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GMED5001 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Obstructive lung disease

+ examples

A

Airway obstruction that causes difficult expiration (dyspnoea) and requires accessory muscles
* Asthma, chronic bronchitis, emphesema

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2
Q

Asthma

A
  • Chronic inflammatory disorder caused by exposure to irritants or allergens
  • Type 1 hyersensitivity response caused by lymphocytes, IgE, mast cells and eosinophils
  • Leads to bronchoconstriction, spasm, oedema, and mucus production
  • Treat inflammation with relievers, preventors and controllers, avoid triggers
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3
Q

COPD

A
  • Coexistance of chronic bronchitis and emphysema (sometimes asthma) that causes impaired airflow and mucous buildup
  • Caused mainly by cigarette smoke
  • Can cause hypoxaemic and hypercapnic resp failure
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4
Q

Chronic bronchitis

A
  • Hypersecretion of thick mucous + SM hypertrophy = airway obstruction
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5
Q

Emphysema

A
  • Descruction of alveolar septa and loss of elastic recoil = collapse and gas flow obstruction
  • Air trapping causes increased chest expansive and workload
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6
Q

Acute bronchitis

Description, Tx

A

Infection of airways due to viral
Assessed with spirometry, sputum MC&S, CXR, ABG

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7
Q

Tuberculosis

A
  • Lung infection caused by mycobacterium TB
  • Inflammation causes isolates of bacteria in tubercles, and surrounding scar tissue
  • Remain dormant until immune system breaks them down and causes active disease
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8
Q

Bronchiolitis

A
  • Viral inflammation of bronchiolar airways in children
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9
Q

Croup

Description, PP, symptoms

A
  • Acute inflammation of upper airways (larynx) in children caused by parainfluenza virus
  • Swelling of trachea causes seal-like barking cough + rhinorrhoea, sore throat, low grade fever
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10
Q

Pertussis

A
  • Bacteria bordatella pertussis that causes thick secretions, chornic cough and fits, spasms (whooping cough)
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11
Q

CF

A
  • Autosomal recessive disease that causes thick secretions in lungs and GI
  • Favours chronic bacterial infection (staph aureus), clogged airways and severe inflammation = lung damage
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12
Q

Pulmonary embolism & vascular disease

A

Pulmonary Vascular disease: embolism or HTN in pulmonary circulation
Embolism: occlusion of pulmonary vessel by thrombus, tissue or air, leading to vasoC, oedema, atalectasis, HTN, shock, death

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13
Q

Hypoxaemia

Description, causes

A
  • Reduced oxygenation of arterial blood due to respiratory alterations
  • Low air O2, hypoventillation, impaired perfusion, resp depression due to drugs
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14
Q

Hypercapnia

A
  • Increased CO2 in the blood, caused by hypoventilation of alveoli

Causes
* respiratory centre depression (drugs)
* Medulla infection
* Thoracic abnormalities & neural issues
* Airway obstruction/obstructive diseases

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15
Q

Hypoxia

A
  • Reduced oxygenation of cells in tissue, not necessarily respiratory (e.g. low BP, low Hb, cardiac output issues)
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16
Q

Dyspnoea

Description, causes

A
  • Subjective sensation of uncomfortable breathing or SOB
17
Q

Haemoptysis

D, causes

A
  • Coughing up blood or bloody mucous
  • Caused by infection or inflammation that damages bronchi (bronchiectasis, TB, cancer
18
Q

Cyanosis

D, Causes

A
  • Bluish discolouration of the skin and mucous membranes due to desaturated Hb, polycythaemia (too many RBC), peripheral vasoC
19
Q

Minute volume

A

Minute volume: TV x RR
Average 700ml x 18/min = 12,600 ml/min or 12.5 L/min
* morphine overdose reduced tidal volume & RR therefore decreased minute volume
* Can cause reduce alveolar exchange, sats and hypoxia

20
Q

Expectorants

A

Aid in the removal of sputum from bronchial passages by diluting or irritating mucuous membranes to stimulate cilia

21
Q

Mucolytics

A

Help disintegrate mucus and reduce viscosity to facilitate removal
Acetylcystine

22
Q

Asthma drugs

Types, examples, order of treatment

A
  • Bronchodilator: relievers for SMrelaxation (B2 adrenoreceptors, SABA (salbutamol), xanthines, theophyllines, anticholinergics
  • Controller: LABA (salmeterol)
  • Preventers: reduce inflammation to prevent symptoms (inhaled corticosteroids, leukotriene-receptor antagonists)

