Med Surge Respiratory
Fever can cause _________ because of excessive fluid loss due to diaphoresis. Increased temperature
also increases _________ and the demands for 02.
Dehydration, metabolism
Clients at high risk for pneumonia
1.) Altered level of consciousness
2.) depressed or absent gag and cough reflex
3.) Susceptible to aspirating oropharyngeal secretions, including alcoholics, anesthetized individuals
4.) Brain injury
5.) drug overdose
6.) stroke victims
7.) Immunocompromised
_____________ are heard over areas of density or consolidation. _______ are easily transmitted over
consolidated tissue
Bronchial breath sounds, sound waves
Hydration purpose in pneumonia
1.) thins out the mucus trapped in the bronchioles and alveoli, facilitating expectoration
2.) Essential for client experiencing fever
3.) Is important because 300-400 ml of fluid is lost daily by the lungs through evaporation.
Early signs of cerebral hypoxia?
Irritability and restlessness. Brain is not receiving enough 02.
Pneumonia preventives in older adults, immunosuppressed and debilitated persons, comatose and
immobile persons, and patients with functional or anatomic asplenia?
Older Adults: Flu shots, immunizations, avoiding pollutants; no smoking
Immunosuppressed and debilitated persons: Flu shots, immunizations, infection avoidance, sensible
nutrition, adequate intake, balance of rest and activity
Comatose and immobile persons: Elevation of head of bed to feed and for 1 hour after feeding;
frequently turning.
Patients with functional or anatomic asplenia: flu and pneumonia immunizations.
Exposure to ____________ is the primary cause of COPD in the united states
Tobacco smoke
, What ABG changes in COPD?
As copd worsens, the amount of 02 in the blood decreases (hypoxemia) and the amount of CO2 in the
blood increases (hypercapnia) causing chronic respiratory acidosis, which results in metabolic alkalosis
as compensation.
Why don't all clients with COPD retain CO2.
CO2 diffuses more easily across lung membranes than 02.
Difference between emphysema and bronchitis
In advanced emphysema, due to alveoli being affected, hypercarbia is a problem, rather than in
bronchitis, where the airways are affected.
Patient Postion for clients with COPD
Productive cough and comfort can be facilitated by semi-fowler or high-fowler position, which lessens
pressure on the diaphragm by abdominal organs. Gastric distention becomes a priority in these clients
because it elevates the diaphragm and inhibits full lung expansion.
Normal ABG Values
Blood Gas Adult Child
Blood Gas 7.35-7.45 same
PC02 35-45 same
Po2 80-100 same
HCO3- 21-28 same
Pink Puffer sign of?
barrel chest is indicative of emphysema and is caused by use of accessory muscles to breathe. The
person works harder to breathe, but he amount of 02 taken in is adequate to oxygenate the tissues.
Blue bloater sign of?
Insufficient oxygenation occurs with chronic bronchitis and leads to generalized cyanosis and often right
sided heart failure
Signs of inadequate arterial oxygenation
Cyanosis and slow capillary refill (<3 seconds). A chronic signs is clubbing of the fingernails, and a late
signs is clubbing of the fingers.
Health promotion tips for respiratory compromised patients
1.) offer mechanically soft diets which don't require as much chewing and digestion
2.) avoid crowds, contact with people who have infectious diseases and smoke to prevent secondary
infections.
3.) Teach client to report any change in characteristics of sputum
Fever can cause _________ because of excessive fluid loss due to diaphoresis. Increased temperature
also increases _________ and the demands for 02.
Dehydration, metabolism
Clients at high risk for pneumonia
1.) Altered level of consciousness
2.) depressed or absent gag and cough reflex
3.) Susceptible to aspirating oropharyngeal secretions, including alcoholics, anesthetized individuals
4.) Brain injury
5.) drug overdose
6.) stroke victims
7.) Immunocompromised
_____________ are heard over areas of density or consolidation. _______ are easily transmitted over
consolidated tissue
Bronchial breath sounds, sound waves
Hydration purpose in pneumonia
1.) thins out the mucus trapped in the bronchioles and alveoli, facilitating expectoration
2.) Essential for client experiencing fever
3.) Is important because 300-400 ml of fluid is lost daily by the lungs through evaporation.
Early signs of cerebral hypoxia?
Irritability and restlessness. Brain is not receiving enough 02.
Pneumonia preventives in older adults, immunosuppressed and debilitated persons, comatose and
immobile persons, and patients with functional or anatomic asplenia?
Older Adults: Flu shots, immunizations, avoiding pollutants; no smoking
Immunosuppressed and debilitated persons: Flu shots, immunizations, infection avoidance, sensible
nutrition, adequate intake, balance of rest and activity
Comatose and immobile persons: Elevation of head of bed to feed and for 1 hour after feeding;
frequently turning.
Patients with functional or anatomic asplenia: flu and pneumonia immunizations.
Exposure to ____________ is the primary cause of COPD in the united states
Tobacco smoke
, What ABG changes in COPD?
As copd worsens, the amount of 02 in the blood decreases (hypoxemia) and the amount of CO2 in the
blood increases (hypercapnia) causing chronic respiratory acidosis, which results in metabolic alkalosis
as compensation.
Why don't all clients with COPD retain CO2.
CO2 diffuses more easily across lung membranes than 02.
Difference between emphysema and bronchitis
In advanced emphysema, due to alveoli being affected, hypercarbia is a problem, rather than in
bronchitis, where the airways are affected.
Patient Postion for clients with COPD
Productive cough and comfort can be facilitated by semi-fowler or high-fowler position, which lessens
pressure on the diaphragm by abdominal organs. Gastric distention becomes a priority in these clients
because it elevates the diaphragm and inhibits full lung expansion.
Normal ABG Values
Blood Gas Adult Child
Blood Gas 7.35-7.45 same
PC02 35-45 same
Po2 80-100 same
HCO3- 21-28 same
Pink Puffer sign of?
barrel chest is indicative of emphysema and is caused by use of accessory muscles to breathe. The
person works harder to breathe, but he amount of 02 taken in is adequate to oxygenate the tissues.
Blue bloater sign of?
Insufficient oxygenation occurs with chronic bronchitis and leads to generalized cyanosis and often right
sided heart failure
Signs of inadequate arterial oxygenation
Cyanosis and slow capillary refill (<3 seconds). A chronic signs is clubbing of the fingernails, and a late
signs is clubbing of the fingers.
Health promotion tips for respiratory compromised patients
1.) offer mechanically soft diets which don't require as much chewing and digestion
2.) avoid crowds, contact with people who have infectious diseases and smoke to prevent secondary
infections.
3.) Teach client to report any change in characteristics of sputum
