| A | B |
|---|
| Acute Laryngotracheobronchitis (LTB) | (1) inflammation in the larynx & trachea cause swelling & obstruction of the airway w/difficulty of moving air thru the narrowed passage (hypoxia devs) (2) child has had UPI for few days following Croup (3) "barking" cough devs w/inspiratory stridor (4) the most common form of croup |
| Acute Epiglottitis | (1) acute supraglottitis (supraglottitis region of the airway becomes obstructed d/t inflammation caused by Haemophilus Influenzae organism (2) child will lean forward & sit upright in the tripod position w/mouth open, chin thrust out & tongue protuding (3) Cyanosis devs (4) form of croup syndrome in which the supraglottic region of airway becomes obstructed as a result of inflammation |
| Acute Laryngitis | (1) form of croup syndrome most common in older children & teenagers (2) caused by a variety of virus infections (3) manifestations: hoarsness w/c/o sore throat, nasal congestion & drainage |
| Acute Respiratory Failure (ARF) | rapid change in respiration that leads to the development of hypoxemia and/or hypercapnia |
| Adult Respiratory Distress Syndrome (ARDS) | characterized by hypoxemia, severe dyspnea, and the development of diffuse bilateral pulmonary infiltrations |
| Anticoagulation Therapy | (1) w pulmonary embolus, heparin bolus 5000 u followed w/IV therapy (2) does not dissolve the existing clot (3) following existing therapy long-term therapy may be required |
| Artificial (Electrical) Larynx | (1) technique used to re-establish speech after a laryngectomy (2) alternative means of communication capable of producing sounds when the patient articulates words (3) easy to use but disadvantage is words maybe difficult to distinguish and sound mechanical |
| Asthma | (1) chronic respiratory disorder caused by inflammation of the airways (2) severe attack: anticipate need for intubation, mechanical ventilation & the appropriate equipment nearby |
| Asthma Clinical Manifestation | (1) most common (a) cough (b) wheezing (i) heard upon expiration as air is pushed through the narrowed airways (ii) may be present upon inspiration (c) dyspnea (d) chest tightness (2) S/S may occur suddenly or may develop over a matter of days (3) cough can be nonproductive or productive of mucus (4) pt must work hard to move air out of lungs, result: expiration becomes prolonged (5) attack continues, hypoxemia devs |
| Asthma (Medications That Precipitate An Attack) | (1) aspirin (2) beta blockers (c) non-steroidal anti-inflammatory drugs (d) cholinergic drugs |
| Atelectasis | (1) condition caused by an accumulation of lung secretions that eventually block the airways and cause collapse of the alveoli (2) dev from airway obstruction |
| Bacterial Pneumonia | (1) tx by admin of ABT given intravenously or orally (2) tx w/broad spectrum ABT therapy until culture & sensitivity results are received |
| Bi-Level Positive Airway Pressure (BiPAP) | ventilator mode used when the patient is able to breathe spontaneously by providing positive pressure at both inspiration & expiration |
| Biologically Based Therapies (Vitamin Therapies & Herbal Meds) | (1) can be used to promote (a) overall well-being (b) incr cardiovascular endurance (c) promote pulmonary function |
| Bronchiolitis | condition caused when an acute viral infection affects the bronchioles |
| Bronchopneumonia | pneumonia that is located in various areas of the bronchi and surrounding tissue |
| Cancer of Larynx (laryneal Cancer) | (1) occurs most often in men (a) d/t smoking (b)alcohol abuse (2) chronic laryngitis (3) inhalation of toxins (2) tumor devs in 3 areas of the laryns (a) most common glottic area around the vocal cords (b) supraglottic area (c) subglottis (3) hoarseness is most common symptom (4) tx: total laryngectomy (or partial laryngectomy) w/leaving permanent airway opening (tracheostomy) in neck |
| Cancer of Larynx (laryneal Cancer) Postop | (1) monitor for hemorrhage (continuous swallowing; vomiting large amountsof bright red or brown (coffee ground emesis) blood) & sh/be reported to dr (2) avoid (a) coughing (b) blowing nose (c) clearing throat (d) milk products (incrs mucous production & clearing throat) |
| Cancer of Larynx (laryneal Cancer) Postop Food | thickened liquids are easiest for pt to swallow |
| Caseation Necrosis | process in which the blood supply of the granuloma is gradually compressed by fibrotic tissue, and a necrotic, cheesy mass develops at the center of the nodule |
| Chronic Obstructive Pulmonary Disease (COPD) | chronic, progressive disorder consisting of chronic |
| Chronic Bronchitis | component of chronic bronchitis caused by inhaling irritants into the lungs |
| Continuous Positive Airway Pressure (CPAP) | (1) ventilator mode used to maintain the existence of a present airway pressure during both phases of the respiratory cycle; also decreases airway resistance |
