NCM 112 - asthma under control

LESSON 1: - use zone determination

Overview and Planning Needs: 3.
1. - amount of albuterol given
-Arterial blood gas and pulse oxymetry results - weight
- Dysrhythmias - 0.2
- wide breathing 4.
2. - ask the client to assume a supine position to
-Attach T-piece to the client’s artificial airway maximize lung expansion
- Use humidifier - standard rnage peak flow meter
- 6 liters - after 4 hours
3.
- Sizes D and E LESSON 4:
- That the client’s activity tolerance was 1.
properly measured - one-half to three quarters of the baseline
- skin irritation and mucous membrane dryness inspiratory capacity
4. - ensure maximal sustained respiration
- embolism - abdominal or thoracic surgey
- client with lung disease cannot tolerate hig 2.
flow rates of exygen - abnormal breath sounds
- the contamination of humidifier - decreased lung expansion
- target expiratory is achieved
LESSON 2: 3.
1. - anorexic client
- immobility - teach the client to examine sputum
- altered tissue perfusion - diaphragmatic excursion
- huff cough 4.
2. - promotes optimal lung expansion
- auscultion after procedure - 2 to 5 sec
- use a pillow or folded towls to splint abdomen - alveoli
- high fowlers 5.
3. - respiratory capacity
- 30 minutes befor eth eprocedure - arthritis
- encourge eclient to increase fluid intake - weakened respiratory muscles
- cliet’s respiratory rate
4.
-Ask client to take deep inspiration
- congested heart failure
- give the client an abdominal binders

LESSON 5:
1.
- gravitational clearance of airway secretions
from specific bronchial segments
- arterial blood gas founding
LESSON 3: - drainspecific bronchial lobes
1. 2.
- find the client’s true personal best peak value - arteriectasis
- to measure rate of air expired at the beginning - decreased emphysema
of respiration 3.
- may not be able to provide an accurate peak - additional blankets
flow meter reading - 1 to 2 hours after meals or bolus feedings
2. - 100ml
- less than 50 4.
- chest sauscultation
- sit up and cough LESSON 8:
- transient dyspnea and fatigue 1.
5. - nausea
- side lying semi-fowlers position - cyanosis
- in the morning before breakfast and about 1 - positive, consistent airway pressure during
hour before bedtie both inspiratio and expiration
- inspect character and amount of sputum 2.
6. - FHG levels
- sole of an adult - An airtight seal
- hypertension - Maintain CPAP for prescribed length of time
- 0.9 3.
- caregiver
LESSON 7: - nurses notes
1. - long-term care facility
- oxygen saturation is less than 90% 4.
- 90 – 100% - Who is responsible for the care of the CPAP
2. machine
- earlobe - Demonstrate the mask on herself
- single use or tape on - mouth
- coughing or sneezing
3.
- bridge nose
- 10 to 30 seconds
- 2 hours
4.
- tissue ischemia
- tremors
- tissuefragility

LESSON 9:
1.
- negative intapleural pressure between the
lungs, chest wall, and diaphgram
- prevent air return into the pleural cavity
- below the level of the chest tube insertion site
LESSON 6: 2.
1. - the airflow through the water in the suction
- atelectasis chamber
- explain the name and amount of any - increases the drainaige of fluid or air fom the
medication to be nebulized pleural cavity
- providing intermittent ventilation for clients - maintain a vent to the air
with hyperventilation 3.
2. - suction control bottle
- drying effect of the gas during the treatment - nurse’s notes
- gas source - explain the sounds and sensations associated
- assist the client to an upright position with the chest tube
3. 4.
- client - increase the noise level in the suction control
- give IPPB via face mask chamber
- nurses notes - 2cm deep in the sterile water or saline
4. - one
- pressure spikes and early termiation of
inspiration LESSON 10:
- decreased intracranial pressure 1.
- pressure limit - blood transfusion
- it is performed to examine the effects of - dullness or flatness in the affected side
changes in blood volume on circulatory function - 3 feet connecting tube
2. 4.
- 48 to 72 hours - inferior aspect of the anaesthesized rib below
- arterial blood gas the insertion site
- hyperventilation - posteriorly and superiorly toward sthe apex of
3. the lungs
- chux pad - 5ml syringe (25-G needle)
- chest pain on expiration 5.
- upright and below the level of tube insertion - 2 hours
4. - an air leak
- B,C,D only
- use a new microaggregate filter
- auto-transfusion unit
5.
- Sp02
- infiltration and phlebitis

LESSON 13:
1.
- restoring negative intrapleural pressure
- pleur-evac 2000
LESSON 11: 2.
1. - in a container with a 2.5 cm sterile water while
- Large (36 to 40 Fr) preparing another chest-drainage device
- emphysema - the ches-drainage breaks or the system
- it can occur as a complication of unintentional becomes disconnected
puncture during centra venous catheter insertion 3.
2. - level of dyspnea and breath sounds
-cystic fibrosis - pleur-evac 2000
- neuropathy 4.
- removal of air, blood, or sputum from the - 90 ml setrile fluid
pleural space - -20 cm
3. - needless access port at the back of the chamber
- tension pneumothorax 5.
- 5ml syringe with 20G, 1 inch needle - fluid from re-entering the chest
- semi fowlers position - -10 to 20 cm H2O
4.
- right or left second intercostal space LESSON 14:
- suture the chest tube to the chest wall 1.
- pleural complications - air and fluid from the pleural space
5. 2.
- semi-fowlers position - have the client cough or exhale forcibly and
- improper tube placement apply an occlusive dressing on the area
- bloody drainage of 100ml/hr - there are obstruction in the system
3.
LESSON 12: - the chets tube is secured to the client’s chest
1. and there is an airtight dressing surrounding the
- tension pneumothorax insertion site
- medium (26 to 36 Fr) 4.
- chylothorax - 320 ml
2. - inserting a needle or syringe through the face
- sputum grommet
- x-ray - float-ball level
3. 5.
- arrhythmias
- the mixing of fluid from some chambers or - mark the level when the chest drainage is first
loss of the water seal set up
- increased itrathoracic pressure - record the total unmarked amount and note that
this is a 16 hour total
- hemothorax

