Term
|
Definition
| How well the cells, tissues, and organs of the body are supplied with oxygen |
|
|
Term
| What systems are involved in oxygenation? |
|
Definition
Pulmonary
Cardiovascular
Musculoskeletal
Neurological |
|
|
Term
| What systems regulate the movement of air into and out of the lungs? |
|
Definition
| musculoskeletal and neurological systems |
|
|
Term
| How do the lungs and heart circulate oxygen around the body? |
|
Definition
| The lungs oxygenate the blood, and the heart circulates the blood throughout the body and back to the lungs. |
|
|
Term
| What does the pulmonary system do? |
|
Definition
Ventilation
Movement of air into/out of the lungs: Inhalation/Exhalation
Hyperventilation
Hypoventilation
Lung compliance
Lung elasticity
Airway resistance |
|
|
Term
| Where are gases exchanged? |
|
Definition
The lungs contain alveoli- where gases (oxygen and carbon dioxide) are exchanged.
Alveoli have gas exchange cells and surfactant cells- lowers surface tension to allow the alveoli to inflate.
Functions: Ventilation: This is affected by respiratory rate and depth; |
|
|
Term
| What does the trachea form? |
|
Definition
| forms right and left mainstem bronchi which branch into smaller bronchioles, bronchi and bronchioles contain layers of smooth muscles, these muscles sometimes spasm (bronchospasm) and they narrow the airway and obstruct flow. |
|
|
Term
|
Definition
|
|
Term
| What is hyperventilation? |
|
Definition
| -removes too much carbon dioxide as in anxiety attack, or may occur in response to hypoxemia: O2 is low-respiration increase to bring in more O2 as in GI bleed (loss of oxygen carrying compacity). |
|
|
Term
|
Definition
| - decreased rate, shallow breathing, moves small amount of air, may result in hypoxemia which then leads to hypoxia (O2 deficiency in the body tissues). |
|
|
Term
| What reduces lung compliancy? |
|
Definition
| reduced when elastin fibers are replaced with scar tissue, increased fluid in the lung (edema), or loss of surfactant. |
|
|
Term
| What increases airway resistance? |
|
Definition
| occurs when mucus or bronchospasms decrease the airway diameter increasing airway resistance, i.e. Asthma. |
|
|
Term
|
Definition
| The physical movement of air in and out of the lungs |
|
|
Term
|
Definition
| The exchange of oxygen and carbon dioxide |
|
|
Term
| WHat is external respiration? |
|
Definition
Alveolar-capillary gas exchange - occurs in the lungs
O2-alveolar capillary membrane into the blood, carbon dioxide (CO2) diffuses out of the blood into the alveoli to be exhaled. |
|
|
Term
| What is internal respiration? |
|
Definition
Capillary-Cellular gas exchange- occurs in the organs and tissues
oxygen diffuses from the blood through the capillary-cellular membrane into the tissues cells and is used for metabolism. CO2 waste products of metabolisms diffuse through the capillary-cellular membrane into the blood, to the lungs and exhaled. |
|
|
Term
| What conditions slow diffusion? |
|
Definition
| : pleural effusion (fluids in the lungs), pneumothorax (lung collapse), asthma (bronchospasms) |
|
|
Term
| What do limitation in ex/interal respiration cause? |
|
Definition
| Hypoxemia - low blood-oxygen levels |
|
|
Term
| What neurological system organs control oxygenation? |
|
Definition
-Chemoreceptors: detect changes in pH, O2, and CO2 levels; then send messages to the central respiratory center in the brains stem. The body responds by increasing or decreasing ventilation to maintain normal blood levels.
