Gas Exchange Flashcards

1
Q

infectious disease caused by mycobacterium tuberculosis

A

tuberculosis

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2
Q

tuberculosis most commonly infects the

A

lungs

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3
Q

what are the risk factors for tuberculosis

A

homeless, residents of inner city neighborhoods, foreign-born, living or working in institutions, IV injecting drug users, poverty, immunosuppression, asian descent

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4
Q

when does multi drug resistant tuberculosis occurs

A

when a strain develops resistance to two of the most potent first line anti TB drugs

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5
Q

what is one of the main causes for resistance to the drug to occur

A

not finishing treatment

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6
Q

how is tuberculosis spread

A

via airborne droplets

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7
Q

how long can the tuberculosis droplets be suspended in the air and why

A

minutes to hours because the droplet itself is so tiny

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8
Q

tuberculosis is NOT spread by

A

touching, sharing food utensils, kissing, or physical contact

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9
Q

once tuberculosis droplet is inhaled it lodges in bronchiole and alveolus and develops into a

A

granuloma

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10
Q

when the granuloma develops the infection becomes

A

walled off and typically stops further spreading

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11
Q

why does tuburculosis the lungs

A

its aerophilic (oxygen loving)

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12
Q

develops active infection within the first 2 years of being exposed is

A

primary infection

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13
Q

activated 2 years AFTER exposure is

A

latent TB infection

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14
Q

Tb comes back when immunocompromised

A

reactivation TB

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15
Q

where is the grandulome/TB found

A

upper to mid lungs

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16
Q

what does TB usually start with

A

dry cough that then becomes productive and frequent

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17
Q

what is a late sign of TB

A

coughing up blood and SOB

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18
Q

large numbers of organism spread via the bloodstream to distant organs

A

milary TB

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19
Q

fluid in the pleura space and causes inflammation

A

pleural TB

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20
Q

for the PPD what indicated that you have been exposed to TB (antibodies)

A

the presence of induration at injection site

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21
Q

low risk of TB at injection site is an induration of

A

> 15

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22
Q

high risk of TB at injection site is an induration of

A

> 10

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23
Q

immunocompromised will have an induration at injection site of

A

> 5

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24
Q

If there is an induration at injection site what is the next steps

A

chest xray and then sputum test (first thing in the morning)

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25
Q

what is the gold standard for testing tuberculosis

A

sputum

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26
Q

instead of getting a skin test every year if positive for TB you will get an

A

xray yearly

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27
Q

when do you prefer to obtain sputum culture

A

before placed on antibiotics

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28
Q

a TB patient is usually infectious the

A

first 2 weeks after starting treatment (if sputum +)

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29
Q

why should you report TB patient to health dept

A

so they can get in touch with people pt has been in contact with

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30
Q

what precaution will the TB pt be on

A

airborne precaution with negative pressure room

31
Q

what PPE should you wear when bathing the pt

A

Gown, goggles, mask (n95) and gloves

32
Q

what are S/S of tuberculosis

A

progressive fatigue, malaise, anorexia, weightloss, chronic cough, night sweats, hemoptysis, low grade fever, pleuritic chest pain

33
Q

what is the treatment for TB

A

TB meds for 6 most of longer, isolation until - sputum results

34
Q

what are the dx of Tb

A

Tb skin test, chest x ray then sputum (3 specimens collected on different days)

35
Q

acute infection of the lung parenchyma

A

pneumonia

36
Q

what could cause pneumonia

A

pollution, smoking, upper respiratory infections, tracheal intubation, aging

37
Q

what are 3 ways organisms reach lungs

A

aspiration, inhalation of microbes in the air, hematogenous spread form primary infection elsewhere in the body

38
Q

occurs in patients who have been hospitalized or resided in a long term care facility within 14 days of the onset of symptoms

A

community acquired pneumonia

39
Q

occuring 48 hours or longer after admission and not incubating at time of hospitalization

