Guidelines for Interpreting Arterial Blood Gas Values: SaO2 normal value | 95% |
| pH = acidity
pH = alkalinity | pH < 7.35 = acidity
pH > 7.45 = alkalinity |
| how can inaccurate pulse ox result | on cold area, nail polish, artificial nails, or irregular heartbeat |
| epistaxis (bleeding from the nose) assessment includes what | duration/severity of bleeding, both nostrils or one, anterior or posterior portion of nasal passageway, assess for hypotension, any signs of shock |
| hay fever clinical manifestations (allergenic condition) | ocular: edema, photophobia, tearing, blurred vision, pruritus
rhinitis: secretions or inability to breathe thru nose
otitis: ear fullness, ear popping, decreased hearing |
| sleep apnea risk factors | males, older age, obesity, nasal conditions, receding chin, pharyngeal obstruction abnormalities |
| laryngitis may cause respiratory distress in | children younger than 5 years because small larynx subject to spasm |
| legionnaires disease pathophysiology (influenza other form) | organism thrives in water reservoirs (such as AC) transmitted thru airborne routes |
| legionnaires disease diagnostic tests | urine, blood, sputum, pulmonary tissue or fluid cultures |
| SARS (severe acute respiratory syndrome) pathophysiology | infection caused by coronavirus, spread by close contact between people, most likely droplets in the air/contaminated objects |
| 3 types on anthrax:
1. most common type, after bacteria enters skin, rarely fatal if treated with antibiotics
2. least common type, occurs after ingestion of contaminated organism, unless treated early can die from sepsis
3. seen in global germ warfare, most deadly type, infects the lungs then other organs | 1. cutaneous anthrax
2. gastrointestinal anthrax
3. inhalational anthrax |
| anthrax medical management | it is important to differentiate with TB, myobacteria |
| pneumonia pathophysiology | inflammatory process of bronchioles and alveolar spaces, most common during winter/early spring, most common in infants and older adults |
| pneumonia nursing interventions | fluid intake of at least 3L/d, “good lung down” high fowler’s |
| atelectasis (collapse of alveoli) pathophysiology | common postoperative complication resulting from shallow breathing |
| pneumothorax (collapsed lung due to collection of air or other gas in pleural space) pathophysiology | can be caused from ruptured bleb on lung surface or coughing episode, penetrating chest injury that punctures the pleural lining, fractured ribs or injury to the pleura from catheter, or NO CAUSE AT ALL |
| pneumothorax clinical manifestations | decreased breath sounds on affected side and sudden, sharp pleuretic chest pain with dyspnea |
| cancer of the lung clinical manifestations | lung cancer insidious because it is asymptomatic in the early stages |
| edema pathophysiology | underlying cardiac disease, failure of left ventricle causes pooling of fluid, patients begin to drown in their own secretions, may lead to death unless treated rapidly |
| pulmonary embolism clinical manifestations | not all patients have all the classic symptoms: sudden, sharp, constant, nonradiating, pleuretic chest pain |
| PE nursing inteventions | TED stocking, patient teaching on TED stocking, anticoagulant therapy |
| PE diagnostic tests | PFT’s & ABG’s |
| emphysema pathophysiology | usually in 40’s increasing by 50-60, enlargement of alveoli accompanied by destruction of their wall (overlap between bronchitis) |
| emphysema pathophysiology cigarette smoking | worsened by cigarette smoking, 30-35 years, 90% of COPD cases are caused by cigarette smoking |
| emphysema clinical manifestations | barrel-chested appearance |
| emphysema nursing interventions | administer low flow oxygen |
| asthma pathophysiology | GERD can trigger attack, recurrent reversible obstruction of airflow, increased capillary permeability, acute inflammatory response by mast calls in the lungs |
| asthma medical management | leukotriene modifiers |
| nursing diagnosis | anxiousness, inability to clear airway, inability to tolerate activity, insufficient oxygenation, insufficient nutrition |
