Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

RRT > pathologies > Flashcards

pathologies Flashcards

(258 cards)

Start Studying
1
Q

COPD meds

A
  • Saba - Albuterol, Xopenex, Ipratropium bromide
  • Laba- Salmetero, spiriva
  • Steroids for inflammation - Fluticasone, budesonid
  • MDI - Advair, Symbicort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

COPD

hospital management for exacerbagtion

A
  • meds: SABA and antibiotics
  • oxygen - 24 -28% for hypoxemian
  • NPPV (pH <7.35 and Paco2 >45)
  • INtubate (pH <7.30 and Paco2 >50)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

COPD

When do you intuate?

A

pH is , 7.30 and Paco2 >50

for pts with acute hypercapnic resp. failure and server hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Short- acting beta agonis

A

Albuterol, Xopenex, Ipratropium bromide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Long acting beta agonist

A

Salmetero, spiriva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Emphysema / c. Bronchitis

Patient assesment

apperance and respiratory pattern

A
  • appearance: barrel chest, increased A-P diameter, clubbing and cyanosid
  • resp. pattern: dyspnea, accessory muscle use, pursed-lip breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ephysema / C. Bronchitis

COPD breath sounds

A

diminished aeration with bilateral expiratory wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ephysema / Chronic Bronchitis

chest percussion

A

Percussion : tympanic or hyperresonant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Emphysema / Chronic Bronchitis

Pulmonary funtion testing

A

decreased flows (FEV1, FEV1/FVC, FEFn25-75)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Terminology used to describe COPD

A

Chronic ventilatory failure, increased lung compliance, chronic hypercapnia, loss of elastic recoil, Chronic CO2 retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment for CB / ephysema

A
  • low o2 spo2 is 88-92%
  • aerosolized bronchodilators
  • bronchial hygiene
  • corticosteroids
  • antibiotics if indicated by sputum culture
  • smoking cessation
  • pulmonary rehabilitation
  • proper nutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Asthma

Patient assessment : Appearance of the chest and Resp pattern:

A

Chest: increased A-P diameter during episode
RP: accessory muscle usage, retractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Asthma severity PEFR or FEV1

A

Mild > 80%
Moderate 60-70%
Severe >60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

med given for status asthmaticus

A

Amoline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Asthma medications

SABA

A

albuterol, Xopenex, Ipratropium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Asthma medications

Corticosteroids for inflamation

A

prednisone
methylprednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Asthma Assessment
Resp. pattern
Chest percussion

A

RP: accessory muscle use, retractions (in children)
CP: Hyperresonant / tympanic note

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Asthma assessment
breath sounds

A
  • Diffuse wheezing
  • diminished
  • prolonged expiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

asthma assesment
physical appearance

A

Diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Asthma assessment
Vital signs

A
  • Tachycardia
  • tachypnea
  • pulsus paradoxus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Astham chest x-ray

A
  • increased A-P diameter
  • translucent lungs fields
  • depressed/ flattened diaphragms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Asthma PFT and post-bronchodilator spirometry

A
  • reduced flowrates (peak flow, FEV1, FEV1/FVC)
  • Post-bronchodialator: considered a significant response if FEV1 increases at least 12% and 200mL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Asthma management of acute episodes

A
  • O2
  • SABA and anticholinergic agents
  • Corticosteroids
  • intubate if ventilatory failure or resp. arrest occurs
  • considere: heliox, magnesium sulfate, subcutaneous epinephrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Asthma Long term control

