Fundamentals of Nursing, 10 Ed., Potter, Perry, Stockert & Hall, 2020 | Practical Nurse (LPN) School Study Aid
Respiratory Anatomy
- Nasal Cavity
- Hair Filters
- Mucus Filters and Moistens
- Capillaries Warm
- Pharynx (Throat)
- Larynx (Voice Box)
- Cilia Expel Mucus and Dust
- Trachea
- Bronchi
- Alveoli
Alveolar Gas Exchange
- Pulmonary Artery Blood is O2-Poor, CO2-Rich
- Two-Cell Thick Air-Blood Barrier
- CO2 Diffuses Into Air
- O2 Diffuses Into Blood
- Gases Equilibrate
- Pulmonary Vein is O2-Rich, CO2-Poor
- Thermoregulation
Hypoxia (Early Symptoms)
- Diaphoresis
- Restlessness
- Tachypnea
- Dyspnea on Exertion
- Tachycardia
- Hypertension
- Arrhythmias
- Decreased Urine Output
- Unexplained Fatigue
Hypoxia (Late Symptoms)
- Cyanosis
- Cool, Clammy Skin
- Use of Accessory Muscles
- Retractions
- Hypotension
- Arrhythmias
Oxygen Delivery Methods
- Nasal Cannula
- Simple Face Mask
- Non-Rebreather Mask
- Venturi-Mask
- Oxygen In Use Sign
- No Electrical Sparks
- Six Feet Away from Open Flames
- Dry Nasal and Upper Airway Mucosa
- Skin Irritation
- Home Education
Chest Tubes: Management and Care
- Confirm suction order
- Crepitus
- Kinking
- Shortness of Breath (SOB)
- Infection
- Excessive bubbling
- If tube dislodges from patient, use petroleum gauze taped 3 ways
- If drainage system is damaged, place disconnected drainage tube in sterile water
Respiratory Alkalosis Assessment
- Increased pH > 7.45
- Decreased PaCO2 < 35 mmHg
- Hyperventilation
- Brainstem Stimulation
- Head Injury
- Shock
- Lightheadedness
- Tingling Lips or Fingers
- Trousseau's
- Chvostek's Sign
- Anxiety
Respiratory Alkalosis Interventions
- Treat Underlying Cause
- Decrease Tidal Volume and/or Respiratory Rate
- Give Adequate Pain Control and Sedation
- Sedatives
- Antidepressants
- Compensatory Drop in Serum Bicarbonate
- Calming Breathing Exercises
- Correct CO2 Slowly
Respiratory Acidosis Assessment
- Decreased pH < 7.35
- Increased PaCO2 > 45
- Reduced Respirations
- Anxiety
- Change in LOC
- Tachycardia
- Cyanosis
- Increased Electrolytes
- ECG Changes
- Muscle Weakness
- Hyporeflexia
Respiratory Acidosis Interventions
- Improve Respiration
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Oxygen
- Assisted Ventilation
- Prevent Complications
Tracheostomy Care
- Inner Cannula Removed and Cleaned
- Clean Q8 Hours Around Stoma
- One Finger Under Ties
- Speak with Deflated Cuff
- Can Eat with Tube in Place
- Keep Replacement Tube Nearby
- Immediately Replace if Dislodged
- Physician Does First Tube Change
Restrictive vs. Obstructive Lung Diseases
- Restrictive Lung Disease
- Decreased Lung Volume
- FEV1/FVC Ratio Normal to Increased
- Obstructive Lung Disease
- Increased Lung Volume
- Decreased FEV1/FVC Ratio
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
- Inhaled Toxins
- Smoking
- AAT Deficiency
- Emphysema
- Chronic Bronchitis
- Asthma
- Spirometry
- Slow Progression
Asthma Assessment
- Triggers (Cold air, Dander, Dust, Infection, Mold, Pollen, Smoke)
- Shortness of Breath (SOB)
- Tachypnea and Tachycardia
- Wheezing
- Diaphoresis
- Accessory Muscles
- Decreased Pulmonary Function Tests