A

Hospital acquired pneumonia

40
Q

what is the #1 cause of pneumonia

A

streptococcal pneumonia

41
Q

what causes HAP

A

not washing hands

42
Q

what are major problems in treating HCAP

A

multidrug resistant organisms

43
Q

what does aspiration pneumonia result from

A

abnormal entry of secretions into lower airway

44
Q

why would you perform a sputum culture BEFORE antibiotics are given

A

antibiotics could give abnormal results

45
Q

what are symptoms of pneumonia

A

cough, fever, dyspnea, pleuritic chest pain, rhonchi and crackles

46
Q

what are a few complications of pneumonia

A

pleural effusion, atelectasis, bacteremia, meningitis, sepsis

47
Q

what is the gold standard for dx pneumonia

A

chest xray

48
Q

collaborative care for pneumonia would be

A

pneumococcal vaccine, antibiotic therapy, oxygen for hypoxemia, analgesics for chest pain

49
Q

what is the minimum days for antibiotic therapy (pneumonia)

A

5 days

50
Q

what should the pts nutritional therapy be for pneumonia

A

adequate hydration, hi calorie, small frequent meals

51
Q

COPD includes

A

chronic bronchitis, emphysema

52
Q

airflow limitation that is not fully reversible and is generally progressive

A

COPD

53
Q

what are symptoms of a COPD patient

A

easily fatigued, frequent respiratory infections, use of accessory muscles to breathe, orthopneic, dysrhythmias, thin in appearance, wheezing, purse lipped breathing, chronic cough, digital clubbing

54
Q

clubbing is a chronic sign of

A

hypoxia as well as cyanosis

55
Q

presence of cough and sputum production for at least 3 months in each of 2 consecutive years

A

chronic bronchitis

56
Q

for pt with chronic bronchitis the alveoli become _____

A

damaged

57
Q

what are some clinical signs of a chronic bronchitis pt

A

frequent cough with foul smelling sputum

pulmonary infecitons, blue bloater appearance, dyspnea and activity intolerance

58
Q

what are S/S of a blue bloater

A
frequent productive cough (3mx2yr)
digital clubbing
barrel chest
easily fatigued
smoke
dyspnea
leans forwatd to breath easier
uses accessory muscles
needs O2
easily fatigued
lots of respiratory infection
59
Q

where is it best to locate cyanosis

A

lips, mucous membranes and fingers

60
Q

what is the progressive destruction of alveoli

A

emphysema

61
Q

emphysema _______ surface area of respiratory bronchioles, alveoli, and alveolar ducts

A

decreases

62
Q

emphysema is the _______ of lung tissue and _______ your elasticity

A

destruction;lose

63
Q

what are clinical manifestations of emphysema

A
chronic cough
exertional dyspnea
sputum production
persistent tachycardia
diminished breath sounds
"pink puffer"
"barrel chest"
64
Q

why do emphysema patients not eat

A

because its hard to breath while eating and they would rather have oxygen

65
Q

what are S/S of pink puffer

A

speaks in short jerky sentences, purse-lip breathing, barrel chest, destruction of alveoli walls, wheezing, smoke, permanent damage, frequent URIs, bronchi collapse on expiration, prolonged expiratory time, thin appearance, loss of lung elasticity, no cyanosis, anxious, easily fatigues

66
Q

what does it mean when a person doesn’t have enough endurance

A

shortness of breath while resting or with activity

67
Q

what are assessment and dx findings for emphysema

A

pulmonary function tests, spirometry

ABGs

68
Q

what is the gold standard for emphysema

A

spirometry

69
Q

what are risk factors for emphysema

A

smoking
occupational exposure
air pollution
genetic abnormalities

70
Q

what is the genetic risk factor for COPD

A

antitrypsin deficiency

71
Q

what is an autosomal recessive disorder

A

AAT

72
Q

some degree of emphysema is common because of physiological changes due to

A

aging

73
Q

what are signs of severity for COPD exacerbationss

A

use of accessory muscles and central cyanosis

74
Q

what are COPD exacerbation treatmens

A

short acting bronchodilators
coticosterioids
antibiotics supplemental oxygen therapy