A

control meds:
* LABA
* inhaled corticosteroids
* mast cell stanbilizers
* leukotrine inhibitos
Asthma action plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Green Asthma cation plan | Peak Flow ? Action plan?
Stable Peak Flow 80 -100 % | continue with med in daily treatment plan , use Preventative medicine
26
Yellow asthma action plan
increase in symptoms Peak Flow 50-80% * Give Preventative (anti-inflammatory) inhalor * ADD: quick relief inhalor (albuterol) * begin / increase oral steroids * call doctor * return to level 1 when symptos improve
27
Red asthma action plan | peak flow?
no improvement after increasing treatment after yellow zone Peak flow <50% * Quick relief bronchodilator inhaker * Begin/ increase treatment with oral steroids * call doctor!
28
Assess severity of asthma with __ or __ | Mild, Moderate, Sever
PEFR or FEV1 Mild >80 % Moderate 60-70% Severe <60%
29
Give for status asthmaticus
Amoline
30
Asthma Medications | In Hospital
* SABA - Albutero, Xopenex, Ipratropium * Corticosteroids - Prednisone, methylprednisolone * oxygen for hypoxdemia | After 3 nebs of albuterol, if wheezing continues give corticosteroids
31
Asthma medication (home care, rehab) | ICS, SABA, LABA, MDI
* Inhaled corticosteroids - Fluticasone, Pulmicort, Azmacort, Singulair * Albuterol * LABA - seravent, only use with ICS * MDI - Advair, Symbicort
32
Bronchiectasis | definition
Chronic dilation and distortion of one or more bronchi as a result of excessive inflammation and destructionon bronchial walls, blood vessels, elastic tissu, and smooth muscle
33
Bronchiectasis | Patient assessment
* hx of pulmonary infections and cystic fibrosis * cyanosis, barrel chest, clubbing * Tachypnea, dyspnea, accessory muscle use
34
Bronchiectaisis | Diagnostic chest percussion and cough
CP: Hyperresonant or tympanic Cough: Pruductive of purulent, fould smellin secretions , hemoptysis, sputus separete into 3 layers
35
Bronchiectasis treatment
* oxygen therapy * bronchopulmonary hygiene * Lung expansion therapy * Antibiotics * expectorants * aeroslized SABA and anticholinergic
36
Cystic Fibrosis
An inherited, genetic disorder involving the exocrine glands. Results in thick viscous mucus accumulation in the lungs and prohibits enzymes from reaching the intestines leading to inhibition of digestion of protein and fat and deficencies of Vitamins A,D,E and K.
37
CF assessment | general apperance breath sounds
GA: Barrel chest, cyanosis, clubing, small for age, malnutrition, poor body development, peripheral edema BS: diminished, crackles, wheezing
38
CF assessment | Respiratory pattern Chest percussion
Rp: tachypnea, dyspnea on exertion, use of accessory muscles of inspiration and expiration, cough productive of large amount of thick purulent secretions CP: hyperresonant or tympanic note
39
CF x-ray
Translucent (dark) lung fields, depressed or flattened diaphragm, right ventricular enlargement, areas of atelectasis and fibrosis.
40
Cystic Fibrosis CBC
elevated Hb and Hct concentration.
41
Cystic Fibrosis sputum culture
Opften positive for *Staphylococcus aureus, Haemophilius influenza, Pseudomonas aeroginosa*
42
Cystic Fibrosis Special test
* New born - screening by immunoreactive trypsin level (IRT) * Sweat Chloride Test (>60 mEq/L) * Genetic testing of CFTR mutation
43
Positive CF Sweat Chloride test
> 60mEq/L
44
Cystic Fibrosis mediactions
* Bronchodilators * Expectorants for mobilizing secretions * Mucolytics - Pulmozyme * Antibiotics for infection (TOBI) * CFTR modulators (Orkambi, Symdeko, Kalydeco)
45
How frequently do you give TOBI for CF
nebulized twice a day every other month to reduce bronchiectic exacerbations.
46
Do you use NPPV for CF?
Yes, for impending ventilatory failure (pH<7.30)
47
" Caftors "
Orkambi Sumdeko Kalydeco | Given to cystic Fibrosis pt
48
Treatment for CF
* Chest percussion and postural drainage * Exercise * PEP therapy * High Frequency chest wall compression * O2 therapy
49
Inhaled antibiotics | 3
* Tobramycin (TOBI) * Colistin * Amikacin
50
name a mucolytic for CF
dornase alpha (Pulmozyme)
51
Apnea is diagnosed in pt who..
have more than 5 episodes of apnea per hour that may occur in REM and/or non-REM sleep over a 6 hour period
52
Hypopnea
shallow or slow breathing
53
Central sleep apnea
caused by failure of the respiratory center of the brain to send signals to the reps. muscles
54
Polysomnography: If both nasal flow and resp effort decrease then desaturation | CSA or OSA
Central Sleep Apnea
55
Polysomnography: If nasal flow decreases with an increase in respiratory effort then desaturation
