Anatomy
What is the primary muscle responsible for breathing
diaphragm
What is the medical term for rapid breathing?
tachypnea
If a patient is experiencing SOB, what is the nurses priority action?
Sit the patient's HOB up in High Fowlers
You walk into your patients room and you hear a harsh high pitched sound when your patient tries to breath. You do not even need your stethoscope to hear it. What is this?
Stridor. Medical emergency!
Demonstrate how to apply a nasal cannula onto an adult mannequin.
Demonstrates with adult size tubing, not pediatric. Prongs facing down. Secure tubing around the ears and secure snug under the chin
What is the name of the site of gas exchange in the lungs
Alveoli
You see in the previous note the nurse writes "DOE". What does that mean?
Dyspnea upon exertion
Your patient remains hypoxic despite intervention. They need a non rebreather. How many liters should you put it up to?
10-15L.
PS, make sure the reservoir bag is also inflated
Your patient is here with pulmonary edema. What lung sound do you anticipate hearing?
Crackles (rales)
Demonstrate how to set up a DuoNeb nebulizer treatment and provide teaching on how to utilize it
Connect the appropriate pieces of the neb set up, pour medication into chamber, secure, connect to O2, set O2 liter. Advise patient to keep mouth sealed around mouthpieces vapor is normal, breath in and out like normal.
DuoNeb: Medications albuterol/ipratropium bromide
How many lobes does the left lung have?
Left: 2 lobes
Right: 3 lobes
Your trached patient has a low pitched snoring sound in their lungs that cleared after suctioning. What is this lung sound called?
Rhonci
You work in the ED and the attending yells out for you to get "rescue" for an incoming asthma patient. What medication are they referring to?
Albuterol
What are some signs of fluid overload in a patient? (must get at least 3)
Crackles in the lungs, weight gain, edema, increased BP, increased SOB, etc
Your patient is being discharged with new O2 requirement. They will be shipped a canister with case/wheels to move. To ensure their safety at home you would tell them what? (Must get at least four )
Keep away from heaters/flames, no smoking, avoid flammable products, ensure canister is secure, keep tubing untangled, remove hazardous rugs, turn off 02 when not in use, keep a smoker detector/fire extinguisher in the home, ensure proper fit of nasal cannula/mask, patient should have an oxygen company come by and put an oxygen sticker on their outside window, they should never use vaseline around irritated nares r/t flammable instead use water based lubricant
What is the double lined membrane that surrounds the lungs and decreases friction during breathing
pleura
Your patient needs a procedure done to remove excess fluid off from the pleural space. What is this called?
Thoracentesis
Your COPD patient is 93% on RA. What next?
Check ordered parameters/baseline/resp distress. Why?
COPD patients tend to have a lower baseline 02. If you supplement their 02 it will decrease their natural drive to breath on their own. However always continue to monitor for distress or persistently declining O2.
Describe Kussmauls breathing and an example of when you might see it?
deep, rapid respirations. Seen in metabolic acidosis.
Perform a complete respiratory assessment on a partner and explaining everything you would document
What is the name of the tissue flap that covers the trachea to prevent aspiration during swallowing
Epiglottis
What are the two main branches/types of COPD
emphysema and bronchitis
Your patient has cystic fibrosis and usually uses a chest vest at home. They currently do not have it, what can you do for comfort?
Chest PT (and with ambu bag masks as cups, RT helps too)
How to describe an expected COPD patients chest anatomy
barrel chest
Increased AP chest diameter
Your patient just coded. Grab a parter and demonstrate 60 seconds of CPR on an adult mannequin.
Demonstrate 30:2 ratio CPR at appropriate depth and rate. Be careful not to hyper inflate the lungs with BVM (check finger placement, seal, neck placement, amt of force) Make sure bed is flat and back board is in place