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Med-Surg I > Exam 2 > Flashcards

Exam 2 Flashcards

(101 cards)

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1
Q

tuberculosis

A

Reportable, communicable inflammatory destructive disease

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2
Q

extrapulmonary TB sites (6)

A

bones, spine, kidneys, reproductive organs, CNS, larynx

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3
Q

facts about mycobacterium tuberculosis

A

aerobic
acid fast
slow growing, sensitive to heat and UV
destroyed by sunlight, heat, and pasteurization
grows inside the body, not outside

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4
Q

risk factors of TB (gender, age, geographical)

A

alcoholism r/t malnutrition
elderly
homeless
overcrowded
men
children <15
young adults (15-44 with preexisting conditions)
africa, asia, latin america, europe, carribean

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5
Q

BCG vaccine

A

makes you test + on skin test
need to do chest x-rays or blood test to get accurate result

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6
Q

routes of TB

A

airborne (droplet)
inhalation of infected droplet nuclei from COUGHING, laughing, sneezing
large droplets settle, small ones are inhaled

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7
Q

treatment of TB

A

6-12 months
bed rest until no symptoms
isolation until - sputum

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8
Q

sensitization of TB

A

phagocytes bombard area with bacteria, lymphocytes start inflammatory response and destroy some lung tissue
2-10 weeks after primary infection

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9
Q

patho of TB

A

inhaled infected droplet deposited in lungs
inflammatory reaction at site
body attempts to phagocytize the wall-off the tubercule
ghon tubercle formed
granuloma in lung tissue

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10
Q

how can dormant TB become active again

A

mental and physical stress
immunosuppressive drugs
oncology agents
inadequate drug prescription

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11
Q

latent TB

A

lives and doesn’t grow
doesn’t make you feel sick
CAN’T spread

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12
Q

active TB

A

grows in the body
makes you feel sick
CAN spread

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13
Q

sputum culture for TB

A

identify tubercule bacilli
essential to confirm diagnosis
3 specimens on consecutive days

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14
Q

TB skin test

A

appearance of “wheal” if done properly
read result within 48-72 hours
10mm or more is +
5-9 is doubtful, repeat
for HIV, 5mm or more is +

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15
Q

what to do with TB converters

A

they are at risk for developing TB
give INH prevention

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16
Q

TB symptoms (8)

A

Fatigue
Malaise
Anorexia
Weight loss
Chronic productive cough
Night sweats
Advanced state hemoptysis=blood in sputum
Low grade fever in the late afternoon

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17
Q

primary resistance to TB

A

resistance to 1 or more TB agents with no previous treatment

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18
Q

secondary resistance to TB

A

resistant to 1+ TB agent, undergoing therapy

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19
Q

multidrug resistance to TB

A

resistant to 2+ agents (INH and rifampin)

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20
Q

what to give with INH (TB)

A

vitamin B6

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21
Q

anti TB drugs

A

INH, rifampin
pyrazinamide
ethambutol (myambutol)

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22
Q

foods to avoid with INH

A

Tuna
aged cheese
red wine
soy sauce
yeast extract bc it could have histamine (causes side effects [headaches, diaphoresis, etc] and decreased absorption)

