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Adult health 2 > Exam 2: Upper Resp > Flashcards

Exam 2: Upper Resp Flashcards

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1
Q

Rhinitis

A

inflammation of the mucous membranes of the nose

can be acute (coryza), chronic, allergic

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2
Q

What are the symptoms of acute rhinitis

Nasal discharge

Eyes

Turbinates

Nasal polyps

Headache

A

watery then mucoid

tearing early

edematous

No

generalized

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3
Q

What are the symptoms of allergic rhinitis

Nasal discharge

Eyes

Turbinates

Nasal polyps

Headache

A

thin, watery

tearing, itching

pale, mucoid, edamatous

sometimes

generalized

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4
Q

What are the symptoms of chronic rhinitis

Nasal discharge

Eyes

Turbinates

Nasal polyps

Headache

A

serous, purulent

no tearing

enlarged

sometimes

generalized

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5
Q

Sinusitis

A

inflammation of the mucous membranes lining the sinuses (air-filled cavities)

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6
Q

Sinusitis

acute

subacute

chronic bacterial

fungal

A

Acute: less than 4 weeks: allergic, viral, and bacterial

Subacute: 4 to 12 weeks

Chronic bacterial: over 12 weeks

Fungal

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7
Q

Acute bacterial sinusitis is usually caused by

A

Strep pneumoniae, H. influenzae

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8
Q

Acute bacterial sinusitis: symptoms worsen over

A

48 to 72 hours with severe, localized pain and tenderness over involved sinu

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9
Q

Acute bacterial sinusitis examination revelas

A

enlarged turbinates with visible fluid

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10
Q

Acute bacterial sinusitis diagnosis

A

H and P, X ray, CT, MRI

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11
Q

Acute laryngitis

A

inflammation of the mucous membrane lining the larynx and edema of the vocal cords

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12
Q

Acute laryngitis symptoms

A

sore throat, hoarseness, loss of voice

WE DO SYMPTOMATIC TREATMENT

if persistant we may do a laryngoscopy

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13
Q

Laryngeal paralysis

A

laryngeal nerves or vagal nerve due to varied reason (prolonged intubation) that can be unilateral or bilateral

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14
Q

What are possible treatments of laryngeal paralysis

A

treat the underlying cause

tracheostomy

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15
Q

Acute laryngeal edema includes

A

anaphylaxis, urticaria, acute laryngitis, edema related to intubation

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16
Q

Acute laryngeal edema treatment

A

corticosteroid, epi, intubation, trach

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17
Q

What do traumas to upper airway include

A

fractures of nasal bones, septum

fractures of maxillary or zygomatic bones

jaw wiring

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18
Q

Epistaxis

A

kiesselbach plexus damage due to trauma, irritation, coagulant disorder resulting in nose bleeding

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19
Q

Epistaxis is

A

unilateral

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20
Q

Management of epistaxis

A

ice 10 to 15 minutes
alpha 1 agonist
silver nitrate cauterizing
nasal packing

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21
Q

Obstructive sleep apnea

A

airflow obstruction from narrowing of the air passages or obstruction of the pharynx by the tongue

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22
Q

What are complications of obstructive sleep apnea

A

HTN, cardiovascular disease, weight gain, memory loss, mood changes, job impairement

