Flashcards in NURS 302 EXAM 4 RESPIRATORY Deck (78):
The term for coughing up bloody sputum (secretions)?
Causes of hemoptysis?
& lung cancer.
Most common post-op pulmonary problems?
How to prevent these?
turn, cough, deep breathe.
Excess water in the lungs.
most common cause of pulmonary edema
Left sided heart dx.
Also acute respiratory dx syndrome (ARDS), and inhalation of toxic gases. Also caused by obstruction of lymph system: tumors, edema, & fibrotic tissue.
what blocks the drainage in pulmonary edema?
compression of the lymphatic vessels
manifestations of pulmonary edema
Dyspnea, drowning feeling, increased work of breathing, inspiratory crackles, pink frothy sputum if severe.
Tx of pulmonary edema
get rid of the fluid!!
supportive therapy (oxygen & may need mechanical ventilation)
Occurs after inhaling foreign matter into the lungs.
Aspiration pneumonitis (pneumonia)
Preventative measures for patients at risk for aspiration:
semi recumbent position.
Monitor patient on enteral tube feeding
Use of pro-motility agents (speed digestion)
avoid excessive sedation
Add thickeners to liquids
Collapse of lung tissue or incomplete expansion of a lung.
3 types of atelectasis?
manifestations for atelectasis?
dyspnea, cough, fever, & leukocytosis
who's at risk for developing atelectasis?
patients after surgery
how is atelectasis prevented?
Presence of air or gas in pleural space. Caused by: rupture in parietal pleura or visceral pleura. Air separates visceral and parietal pleura (destroys neg. pressure). Can cause partial or complete collapse of affected lung.
Which type of pneumothorax is life threatening?
why is tension pneumothorax life threatening?
it causes a mediastinal shift—heart, vessels, & trachea are compressed and displaced from midline.
Treatment of Tension pneumothorax.
Chest tube insertion.
Presence of fluid in pleural space. fluids migrate through walls of capillaries bordering pleura.
Types of fluid/effusion:
WBCs, plasma proteins
causes of pleural effusion?
when the rate of of fluid formation exceeds the rate of its removal.
airway obstruction out of lung (difficult expiration). More force is required to empty lungs or emptying of lungs is slowed or both.
lungs have limited ability to expand. Increased work of breathing, alveolocapillary membrane often affected, therefore decreased diffusion of oxygen into blood.
Restrictive (Interstitial) disorders
acute respiratory distress syndrome
Characterized by acute lung inflammation and alveolocapillary injury.
predisposing factors for ARDS?
multiple trauma. pneumonia,
drug OD, &
manifestations of ARDS
rapid, shallow breathing,
inspiratory crackles, &
unresponsive to oxygen therapy.
Etiology unknown—however, if other people in your family have asthma, you are more likely to develop it. Being exposed early in life to things like tobacco smoke, infections, and some allergens may also increase changes of developing asthma.
Common things that can trigger asthma?
manifestations of asthma
chest tightness, breathlessness and
Severe— use of accessory muscles,
diminished breath sounds,
these patients have excess mucus production and chronic productive cough
Presence of cyanosis and edema
Dx requires history of
hyper secretion of mucus and chronic productive cough for at least 3 consecutive months in at least 2 consecutive years.
Risk factors for chronic bronchitis
exposure to air pollutants.
mucus is thicker than normal
Tx of chronic bronchitis
bronchodilators & expectorants— NEED TO COUGH IT UP.
these patients are usually thin and have pursed-lip breathing.
Loss of elastic recoil. Difficult to expel trapped air. “PINK PUFFERS”
Abnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls.
Obstruction occurs from changes in lung tissues rather than mucus production and inflammation.
risk factors for emphysema
Smokers, inhaled irritants, & elderly.
manifestations for emphysema
& use of accessory muscles (barrel chest)
infection of lower respiratory tract. (Bacteria, viruses, fungi, protozoa, & parasites)
A leading cause of death world wide.
who's at risk for pneumonia?
& intubated patients.
manifestations for pneumonia
Fever, chills, cough (productive or dry), malaise, pleural pain, & may have dyspnea & hemoptysis.
Tx of pneumonia depends on?
if it's CAP or nosocomial pneumonia
is a term used to describe infections from organisms found in the community rather than in the hospital or nursing home. It is defined as an infection that begins outside the hospital or id diagnosed within 48 hours after admission to the hospital in a person who has not resided in a long-term care facility for 14 days or more before admission. Can be bacterial or viral.
Is defined as a lower respiratory tract infection that was not present or incubating on admission to the hospital. Usually, infections occurring 48 hours or more after admission are considered hospital acquired. Person’s requiring intubation and mechanical ventilation are particularly at risk, as are those with compromised immune function, chronic lung disease, and airway instrumentation, such as endotracheal intubation or tracheotomy.
hospital acquired pneumonia
Leading cause of death from a curable infectious dx in the world. Airborne transmission (patients are on isolation contact)
Tubercle (lesion) formation
cause of TB
manifestations of TB
Fatigue, weight loss, lethargy, anorexia, night sweats, fever, & cough.
who's at risk for TB
Immunocompromised, substance abuse, homelessness, prisons, & close proximity.
tx of TB
antibiotic therapy for 3 month minimum & directly observed therapy. (supervised by health care workers if patient suspected to be noncompliant)
blocks pulmonary artery
Embolus can be: thrombus (blood clot), tissue fragment, lipids (fats), foreign body, or air bubble.
Commonly arise from deep veins in the leg.
cause of pulmonary embolism
Obese, trauma, immolbile, surgery, childbirth, CA, oral contraceptives, & smokers.
manifestations of pulmonary embolism
Tachypnea, tachycardia, hypotension, sudden acute dyspnea with extreme anxiety, chest pain, & sudden respiratory arrest. DEATH IS IMMINENT!
how to prevent pulmonary embolism
Eliminate predisposing factors
Low molecular-weight heparin—lovonox
Pneumatic compression devices: SCDs—sequential compression devices. Plexi-pulses.
Right sided heart failure (R ventricular enlargement and failure) due to long-term pulmonary hypertension. Pulmonary hypertension causes chronic pressure overload in R ventricle, leads to hypertrophy, then failure. AKA pulmonary heart dx.
Usually occurs after episode of rhinorrhea, sore throat, and fever.
Seal-like barking cough
Nasal flaring indicates worsening of symptoms
Common in children 6 months to 5 years.
causes of croup
commonly caused by a virus. Causes subglottic edema.
manifestations of croup?
Severe— deep retractions, stridor, agitation, tachycardia, & pallor or cyanosis.
Severe rapidly progressive, life-threatening infection of epiglottis and surrounding area. Death can occur in a few hours.
causes of Acute Epiglottitis
Haemophilus influenzae type B. Current cases caused primarily by group A Streptococcus
manifestations of Acute Epiglottitis
severe respiratory distress,
mufled voice, & drooling.
Children 2 to 7 years old.
tx of Acute Epiglottitis
keep child calm and undisturbed. do NOT attempt to examine throat. Emergency airway and antibiotics.
major cause of severe chronic respiratory dx in children and young adults, is an inherited disorder involving fluid secretion by the exocrine glands in the epithelial lining of the respiratory, gastrointestinal, and reproductive tracts.
manifestations of CF
pancreatic exocrine deficiency and elevation of sodium chloride in the sweat.
the leading cause of cancer-related death in the US and world wide. a persistent cough is often an early characteristic manifestation