-Lung Receptors: sense respiratory irritants; dust, cold air, tobacco smoke- the respiratory center triggers airway constriction, rapid shallow breathing pattern. |
|
|
Term
| What do high CO2 levels stimulate the body to do? |
|
Definition
| Breathing to eliminate it |
|
|
Term
| What do low O2 levels stimulate the body to do? |
|
Definition
| Breathing to get more O2 in the body. |
|
|
Term
| What test shows a client's level of hypoxemia? |
|
Definition
|
|
Term
| What are the early signs of hypoxemia? |
|
Definition
-Tachypnea
-Tachycardia
-Restlessness
-Pallor of skin and mucous membranes
-Respiratory distress |
|
|
Term
| What are late signs of hypoxemia? |
|
Definition
-Confusion and stupor
-Cyanosis of skin/mucous membranes
-Bradypnea
-Hypotension
-Cardiac dysrhythmia |
|
|
Term
| What are factors that influence oxygenation? |
|
Definition
-Lifespan and development
-Environment
-Lifestyle
-Medications
-Asthma
-Pathophysiological Conditions
-Neuromuscular abnormalities
-Cadiovascular abnormalities
-Oxygen Transport Ptoblems
- Metabolic problems (DKA) |
|
|
Term
| What is a developmental consideration of premies? |
|
Definition
| poor development of surfactant system. Surfactant keeps alveoli inflated. Immature pulmonary circulation with hypoventilation leads to Hypercarbia (high CO2 levels) and hypoxemia. |
|
|
Term
| What is a developmental consideration of toddlers? |
|
Definition
| Upper respiratory tract infections |
|
|
Term
| What is a developmental consideration of young adults? |
|
Definition
| smoking, lack of exercise |
|
|
Term
| What is a developmental consideration of older adults? |
|
Definition
| reduced lung expansion and less alveolar inflation, dificulty expelling mucus, O2 demands increase with exercise, declining immune response, GI reflux dx-aspiration stomach contents into the lungs. |
|
|
Term
| What is a developmental consideration of pregnant women |
|
Definition
| O2 demands increase, maternal metabolism increased |
|
|
Term
| What are pathophysiological considerations? |
|
Definition
Alterations in O2 and CO2 levels (life threatening)
Alterations in
Gas Exchange
Respiratory infection: flu, colds, pneumonia
Pulmonary system: structure, airways, tissue
Pulmonary circulation |
|
|
Term
| How can you assess poor gas exchange effect the tissues and organs? |
|
Definition
| assess both circulation and tissue/organ function: pulses, skin color & temp, mucous membranes, are the organs working? |
|
|
Term
| What are the 4 problems with gas exchange? |
|
Definition
- Hypoxemia
- Hypoxia
- Hypercarbia
- Hypocarbia |
|
|
Term
| What are structural abnormalities that lead to poor perfusion? |
|
Definition
- Ribs
- Pnuemothroax
- Blood or lymph in pleural space that inhibits lung expansion
- Inflammation or obstruction (asthma)
- Atelectasis |
|
|
Term
| What are pulmonary circulation abnormalities that affect perfusion? |
|
Definition
| Pulmonary embolus- obstruction of pulmonary artery, pulmonary hypertension- elevated pressure within the pulmonary arterial system-this increase the work load of the heart- causes right sided heart failure. |
|
|
Term
| What causes neuromuscular abnormalities? |
|
Definition
| trauma, stroke, medications, Disorders like Guillain Barre syndrome, ALS, and myasthenia gravis. |
|
|
Term
| How do you assess oxygenation status? |
|
Definition
Using inspection, palpation, percussion, and ausculatation.
-Breathing pattern
-Respiratory effort
-Pulse oximetry |
|
|
Term
| If you have less than 91% SaO2? |
|
Definition
|
|
Term
| IF you have less than 86% SaO2? |
|
Definition
|
|
Term
| If you have less than 80% SaO2? |
|
Definition
|
|
Term
| What are some examples of nursing diagnoses related to poor oxygen perfusion? |
|
Definition
Ineffective airway clearance r/t excessive mucus
Ineffective Breathing pattern
Impaired gas exchange
Fatigue
Activity intolerance
Imbalanced nutrition; less than body requirements |
|
|
Term
| What are diagnostic tests used to assess oxygenation status? |
|
Definition
Arterial blood gases (ABGs)
PO2, PCO2, HCO3 (Chp. 36)
Peak flow monitoring
Cardiac monitoring: electrocardiogram |
|
|
Term
|
Definition
measures the levels oxygen and carbon dioxide in arterial blood. Painful. Arterial line.