| Cor Pulmonale | right-sided ventricular heart failure due to increased pressure in the right ventricle from pumping against the increased pulmonary vascular resistance |
| Croup Medical Goal | (1) maintain an open airway (2) mild croup managed at home (3) cool mist humidifiers provide moisture decreasing inflammation & providing relief from the cough (4) hospitalized: oxygen tent provide humidified air & oxygen (5) nebulized epinephrine may be used to decrease swelling w/serious breathing difficulty (6) corticosteroids used for their anti-inflammatory effect, which causes a decrease in edema & provides respiratory relief |
| Croup (Signs of Airway Obstruction) | (1) increased restlessness (2) increased respiratory rate & pulse (3) flaring nostrils (4) retraction of the accessory muscles are indications of increasing airway obstruction (5) signs of airway obstruction demand prompt action (a) intubation equipment should be readily available for emergency intervention |
| Croup Syndrome | (1) childhood disorder caused by acute respiratory infection that affected the y larynx, trachea &/or bronchi (2) life-threatening d/t significant airway problems (3) uppper respiratory infection characterized by a "barking" cough, inspiratory stridor, hoarseness & respiratory distress d/t swelling of the larynx (4) most common form is laryngotracheobronchitis (LTB) |
| Deep Vein Thrombosis (DVT) | (1) primary cause of pulmonary embolus characterized by pain, edema, warmth, and redness, among other symptoms (2) carefully monitor pt for dev (tx can begin w/early intervention) (3) Tx (a) anticoagulation therapy (b) leg elevation (c) analgesics (d) application of warm, moist packs |
| Emergency Thoracentesis | (1) w/acute respiratory distress (r/t pneumthorax) an 18-gauge needle or chest tube is inserted into the second or third intercostals space to remove the air |
| Esophageal Speech | (1) technique used to re-establish speech after a laryngectomy (2) speech produced by belching air that is seldom used, as it is difficult for the patient to learn to make intelligible sounds |
| Exudate | secretions that develop within the alveoli because of an inflammatory response |
| Forced Expiratory Volume (FEV) | pulmonary function study in which a decrease is a sign of an asthma attack |
| Forced Vital Capacity(FVC) | pulmonary function study in which a decrease is a sign of an asthma attack |
| Ghon Tubercle | calcified tubercle in which tuberculosis is no longer present |
| Granulomas | deposits of live and dead bacilli that are surrounded by the macrophages during the process of tuberculosis transmission |
| Hemothorax | (1) development of blood in the pleural space d/t major chest trauma (2) called a hemopheumothorax w/air & blood present |
| Huff Coughing | technique recommended to help move secretions and minimize bronchospasms |
| Hypocapnia | decreased carbon dioxide levels that can lead to respiratory alkalosis |
| Incentive Spirometry | (1) technique used to help promote expansion of the alveoli and prevent the dev of atelectasis (2) semi-fowler’s position is best or sitting (3) take a few normal breaths before using spirometer then (a) place mouthpiece in mouth inhaling slowly and deeply (b) hold breath at end of inspiration for approx 3 seconds (c) slowly exhale (4) do qhr for 10 mins each time during waking hours (5) cough after deep breathing exercises |
| Inferior Vena Cava Filters | (1) may be used for pts who (a) cannot undergo anticoagulation therapy (b) experience multiple or re-occurring pulmonary embolisms (2) filter inserted in vena cava near the renal arteries (3) allows uninterrupted blood flow filtering out any clots (4) disadv (a) perforation of vessel vall (b) thrombosis at site of device |
| Laryngectomy | (1) surgical treatment in which the larynx is removed and a tracheostomy is created in the neck |
| Laryngeal Obstruction | (1) medical emergency (2)obstruction d/t inflammation of larynx leading to edema or obstruction by foreign body (Heimlich maneuver) |
| Leukotriene Modifers | (1) are leukotriene receptor antagonists & leukotriene Synthesis Inhibitors that are used to decrease inflammation in asthma that is caused by environmental & allergis triggers (2) a chemical mediator that stimulates inflammatory changes in lung tissue (3) work by reducing the production of leukotriens, the modifers decrease inflammation & bronchoconstriction (4) used for prophylactic & maintenance tx of chronic asthma (5) also used in exercise-induced asthma (6) are not effective in controlling acute asthma attacks |
| Lobar Pneumonia | type of pneumonia in which areas of consolidation develop and completely obstruct airflow |
| Lower Respiratory Tract (Evaluation) | (1) outcomes r/t (a) health promotion (b) health restoration (c) health rehabilitation |
| Lower Respiratory Tract (Implementation) | (1) intervention (a) patient education (b) medical (c) surgical (2) pharmacology (3) nutrition |
