MED SURG 2 EXAM 2 REVIEW (respiratory system) CHAPTER 29 (2022 Solution)

MED SURG 2 EXAM 2 REVIEW (respiratory system) CHAPTER 29 (2022 Solution) • Pulmonary function test- measures the amount of air remaining in the lungs after normal expiration. Residual volume (RV) Air remaining in lungs after maximum exhalation 1,000–1,500 mL • Dyspneic scale: if pt experiences 7 out of 10 o 1ST: place the pt in a FOWLER’S position. Or tripod position (sit in a chair while leaning forward and placing their elbows on their knees or an over-the-bed table) • If you hear adventitious breath sounds on one side- ASCULTATE THE OTHER SIDE AND COMPARE TO DETERMINE IF ABNORMAL. Fine crackles (rales) Alveoli popping open on inspiration Velcro being torn apart, heard at end of inspiration Heart failure, atelectasis Stridor Airway obstruction Loud crowing noise heard without stethoscope obstruction from tumor or foreign body Pleural friction rub Inflamed pleura rubbing together Sound of leather rubbing together; grating sound Pleurisy, lung cancer, pneumonia, pleural irritation • If pt has a high PACO2 of 73? 1ST SIT PT IN A FOWLER’S POSISTION to assist with ventilation while someone calls the HCP. • The NORMAL PACO2= 35-45. If elevated that means the patient is holding onto CO2 and is shallow breathing. • FOWLER’S position gives the pt maximum lung capacity. • Nonrebreather mask- one or both side vents closed to limit the mixing of room air with oxygen. The vents open to allow exhalation but remain closed on inhalation. The reservoir bag has a valve to store oxygen for inhalation but does not allow entry of exhaled air. It is used to deliver oxygen concentrations of 70% to 100%. Patient is breathing 100% oxygen. • MDI inhaler-using it more than prescribed can cause rebound bronchoconstriction, which results in worsening symptoms and/or death. Adrenergic bronchodilators can