Measures pH, partial pressure of oxygen (Po2), partial pressure of carbon dioxide (Pco2), saturation of oxygen (Sao2), and bicarbonate (HCO3) levels |
|
|
Term
| Why is hemoglobin important to gas exchange? |
|
Definition
the iron-containing part of the red blood cell that carries oxygen in the blood= oxyhemoglobin
Po2- the amount of oxygen available to combine with hemoglobin to make oxyhemoglobin. Normal 80-100mm Hg, veinous return is around 40 mm Hg. |
|
|
Term
|
Definition
| oxygen that is actually bound to hemoglobin. |
|
|
Term
|
Definition
is the percentage of oxygen in the air that the patient is inhaling.
Room Air is 21% |
|
|
Term
| How does impaired gas exchange effect PO2 and SaO2? |
|
Definition
| results in a decrease in Po2 and Sao2 levels but can be kept at normal if supplemental oxygen is given. |
|
|
Term
|
Definition
| Partial pressure of carbon dioxide (Pco2) is a measure of the CO2 dissolved in the blood. Normal is 35-45 mm Hg. Directly influenced by ventilation-the exchange of gases in the alveoli. |
|
|
Term
| What does hypocarbia cause? |
|
Definition
| hyperventilation caused pt to exhale large amounts of CO2 |
|
|
Term
| What does hypercarbia cause? |
|
Definition
| hypoventilation- less Co2 moves in to alveoli for exchange, leaving more CO2 in the blood, this is toxic and usually occurs with hypoxemia because not enough oxygen is inhaled. |
|
|
Term
| What are interventions used for optimal oxygenation? |
|
Definition
Use of a mechanical ventilator
Use of chest tube drainage systems
Promoting circulation
Administering respiratory medications |
|
|
Term
| What should you be aware of when using a ventilator? |
|
Definition
| - be aware of advanced directives. Most widely used ventilators are called Positive pressure ventilators. Risk- pneumonia. Oral care is important. |
|
|
Term
| What is a chest tube used for? |
|
Definition
| used to remove air or fluid from the pleural space. Nursing interventions: monitor breathing, gas exchange, and chest drainage. |
|
|
Term
| What factors promote respiratory fxn? |
|
Definition
Immunizations/prevent URIs
Positioning: maximum lung excursion
Incentive spirometry
Aspiration precautions
Promote pulmonary toileting: turn, cough, and deep breathing |
|
|
Term
| What helps to mobilize secretions? |
|
Definition
Deep breathing and coughing
Hydration
Chest physiotherapy |
|
|
Term
| Where can an endotracheal tube be placed? |
|
Definition
Oropharyngeal
Nasopharyngeal
Tracheostomy tube |
|
|
Term
| How can an artificial airway be kept patent? |
|
Definition
|
|
Term
| What are safety measures taken when administering O2? |
|
Definition
NO SMOKING, Oxygen in use signs
Educate patient and family
Fire extinguisher
Cotton gown to prevent sparks of static electricity
Check electric devices are in good condition
Do not use flammables around patient |
|
|
Term
| What are signs and symptoms of O2 toxicity? |
|
Definition
Nonproductive cough
Substernal pain
Nasal stuffiness
N&V
Fatigue
Headache
Sore throat
Hypoventilation |
|
|
Term
| What precautions should be taken with COPD patients and O2 delivery? |
|
Definition
Oxygen induced hypoventilation
COPD pts have chronic hypoxemia & hypercarbia
Rely on low levels of arterial O2- primary drive for breathing
High levels of O2 can decrease drive to breath
Monitor for: respiratory depression, decreased resp. rate, use venturi mask, check O2 sat |
|
|
Term
| What kind of oxygen does a nasal cannula deliver? |
|
Definition
| O2 concentrations of 24-40% FIO2 @ a rate of 1-6 L/min. |
|
|
Term
| What nursing interventions should be made with a nasal cannula? |
|
Definition
| Assess patency of nares; ensure proper fit; use water-soluble jelly of nares are dry; may use humidification for rates 4L/min or greater. |
|
|
Term
| What kind of oxygen does a simple face mask deliver? |
|
Definition
| Delivers 40-60% FiO2, rate of 5-8L/min |
|
|
Term
| What nursing interventions should be made with a simple face mask? |
|
Definition
| Ensure proper fit over nose and mouth; nasal cannula during meals; provide emotional support |
|
|
Term
| What kind of oxygen does a partial rebreather mask deliver> |
|
Definition
| Delivers 60-75% FiO2; rate of 6-11 L/min |
|
|
Term