| Lower Respiratory Tract (Planning: Client Outcomes) | (a) maintenance & improved patent airway (b) absence of fluid volume deficit & maintenance of adequate nutrition (c) absence of complications (d) improved activity tolerance & maximal self-management (f) increased knowledge about the disease and treatment regimen and adherence to the medication regimen (g) improved coping ability & decrease anxiety |
| Lower Respiratory Tract (Clinical Manifestations) | (a) pneumonia (b) tuberculosis (c) chronic obstructive Pulmonary Disease (d) chronic bronchitis (e) asthma (f) emphysema pneumothorax |
| Lower Respiratory Tract (Diagnostics) | (a) sputum studies (b) arterial blood gases (c) pulse oximetry |
| Lower Respiratory Tract (Nursing Diagnostics) | (a) ineffective breathing pattern related to infectious process, pain while breathing & decreased lung expansion (b) fluid volume deficit related to decreased oral intake & abnormal fluid loss (c) potential for infection transmission related to coughing & tuberculosis (d) impaired gas exchange related to airflow limitations, mucous production, respiratory muscle fatigue & collapse of an area of the lung (e) ineffective airway clearance related to bronchoconstriction, mucus production, and ineffective cough (f) activity intolerance related to fatigue, hypoxemia, and ineffective breathing pattern (g) anxiety r/t inability to ventilate effectively |
| Mantoux Test | tuberculin skin test that is used to diagnose tuberculosis |
| Mechanical Ventilation | (1) technique used when pts are not able to sustain adequate ventilation under their own efforts |
| Nasal Cannula | common way of delivering low to moderate flow rates of oxygen (1-6 L/min) |
| Orthopnea | clinical manifestation of emphysema in which the patient cannot assume a recumbent position without developing dyspnea |
| Oxygen Hoods | (1) tents that are used to admin oxygen to infants and young child who do not tolerate the use of a cannula or mask |
| Oxygen Masks | (1) different forms each used to administer concentrations of oxygen (2) simple mask delivers low to moderate concentrations of O2 in concentrations ranging form 35 – 60% (3) venture is considered most reliable method for delivering Rx O2 concentration (has a dial on the end piece to regulate the precise concentration of O2) |
| Oxygen Safety | (1) sh/not be used around fire (2) smoking strictly prohibited (3) sh/be humidified & H2O level in humidifier bottle sh/be checked frequently so it does not run dry (4) water-soluble lubricant can be applied to nose to decr irritation (5) flow rate setting sh/be checked regularly for proper admin at Rx rate |
| Oxygen Tent | (1) may be frightening to a child & child may feel isolated (2) it helps if family members are nearby & can be seen thru the tent (3) a favorite toy can be placed in the tent w/for comfort & distraction (4) temp w/in tent can become warm due to the enclosure & sh/periodically check temp (5) moisture may gather on the enclosure, check to be sure child remains warm & dry (6) major disadvantage (a) difficult to keep the oxygen concentrations maintained (b) frequent opening of tent depletes oxygen levels (7) care sh/be planned to minimize disruption of oxygen concentration levels |
| Oxygen Therapy | (1) medicative therapy that is a key component in treating respiration disorders (2) 3 methods of admin (a) nasal cannula (most common method) delivers low to moderate flow rates of O2 (16 L/min) |
| Oxygen Toxicity | (1) condition that can arise from administering too high a concentration (over 50 to 60) of oxygen from a prolonged period of time (over 48 hrs) (2) leads to lung tissue damage & pulmonary edema (3) S&S of oxygen toxicity incl (a) dyspnea (b) restlessness (c) lethargy (d) paresthesias (e) substernal chest discomfort (f) increasing respiratory discomfort. It is important to only use the amount of oxygen necessary to achieve a satisfactory oxygen saturation level |
| Pneumonia | (1) inflammation of lung tissue caused by microorganisms (2) Four classifications (a) community-acquired (b) hospital-acquired (c) immunocompromised host (d) aspiration |
| Positive End-Expiratory Pressure (PEEP) Interventions | (1) ensure prescribed settings are maintained (b) monitor functioning of equipment (3) note pt’s response to therapy (4) assess (a) control mode (b) setting for respiratory rate, tidal volume & fraction of inspired oxygen (FiO2) (c) inspiratory pressure reading (d) inspiratory/expiratory ratio (e) minute volume (f) use of PEEP (g) sigh setting (h) sensitivity of ventilator triggering (i) periodic (hrly) checks of ventilator alarms to ensure proper functioning (j) assess humidifier water level; empty accumulated condensation from tubing |
