Med Surg: Lower Respiratory Problems Flashcards by katie hill

What is chronic airflow limitation?

Asthma

Chronich Bronchitis

Pulmonary Emphysema

Chronic Obstructive Pulmonary Disease

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What is Asthma and what does is occur from?

Chronic inflammatory disorder of the airways that result in intermittent and reversible airflow obstruction of the bronchioles

Occurs from inflammation and airway hyperresponsiveness

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What are the manifestations of Asthma?

Mucosal edema

Bronchoconstriction

Excessive mucous production

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What are the S&S of asthma?

Dyspnea

Chest tightness

Wheezing

Anxiety and or stress

coughing sputum

Mucous production

Use of accessory muscles

Tachypnea with hyperventilation

Low oxygen saturation

Diaphoresis

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How do you assess asthma?

ABG: hypoxemia, hypocarbia, hypercarbia

Sputum culture

PFT: decreased FEV1 or PEF

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What is the treatment for asthma?

High fowlers position

Oxygen therapy

Monitor cardiac rate and rhythm

Medications

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What are the medications for asthma?

Bronchodilatiors: inhalers, Theophalin, Methylxanthines

Anti-inflammatory agents: decrease inflammation in airway, corticosteriods, leukotriene antagonists, mast cell stabilizers and monoclonal antibodies

Combination agents-bronchodilator and anti-inflammatory

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What is asthma care?

Respiratory care: teach how to use, not overuse

Nutrition: have wt gain if thin

Rehabilitation services: for generalized weakness

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What are asthma complications?

Respiratory failure: persistent hypoxemia, mechanical ventilation

Status asthmaticus: life threatening acute episode airway obstruction that intensifies once beings, doesnt respond to common therapy

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What is COPD?

Emphysema: can be genetic

Loss of elasticity: destruction of alveoli, deacrease gas exchange, CO2 retention, respirators

Hyperinflation of lung tissue: chronic exposure to irritants

Chronic Bronchiits: inflammation of bronchi and bronchioles

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What is Emphysema and the S&S?

Dyspnea

Decreased exercise tolerance

cough-minimal except with infection

Sputum expectoration if have cough

Barrel chest due to air trapping, round chest, disphragmatic flattening

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What is chronic Bronchitis and its S&S?

Productive cough: lasting at least 3 months out of a year for 2 successive years

Production of thick, gelatinous sputum

Wheezing and dyspnea

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What is Exacerbation of COPD and the triggers?

acute change in baseline dyspnea, cough or sputum

Triggers: viral or bacterial infection, air pollution, allergens, sedatives, heart failure and pulmonary embolism

Increased sputum production with bacterial infection

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How do you evaluate COPD?

PFT: decrease FFV and forced vital capacity and increased residual volume trapping

ABG: decrease PaO2, pH, SaO2 and increase CO2

CXR: flattened diaphram, hyperinflated lungs

Alphat antitrpsin assay

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What are COPD complications?

Hypoexmia and acidosis

Respiratory infection risk increased

Cardiac failure

Cardiac dysrhythmias

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What is COPD Management?

Smoking cessation/irritant reduction

Airway maintenance

Cough enhancement

Oxygen therapy

Drug therapy

Pulmonary rehab

Energy conservation/dietary needs

Lung transplant

Lung reduction

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What is interstitial pulmonary dieases?

actue and chronic lung disorders with variable degress of pulmonary inflammation and fibrosis

Idiopathic pulmonary fibrosis: scar tissue formation in the connective tissue of the lung

Sarcoidosis: chronic multi-system granulomatous disease of unknown cause

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What is pneumonia?

excess of fluid in the lungs resulting from an inflammation

Inflammation triggered by infectious organisms and inhalation of irritants

Inflammation occurs in interstitial spaces, alveoli and bronchioles

Organisms penetrate the airway mucosa and multiply in the alveolar spaces

Reduced lung compliance and vital capacity

Atelectasis-decreased oxygenation of blood

Lobar with consolidation

Bronchopneumonia

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What is infectious pneumonia?

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Hospital acquired

Community acquited: complication of influenza

What is the assessment of pneumonia?

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Chest or pleuritic pain

Fever, chills

Cough, muscle weakness from sustained coughing

Tachycardia and tachypnea

Dyspnea

Sputum production

Lung sounds

Labs

Radiological studies

What are interventions for pneumonia?

