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NURS 500 > Exam 2 - respiratory > Flashcards

Exam 2 - respiratory Flashcards

(84 cards)

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1
Q

Which individuals should be prioritized for the influenza vaccine?

A

Adults with chronic pulmonary and cardiovascular conditions and renal, hepatic, neurologic, hematologic, or metabolic disorders Immunocompromised, morbidly obese, adults >50 years of age Pregnant women and women up to 2 weeks postpartum Residents in nursing homes and longterm care facilities, healthcare personnel Household contacts and caregivers of children <5 years and adults >50 years with clinical conditions placing them at higher risk

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2
Q

Which individuals should be prioritized for the pneumococcal vaccine?

A

Adults >65 years Children and adults 2-64 years with chronic illnesses associated with increased risk (sickle cell, cardiovascular and pulmonary disease, DM, alcoholism, cirrhosis, cochlear implants, leaks of CSF) Adults 19-64 who are smokers or have asthma Adults and children >2 years who are immunocompromised Residents of nursing homes or longterm care facilities

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3
Q

What are the various lung cancer screening recommendations?

A

Annual low-dose computed tomography (LDCT) for current smokers (or those who have quit within the last 15 years) aged 55-79 years American Cancer Society - annual screening until 74 years old

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4
Q

Causes of chest pain: angina pectoris - process

A

Temporary myocardial ischemia (secondary to coronary atherosclerosis)

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5
Q

Causes of chest pain: angina pectoris - symptoms

A

Dyspnea, nausea, sweating

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6
Q

Causes of chest pain: angina pectoris - quality

A

Pressing, squeezing, tight, heavy, occasionally burning Often described as discomfort rather than pain

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7
Q

Causes of chest pain: MI - process

A

Prolonged myocardial ischemia, resulting in irreversible muscle necrosis

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8
Q

Causes of chest pain: MI - symptoms

A

Dyspnea, N/V, sweating, weakness

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9
Q

Causes of chest pain: MI - quality

A

Pressing, squeezing, tight, heavy, occasionally burning

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10
Q

Causes of chest pain: pericarditis - process

A

Irritation of parietal pleura adjacent to pericardium

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11
Q

Causes of chest pain: pericarditis - symptoms

A

Seen in autoimmune disorders, post myocardial infarction, viral infection, chest irradiation

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12
Q

Causes of chest pain: pericarditis - quality

A

Sharp, knife-like

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13
Q

Causes of chest pain: aortic dissection - process

A

Splitting within layers of aortic wall, allowing passage of blood to dissect a channel

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14
Q

Causes of chest pain: aortic dissection - symptoms

A

Hoarseness, dysphagia, syncope, hemiplegia, paraplegia

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15
Q

Causes of chest pain: aortic dissection - quality

A

Ripping, tearing

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16
Q

Causes of chest pain: pleuritic pain - process

A

Inflammation of parietal pleura (e.g. pleurisy, PNA, pulmonary infarction)