| What nursing interventions should be made with a partial rebreather mask? |
|
Definition
| Assess reservoir bag for twisting; prevent bag from deflation by keeping full; ensure fit over nose and mouth; nasal cannula during meals, emotional support |
|
|
Term
| What kind of oxygen does a nonrebreather mask deliver? |
|
Definition
| Delivers 80-95% FiO2; rate of 10-15 L/min in order to maintain reservoir bag 2/3 full |
|
|
Term
| What nursing interventions should be made with a nonrebreather mask? |
|
Definition
| Prepare client for emergency intubation; hourly assessment of valve and flap; ensure fit over nose and mouth; nasal cannula during meals; provide emotional support |
|
|
Term
| What kind of oxygen does a venturi mask deliver? |
|
Definition
| Delivers 24-55% FiO2; rate of 2-10L via different size adaptors |
|
|
Term
| What nursing interventions should be made with a venturi mask? |
|
Definition
| Ensure accurate flow; tubing free of kinks; emotional support |
|
|
Term
| What kind of oxygen is delivered with an aerosol mask, face tent and a tracheostomy collar? |
|
Definition
| Delivers 24-100% FiO2; rates of at least 10L/min; allow high humidification of oxygen |
|
|
Term
| What interventions should be made with an aerosol mask, face tent and a tracheostomy collar? |
|
Definition
| Frequently empty condensation from tubing; adequate water in humidification canister; don’t allow tubing to pull on tracheostomy; ensure fit over nose and mouth; nasal cannula during meals; emotional support |
|
|
Term
| What is included in the cardiovascular system? |
|
Definition
-Heart
-BV
-COronary arteries |
|
|
Term
| Where do the L and R coronary arteries originate |
|
Definition
| originate at the base of the aorta & branch out to encircle the myocardium, supplying blood, O2, & nutrients to the myocardium |
|
|
Term
| What dose the L coronary artery divide into? |
|
Definition
| divides to form the anterior descending & circumflex arteries. |
|
|
Term
| Where does the anterior descending artery supply blood to? |
|
Definition
| the anterior interventricular septum & the LV. |
|
|
Term
| Where does the circumflex artery supply blood to? |
|
Definition
| supplies the L lateral wall of the LV. |
|
|
Term
| Where does the right coronary artery supply blood to? |
|
Definition
| supplies the RV & forms the posterior descending artery. |
|
|
Term
| What happens to the coronary arteries during systole and diastole? |
|
Definition
| While ventricular contraction (systole) delivers blood thru the pulmonary circulation & the systemic circulation, it is during ventricular relaxation (diastole) that the coronary arteries fill w/O2-rich blood. |
|
|
Term
| What happens after the blood perfuses the heart muscle? |
|
Definition
| the cardiac veins drain the blood into the coronary sinus, which empties into the RA of the heart. |
|
|
Term
| What factors regulate blood flow through the coronary arteries? |
|
Definition
| Aortic pressure is the primary factor – other factors include: heart rate (most flow occurs during diastole, when the muscle is relaxed), metabolic activity of the heart, & blood vessel tone (constriction). |
|
|
Term
| What is the cardiac cycle? |
|
Definition
| -One heartbeat of contraction and relaxation |
|
|
Term
|
Definition
60 – 100 ml/beat, average adult 70 ml/beat
Amount of blood ejected from the left ventricle with each contraction |
|
|
Term
|
Definition
SV x HR
Average range 4 – 8 L/min
Amount of blood ejected from the left ventricle each minute |
|
|
Term
| What is ejection fraction? |
|
Definition
SV/end-diastolic volume & represents the fraction or % of the diastolic volume that is ejected from the heart during systole
Normal range: 50% to 70% |
|
|
Term
|
Definition
| end diastolic stretch of heart muscle (filling) |
|
|
Term
|
Definition
| forces that impede flow of blood out of heart (resistance) |
|
|
Term
|
Definition
| the force with which the left ventricular ejection occurs. |
|
|
Term
| What is ejection fraction? |
|
Definition
| the % of blood emptied from the ventricle during systole (60-70%), measures SV |
|
|
Term
| What is the difference between the SA node and the AV node? |
|
Definition
SA node initiates an impulse that triggers the hearbeat.
