CHA 1: Unit 6 Respiratory Exam Study
Guide
Cystic fibrosis (CF) - answerAutosomal-recessive trait
Hereditary disorder; altered functions of exocrine glands: Lung, Pancreas, Sweat Gland,
Reproductive Organs
Characterized by: lung congestion, infection, and malabsorbtion of nutrients by the panc...
Cystic fibrosis pulmonary manifestations - answer✔✔Respiratory infections
Chest congestion
Limited exercise tolerance
Cough and sputum production
Use of accessory muscles
Decreased pulmonary function
Changes in chest x-ray
Increased anteroposterior diameter
Cystic Fibrosis Diagnostic Test - answer✔✔sweat test-chloride test (excess chloride release)
Diet: High calorie & protein, moderate fat
Water-miscible forms of Vit A, D, E supp
Generally not breast fed, not enough protein
Pancreas-lung transplant
Tobramycin (TOBI) - answer✔✔used to treat chronic P. aeruginosa infection in CF patients
Dornase alfa (Pulmozyme) - answer✔✔decreases viscosity of mucus and improves lung
function. improvement monitored by pfts. use once daily.
Pancreatic Enzyme Replacement - answer✔✔Pancreatic enzymes (pancreatin and pancrelipase);
action: aid in the digestion of starches, fats, protein; side effects: anorexia, N/V, diarrhea,
hypersensitivity, sneezing, lacrimation, skin rashes; nursing responsibilities: do not use with
antacids, avoid inhaling powder, client education: take with meals
Cystic Fibrosis Family Teaching - answer✔✔Functions of oxygen and how to regulate flow
Postural drainage
Encourage them to think about fitting the treatment/illness into family life (DO both parents
work)
Respiratory Distress Syndrome (RDS) - answer✔✔A respiratory disorder that affects premature
infants born without enough surfactant in the lungs. It is treated with respiratory support and
surfactant administration
Production starts at 24 weeks (gestation)
Patho
Poorly developed alveoli are difficult to inflate.
-alveolar instability/diffuse atelectasis results
-Decreased pulmonary vasoconstriction (severe hypoxia)
-Increased alveolar capillary permability
-Fluid and protein are leaking into the interstitial area and alveoli, hyaline membrane formation
atelectasis - answer✔✔collapsed lung; incomplete expansion of alveoli
Normal Newborn Assessment - answer✔✔-RR 30-60 /minute
-Brief periods of apnea (less than 15 seconds) with no color or HR change
-HR 120-160 while awake (sleeping can be as low as 80 and crying as high as 180)
-Synchronous chest and abdominal movement
respiratory distress syndrome (RDS) Symptoms - answer✔✔-RR >60/min, shallow & irregular
-Apnea longer than 20 seconds
-Labored breathing (retractions, grunting, nasal flaring, chin tug, head bobbing, decreased BS)
-Frothy sputum and expiratory grunt
-Hypothermia-inadequate functioning of metabolic process that require O2 to produce heat
-Flaccid & unresponsive d/t severe hypothermia
-Cyanosis & peripheral edema
-BP falls
Flaccid - answer✔✔(adj.) limp, not firm; lacking vigor or effectiveness
Cyanosis - answer✔✔a bluish discoloration of the skin resulting from poor circulation or
inadequate oxygenation of the blood.
Hypothermia - answer✔✔abnormally low body temperature
Frothy sputum - answer✔✔pulmonary edema
Respiratory Distress Syndrome (RDS) Treatment(s) - answer✔✔1st prevent labor
-Dobutamine (stop labor), may develop tachycarida for mon
-Magnesium sulfate (slows contractions)-Assess Deep tendon reflexes for toxicity
Determine fetal lung development via amniocentesis
-L/S ratio (lecithin/sphingomyelin)-at 32 weeks lecithin increases and sphingomyelin decreases,
resulting ratio is 2:1
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