NURS 302 EXAM 4 RESPIRATORY Flashcards Preview

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Flashcards in NURS 302 EXAM 4 RESPIRATORY Deck (78):
1

The term for coughing up bloody sputum (secretions)?

Hemoptysis

2

Causes of hemoptysis?

localized abnormlity.
Bronchitis,
TB,
lung abscesses,
& lung cancer.

3

Most common post-op pulmonary problems?

Atelectaisis
Pneumonia
Pulmonary edema
Pulmonary emboli

4

How to prevent these?

turn, cough, deep breathe.

5

Excess water in the lungs.

Pulmonary edema

6

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.

7

what blocks the drainage in pulmonary edema?

compression of the lymphatic vessels

8

manifestations of pulmonary edema

Dyspnea, drowning feeling, increased work of breathing, inspiratory crackles, pink frothy sputum if severe.

9

Tx of pulmonary edema

get rid of the fluid!!

supportive therapy (oxygen & may need mechanical ventilation)

10

Occurs after inhaling foreign matter into the lungs.

Aspiration pneumonitis (pneumonia)

11

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

NO straws!

12

Collapse of lung tissue or incomplete expansion of a lung.

Atelectasis

13

3 types of atelectasis?

compression
absorption
surfactant impairment

14

manifestations for atelectasis?

dyspnea, cough, fever, & leukocytosis

15

who's at risk for developing atelectasis?

patients after surgery

16

how is atelectasis prevented?

incentive spirometer

17

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.

Pneumothorax.

18

Which type of pneumothorax is life threatening?

Tension pneumothorax.

19

why is tension pneumothorax life threatening?

it causes a mediastinal shift—heart, vessels, & trachea are compressed and displaced from midline.

20

Treatment of Tension pneumothorax.

Chest tube insertion.

21

Presence of fluid in pleural space. fluids migrate through walls of capillaries bordering pleura.

Pleural effusion

22

Types of fluid/effusion:

Transudative
Exudative
Hydrothroax
Emphyema
Chylothroax
Hemothorax

23

watery

transudative

24

WBCs, plasma proteins

exudative

25

serous fluid

Hydrothorax

26

pus, infection

emphyema

27

lymph

chylothroax

28

blood

hemothorax

29

causes of pleural effusion?

when the rate of of fluid formation exceeds the rate of its removal.

30

airway obstruction out of lung (difficult expiration). More force is required to empty lungs or emptying of lungs is slowed or both.

Obstructive disorders

31

lungs have limited ability to expand. Increased work of breathing, alveolocapillary membrane often affected, therefore decreased diffusion of oxygen into blood.

Restrictive (Interstitial) disorders

32

ARDS

acute respiratory distress syndrome

33

Characterized by acute lung inflammation and alveolocapillary injury.

ARDS

34

predisposing factors for ARDS?

Sepsis
multiple trauma. pneumonia,
burns,
aspiration,
bypass surgery,
drug OD, &
smoke inhalation.

35

manifestations of ARDS

Dyspnea,
rapid, shallow breathing,
inspiratory crackles, &
unresponsive to oxygen therapy.

36

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.

asthma

37

Common things that can trigger asthma?

Exercise
Allergens
Irritants
Viral infections

38

manifestations of asthma

Dyspnea,
tachypnea,
tachycardia,
wheezing,
chest tightness, breathlessness and
nonproductive coughing.
Severe— use of accessory muscles,
diminished breath sounds,
wheezing,
fatigue,
and anxiety.
DEATH.

39

these patients have excess mucus production and chronic productive cough

chronic bronchitis

40

Presence of cyanosis and edema

chronic bronchitis

41

"blue bloaters"

chronic bronchitis

42

Dx requires history of

hyper secretion of mucus and chronic productive cough for at least 3 consecutive months in at least 2 consecutive years.

43

Risk factors for chronic bronchitis

Middle-aged men,
smokers,
exposure to air pollutants.

