Anatomy
Following the respiratory tract, the trachea splits down into two
bronchi
What is the gold standard test to confirm PE?
What is CT angiography
Good or bad: continuous bubbling in water seal chamber?
You're caring for a patient being treated for aspiration PNA. The patient is on a 100% non-rebreather mask. Which finding below is a HALLMARK s/sx that the pt is developing ARDS?
Bradypnea
Tired and confused
PaO2 remains at 45mmHg
BP is 180/96
What is C - refractory hypoxemia
The key here is the pt is on 100% nonrebreather and PaO2 is still 45 (normal is 80, but goal with ARDS is more like 60). Tiredness and confusion are also signs, but this is the hallmark sign.
Gas exchange happens in these sac-like structures in the lungs
Other than CT angio, what are two tests that can support findings of PE?
What are VQ scan and D-dimer
Good or bad: no bubbling in the water seal chamber?
What is... bad. Should be tidaling (intermittent bubbling)
Two types of COPD?
What are... bronchitis and emphysema
Emphysema = loss of lung elasticity & hyperinflation of lung
Chronic bronchitis = inflammation of bronchi & bronchioles d/t chronic exposure to irritants
True or false: the left lung has 3 lobes, while the right lung only has 2.
What is false - the left lung has 2 lobes to make room for the heart.
Name 3 signs/symptoms of PE
What are sudden onset of dyspnea, sharp stabbing chest pain, restlessness, feelings of impending doom, tachypnea, pleural friction rub, tachycardia, diaphoresis, decreased O2 sat?
Tip: remember cows
True or false: the suction control chamber should have continuous bubbling
What is.... true, it should have continuous bubbling when connected to suction.
Medications for COPD and asthma include
What are... bronchodilators, anti-inflammatories, and mucolytics.
Asthma - also long-acting beta2 agonists to prevent attacks
Chest PT
What is the difference between visceral pleura and parietal pleura?
What is... visceral pleura = inner layer, lines the lungs, innervated. Parietal pleura = outer layer, lines the abdominal wall
What VQ scan result may indicate the presence of a PE?
What is... high ventilation (v), low perfusion (q)
ventilation = air flow to the lungs
perfusion = blood flow through the lungs
The chest tube drainage system should be placed where?
What is... upright, below the chest.
Accumulation of fluid in the pleural space, leading to compression of the lung tissue and impaired gas exchange
What is... pleural effusion
What is the purpose of surfactant?
What is... it lines the alveoli to reduce surface tension and prevent atelectasis/collapse of alveoli
a) venous stasis
b) hypokalemia
c) hypercoagulability
d) endothelial injury
What is B - hypokalemia. Injury to veins, poor blood flow, and known clotting risk/active clots are risk factors.
A nurse is assisting a provider with removal of chest tube. Which should the nurse instruct the client to do?
A) Perform Valsalva maneuver
B) Cough at regular intervals
C) Lie on left side
D) Use incentive spirometer
What is.... A. This prevents air embolism.
Abnormal accumulation of fluid in the alveoli and interstitial spaces of the lungs, impairing oxygenation and ventilation
What is... pulmonary edema