Asthma
What are the causes of asthma?
Inflammation (allergies, chemicals, general irritation), bronchospasm (pollutants, viruses, inflammation), ASA and other NSAIDS, GERD
What happens with emphysema?
loss of lung elasticity, hyperinflation of the lung, dyspnea, air trapping
If a patient is getting a thoracentesis, what are some important factors in this process?
Patient shouldn't move, deep breathe, or cough during procedure, no more than 1000ml removed at a time, apply pressure to puncture site when complete and apply a sterile dressing, chest xray after to make sure no pneumothorax, assess for subcutaneous emphysema
What are the most common symptoms of Covid?
Fever, chills, cough, dyspnea, fatigue, muscle aches, headache, loss of taste or smell, sore throat, nausea, vomiting, diarrhea, abdominal pain
What is the term for low levels of oxygen in the blood?
Hypoxemia
What are some nonsurgical managements with sleep apnea?
change of sleep position, weight loss, positive pressure ventilation
What are clinical manifestations of asthma?
Wheezing, increased respiratory rate, dyspnea, increased mucus production, chest tightness, cough, use of accessory muscles, barrel chest, hypoxia
What are the two main causes of COPD?
Cigarette smoking
Alpha 1 antitrypsin deficiency
What does a chest tube do?
Restores intrathoracic pressure so the lung can re-inflate, drains air, fluid, blood that collects in the pleural space, allows lung expansion and prevents air and fluid from returning to the chest
Do we give antibiotics before or after we draw blood for blood cultures?
After
What are the flow rates for each apparatus: (1) nasal cannula, (2) simple facemask, (3) partial rebreather, (4) non-rebreather
1. 1-6L
2. 5-8L
3. 6-11L
4. 10-15L
What are the clinical manifestations of sleep apnea?
fatigue, daytime sleepiness, HA, waking with gasping, difficulty concentrating, irritability, depression, memory problems, loud snoring
What are the different types of classes of asthma medications?
control drug therapy, reliever drugs, bronchodilators, anti-inflammatory agents
What are the complications of COPD?
Hypoxemia, acidosis, respiratory infections, cardiac failure, cardiac dysrhythmias, respiratory failure
What is tidaling in a chest tube?
when the fluid level within the water seal chamber rises and falls with inhalation and exhalation
This is normal
What are common symptoms of influenza?
Headache, sudden onset of fever 102-104, severe aches and pains, extreme fatigue, severe cough, chest discomfort
What do Noninvasive positive pressure ventilation (CPAP, BiPaP) systems do?
uses positive pressure to keep alveoli open, improve gas exchange without airway intubation
What is the first intervention for epistaxis?
Apply direct lateral pressure to the nose for 10 minutes
What does albuterol do in the body?
It is a bronchodilator so it causes bronchial smooth muscle relaxation but has not effect on inflammation. It dilates the airways
What are nonsurgical interventions with COPD?
Breathing techniques like pursed lip breathing and diaphragmatic breathing, Positioning, effective coughing, oxygen therapy, drug therapy, exercise, suctioning when needed, hydration
What assessments should you perform on a patient with a chest tube?
Assess breathing, lung sounds, pain, signs and symptoms of infection, trachea deviation, respiratory rate, depth and strength of breathing, check tubing, output- color, amount, insertion site for infection, subcutaneous emphysema
What can we teach our patients about preventing as well as after being diagnosed with influenza?
Handwashing, sneeze into sleeve rather than hand, get influenza vaccine, may be able to take antivirals if within 48-72hrs of the onset of symptoms, highly contagious, can lead to pneumonia, contagious 24 hours before symptoms to 5 days after
What are complications of oxygen therapy?
Combustion, oxygen toxicity, absorptive atelectasis, drying of mucous membranes, infection
With facial trauma, what is the priority assessment?
Airway
What type of medication is prednisone and how does it work on the body?
It's a corticosteroid. It decreases inflammation
What classes of drugs are used for COPD therapy?
Beta-adrenergic agents, cholinergic antagonists, methylxanthines, corticosteroids, cromolyns, mucolytics
What can cause a pleural effusion?
CHF - fluid leaking into pleural space, blocked blood or lymph vessels by inflammation, injury, infection, tumors- cancer, pneumonia, PE
What are the infectious causes of pneumonia?
community acquired infectious pneumonia, hospital acquired, ventilator associated pneumonia, Streptococcus pneumoniae, influenza A and B, Covid
What are complications of a tracheostomy?
Tube obstruction, tube dislodgement or decannulation, pneumothorax, subcutaneous emphysema, bleeding, infection
What are the long term complications for Sleep apnea?
What complication can corticosteroids have in the mouth and the body?
When a patient with COPD is eating, what teaching could you provide for this patient?
eat when energy level is highest, eat 5-6 small, high calorie meals, watch salt, avoid liquid, wear oxygen while eating. rest before meals, eat slowly, chew food well, eat soft foods
What can excessive bubbling in the water seal chamber mean?
Air leaking from the lungs, the tubing or insertion site
What is included in the ventilator bundle to reduce the incidence of ventilator associated pneumonia?
Elevate HOB 30 degrees, daily weaning assessment, DVT prophylaxis, Oral care regimen, Stress ulcer prophylaxis, suctioning prn or continuous subglottal suction, hand hygiene
When suctioning a tracheostomy, what are some key elements to the technique?
insert until resistance is met, withdraw catheter, apply continuous suction in a twirling fashion for no longer than 10-15 seconds. Reoxygenate until the heart rate returns to normal.
What are the manifestations of upper airway obstructions?
diaphoresis, tachycardia, anxiety, elevated BP, hypoxia, hypercarbia, restlessness, sternal retractions