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NURS 444 > NURS444 Pulmonary > Flashcards

NURS444 Pulmonary Flashcards

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1
Q

Hypoventilation RR

A

respiratory rate < 12

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2
Q

Hyperventilation RR

A

respiratory rate > 20

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3
Q

O2 levels in Hypoxia

A

(PaO2) < 60 mmHg

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4
Q

CO2 levels in Hypercapnia

A

(PaCO2) > 50 mmHg

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5
Q

Define Hypoxemia

A

Reduced oxygenation of the arterial blood (PaO2)

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6
Q

When do you get Acute Respiratory Failure?

Hint: Levels!

A

PaO2 <60 mmHg or PaCO2 >50 mmHg at rest

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7
Q

Causes of
Type I Respiratory Failure
(Decrease in PaO2 < 60 mmHg)

A

Pulmonary oedema Infection
Inflammatory lung disease
Pulmonary embolism

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8
Q

Causes of
Type II Respiratory Failure
(PaCO2 > 50 mmHg and in PaO2 < 60 mmHg)

A 
COPD
Asthma
Obesity
Kyphoscoliosis
CNS depression due to drugs
Neuromuscular disease
Pneumothorax
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9
Q

Define Oxygen Saturation

A

% of Haemoglobin (Hgb) binding sites

in the blood that are carrying oxygen.

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10
Q

Define COPD and mention 3 conditions that cause it

Wheeze = always

A

Progressive airflow limitation that is not fully reversible

Emphysema, chronic bronchitis and chronic asthma

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11
Q

Define Emphysema

A

i.e. COPD
Permanent enlargement of airspaces beyond the terminal bronchiole and destruction of alveolar wall (due to alveolar dilation)

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12
Q

Emphysema: Pathophysiology

A

Alveolar walls destroyed - air trapped - no alveoli recoil - bronchioles collapse (expiration)

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13
Q

Emphysema: Causes

A

Alpha- antitrypsin (AAT) deficiency

Cigarette smoking

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14
Q

Emphysema: Clinical manifestations

A

Loss of lung elastic tissue - airway wall collapse during expiration - hyperinflation - increased work of breathing
Barrel-shaped chest
Clubbing (chronic hypoxia)

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15
Q

Define Chronic bronchitis

A

i.e. COPD
Hyper-secretion of mucus and chronic productive cough for at least 3 months of the year and for at least 2 consecutive years

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16
Q

Chronic bronchitis: Pathophysiology

A

Increase in mucus production and damaged cilia in the bronchi

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17
Q

Chronic bronchitis: Causes

A

Smoking
Air pollution
Respiratory tract infection
Genetic predisposition

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18
Q

Chronic bronchitis: Clinical manifestations

A 
Copious grey, white or yellow sputum
Dyspnea
Wheezing and rhonci
Tachypnea
Prolonged expiratory wheeze
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19
Q

COPD: Complications

A

Cor pulmonale - right sided heart failure

Alteration in structure and function of right ventricle (RV) to compensate for increased pulmonary P

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20
Q

Asthma

A

Variable airflow obstruction secondary to inflammation of the airways.
Airways are hyper-responsive and chronically inflamed

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21
Q

Asthma: Clinical manifestations

A 
Decreased FEV1 and PEFR (peak expiratory flow rate)
Use of Accessory muscles 
Hypercapnia
Hyperinflation
Chest tightness - bronchoconstriction
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22
Q

Asthma: Pathophysiology

A

Abnormal stimulation of the inflammatory immune response
Production of IgE.
Inflammatory mediators released e.g. histamine, prostaglandins and leukotrienes
Smooth Muscle swelling + Increased cap permeability