SABA - SABA + CS - SABA + CS + LABA - all 3 + high dose CS

23
Q

Cough suppressant

A

Antitussive opioid that inhibits sensory receptors responsible for non-productive coughs

24
Q

Pneumonia

+ mechanisms of organism spread, extrinsic and intrinsic factors

A

Infection of the lung parenchyma
* Aspiration from nasopharyn or oropharynx
* Inhalation of microbes in air
* Haematogenous spread from primary infection

Extrinsic: exposure to causative agent or irritant (infection)
Intrinsic: loss of airway reflexes (sedation, intoxication, ETT, neurological), immune impairment, defence mechanism dysfunction - COPD)

25
Q

Natural respiratory defence

A
  • Warmth & humidity
  • Cough reflex
  • Mucociliary clearance
  • Macrophages in surfactant
  • Ventilation
26
Q

Pneumonia risk factors

A
  • Elderly
  • Pollution & smoking
  • Chronic diseases
  • Immunosuppression (neutropenia)
  • URTI & co-infection with influenza
  • Lung pathologies
  • CNS depressants/impairment that predispose aspiration
27
Q

Classifications of pneumonia

4 types + organism

A
  • Community aquired (strep pneumoniae)
  • Medical-care associated (hospital, ventilator, healthcare) (e. coli)
  • Aspiration pneumonia (material triggers an inflam response & usually bac inf)
  • Opportunistic (pathogens are usually those that dont cause disease)

NB: put 4 organisms in exam notes

28
Q

Pathophysiology of pneumonia

A
  • Organism trigger inflammatory response, causing hyperaemia & vascular permeability
  • Neutrophils and oedema fill alveoli, impaired ventilation/perfusion mismatch & mucus production disrupts O2 causing hypoxia, worsened by mucus production = consolidation
  • Strep pneumonia produces pneumolysin that is toxic to epi and endo & decreases clearance
29
Q

PP - patterns of involvement in pneumonia

A

Lobular pneumonia: classical of one or more lobes by pneumococci. Inflammation if intra-alveoli exudate & consolidation that eventually spreads to bronchioles

Bronchopneumonia: involved bronchi, bronchioles and alveoli where consolidation is from suppurative, leukocyte filled exudate that fills bronchi first then other spaces (staph aureus)

30
Q

PP - stages of lobular pneumonia

A
  1. Congestion: vascular engorgement, intraalveolar fluid, bacteria. Lung is heavy and red
  2. Red hepatization: massive exudate (RBC, leukocytes, fibrin fill alveoli). Lung is red, firm, airless
  3. Grey hepatization: disintegration of RBC, lots of fibrin exudate
  4. Resolution: enzymatic digestion of consolidation that is ingested by macrophages and coughed up
31
Q

Pneumonia Manifestations

A

Depends on type of organism

  • Cough (green/yellow sputum), dyspnoea, tachypnoea, chest pain
  • Fever, shakes
  • Low O2
  • Accessory muscles
  • Cognitive change due to hypoxia in elderly patients
  • Auscultated crackles, fremitus, adventitious breath sounds
32
Q

Diagnostic studies in pneumonia

A
  • History & physical
  • CXR
  • Sputum analysis
  • FBC: leukocytosis, blood cultures
  • ABGs
  • Thoracentesis/bronchoscopy (fluid samples)
33
Q

Pneumonia complications

A
  • Fibrosis & scarring of parenchyma
  • Pleurisy: inflammation of pleura
  • Pleural efflusion
  • Atelectasis : collapsed lung caused by airway blockage
  • Pneumothorax: traumatic (penetration) or tension (air in pleural space)
  • Bactereamia, sepsis, meningitis, pericarditis
  • Resp failure
34
Q

Pneumonia management

A
  • Pneumococcal vax
  • Supportive: O2, analgesia, antipyretics
  • Antivirals
  • IV AB therapy (then oral) based on likely organism, risk factors for MDR, and local AB resistance patterns, minimum 5 days
  • Hydration, nutritional support, ambulation & side lying, breathing exercises (Identify at risk patients, health habits)
35
Q

Nursing assessment

A
  • Health history (resp, immunity, allergen exp), meds (ABs, immunosupp), surgery, nutrition, activity/exercise
  • O2 sats

Focussed assessment:
* General: fever, lethargy
* Resp: tachypnoea, assumetry, accessory muscle, crackles, fullness, sputum
* CV: tachycardia, confusion, hypoxia

36
Q

Nursing goals/evaluation

A
  • Effective RR, rhythm, depth
  • Clear auscultation
  • Pain management
  • SpO2 > 95
  • No adventitious breath sounds
  • Clear sputum

GMED5001 (13 decks)

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