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23
Q

Sleep apnea s/s

A

snoring, choking, daytime sleepiness

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24
Q

management of sleep apnea

A

avoid alcohol, sleep medication

weight loss

lateral sleep position

CPAP if over 15 episodes in one hour

surgery if all else fails: uvulopalatopharyngoplasty

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25
Restrictive pulmonary disorder
limited expansion of the lungs intrinsic: pneumonia, acute bronchitis) extrinsic: chest trauma, obesity, kyphoscoliosis
26
Vascular (pulmonary) disorders
narrowing or occlusion of the pulmonary blood vessels (PE)
27
Obstructive pulmonary disorder
limited airflow on expiration e.g. COPD
28
When are antivirals effective with seasonal flu
if started within 24 to 48 hours of symptoms
29
Risk factors of COVID
cardio, DM, HTN, Lung disease, CKD, obesity, smoking, cancer
30
Physical findings with COVID
tachypnea, tachycardia, respiratory distress, abnormal CN l, rales, rhonchi, wheezing
31
Acute bronchitis
acute inflammation of the bronchi and usually the trach
32
Clinical manifestations of acute bronchitis
painful cough, sputum production, low-grade fever, malaise, rhonchi, wheeze
33
Acute bronchitis can progress to
pneu
34
Pneumonia
acute inflammation of the lung tissue most common cause of death in US
35
Prevention of pneu
PCV 13, PPSV 23, flu vaccine
36
Patho of pneu
inflammatory response, alveoli fill with fluid (consolidation) and/or increased production of mucus (obstruction), decreased gas exchange, resolution of infection
37
Types of pneu
community acquired hospital acquired ventilator associated (over 48 hours on it)
38
What do we hear with pneumonia
tactile fremitus over these areas because fluid emphasizes vibration and ecophene
39
What are the guidelines for hospital acquired pneu
following 48 hours or more hospital stay VAP
40
Pleural effusion vs empysema
Pleural: fluid in pleural space Emphysema is fluid with pus in pleural space
41
W/ emphysema what can we do to test the fluid
a thoracentesis
42
COPD
disease state characterized by airflow obstruction resulting from chronic bronchitis or emphysema
43
COPD is commonly caused by
smoking tissue damage is not reversible and increases in severity lead to respiratory failure
44
What are the two major changes that occur with emphysema
loss of lung elasticity and hyperinflation of the lung and use of accessory muscles
45
With emphysema air is
trapped due to loss of elastic recoil in the alveolar walls, overstretching and enlarging the alveoli into bullae
46
Drug therapy for COPD
beta adrenergic agents: bronchodilator prior to anticholinergic choinergic antagonist methylxanthines corticosteroid (inhaled; IV for emergent) muculytics
47
What is asthma
bronchial asthma is intermittent and reversible airflow obstruction affecting only the airways, not the alveoli inflammation airway hyperresponsiveness
48
Which nurse assessment finding during an acute asthma attack requires immediate interventions
diminished breath sounds
49
What is status asthmaticus
severe, life threatening, acute episode of airway obstruction intensifies once it begins and does not respond to common therapy
50
TB is
highly contagious cause by mycobacterium TB transmitted via aerosolization
51
What are signs of TB
low grade fever, hemoptysis, weight loss, night sweats
52
Later with TB what do we see
elevated liver enzymes, RUQ pain, dyspnea, chest pain
53
If the TB test is over 5mm induration what is the possible cause
HIV people who had contact w/ a person with TB people with fibrotic lesion on chest x ray consistent with TB organ tranplants immunosupressant
54
If the TB test is over 10 mm induration what is the cause
recent immigrants IV drug users Residence and employees of high risk settings people w/ clinical conditions mycobacteriology lab personnel
55
If the TB test is over 15 mm induration what is the cause
all other people who are at low risk
56
Latent TB meds
6 to 9 months of INH and Vitamin B6
57
Active TB meds
INH + RIF + PZA + ETM + Vitamin B6 x 2 months INH + RIF + vitamin B6 x 4 months
58
Negative sputum culture = ______ TB
no longer TB infection
59
Rifampin can turn
urine, saliva or tears orange so avoid contact use make patients sensitive to the sun decrease birth control decrease methadone levels
60
What isolation is TB
airborne
61
Both lungs connect to the _______ through the vessels and bronchus
mediastinum
62
Who do we breathe: inspiration
CNS stimulates diaphragm to contract and descend external intercostals contract and raise ribs volume of chest cavity increases pull them outwards negative pressure increases air flows in
63
How do we breathe: expiration
respiratory muscles relax chest wall and diaphragm return to normal position volume of chest decreases pressure increases air flows out of the lungs
64
what is flail chest
Flail chest is a life-threatening medical condition that occurs when a segment of the rib cage breaks(usually 4 or more in 2 or more locations) due to trauma and becomes detached from the rest of the chest wall. Two of the symptoms of flail chest are chest pain and shortness of breath
65
Management of flail chest
supplemental O2, pain contro, respiratory care
66
Pneumothorax causes
surgery trauma line placement air enters the lung and moves through the visceral pleura to the pleural space makes the pressure more positive
67
Open pneumothorax
opening in the chest wall allows outside air to enter through the chest and parietal pleura into the pleural space
68
Hemothorax
blood or serosanguineous fluid collects in the pleural space instead of air
69
Hemopneumothorax
air and blood
70
Tension pneumothorax
more serious than simple air leaks in and becomes trapped so volume of air continues to build can cause a mediastinal shift compression of heart and great vessels
71
Chest tube sizes
small for air large for blood/fluid
72
Placement of chest tube
air rises so high on chest for pneumothorax and blood settles so low on chest for hemothorax
73
Collection chamber
collects drainage allows for monitoring of the volume, rate, and nature of drainage holds up to 2500 cc
74
Collection chamber: blood drainage should be monitored for
clots --> notify HCP if they are seen
75
stripping a collection tube
a technique used to remove clots or debris from the tube by squeezing and moving it in a way that pushes the contents toward the drainage chamber do not routinely strip the tube as stripping can create high negative pressure, causing discomfort and tissue damage
76
Water seal chamber
used as a seal or a one way valve to allow air or fluid to drain from the patient's chest but not return
77
What do we monitor for with water seal chamber
bubbling, tidaling, negative pressure bubbling may be present after initial insertion when patient has an air leak into the pleural space
78
What is true about bubbling in a water seal chamber
in large amounts it can indicate a large air leak should stop once lung is re inflated if excessive rule out a leak in drainage system check all connection sites and notify MD
79
What is tidaling
fluctuation in the fluid level of the water seal chamber reflects changes in pressure in the pleural space normally will fluctuate 5 to 10 cm, the column of water will go up with inspiration and down with expiration
80
Suction control chamber
suction will increase the drainage rate and help re expand the lungs dry system the suction is controlled by a dial wet system it is controlled by water
81
Chest tubes should be _______ below a patients chest
1 foot
82
What do we do if a chest tube becomes dislodged
place a gauze with tape on three sides, leave lower part untaped either case, notify HCP and prepare x ray
83
When do we change dressings for chest tubes
every 48 hours do not remove Dsg for 24 hours post insertion use petroleum gauze
84

Adult health 2 (15 decks)

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