Chest Tubes
Where must the chest tube system be placed relative to chest tube placement?
must be below chest level, especially below the drainage site
What 2 conditions make up COPD?
Chronic Bronchitis and Emphysema
What are day-time symptoms of sleep apnea?
excessive fatigue/sleepiness
morning headache
unrefreshed sleep
increased irritability
What are the 3 components used to interpret an ABG?
pH
carbon dioxide (PaCO2)
bicarb (HCO3-)
What are 2 purposes of humidified oxygen?
to protect the mucous membranes
to moisten secretions
Where is proper chest tube placement for a pneumothorax relative to a hemothorax or pleural effusion?
pneumothorax (air) : 2nd or 3rd intercostal space
hemothorax/pleural effusion (liquid) : 4th intercostal space or lower
You are concerned that your patient is experiencing a pulmonary embolism.
What are 2 diagnostic procedures would you anticipate being ordered?
DDimer
CT angiogram, or VQ scan in nuclear med
What are you concerned for when a patient post-tonsillectomy exhibits frequent swallowing or throat clearing?
bleeding and hemorrhage
What are the expected values for each part of the ABG interpretation?
pH: 7.35-7.45
CO2: 45-35
HCO3: 22-26
Aspirin should not be given to children younger than 18 years of age for what reason?
Reyes Syndrome
Confusion, brain swelling and liver damage
What is your immediate PRIORITY if a chest tube becomes completely dislodged?
cover site with a sterile gauze dressing, secured on 3 sides only
What are 3 common triggers for asthma?
hypersensitivity
upper respiratory infections
exercise
air pollutants
acid reflux (GERD)
List 4 factors that increase risk for epistaxis.
pregnancy blood thinners
nasal sprays (Afrin) street drugs
Dry air picking of the nose
high blood pressure oxygen
Respiratory Alkalosis
what are the early signs of hypoxia?
Restless
Anxiety
Tachycardia/Tachypnea
What is your immediate PRIORITY if the tubing becomes disconnected from the drainage unit?
instruct the patient to cough and exhale to expel as much air as possible, and submerge the end of the chest tube in sterile water to maintain water seal
What disease is associated with decreased lung elasticity and permanently inflated alveolar spaces?
Emphysema
What illness causes acute airway obstruction, characterized by stridor?
epiglottitis
Metabolic Acidosis
What are the late signs of hypoxia?
Bradycardia
Extreme restlessness
Dyspnea (severe)
Why is a tension pneumothorax a medical emergency?
air enters the pleural space and is unable to escape.
Builds up pressure in the chest cavity, which displaces internal organs, impairs blood return to the heart, and causes respiratory distress
What are 3 recommended treatments for pulmonary edema?
high fowlers position oxygen
CPAP Lasix
Morphine
why are upper respiratory infections often associated with otitis media?
Eustachian Tubes
direct portal from the nasopharnyx to the middle ear
Why does a patient in diabetic ketoacidosis exhibit Kussmaul Respirations?
The body is in metabolic acidosis.
the respiratory system's attempt to blow off large amounts of CO2 to decrease the acidity of the blood.
List 3 factors that increase risk of respiratory infections.
older than 65 years ECF
cigarette smoking Diabetes
compromised immune systems heart defects
chronic respiratory disorders