AV node-impulse passes to the left and right bundle of His and into Purkinje fibers to the ventricles.
A unified cardiac muscle contraction is created to pump blood out of the chamber. |
|
|
Term
| What creates the S1 sound? |
|
Definition
Av valve
heard loudest over the mitral and tricuspid areas, marks the beginning of systole |
|
|
Term
| What creates the S2 sound? |
|
Definition
Semilunar
loudest in the aortic and pulmonic areas, |
|
|
Term
|
Definition
| may occur in either if there is a delay in closure of one of the valves |
|
|
Term
| What is S3? (Ventricular Gallop) |
|
Definition
Heard after S2, place patient on side, use the bell with light pressure over apical area, sounds like “slosh ing in”, or “lub dub da” or KenTUCKy; happens with CHF
When AV valves open, blood flow into the ventricles may cause vibrations
Vibrations create S3 sound during diastole |
|
|
Term
| What is S4? (Artial Gallop) |
|
Definition
Atrial contraction & ejection of blood into the ventricles in late diastole
Heard before S1, sounds like “A stiff wall” or “Til lub dub” or “FLOrida”, it sounds lower than S1, Occurs with atrial contracting into a non-compliant ventricle as in acute MI, CAD, HTN, and pumonic stenosis. |
|
|
Term
|
Definition
Marks beginning of systole! LOW PITCHED
-Mitral/Tricuspid valve closes |
|
|
Term
|
Definition
Marks the beginning of diastole! HIGH PITCHED
-Aortic/Pulmonic valves close |
|
|
Term
| Right side of the heart... |
|
Definition
|
|
Term
| Left side of the heart... |
|
Definition
|
|
Term
|
Definition
Oxygenated blood to tissues
Systole-cardiac muscle contraction
Diastole-resting state, ventricular filling, coronary artery filling |
|
|
Term
|
Definition
| Deoxygenated blood back to heart/lungs |
|
|
Term
| When do coronary arteries fill? |
|
Definition
|
|
Term
| What does maintaining blood flow require? |
|
Definition
| adequate cardiac output; adequate circulation; effective regulation of cardiovascular function. |
|
|
Term
| What does the ANS control? |
|
Definition
Cardiac rate
Muscle contractility
Vascular tone- |
|
|
Term
| Sympathetic fibers ______ ____ the heart |
|
Definition
|
|
Term
| Parasympathetic fibers _____ ______ the heart |
|
Definition
|
|
Term
|
Definition
| the force of blood ejected by the heart is determined by the length of the fibers of its muscular wall, i.e. an increase in diastolic filling lengthens the fibers and increases the force of muscular contractions |
|
|
Term
| What do sympathetic fibers do? |
|
Definition
| maintain blood vessels in a constant state of partial contraction (tone). This vascular tone maintains BP and blood flow at rest or sleep. |
|
|
Term
| What does an increase in sympathetic stimulation cause? |
|
Definition
| constriction of some vessels (skin, GI, and Kidneys) and dilatation of other vessel (skeletal muscles) resulting in a fight or flight response. Ex: hypovolemic shock; low BP, High HR, skin cool clammy, no bowl sounds, low urinary output. |
|
|
Term
| What are some brain stem centers? |
|
Definition
-baroreceptors
-chemoreceptors |
|
|
Term
| What do beta-adrenergic blocking agents do? |
|
Definition
| reduce the workload of the heart by decreasing HR, control dysrhythmias, and HTN; drugs that block beta 1 receptors slow the heart rate |