LESSON 17
1.
-vacuum seal in the pleural cavity
- Syringe without needle
- assess the physician’s or qualified
LESSON 15: practitioners’ orders
1. 2.
- -40 cm H20 - withdraw the drainage specimen without
- Sahara opening the system
- 100% latex-free pathway and tubing - 45 degree angle
2.
- withdraw the system ½ inch
- tension pneumothorax
- accidental dislodgement of the chest tube 3.
occurs - input and output record
- place the end pf the tubing in a container of - prevent the child from watching while the
sterile water until another device can be specimen is collected
prepared - nurses notes
3. 4.
- 30ml syringe
- use gentle suction when withdrawing the
- 30 ml syringe with needle
- dyspnea specimen
4. - insert the needle at a 45 degree angle
- B,D,A,C - re-inflating the client’s lung
- Attach the tubing from the suction control
chamber to a suction source LESSON 18
- 18 gauge or smaller needle only 1.
5.
- 50-100mL in 24 hrs
- the device is above the client’s chest level
- -10 to 20cm H2O - 7 days
- increased intrathoracic pressure - respiratory rate less than 25 breaths
2.
LESSON 16: - hemothorax
1. - normal count of ECG
- urine -
- chest drainage system is an closed system
3.
- allow the lung to re-expand after surgery or
trauma - 100mL in 8hrs
2. - wet 4x4 gauze sponges
- mark the previous fluid level - Intravenous morphine
- the amount of drainage since the last 4.
measurement - A chest x-ray
-plastic, disposable system - Performing the valsava maneuver
3.
- Clamp each tube to be removed with two
- significantly different from the previous
readings umbilical clamps
- dehydration 5.
- the home care setting - Pneumothorax
4. - Crepitus
- Skin necrosis 1.
- facilitate removal of tracheobronchial
secretions
- naris and tragus of the ear
- the post anesthesia recovery period
2.
- decreased airway resistance
LESSON 19 - frequent suction attempts
1. 3.
- unknotted until the chest tube is removed - normal saline
- the drainage has changed from the bloody to - mental status
serosanguinous - high-fowlers position
- pleural or mediastinal space 4.
2. - generously lubricate the tip and outer cannula
- skin necrosis with water-soluble lubricant
- expansion of lungs - maxillofacial injuries
3. - removing the tube
- assess the clients increased use of accessory 5.
muscles - 4 to 8 hours
- specimen collection cup - Displacement of oral airways
- 15 minutes before the procedure - airway obstruction
4.
- 1to 24 hour after the removal, or as clinically LESSON 22
indicated 1.
- pneumothorax - abdominal thrust
- square knot - an unconscious client with an excessive gag
5. reflex
- vein or artery on the chest wall before removal - the removal of oral secretions
- air was introduced into the pleural space 2.
through the chest tube tract - airway obstruction
3.
LESSON 20 - tragus of the air
1. - oropharynx
- Teach relaxation techniques -4
- Oxygen saturation 4.
- 240 to 2,000 ml per breath - distal tip
2. - equal and clear breath sound during ventilation
- provide hyperinflation and increase 02 levels - 180 degrees to the proper position
- increase intracranial pressure 5.
-compress the reservoir 20 times per minute - pulmonary gas exchange
3. -evaluate the client’s chest for asymmetrical
- whether the client was able to maintain rise and fall during ventilation
effective ventilation during transportation -remove the client immediately after the client
- age and correlated lung capacity retains gag reflex
- tachycardia
4.
- hypocarbia
- gather history regarding the events that LESSON 23
preceded the onset of respiratory arrest 1.
- note the length of and tolerance to procedure -5ml/kg
-SVt
- three times SVt
LESSON 21 2.
- psychological - 3.5 to 4.5 mm
3. - 15mL
- decreasing arterial carbon dioxide tension 4.
- increasing or decreasing heart rate - arterial oxygen levels
- extubation equipment - connecting tubing
4. - increased venous oxygen saturation
- divide minute ventilation by fx 5.
- 20 seconds - the specific unexpected outcomes during or
- respirometer after the procedure
5. - development of any unexpected outcomes
- +30 cm H2O during or after the procedure
- fatigue
- positive pressure ventilation LESSON 26
1.
LESSON 24 -
1. -
- progressively longer interval trials -
- high-pressure, low-volume work 2.
- decreasing arterial partial pressure -
2. -
- an adequate breathing pattern -
- hypocapnia 3.
3. -
- mobility -
- MDI adapter -
- functional, heated aerosol humidifier 4.
4. -
- 20 -
- pressure support weaning -
- IMV and SIMV weaning 5.
5. -
- positive expiratory pressure -
- presence of ventilator sounds -
- changes in pulse rate

LESSON 27
1.
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LESSON 25 -
1. -
- removing secretions from the trachea and main 2.
steam bronchi -
- decrease in respiratory rate, frequent coughing -
or both -
- increased venous oxygen saturation 3.
2. -
- bronchospasms -
- pericardial effusion -
3. 4.
- greater than 5cm H2O PEEP -
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LESSON 29
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