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17
Q

Causes of chest pain: pleuritic pain - symptoms

A

Of underlying illness

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18
Q

Causes of chest pain: pleuritic pain - quality

A

Sharp, knife-like

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19
Q

Causes of chest pain: GERD - process

A

Irritation or inflammation of esophageal mucosa

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20
Q

Causes of chest pain: GERD - symptoms

A

Regurgitation, dysphagia, cough, laryngitis, asthma

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21
Q

Causes of chest pain: GERD - quality

A

Burning, squeezing

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22
Q

Causes of chest pain: diffuse esophageal spasm - process

A

Motor dysfunction of esophageal muscle

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23
Q

Causes of chest pain: diffuse esophageal spasm - symptoms

A

Dysphagia

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24
Q

Causes of chest pain: diffuse esophageal spasm - quality

A

Squeezing

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25
Causes of chest pain: chest wall pain, costochondritis - process
Trauma, inflammation of costal cartilage
26
Causes of chest pain: chest wall pain, costochondritis - symptoms
Local tenderness
27
Causes of chest pain: chest wall pain, costochondritis - quality
Stabbing, sticking, or dull, aching
28
Causes of chest pain: anxiety, panic disorder - symptoms
Breathlessness, palpitations, weakness, anxiety
29
Causes of chest pain: anxiety, panic disorder - quality
Stabbing, sticking, or dull, aching
30
Causes of dyspnea: left sided HF - process
Elevated pressure in pulmonary capillary bed with fluid into interstitial spaces and alveoli, decreased compliance, increased work of breathing
31
Causes of dyspnea: left sided HF - timing
Dyspnea may progress slowly or suddenly like in acute pulmonary edema
32
Causes of dyspnea: left sided HF - symptoms
Cough, orthopnea, paroxysmal nocturnal dyspnea, sometimes wheezing
33
Causes of dyspnea: chronic bronchitis - process
Excessive mucus production in bronchi followed by chronic obstruction of airways
34
Causes of dyspnea: chronic bronchitis - timing
Chronic productive cough followed by slowly progressive dyspnea
35
Causes of dyspnea: chronic bronchitis - symptoms
Chronic productive cough, recurrent respiratory infections, wheezing
36
Causes of dyspnea: COPD - process
Over distention of air spaces distal to terminal bronchioles, with destruction of alveolar septa, alveolar enlargement, limitations of expiratory air flow
37
Causes of dyspnea: COPD - timing
Slowly progressive dyspnea, mild cough later
38
Causes of dyspnea: COPD - symptoms
Cough, scant mucoid sputum
39
Causes of dyspnea: asthma - process
Reversible bronchial hyper responsiveness, increased airway secretions, bronchoconstriction
40
Causes of dyspnea: asthma - timing
Acute episodes, separated by symptom-free periods (nocturnal periods common)
41
Causes of dyspnea: asthma - symptoms
Wheezing, cough, tightness in chest
42
Causes of dyspnea: diffuse interstitial lung diseases - process
Abnormal and widespread infiltration of cells, fluid, collagen into interstitial space between alveoli
43
Causes of dyspnea: diffuse interstitial lung diseases - timing
Progressive dyspnea
44
Causes of dyspnea: diffuse interstitial lung diseases - symptoms
Weakness, fatigue, cough less common
45
Causes of dyspnea: PNA - process
Infection of lung parenchyma from the respiratory bronchioles of the alveoli
46
Causes of dyspnea: PNA - timing
Acute illness; timing varies with causative agent
47
Causes of dyspnea: PNA - symptoms
Pleuritic pain, cough, sputum, fever
48
Causes of dyspnea: spontaneous pneumothorax - process
Leakage of air into pleural space through blebs on visceral pleura --\> partial or complete collapse of the lung
49
Causes of dyspnea: spontaneous pneumothorax - timing
Sudden onset dyspnea
50
Causes of dyspnea: spontaneous pneumothorax - symptoms
Pleuritic pain, cough
51
Causes of dyspnea: acute pulmonary embolism - process
Sudden occlusion of part pulmonary arterial tree by blood clot that usually originates in deep veins of legs or pelvis
52
Causes of dyspnea: acute pulmonary embolism - timing
Sudden onset dyspnea, tachypnea
53
Causes of dyspnea: acute pulmonary embolism - symptoms
Retrosternal oppressive pain if massive occlusion, pleuritic pain, cough, syncope, hemoptysis, unilateral leg swelling and pain from instigating DVT
54
Causes of dyspnea: anxiety with hyperventilation - process
Overbreathing, with resultant respiratory alkalosis and fall in arterial partial pressure of CO2
55
Causes of dyspnea: anxiety with hyperventilation - timing
Episodic, often recurrent
56
Causes of dyspnea: anxiety with hyperventilation - symptoms
Sighing, lightheadedness, numbness or tingling of hands and feet, palpitations, chest pain