| Positive End-Expiratory Pressure (PEEP) | (1) ventilator mode in which the positive pressure is only applied by the ventilator at the end of expiration (2) use to help decr dev of atelectasis & reduce shunting (3) can result in lung tissue damage if applied at a pressure that is too low or can lead to Hypotension d/t < intrathoracic pressure that impedes blood flow |
| Positive Pressure Ventilators | (1) exert positive pressure upon the airway, this inflating the lungs |
| Principles of Drainage (Single-Bottle System) | (1) water-seal drainage system (a) end of chest drainage tube is submerged below water (b)underwater seal creates a (-)pressure w/in pleural space allowing air & fluid to drain from the pleural space into the bottle while preventing air re-entry to pleural space (2) lung expands w/fluid removal (3) gentle suction can be applied to aid in removal of air & fluid |
| Principles of Drainage (Two-Bottle System) | (1) consists of underwater seal bottle (single-bottle system or water-seal drainage system) w/an additional bottle use to collect fluid (2) first bottle in system collects fluids (3) second bottle creates under water seal (4) in this system, the underwater seal fluid level remains unaffected by the amount of drainage coming from the pleural space (5) suction is added to the underwater seal bottle by attaching the suction connection to the vent stem on the underwater seal bottle |
| Principles of Drainage (Three-Bottle System) | (1) third bottle used to control amount of suction applied to drainage system (2) level to which venting tube is submerged in water controls the amount of water suction that is applied to the patient (3) watch constant gentle bubbling (tideling) in third bottle (means system is properly functioning) (4) outside vent to room air in third bottle |
| Respiratory Syncytial Virus (RSV) | acute viral infection that primarily affects the bronchioles, causing bronchiolitis |
| Status Asthmaticus | (1) life-threatening, severe and continuous asthma attack (2) exhibition of labored, prolonged expiration & wheezing (3) worsening attack pt becomes cyanotic & WHEEZING DISAPPEARS (4) ominous sign that air has stopped moving in & out of the lungs |
| Stoma | (1) swimming is not allowed (2) pt may shower as long as instrument is protected from flow of water (3) sh/always be protected from sprays, powders, cut hair & any substance considered an irritant to airway |
| Sucking Chest Wound | (1) wound large enough for air to move freely into & out of the wound w/ea expiration (2) cover immediately w/airtight (non-porous) dressing to prevent dev of tension pneumothorax (3) emergency: use anything (waste no time looking for a sterile dressing) (4) ideal dressing is a piece of sterile petrolatum gauze |
| Surgical Management of PE | (1) attempted w/unsuccessful/ineffective or unfeasible anticoagulation therapy (2) a surgically performed (pulmonary embolectomy) removal of clot from pulmonary vessel thru (a) thoracotomy (b) special embolectomy catheter (3) mortality rate is high for this procedure |
| Tidaling | fluctuation of the fluid in the water seal chamber tht should occur w/the patient’s respirations when using a drainage system |
| Tonsilitis | (1) dificulty swallowing d/t sore throat (2) accompanied by adenoiditis (Inflammed adenoids) (3) otitis media can dev as the infection spreads to the ears (4) caused by a virus (A B hemoltyic Streptococci) |
| Tuberculosis | (1) infectious disorder that primarily affects the lungs (2) caused by mycobacterium buberculosis an acid-fast aerobic rod that is inhaled by a susceptible individual (2) bacteria lodges in the alveoli & begin to multiply, spreading thruout longs |
| Venturi Mask | oxygen mask that is considered to be the most reliable method to delivering a prescribed oxygen concentration |
| Ventilation (Mechanical) | (1) 4 conditions (a) postop thoracic surgery (b) acute respiratory failure (c) drug overdose (d) neuromuscular disorder that impair respiratory system (a) trauma (b) shock (c) head injuries (d) spinal chord injuries (e) multisystem organ failure |
| Ventilation (Mechanical) Types | (1) pressure-cycled (2) time-cycled (3) volume-cycled ventilators |
| Ventilator Modes | (1) assisted/controlled (A/C) (a)ventilator assists w/each breath for the patient at the preset respiratory rate (b) in cases where pt cannot breathe & trigger the machine, the ventilator breaths for the pt at the preset respiratory rate (2) synchronized intermittent mandatory ventilation (SIMV) (a) pt still allowed to breathe spontaneously & the ventilator provides additional pre-set intermittent breaths (b) eventually the amount of ventilator support can be decreased to allow the pt to breathe w/o assistance |
| (Volume-Cycled Ventilator | (1) delivers a preset volume of air w/each inspiration (2) w/delivery of present volume, ventilator cycles off & exhalation begins (3) delivers a consistent amount of air to the pt w/o regard to airway resistance or compliance |