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23
Q

Asthma: 2 types

A

Intrinsic asthma e.g., Familial

Extrinsic asthma

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24
Q

Asthma: Typical clinical symptoms

A

Dyspnoea
Wheeze
Chest tightness

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25
Management of Acute Asthma Episode
Observation Positioning Continue Treatment Monitoring
26
Define Status Asthmaticus
Severe asthmatic episode that does not response to pharmacological control
27
Bronchiectasis
Irreversible bronchial dilation and chronic inflammation, resulting in chronic wet cough.
28
Name the 6 Respiratory Tract infections (RTI)
``` Pneumonia Tuberculosis Acute bronchitis Bronchiolitis Influenza Pertussis ```
29
Define Acute bronchitis
i.e. RTI Acute infection or inflammation of bronchi due to viral illness No chest infiltrates
30
Define Bronchiolitis
i.e. RTI Lower respiratory tract Respiratory syncytial virus
31
Causes of Influenza
i.e. RTI | Antigenic drift
32
Causes of Pertussis
i.e. RTI Whooping cough Bordetella pertussis
33
Define Pneumonia
i.e. RTI Acute inflammatory illness of the lung parenchyma that impairs gas exchange L Parenchyma = gas transfer site
34
What happens in your lungs when you get Pneumonia?
Inflammation and oedema Alveoli filled with debris and exudate Consolidation is formed (WBC, RBC and platelets)
35
Pneumonia: Causes
Upper resp tract infection - bacteria - virus - fungi
36
Hospital (nosocomial) Acquired Pneumonia | Definition and Pathogens
Appears 48 hours or more after admission Not incubating at the point of admission - Staphlycoccus aureus - Pseudomonas
37
Community Acquired Pneumonia | Pathogens
- Streptococcus pneumoniae - Mycoplasma pneumoniae - Influenza, Legionella
38
Pneumonia: Symptoms
SOB Wheezing Fatigue Fever
39
Pneumonia: Clinical manifestations (7)
* Fever, pleuritic pain, chills - inflammatory process * Productive cough, yellow sputum * Dyspnea * Pleuritic chest pain * Rhonchi, crackles and wheezes * Tachycardia - hypoxic * Cyanosis
40
Pneumonia: Clinical investigations
White blood cell (WBC) count above 11 × 109/L Urea >7 mmol/L Blood and sputum cultures
41
Define Tuberculosis (TB)
Pulmonary infiltrates and formation of granulomas with fibrosis and cavitation
42
Tuberculosis (TB) | Pathogens
Airborn transmitted - Mycobacterium tuberculosis - Mycobacterium bovis
43
TB: Pathophysiology | 1° and 2° Infection
1° Infection - Upper lobes - Lymphocytes and neutrophils congregation - Bacilli in fibrous tissue. 2° Infection - Bacilli reactivation and multiplication - Symptomatic and Infectious
44
TB: Clinical manifestations (6)
* Heamoptysis * Fever/night sweat * Weight loss * Appetite loss * Sputum * Persistent cough
45
What happens in Restrictive Lung Disease?
Difficulty in expanding thorax
46
What happens in Pulmonary Oedema?
Fluid in extravascular spaces
47
Pulmonary oedema: | Cardiogenic vs Non-cardiogenic Pressures (P)
``` Cardiogenic = increased P in pulmonary capillaries Non-cardiogenic = P unaffected ```
48
Define Acute Respiratory Distress Syndrome (ARDS)
Pulmonary oedema that can quickly lead to acute respiratory failure Immune mediators = inflammation = decrease O2 exchange
49
ARDS: Pathophysiology
Sepsis - Leaky capillaries - No surfactant - Decrease lung compliance (stiff lungs)
50
ARDS: Clinical presentation case scenario
A 42-year-old female presents with dyspnoea, rapid, shallow breathing, tachycardia, inspiratory crackles, decreased lung compliance and hypoxaemia.
51
What is Dyspnea?
SOB
52
Define Atelectasis
Partial/complete lung collapse due to incomplete expansion of alveolar sacs
53
Atelectasis: Clinical manifestations
- dyspnea - cough - fever - leukocytosis
54
What happens in Pleural Effusion?
Excess fluid (protein and WBC) in the plural space
55
How is Empyema different to Pleural Effusion?
Pus in the plural space
56
What happens in Pneumothorax?
Partial/complete lung collapse due to air in the pleural cavity
57
Pneumothorax: Clinical manifestations
Reduced chest wall movement Diminished breath sounds Surgical (subcutaneous) emphysema = air under skin Trachea deviation
58
Tension Pneumothorax Complications
Decrease venous return = decreased CO Hypoxemia Cardiac arrest
59
What happens to bronchi and bronchioles in Bronchiectasis?
Chronic dilation of the bronchi and bronchioles due to inflammation
60
Croup | Definition and symptoms
In infants: Upper airways infection due to immature immune system - Barking cough
61
Respiratory distress syndrome (RDS) | Definition and symptoms
In newborns: Immature lung and no surfactant - Tachypnoea, expiratory grunting, use of accessory muscles, nasal flaring, pallor
62
What happens in Cystic fibrosis?
- Autosomal recessive - Defective epithelial Cl+ transport - Decrease in airway surface liquid - Non rhythmic beating of cilia - Exocrine glands produce excessive thick mucus
63
Sudden infant death syndrome (SIDS)
Preterm / low birth weight babies | Possible relationship to respiratory infections
64
Pulmonary embolism
Blood clot wedged into an artery in lungs due to venous stasis, hypercoagulability and bleeding injuries
65
Causes of Increased Pulmonary Pressure
hypoxic vasoconstriction acidosis obstructions in the pulmonary vasculature increased blood volumes

NURS 444 (7 decks)

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