|
|
Term
| What do calcium channel blocking agents do? |
|
Definition
| block the flow of calcium into cells of the heart and bld. Vessels; decrease BP and strength of myocardial contraction, slow HR, and dilate the arteries. |
|
|
Term
| What are some cardiovascular abnormalities? |
|
Definition
Heart failure
Cardiomyopathy
Cardiac Ischemia
Coronary artery disease
Dysrhythmias
Heart valve abnormalities |
|
|
Term
|
Definition
| inefficient pump, blood is oxygenated but not circulated well. Leads to systemic and pulmonary edema and further impairs gas exchange. |
|
|
Term
|
Definition
| heart muscle disorder, enlarged heart and impaired contractility. |
|
|
Term
| What is cardiac ischemia? |
|
Definition
| no oxygen, leads to MI, Angina pectoris- injured tissue but not necrosis |
|
|
Term
| What is coronary artery disease? |
|
Definition
| cause of cardiac ischemia, plaque in coronary atreries, arteries are narrow, clots form and block arteries. |
|
|
Term
| What are arterial peripheral vascular abnormalities? |
|
Definition
| pallor, pain, weak or absent pulses, poor capillary refill, cool skin, and tissue dysfunction. |
|
|
Term
| What are venous peripheral vascular abnormalities? |
|
Definition
| edema, brown skin, stasis ulcers. |
|
|
Term
|
Definition
| Decreased carrying capacity, low RBC/hemoglobin or both |
|
|
Term
|
Definition
| when inhaled, binds to hemoglobin at the oxygen receptor site. Competes with oxygen. |
|
|
Term
| What are some diagnostic tests for determining cardiac fxn? |
|
Definition
Serum cholesterol, triglycerides, lipids
Stress/exercise tests
X-ray, MRI, CT, PET
Echocardiogram
Transesophageal echocardiogram
Cardiac catheterization, angiography
Pericardiocentesis
Electrocardiography
Troponin, MB isoenzyme of creatine kinase/
CK-MB |
|
|
Term
| What are nursing responsibilities related to diagnostic testing? |
|
Definition
Explain the procedure and preparation
Assess for medication use
Support client during test if necessary
Document procedure, monitor results |
|
|
Term
|
Definition
Chronic inflammatory disease
Recurrent episodes wheezing, breathlessness
Airways in persistent state of inflammation
Trigger causes acute response
Late-phase response - 4–12 hours after exposure |
|
|
Term
| What is an untreated attacks effect? |
|
Definition
Limited expiratory airflow
Trapping of air in alveoli
Hypoxemia
Hyperventilation
Causes CO2 retention leading to resp alkalosis |
|
|
Term
| What is the pathology of asthma? |
|
Definition
Inflammatory mediators released
Cause activation of inflammatory cells
Bronchoconstriction, airway edema
Increases work of breathing
Trapped air mixes with inhaled air
Impairs gas exchange |
|
|
Term
| Bronchial asthma is ________ and ________ airflow obstruction affecting only the airways NOT the alveoli. |
|
Definition
| intermittent and reversible |
|
|
Term
| What 2 ways does airway obstruction manifest itself? |
|
Definition
1.) Inflammation
2.) Airway hyperresponsiveness |
|
|
Term
| What is the etiology of asthma? |
|
Definition
Allergies
Accounts for 50% of asthma attacks in US
Pollen, weeds, molds, dust mites, animal dander
Exposure to ASA, NSAIDs
Exercise, hot/cold air, infections, stress, etc.