57
Causes of cough and hemoptysis: laryngitis - symptoms
Acute fairly minor illness with hoarseness Often associated with viral rhino sinusitis
58
Causes of cough and hemoptysis: acute bronchitis - symptoms
Acute, often viral, illness general w/o fever or dyspnea At times with burning retrosternal discomfort
59
Causes of cough and hemoptysis: mycoplasma and viral PNA - symptoms
Acute febrile illness, often with malaise, HA, possible dyspnea
60
Causes of cough and hemoptysis: bacterial PNA - symptoms
Acute illness with chills, high fever, dyspnea, chest pain
61
Causes of cough and hemoptysis: postnasal drip - symptoms
Seen in posterior pharynx Associated with allergic rhinitis, with or without sinusitis
62
Causes of cough and hemoptysis: chronic bronchitis - symptoms
Recurrent wheezing and dyspnea
63
Causes of cough and hemoptysis: bronchiectasis - symptoms
Recurrent bronchopulmonary infections, sinusitis may co-exist
64
Causes of cough and hemoptysis: pulmonary TB - symptoms
Early, no symptoms Later, anorexia, weight less, fatigue, fever, night sweats
65
Causes of cough and hemoptysis: lung abscess - symptoms
Usually from aspiration PNA with fever and infection Often with dysphagia or episodes of impaired consciousness
66
Causes of cough and hemoptysis: asthma - symptoms
Episodic wheezing and dyspnea, cough may occur alone History of allergies
67
Causes of cough and hemoptysis: GERD - symptoms
Wheezing (at night, often mistaken for asthma), early morning hoarseness, repeated attempts to clear throat Heartburn and regurgitation
68
Causes of cough and hemoptysis: lung cancer - symptoms
Dyspnea, weight loss
69
Causes of cough and hemoptysis: left ventricular failure or mitral stenosis - symptoms
Dyspnea, orthopnea, paroxysmal nocturnal dyspnea
70
Causes of cough and hemoptysis: pulmonary embolism - symptoms
Tachypnea, chest or pleuritic pain, dyspnea, fever, syncope, anxiety
71
Causes of cough and hemoptysis: irritating particles, chemicals, gases
Exposure to irritants; eyes, nose, throat
72
What exam findings would the FNP expect in the patient with: pneumonia?
Percussion: dull Trachea: midline Breath sounds: bronchial over involved area Adventitious sounds: late inspiratory crackles Tactile fremitus: increased (w/ egophony, bronchophony)
73
What exam findings would the FNP expect in the patient with: COPD?
Percussion: hyperresonant Trachea: midline Breath sounds: decreased to absent, with delayed expiration Adventitious sounds: none Tactile fremitus: decreased
74
What exam findings would the FNP expect in the patient with: atelectasis?
Percussion: dull Trachea: shifted toward involved side Breath sounds: usually absent when bronchial plugs persist Adventitious sounds: none Tactile fremitus: usually absent when bronchial plugs persist
75
What exam findings would the FNP expect in the patient with: pleural effusion?
Percussion: dull Trachea: shifted toward unaffected side in large effusions Breath sounds: decreased to absent Adventitious sounds: none except a possible pleural rub Tactile fremitus: decreased to absent, but may be increased toward top of large effusion
76
What exam findings would the FNP expect in the patient with: pneumothorax?
Percussion: hyper resonant Trachea: shifted toward unaffected side if tension Breath sounds: decreased to absent Adventitious sounds: none, except possible pleural rub Tactile fremitus: decreased to absent
77
What exam findings would the FNP expect in the patient with: asthma?
Percussion: resonant to diffusely hyperresonant Trachea: midline Breath sounds: often obscured by wheezes Adventitious sounds: wheezes, possibly crackles Tactile fremitus: decreased
78
What exam findings would the FNP expect in the patient with: rib fracture?
Tenderness, bruising, bony "step offs", increase in local pain
79
What exam techniques would the FNP use to assess for a rib fracture?
AP compression of chest will elicit local pain and tenderness One hand on sternum, and other side of thoracic spine, squeeze chest
80
What are the various locations in which retractions can occur?
81
What is different about the pediatric thorax and lung exam as compared to the adult?
Infant breath sounds louder and harsher than those adults because stethoscope closer to origin of sounds Periodic breathing (5-10 seconds) Check for retractions, nasal flaring, grunting, wheezing
82
What are the pediatric cutoffs for bradypnea? Tachypnea?
Tachypnea \>60/min from birth to 2 months and \>50/min from 2-12 months
83
What exam findings would the FNP expect in the patient with: PNA in peds?
Best physical finding to r/o PNA is absence of tachypnea Rapid respirations (up to 80-90/min) and increased work of breathing (grunting, nasal flaring, use of acessory muscles)
84
What exam findings would the FNP expect in the patient with: croup?
Stridor, hoarse voice plus cough, prolonged inspiration

NURS 500 (8 decks)

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