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23
Q

nutrition for TB

A

high protein, calories, and Ca+
iron and vit B6

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24
Q

labs for TB

A

AST and ALT

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25
purpose of alveoli
gas exchange diffusion separates alveolar from vascular membrane damage permits exchange between lungs and blood
26
how much mucus production a day
3 oz
27
pleura
Lines lungs and thoracic cavity Kept moist from fluids secreted between pleural surfaces, prevents friction and facilitates filling and emptying of lungs Secretes pleural fluid–smooth motion of lungs within pleural cavity (air filled so it’s subject to 3rd spacing with pleural effusion) Depends on mucus and surfactant
28
when does surfactant develop
34 weeks of gestation
29
what does surfactant do
facilitates inflation of alveoli prevents the alveoli from collapsing (keeps them slightly open even when lungs are empty)
30
tidal volume (what is it, amount, and what effects it)
The amount of air inspired and expired in a normal breath 500 mL May not vary
31
total lung capacity (what is it, amount, and what effects it)
the maximum amount the lungs can expand TV+IRV+ERV+RV (5800 mL) decreased with atelectasis and pneumonia increased in COPD
32
vital capacity (what is it, amount, and what effects it)
the maximum amount of air exhaled after maximal inhalation TV+IRV+ERV (4600 mL) decrease in neuromuscular disease, generalized fatigue, atelectasis, pulmonary edema, COPD, and obesity
33
inspiratory reserve volume (what is it and amount)
the maximum amount of air inhaled after a normal inhalation 3000 mL
34
expiratory reserve volume (what is it, amount, and what effects it)
maximum amount of air that can be exhaled forcibly after normal exhalation 1100 mL decreased with obesity, ascites, pregnancy
35
residual volume (what is it, amount, and what effects it)
volume of air remaining in lungs after maximum exhalation 1200 mL may be increased with obstructive disease
36
inspiratory capacity (what is it, amount, and what effects it)
maximum amount of air inhaled after normal expiration TV+IRV (3500 mL) decrease in restrictive disease or obesity
37
functional residual capacity (what is it, amount, and what effects it)
amount of air remaining in lungs after normal expiration ERV+RV (2300 mL) may be increased in COPD decreased in ARDS and obesity
38
what do accessory muscles do
get rid of trapped air and increase tidal volume
39
Why does pursed lip breathing work
increases exhalation time to reduce airway resistance and prevent airway collapse
40
How often to do diaphragmatic breathing
5x/hour for 1 minute with 2 min rest periods
41
controlled cough
breath normally for one cycle, end next cycle with cough
42
lordosis
inward curvature of spine
43
kyphosis
forward rounding of upper back
44
peak lung function ages
20-25
45
premature babies are at risk for what (no surfactant)
poor alveolar exchange
46
older adults respiratory
less capillaries in alveolar walls tissues of resp tract become more rigid inefficient diaphragm and coughs poor compliance dilation of air sacs (emphysema) low O2 from smaller airway kyphosis, barrel chest, SOB, abd breathing, decreased gas exchange
47
why is losing gravity in resp bad
prevents alveoli from expanding
48
mucus with bacterial infection
purulent and green
49
mucus from allergies
sticky and white
50
hemoptysis
blood in sputum
51
sputum collections
done in the morning sterile container RIGHT AWAY
52
pleural pain (avoid what)
activity that will make you breathe hard
53
ratio in barrel chest vs normal
barrel chest- 1:1 normal: 1:2
54
fine crackles
mucus in small airways heard in emphysema with distended alveoli heard on inspiration high pitched alveoli heard near the end of inspiration
55
coarse crackles
loud, bubbling larger airways may be heard in inspiration AND expiration CHF, pneumonia, emphysema
56
rhonchi
gurgles Thick secretions Loud, harsh, low pitched, like snoring May be cleared with coughing Large airways Mostly expiration but also inspiration Asthma, bronchiectasis, emphysema, chronic bronchitis
57
wheezes
from swollen airways asthma or partial obstruction blocked by mucus or tumor heard throughout the lung on inspiration or expiration WITHOUT A STETHOSCOPE abrupt cessation of wheezing is BAD!! It means complete obstruction
58
pleural friction rub
inflamed pleura harsh, cracking sounds like leather inflammation or pleural effusion
59
consolidation
solidification of lung tissue that causes poor ventilation in certain areas (gets filled with mucus and debris)
60
Q scan
detects abnormal functioning of pulmonary blood vessels and blood flow (PE)
61
V scan
detects abnormalities in ventilation such as emphysema
62
bronchoscopy
tubes examine larynx, bronchi, and trachea flexible NPO for 4-6 hours
63
what to give for throat irritation after endoscopy
warm gargle
64
ABG time to put pressure
5 min for radial and brachial 10 for femoral
65
compensation for decreased O2 in COPD
increased RBCs causing polycythemia
66
how long before a pulmonary function test should pts not smoke or use bronchodilators
6 hrs
67
what makes O2 sat ineffective
hypotension sepsis hypothermia vasoconstriction (these reduce arterial blood flow)
68
thoracentesis
fluid removed from pleural space and send for biopsy or just for therapeutic purposes upright position and lean forward to increase intercostal space do VS and place pt on unaffected side
69
nasal cannula oxygen
1-3 Liters
70
oxygen toxicity (6)
dyspnea restlessness substernal pain fatigue headache coughing
71
how much liquids to get rid of secretions
2-3 quarts
72
guaifenesin
expectorant
73
dextromethorphan
cough suppressant
74
ineffective airway clearance treatment
warm, humid air
75
diet for respiratory pts
high fat and protein avoid foods that cause constipation
76
what stimulates peristalsis
fluids and fruit juices
77
who shouldn't take flu vaccine
allergies to eggs or history of guillain-barre
78
community acquired pneumonia (another name, when diagnosed, who is at risk and what seasons)
legionnaires disease on admission or within 48 hours smokers, elderly, substance abusers summer and fall
79
hospital acquires pneumonia
bacterial nosocomial (from a hospital) most lethal (pts already immunocompromised and abx resistant)
80
aspiration pneumonia
from inhaling foreign matter keep head of bed elevated during feeding assess gag reflex
81
Patho of pneumonia
bacteria gets into alveolar space, weakens the fragile membrane, capillary leak, bacteria spreads to lungs and blood stream. septicemia RBC goes from blood vessels to damaged alveoli, causing lung infection and blood tinged sputum
82
slow surfactant production leads to
decrease in compliance, atelectasis and consolidation
83
symptoms of pneumonia
high fever (101-105) in bacterial shaking chills headache productive cough (green, purulent, or rust colored sputum) orthopnea tachypnea/cardia cyanosis of lips and nails anorexia N/V anxiety cerebral hypoxia increased metabolic rate pleural pain malaise
84
what happens when you give antitussives (bad)
retains secretions, causing atelectasis and hypoxia
85
greenish yellow sputum
STREP
86
yellow or blood tinged sputum
STAPH
87
precautions for bronchoscopy
need consent no jewelry, contacts, dentures, allergies may cause lower airway spasms gag reflex returns after 2 hours pulse ox every 15 min
88
how often to do incentive spirometry
10 breaths per hour hold for 2-10 seconds
89
how much fluids to drink to thin secretions
2 L
90
pneumonia diet
high fat, calorie, protein avoid gassy foods or hard candies warm liquids increase peristalsis (good) 10 glasses of fluids a day
91
empiemia
pus in blood
92
how to prevent superinfection
lactobacillus tablets or yogurt (live cultures)
93
strongest predisposing factor of asthma
allergies
94
3 chronic airflow limitations and are they COPD
asthma (not COPD) chronic bronchitis and emphysema (COPD)
95
asthma risk factors
allergies (most common) esophageal reflux genetics male elderly urban bad conditions black, white, and hispanic
96
4 chemical mediators in asthma and what they do
bradykinin, histamine (immediate), prostaglandins, and leukotrienes causes inflammatory response capillary leak in airway
97
vasoactive amines
vasodilation capillary leak edema of airway increased secretions
98
what type of oxygen for asthma pts
nasal cannula (less suffocating feeling)
99
clear and foamy sputum
allergies
100
thick, white, stringy sputum
nonallergic asthma
101
2 CBC results of asthma
elevated eosinophils immunoglobin levels

Med-Surg I (6 decks)

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