44

mucus is thicker than normal

chronic bronchitis

45

Tx of chronic bronchitis

bronchodilators & expectorants— NEED TO COUGH IT UP.

46

these patients are usually thin and have pursed-lip breathing.

emphysema

47

Loss of elastic recoil. Difficult to expel trapped air. “PINK PUFFERS”

emphysema

48

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.

emphysema

49

risk factors for emphysema

Smokers, inhaled irritants, & elderly.

50

manifestations for emphysema

Dyspnea,
Thin,
Tachypnea,
& use of accessory muscles (barrel chest)

51

infection of lower respiratory tract. (Bacteria, viruses, fungi, protozoa, & parasites)
A leading cause of death world wide.

pneumonia

52

who's at risk for pneumonia?

Elderly,
lung dx,
alcoholism,
malnourished,
immunocompromised,
smokers,
& intubated patients.

53

manifestations for pneumonia

Fever, chills, cough (productive or dry), malaise, pleural pain, & may have dyspnea & hemoptysis.

54

Tx of pneumonia depends on?

if it's CAP or nosocomial pneumonia

55

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.

Community-acquired pneumonia

56

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

57

Leading cause of death from a curable infectious dx in the world. Airborne transmission (patients are on isolation contact)
Tubercle (lesion) formation

TB

58

cause of TB

Mycobacterium tuberculosis

59

manifestations of TB

Fatigue, weight loss, lethargy, anorexia, night sweats, fever, & cough.

60

who's at risk for TB

Immunocompromised, substance abuse, homelessness, prisons, & close proximity.

61

tx of TB

antibiotic therapy for 3 month minimum & directly observed therapy. (supervised by health care workers if patient suspected to be noncompliant)

62

blocks pulmonary artery

pulmonary embolism

63

Embolus can be: thrombus (blood clot), tissue fragment, lipids (fats), foreign body, or air bubble.
Commonly arise from deep veins in the leg.

pulmonary embolism

64

cause of pulmonary embolism

Obese, trauma, immolbile, surgery, childbirth, CA, oral contraceptives, & smokers.

65

manifestations of pulmonary embolism

Tachypnea, tachycardia, hypotension, sudden acute dyspnea with extreme anxiety, chest pain, & sudden respiratory arrest. DEATH IS IMMINENT!

66

how to prevent pulmonary embolism

Eliminate predisposing factors

Early ambulation

Low molecular-weight heparin—lovonox

Pneumatic compression devices: SCDs—sequential compression devices. Plexi-pulses.

67

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.

Cor Pulmonale?

68

acute laryngotracheobronchitis.

Usually occurs after episode of rhinorrhea, sore throat, and fever.

Seal-like barking cough

Self-limiting condition.

Nasal flaring indicates worsening of symptoms

Common in children 6 months to 5 years.

Croup

69

causes of croup

commonly caused by a virus. Causes subglottic edema.

70

manifestations of croup?

Severe— deep retractions, stridor, agitation, tachycardia, & pallor or cyanosis.

71

Severe rapidly progressive, life-threatening infection of epiglottis and surrounding area. Death can occur in a few hours.

Acute Epiglottitis

72

causes of Acute Epiglottitis

Haemophilus influenzae type B. Current cases caused primarily by group A Streptococcus

73

manifestations of Acute Epiglottitis

sudden onset.
fever,
sore throat,
inspiratory stridor,
severe respiratory distress,
mufled voice, & drooling.


Children 2 to 7 years old.

74

tx of Acute Epiglottitis

keep child calm and undisturbed. do NOT attempt to examine throat. Emergency airway and antibiotics.

75

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.

cystic fibrosis

76

manifestations of CF

pancreatic exocrine deficiency and elevation of sodium chloride in the sweat.

77

the leading cause of cancer-related death in the US and world wide. a persistent cough is often an early characteristic manifestation

lung CA

78

Which type of lung cancer has the greatest association with smoking?

Non-small cell lung cancers.