-upper chest for air removal

-lower lateral chest for removal of fluid

-2 tubes if needs removal of both

NEVER EMPTIED

-mark level of drg with tape at the end of each shift

-count as output

assist breathing after removal of cancerous larynx

-airway obstruction(trauma/tumor)

-difficulty clearing secretions from airway

-prolonged ventilation

outer cannula

-inner cannula

-obturator

suctioning

-cleaning

-commun.

-teaching

devices that provide ventilation for pts who are unable to breathe effectively on their own

-uses pos. pressure to push oxygenated air via ET tube or trach into the lungs at preset intervals

after surgery

-after cardiac or resp arrest

-for declining ABGs; worsening resp.disease

-in cases of Neuromuscular disease or injury in which the muscles used for breathing are very weak

higher than normal resistance to airflow to:

**-secretions indication need to be suctioned,

pt biting tube,coughing,trying to talk

-kinked or obstructed tubing,H2O in tube

-worsening resp disease that has caused decreased lung compliance/anxious breathing

-severe resp disease

-sleep apnea

-neuromuscular muscular diseases that weaken resp muscles

-pt must be alear, cooperative, not have excessive secretions, able to breathe on own

dry/cracked mucous membranes

-traume

-HTN

-blood clotting disorders--hemophilia,leukemia

-meds-aspirins,anitcoagulants,chemo drugs

-cocaine use

stuffy nose

blocked sinus drg
HA 

-pain over affected sinus

-fever

-nasal discharge

-foul breath

red/swollen sore throat,dysphagia

-exudate and fever,chills,HA,malaise

-throat lozenges,fluids,Acetaminophen,rest

smoking,alcohol,chemical exposure

-GERD

-viral,fungal,or bacterial infection

rest,fluids

-humidified air

-ASA (adults only), Acetaminophen

-ABX if bacterial

-throat lozenges

-tx of GERD

-voice rest

sore throat,fever,chills

-pain on swallowing

-HA, malaise, myalgia

-red,swollen tonsils with yellow/white exudate

**if adenoids are involved--snoring, nasal obstruction and nasal tone to voice

semi fowlers pos

monitor bleeding and airway

cold fluids

room humidifier

suction at bedside for emergencies

actaminophen,rest,fluids, no ASA in kids

-abx only if secondary bacterial infection

-antiviral meds to reduce severity and duration

-monitor lung sounds,VS, s/s dehydration

hoarseness

-change of voice

-pain(throat,ear)

-dyspnea

-cough

-dysphagia

-airway obstruction

-late signs(wt loss and halitosis)

-dyspnea

-cough

-lg amts of sputum

-anorexia

-recurrent infection

-clubbing w/ chronic infections

-crackles and wheezes

micro-org. enter the lungs and releases toxins, cause acute inflammation of lungs, can cause alveolar damage, alveoli filled with exudate

-reduced surface area for gas exchange

-can be in one lobe,both lobes or scattered throughout the lungs/bronchi

chest pain

-fever,chills

-cough,dyspnea

-yellowmrusty,or blood-tinged sputum

-crackles,wheezes

confusion

-lethargy

-fever

-dyspnea

pleurisy

pleural effusion

atelectasis

spread of infection

elderly

-alcoholics

-those living in crowded conditions

-new immigrants

-those with HIV & AIDS

-person receiving chemo

signs and symptoms of TB?

cough

**blood tinged sputum(Hemoptysis)

**night sweats

anorexia and wt loss

-low grade fever

-dyspnea,chest pain

what are some diagnostic test that can be done for TB?

PPD

-CXR

-sputum cultures

-QuatifFERON-TB Gold

combo of first line drugs for 6 to 9 months or up to 24 months for multi drug resistant type

-occasional surgical removal

-isolation until cultures neg x3 specimens

clean,well ventilated living areas

-isolation of pts who have active TB

-high efficiency filtration masks

-gowns.gloves,goggles if contacted with sputum likely

handwashing

-COMPLIANCE WITH DRUG THERAPY

dyspnea

-pleuritic pain

-cough

-tachypnea

-diminished lung sounds or friction rub

-symptoms will depend on amt of fluid in the pleural space

injury to alveoli

-scarring,fibrosis of lung tissues

-impaired gas exchange

-normal soft tissue is replaced by scarred connective tissue

progressive dyspnea

-crackles

-chronic cough

-fatigue

-clubbing of fingers

-pt steadily worsens

cough

sputum production

dyspnea on exertion

prolonged expiration

barrel chest

activity intolerence

right sided heart failure

-wt loss

-pneumothorax

-resp failure

-resp infection

stop smoking

-O2 1-2lpm

-supportive care

-pulmonary rehab

-surgery

-mechanical vent

-end of life planning

what should you avoid with a COPD pt?

