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Med Surg Test 3: Respiratory > Med Surg: Lower Respiratory Problems > Flashcards

Med Surg: Lower Respiratory Problems Flashcards

1
Q

What is chronic airflow limitation?

A

Asthma

Chronich Bronchitis

Pulmonary Emphysema

Chronic Obstructive Pulmonary Disease

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2
Q

What is Asthma and what does is occur from?

A

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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3
Q

What are the manifestations of Asthma?

A

Mucosal edema

Bronchoconstriction

Excessive mucous production

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4
Q

What are the S&S of asthma?

A

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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5
Q

How do you assess asthma?

A

ABG: hypoxemia, hypocarbia, hypercarbia

Sputum culture

PFT: decreased FEV1 or PEF

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6
Q

What is the treatment for asthma?

A

High fowlers position

Oxygen therapy

Monitor cardiac rate and rhythm

Medications

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7
Q

What are the medications for asthma?

A

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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8
Q

What is asthma care?

A

Respiratory care: teach how to use, not overuse

Nutrition: have wt gain if thin

Rehabilitation services: for generalized weakness

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9
Q

What are asthma complications?

A

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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10
Q

What is COPD?

A

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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11
Q

What is Emphysema and the S&S?

A

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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12
Q

What is chronic Bronchitis and its S&S?

A

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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13
Q

What is Exacerbation of COPD and the triggers?

A

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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14
Q

How do you evaluate COPD?

A

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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15
Q

What are COPD complications?

A

Hypoexmia and acidosis

Respiratory infection risk increased

Cardiac failure

Cardiac dysrhythmias

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16
Q

What is COPD Management?

A

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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17
Q

What is interstitial pulmonary dieases?

A

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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18
Q

What is pneumonia?

A

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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19
Q

What is infectious pneumonia?

A

Hospital acquired

Community acquited: complication of influenza

20
Q

What is the assessment of pneumonia?

A

Chest or pleuritic pain

Fever, chills

Cough, muscle weakness from sustained coughing

Tachycardia and tachypnea

Dyspnea

Sputum production

Lung sounds

Labs

Radiological studies

21
Q

What are interventions for pneumonia?

A

Oxygen therapy: combat hypoxemia

Bronchial hygiene: suction cough, deep breathing

Hydration: careful if CHF, help with status

Medications

22
Q

What is severe acute respiratory syndrome?

A

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

23
Q

What is the assessment for SARS?

A

Respiratory infection S&S

Dry cough and difficulty breathing

CXR

Rapid SARS test

24
Q

What are interventions for SARS?

A

Oxygen

Medications

Prevent spread

25
Q

What is pulmonary Tuberculosis?

A

Highly communicable disease caused by mycobacterium tuberculosis

Transmitted by aerosolization

Sets up inflammatory process

Cell-mediated immunity occurs and get positive TB test

26
Q

What is TB progression?

A

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

27
Q

What is the assessment for TB?

A

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

28
Q

What are TB interventions?

A

Combination drug therapy: multidrug and extensively drug resistant strains-organism is highly resistant

Prevention of spread

Proper nutrition

29
Q

What is the surgical procedure for lung cencer?

A

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

30
Q

What is a Thoracotomy?

A

Surgical incision of the chest wall

Chest tube: drain placed in pleural space to restore intrapleural pressure

Pain management

Respiratory management

Pneumonextomy care

31
Q

What is a flail chest?

A

inward movement of the thorax during inspiration and outward movement during expiration

Usually from rib fractures or carilage separation anteriorly

32
Q

What is a flail chest assessment?

A

Paradoxical movement of the chest

Dyspnea

Cyanosis

Hypotension

ABG

33
Q

What is flail chest intervention?

A

Humidified oxygen

Pain management

Lung expanion

Clear secretions

Mechanical ventilation if needed

Monitor Vital Signs

34
Q

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

A

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

35
Q

Hemothorax:

A

Blood loss into the chest cavity

Simple: less than 1500mL

Massive: more than 1500mL

36
Q

What is the assessment for a Pneumothroax?

A

Lung sounds

Tracheal deviation

Pleuritic pain/cough

Tachypnea

Subcutaneous emphysema

CXR

37
Q

What is a Hemothroax assessment?

A

Same as pneumothorax

38
Q

What are interventions for Pneumothorax/Hemothorax?

A

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

39
Q

What is chest tube management?

A

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
40
Q

What is a pulmonary embolism?

A

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

41
Q

What is Actue Respiratory Failure?

A

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

42
Q

What are interventions of acute respirtory failure?

A

Oxygen

Mechanical ventilation

Bronchodilators

Anxiety control

43
Q

What is the ARDS form of pulmonary edema?

A

Lung inflammation

Severe hypoxemia

Decreased compliance of lungs

Leads to both ventilatory and oxygenation failure

44
Q

What are manifestations of Lower Respiratory System?

A

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)

45
Q

What are interventions for ARDS?

A

Intubation and mechanical ventilation

Suctioning

Positioning and turning

Corticosteriods

Antibiotics

IV fluids

Enternal feedings

46
Q
A

Med Surg Test 3: Respiratory (4 decks)

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