Stimuli results in airway hyperresponsiveness
Status asthmaticus |
|
|
Term
| Inflammation occurs in response to what? |
|
Definition
| specific allergens, general irritants, microorganisms, and aspirin |
|
|
Term
| Hyperresponsiveness occurs in response to what? |
|
Definition
with exercise, URI, or unknown reasons
Genetic variations in the gene that controls the synthesis and activity of beta-adrenergic receptors impact drug therapy |
|
|
Term
| What immunoglobulin is related to inflammation? |
|
Definition
|
|
Term
| Bronchospasm is a result of what? |
|
Definition
| airway hyperresponsivnesss |
|
|
Term
| What is status asthmaticus? |
|
Definition
Status asthmaticus is a severe, life-threatening, acute episode of airway obstruction that intensifies once it begins and often does not respond to common therapy
If the condition is not reversed, the patient may develop pneumothorax and cardiac or respiratory arrest
Treatment: IV fluids, potent systemic bronchodilator, steroids, epinephrine, and oxygen |
|
|
Term
| What are pediatric developmental considerations in asthma? |
|
Definition
Narrower airway
Edema and swelling
Ribs flexible
Oxygen consumption higher
Retractions
Frightening for children and parents
Written asthma action plan
Secondhand smoke dangers |
|
|
Term
| What are adult developmental considerations in asthma? |
|
Definition
35% higher incidence in men
Teach correct use of preventive & rescue drugs |
|
|
Term
| What are pregnant women developmental considerations w/ asthma? |
|
Definition
Improves in 1/3, maintains in 1/3, worsens 1/3
Prematurity, low birth weight
Multidisciplinary care |
|
|
Term
| What are older adult developmental considerations w/ asthma? |
|
Definition
Changes in sensitivity to allergens and medications occur with age
Teach how to prevent asthma attacks |
|
|
Term
| What are risk factors for asthma? |
|
Definition
Genetic factors
Common causes of asthma
Air pollutants
Allergens
Chemicals and food
Stress
Respiratory infections |
|
|
Term
| What are the clinical manifestations of asthma? |
|
Definition
Coughing, wheezing, shortness of breath, chest tightness, tachypnea, tachycardia
Abrupt or insidious
Frequency, severity varies
Anxiety and apprehension
Disease monitoring
Peak expiratory flow reading (PEFR)
Preventive measures
Avoid allergens, environmental triggers |
|
|
Term
| What are the diagnostic tests for asthma? |
|
Definition
PFTs
CBC with diff
ABG
Sputum studies
Chest x-ray
Oxygenation saturation monitoring |
|
|
Term
| What are the most accurate measures for asthma? |
|
Definition
Pulmonary fxn tests using spirometry.
-Forced vital capacity
-Forced expiratory volume in the first second
-Peak expiratory flow rate |
|
|
Term
| What is elevated in the blood in asthma patient? |
|
Definition
| Eosinophils count and immunglobulin E levels |
|
|
Term
| What do you see in an ABG w/ asthma patients? |
|
Definition
| Arterial carbon dioxide level may decrease early in the attack and increase later, indicating poor gas exchange |
|
|
Term
| What patient education should be provided with asthmatics? |
|
Definition
| asthma is often an intermittent disease; with guided self-care, patients can co-manage this disease, increasing symptom-free periods and decreasing the number and severity of attacks |
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Term
| What is the main drug used to treat asthma? |
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Definition
Bronchodilators
Relax smooth muscles of airway
Short Acting Beta Agonists/albuterol/Proventyl
Long Acting Beta Agonists/oral albuterol
Anticholinergic agents/Ipratropium bromide/Atrovent
Methylzanthine/Theophylline |
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Term
| What is used to treat the inflammation of asthma? |
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Definition
Corticosteroids
Axmacort/triamcinolone acetonide
NSAIDS
Cromolyn sodium/Intal, nedocromil/Tilade |
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Term
| What is used to treat the inflammatory response NOT the inflammation? |
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Definition
Leukotriene modifiers
Oral medications
Montelukast/Singulair
Zafirlukast/Accolate |
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Term
| What else can you use to treat asthma? (nonpharmalogical) |
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Definition
Dietary, environmental, nutritional
Elimination of certain foods
Herbals
Biofeedback, yoga, breathing techniques
Acupuncture
Exercise and activity is recommended to promote ventilation and perfusion
Oxygen therapy is delivered via mask, nasal cannula, or endotracheal tube in acute asthma attack |
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Term
| What assessments should be made with an asthmatic patient? |
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Definition
Physical assessment and clinical manifestations:
Audible wheeze and increased respiratory rate
Increased cough