chronic inflammation

-low grade infection

-hypertrohied mucous glands in bronchi

-inpaired ciliary function

-ineffective airway clearance

**diagnosed after ill 3 months of year for 2 consecutive years

wheezing,crackles

-chronic cough

-dyspnea

-thick,tenacious sputum

-increased susceptibilty to infection

-mucous plugs

destruction of alveolar walls,loss of elastic recoil

damage to pulmonary capillaries,air trapping,inpaired gas exchange

diminished breath sounds

-dyspnea

-progressive activity intolerance

-AGGs show increase Pa CO2 and a decrease Pa O2

pt cyanotic

inflammation/edema of Bronchial Mucosa-triggers include histamine,leukotrienes,inflammatory substance in body

-spasm of bronchial smooth muscles

-air trapping

-usually reversible

-airway remodeling

-smoking

-allergens

-infection

-sinusitis

-stress

-GERD

dyspnea

wheezing

cough

sputum

use of accessory muscles

may be worse at night

exocrine gland disorder

-thick tenacious secretions

-blocked pancreatic enzymes-cant digest food properly

begins in infancy,baby tastes salty,excessive NaCl in sweat

-thick,tenacious sputum

-frequent resp infections

-finger clubbing

malabsorption

-fatty,foul smelling stools

-can cause delayed puberty/infertility

-death from abx resistant infection

kiss your baby

-sweat chloride test

-CXR

-spirometry

-genetic testing/counseling

reg. ambulate

-prompt tx of DVT

**in high risk pts for DVT

-blood thinners

ted hose

sometimes none

-sudden onset of dyspnea

-tachycardia

-tachypnea

-cough

-crackles

-hemoptysis

pulmonarty HTN-causing rt sided heart failure

spiral CT scan

-lung scan

-angiogram

-D-Dimer

-CXR,MRI,ECG,ABG>done secondary

thrombolytics,heparin,coumadin,O2,embolectomy,greenfield filter

monitor labs(PT and INR)

elevated pressure in pulmonary arteries

-right ventricular failure

dyspnea,syncope(near fainting)

fatigue,crackles,cyanosis,tachypnea

angina-due to R ventricular ischemia

shallow,rapid resp

-asymmetrical chest expansion

-dyspnea,tachypnea

-chest pain

****absent breath sounds over affected area

reslessness

-anxiety

-tachycardia

control pain

-encourage coughing and deep breathing-splint and support

-promote adequate ventilation

-can take 6 weeks to heal

multiple rib rx-no structural support

-ribcage not able to maintain rise/fall of chest

hypoventilation

-unable to maintain ABGs

-dx when pt unable to maintain adequate oxygenation,unable to eliminate CO2

COPD

-aspiration

-neurological disease

worsening ABGs-low O2,high CO2,cyanosis

-increasing dyspnea

-reslessness,confusion,agitation,drowsiness

-lethargy

-coma and death

sudden onset bc of illnesses like sepsis,pneumonia,trauma,shock,an overdose,pancreatitis,aspiration,-causes a chain of events that lead to:

alveolocapillary membrane damage,pulmonary edema,alveolar collapse,lungs stiff and noncompliant,lungs may hemmorhage

dyspnea

-elevated resp

fine crackles

-resp acidosis

-restlessness,confusion

death rate 45%-50%

O2

-intubation

-mechanical ventilation

-treat underlying cause

-supportive care

depends on tymor location

-sometimes none until late in the disease

-productive cough

-recurrent infection

-dyspnea

**do not ignore a persistent cough

CXR

-CT scan

-sputum analysis

-bx

-additional test to find metastasis

chemo

-radiation

-surgery to remove tumor area

-goal is to comfort, not cure especially in small cell type

transporting medium

-important in maintaining body temp

biconcave disks, carry O2 bonded to iron in Hgb

-lack of iron,hemoglobin, or RBCs can cause anemia

-live for 120 days

rate of production is most influenced by the blood oxygen level

involved in immunity or inflammatory response to injury

stores up to 1/3 of the body's platelets

-not considered a vital organ;but if removed a person is more susceptible to certain bacterial infections

atrophies with increasing age

-contains T lymphocytes or T cells

abnormal bleeding such as

-petechiae

-ecchymoses

-purpura

-fatigue

-weakness

-SOB

-fever

-coordinate btw lab & DR

-gather supplies

-admin analgesic prior to procedure, help pt. maintain proper pos after procedure, observe aspiration site for bleeding and infection and provide emotional support

injection of dye into the lyphatic vessels of the hand or foot.

-xrays are taken and examined to determine lymph flow or blockages and lymph node involvement

needed for transportation of chemicals,metabolism,maintain blood volume,ant temp regulation.

-has to be replaced daily to survive. replaced from liquids, food, and the metabolizing of nutrients.

-to prevent dehydration when body is losing fluids the thirst mechanism kicks in.

we are aware of

ex.urination

we are not aware of

ex.breathing

vomiting

-starvation

-major burns

-diuretics

-fever

-gastric suctioning

kidney failure

-heart failure

-to much sodium

***corticosteroid therapy

-to much IVF

major electrolyte in blood

-inportant for CNS functions,acid base balance, & normal heart function

used to treat hypokalemia

-digoxin toxicity can occur

-

found in bones and teeth

-needed for functioning of nerves,heart muscle,and for blood clotting

given to treat hypocalcemia and in CPR