Asthma Implementation and Education
- Oxygen
- Corticosteroids
- Ipratropium (Anticholinergic)
- Albuterol
- Inhaler/nebulizer
- Pulse Oximetry
- Pursed Lip Breathing
- Carry Inhaler
- Rinse Mouth after Inhaler
- Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Chronic Bronchitis Assessment
- Chronic Productive Cough
- > 3 Months for 2 Years
- Increased Mucus Production
- Dyspnea
- Cyanosis
- Wheezes
- Right Side Heart Failure
- Jugular Venous Distention (JVD)
- Peripheral Edema
Chronic Bronchitis Interventions
- Tripod Position
- Humidified Oxygen
- Pursed Lip Breathing
- Increase Fluid Intake
- ABGs
- Early Detection of Exacerbation
- Lowest O2 Therapy
- Assisted Ventilation
- Increased Infection Risk
Emphysema
- Hyperinflation and Loss of Elasticity
- Pursed Lip Breathing
- Barrel Chest
- Dyspnea on Exertion
- Clubbing
- Depression and Anxiety
- Thin Appearance
- CO2 Retention
- Low Concentration of O2
- High Fowler's Position
- High Calorie, High Protein Diet
Pneumonia Assessment
- Older Adult
- Immunocompromised
- Long Term Care
- Shortness of Breath (SOB)
- Hypoxemia
- Cough and Sputum Production
- Wheezing or Crackles
- Fever
- Pleuritic Pain
- Chest X-ray
Pneumonia Intervention
- Humidified Oxygen
- Deep Breathing Exercises
- Position of Comfort
- Increase Fluid Intake
- Manage Fever
- Antibiotics
- Mucolytics
- Expectorants
- Pneumococcal Vaccine
- Sepsis
- Acute Respiratory Failure (ARF)
- Prevention Education
Tuberculosis Assessment
- Airborne Droplet
- 3 Week Productive Cough
- Night Sweats
- Chest Pain
- Fever
- Weight Loss
- Fatigue
- Chest X-Ray
- Blood Tests
- Mantoux Skin Test
- 3 Positive Sputum Tests
Tuberculosis Intervention
- Airborne Isolation
- Combination Drug Therapy (RIPE)
- 6-12 Months
- DOT
- BCG Vaccination
- Medication Education
- 3 Negative Sputum Specimens
- Infection Control
Pneumothorax
- Air Enters Pleural Space
- Sudden Dyspnea
- Absent or Restricted Movement on Affected Side
- Decreased or Absent Breath Sounds on Affected Side
- Chest Pain
- Tracheal Deviation
- Vital Sign Changes
- Crepitus
- High Fowler's Position With Oxygen
- Prepare For Chest Tube Placement
- Educate High Risk Patients
Pulmonary Embolism Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Hypercoagulable
- Central Venous Lines
- Immobilized
Pulmonary Embolism Assessment
- Shortness of Breath (SOB)
- Pleuritic Chest Pain
- Tachypnea
- Hemoptysis
- Hypoxemia
- Sudden Death
Obstructive Sleep Apnea (OSA)
- Narrowed or Obstructed Air Passage
- Apnea
- Loud Snoring
- Startle Response
- Daytime Drowsiness
- Positional Therapy
- Oral Appliance
- Continuous Positive Airway Pressure (CPAP)
- Surgery
- Weight Loss
Acute Respiratory Distress Syndrome (ARDS) Assessment
- Damaged Alveolar-Capillary Membrane
- Restlessness
- Dyspnea
- Refractory Hypoxemia
- Decreased PaO2
- Diffuse Pulmonary Infiltrates
- Atelectasis
- Pulmonary Hypertension
Acute Respiratory Distress Syndrome (ARDS) Interventions
- Closely Monitor Patient
- ABG's (Arterial Blood Gases)
- Oxygen
- Assess for O2 Toxicity
- Mechanical Ventilation
- PEEP
- Assess for Pneumothorax
- Permissive Hypercapnia
- High Mortality Rate