Use of accessory muscles
”Barrel chest” from air trapping
Long breathing cycle
Cyanosis
Hypoxemia |
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Term
| What nursing diagnoses are related to asthma? |
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Definition
Ineffective Breathing Pattern
Ineffective Airway Clearance
Impaired Gas Exchange
Activity Intolerance
Anxiety
Ineffective Family Therapeutic Regimen Management |
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Term
| What is included in client planning with asthmatic patients? |
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Definition
Client will
Experience decreased number and frequency of exacerbations
Require fewer unscheduled visits to primary care provider or emergency department
Reduce exposure to irritants that aggravate asthma control
Experience improved quality of life |
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Term
| How do you implement treatment for ineffective airway clearance? |
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Definition
Monitor skin color, temperature, LOC
Assess ABG results, pulse oximetry
Place in Fowler’s high-Fowler’s, orthopneic position
Administer oxygen as ordered
Administer nebulizer treatments, humidification as ordered
Increase fluid intake |
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Term
| How do you implement treatment for ineffective breathing pattern? |
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Definition
Monitor vital signs and laboratory results
Assist with ADLs as needed
Provide rest periods
Administer medications |
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Term
| How do you implement treatment for anxiety? |
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Definition
Assess level of anxiety
Assist to identify previous coping skills
Listen actively to concerns
Include client in care planning, decision making
Reduce excessive environmental stimuli
Supportive family members with client
Assist to use relaxation techniques |
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Term
| How do you implement treatment for ineffective therapeutic regimen management? |
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Definition
Assess client’s level of understanding
Discuss client’s perceptions
Assist client, significant others to identify
Problems integrating treatment into lifestyle
Assess knowledge and understanding of medications
Provide verbal and written instructions |
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Term
| How do you implement treatment for activity intolerance? |
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Definition
Teach client to monitor cardiopulmonary response to activity
Teach client how to monitor, record PFR
Help client assess capacity to sustain activities
Assess need for short-acting bronchodilators
Before activity, exercise
Teach client to space periods of rest, activity
Assist with ADLs as needed
Referrals as needed |
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Term
| How do you evaluate your regimens effectiveness? |
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Definition
Maintains oxygen saturation greater than 90%
Demonstrates proper use of inhalers
Lists common triggers, strategies to avoid
List symptoms requiring immediate notification of primary provider
Responds appropriately to asthma flare up
Maintains optimal nutrition to promote health
Describes appropriate follow-up care |
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Term
| When a client is using an MDI, can they use an anti-inflammatory drug as well? |
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Definition
| yes! Use it as needed to treat acute episodes of wheezing |
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Term
| The nurse should counsel the parents of a child with asthma that, before performing postural drainage exercises, the parents should |
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Definition
| Adminster the bronchiodilator |
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Term
| The nurse would anticipate administering respiratory medications to a child hospitalized with asthma by which of the following most frequently used routes? |
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Definition
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Term
| The nurse teaches the parent how to attach a spacer to the metered-dose inhaler for a young child, explaining that the spacer: |
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Definition
| Reduce the risk for oral yeast |
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Term
| A child is hospitalized after an acute asthmatic episode. The nurse determines that the parents need further instruction if which of the following statements is made? |
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Definition
| After discharge, our child will quit the swim team.” |
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