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Oxygen therapy: combat hypoxemia

Bronchial hygiene: suction cough, deep breathing

Hydration: careful if CHF, help with status

Medications

What is severe acute respiratory syndrome?

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Coronavirus infects cells of respiratory tract and causes inflammatory response

Easily spread by airborne droplets

Portal of entry is mucous membranes of the eyes, nose and mouth

What is the assessment for SARS?

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Respiratory infection S&S

Dry cough and difficulty breathing

CXR

Rapid SARS test

What are interventions for SARS?

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Oxygen

Medications

Prevent spread

What is pulmonary Tuberculosis?

Highly communicable disease caused by mycobacterium tuberculosis Transmitted by aerosolization Sets up inflammatory process Cell-mediated immunity occurs and get positive TB test

What is TB progression?

area of inflammation gets surrounded by collagen, fibroblasts and lymphocytes Caseation necrosis-center of lesion turns into granular mass Caseation get resorbed, degenerated or fibrosed Necrotic area get calcified or liquefied

What is the assessment for TB?

Suspect in patients with persistent cough, weight loss, anorexia, night sweats, hemoptysis, SOB, fever or chills History of travel or recent immigration Labs: sputum for AFB Blood for QFT-G Sputum culture TB test

What are TB interventions?

Combination drug therapy: multidrug and extensively drug resistant strains-organism is highly resistant Prevention of spread Proper nutrition

What is the surgical procedure for lung cencer?

Segmentectomy: bronchus, pulm artery and vein and involved lung tissue Wedge resection: removal or peripheral portion of small localized areas of disease Lobectomy: removal of a lobe Pneumonectomy: removal of an entire lung

What is a Thoracotomy?

Surgical incision of the chest wall Chest tube: drain placed in pleural space to restore intrapleural pressure Pain management Respiratory management Pneumonextomy care

What is a flail chest?

inward movement of the thorax during inspiration and outward movement during expiration Usually from rib fractures or carilage separation anteriorly

What is a flail chest assessment?

Paradoxical movement of the chest Dyspnea Cyanosis Hypotension ABG

What is flail chest intervention?

Humidified oxygen Pain management Lung expanion Clear secretions Mechanical ventilation if needed Monitor Vital Signs

What is a Pneumothorax (open, closed and tension)?

Closed: air enters pleural space from within the lung Open: chest injury allows air to enter the pleural space Tension: pressure in plerual space becomes higher then in adjacent lung

Hemothorax:

Blood loss into the chest cavity Simple: less than 1500mL Massive: more than 1500mL

What is the assessment for a Pneumothroax?

Lung sounds Tracheal deviation Pleuritic pain/cough Tachypnea Subcutaneous emphysema CXR

What is a Hemothroax assessment?

Same as pneumothorax

What are interventions for Pneumothorax/Hemothorax?

Chest tubes: remove air or blood from pleural space, allow re-expansion of lung

What is chest tube management?

Placement of tubes in chest Collection device Care: - tape conections - keep padded hemostats at bedside - keep sterile gauze at bedside - position tubing for drainage - monitor for leaks

What is a pulmonary embolism?

collection of particulate matter that enters venous circulation and lodges in pulmoary vessels Blood clot is most common Obstruct pulmonary blood flow= reduces oxygenation of body, pulmonary tissue hypoxia and death

What is Actue Respiratory Failure?

PaO2: less then 60 mmHg SaO2: less than 90% (arterial) PaCO2: more than 50 mmHg (arterial) Acidemia: (pH less than 7.30) Venilatory Oxygenation Combination of ventilatory and oxygenation

What are interventions of acute respirtory failure?

Oxygen Mechanical ventilation Bronchodilators Anxiety control

What is the ARDS form of pulmonary edema?

Lung inflammation Severe hypoxemia Decreased compliance of lungs Leads to both ventilatory and oxygenation failure

What are manifestations of Lower Respiratory System?

Severe dyspnea rapid shallow breathing tachycardia increasing requirements for oxygen without improvement in oxygenation scattered crackles and bronchi on auscultation CXR-bill infiltrates (ground glass apperance)

What are interventions for ARDS?

Intubation and mechanical ventilation Suctioning Positioning and turning Corticosteriods Antibiotics IV fluids Enternal feedings

Med Surg: Lower Respiratory Problems Flashcards

(46 cards)