Obstructive sleep apnea
56
the average number of apneas and hypopneas per hour of sleep
AHI | apnea-hypopnea index
57
Normal AHI | apnea-hypopnea index
<5 episodes/ hour
58
AHI * Mild * Mod * Severfe
* mild 5-15 * mod 16-30 * Severe >30
59
Treatment for Central sleep apnea
NPPV
60
Treatment for Obstructive apena
* nasal CPAP * weight loss * sleep posture (lateral or upright) * oxygen therapy * surgery (UPPP, trach) * oral appliances * neck collar
61
Chest Trauma / Flail Chest | General apperance & Resp pattern
GA: Anxious, cuanosis, bruising over area RP: shallow, rapid respirations, paradoxical chest movement (flail chest)
62
Diagnostic chest precussion for flail chest/ chest trauma
May have sign and symptosm of penumothorax ( hyperresonant/ tympanic note)
63
Chest Trauma / Flail Chest Breath Sounds
diminished breath sounds over affected area
64
Treatment for Chest Trauma / Flail Chest | Mild/ Severe
* Mild - Pain medication, lung expansion therapy and bronchial hygiene (IS and deep breathing and coughing, IPPV) * Severe - Stabilization of chest (NPPV, VC/AC with peep for acute ven failure)
65
Pneumothorax General assessment
Possible diaphoresis, cyanosis, tracheal or mediastinal shift away from the affected side, bruising over affected area
66
Pneumothorax Resp. pattern
Tachypnea reduced movement on affected side
67
Pneumothorax * Breath sounds * Chest percussion
* BS: diminished or absent on affected side * CP: Hyperresonant/ tympanic note over affected side
68
Pneumothorax Vital signs
Tachycardia, pulsus paraxoxus, hypertension
69
Pneumothorax Chest X-ray
Hyperlucency with absence of vascular markings on the affected side, tracheal shift to the unaffected side, depressed diaphragm, lung collapse
70
Treatment for Pneumothorax less than 20% of lung collapse
may only require bed rest and limited physical activity | absorption occurs withing 30 days
71
Treatment for Pneumothorax greater than 20% lung collapse
should be evacuated by chest tube or needle if patient is unstable ( bradycardia, hypotension, cyanosis) * Give Hyperinflation therapy (IS/SMI, IPPV) after chest tube insertion
72
Hemothorax general appearance
* Cyanosis, * tracheal or mediastinal shift away from the affected side
73
Hemothorax * Resp. patterns * Breath sounds
* RP: tachypnea, productive cough (hemoptysis) * BS: diminished or absent on affected side
74
Treatment for Hemothorax
* thoracentesis or chest tune * Hyperinfaltion therapy (IS,/SMI, IPPB) * mechanical ventilation
75
Carbon monoxide poisoning is present when...
COHb > 20%
76
Carbon Monoxide Poisoning General appearance
* Anxious * surface burns * singed facial hair * black soot marks * Cyanosis or cherry red color
77
Carbon Monoxide Poisoning Breath sounds
Normal in early stages, may present with wheezing, crackles or rhonchi inspiratory Stridor
78
Pulmonary Function of Carbon Monoxide Poisoning
Decreased volumes and flowrates (Vt,VC,FEV...) * decreased DLco
79
Treatment of Carbon Monoxide Poisoning
* marked or severe distress/ stridor - intubate * Oxygen therapy 100% * Hyperbaric oxygen therapy - for severe poisoning * Mechanica ventialtion for ventilatory failure * Pulmonary hygiene * Hyperinflation therapy
80
Carbon Monoxide Poisoning aerosolized Medication
* Bronchodilators ( Albuterol , Xopenex) * Mucolytics and expectorants * Corticosteroids * Analgesics for pain * Antiniotics for infection
81
In Carbon Monoxide Poisoning use ___ to diagnose burn injury to upper airway
bronchoscopy
82
Congestive Heart Failure
Abnormal condition that reflects impaired cardia pumping. Caused by myocardial infarction, Ischemic heart disease or cardiomyopathy
83
Pulmonary Edema
Excessive movement of fluid from the pulmonary vascular system to the extravascular system and air spaces of the lungs (alveoli). Most commonly caused by CHF
84
Most common cause of Pulmonary Edema
CHF
85
CHF / P. Edema general appearance
Peripheral / pedal edema Diaphoresis Cyanosis
86
CHF / P. Edema Respiratory Pattern
Tachypnea, orthopnea, paroxysmal nocturnal dyspnea | orthopnea - elevate at 30 -35 degrees so they can breath
87
CHF / P. Edema cough & diagnostic percussion
cough: pink frothy secretions Percussion: flat or dull percussion note other: increased tactile and vocal fremitus
88
CHF / P. Edema Chest x-ray
* bilateral fluffy opacities * dilated pulm. arteries * Left ventricular hypertrophy (cardiomegaly) * butterflu or bat wing pattern * Kerley A&B lines
89
CHF / P. Edema PFT
rexuced volumes and capacities * Normal FEV1/FVC ratio
90
CHF / P. Edema * hemodynamics * cardiac enzymes
* Hemo: Increased PCWP, PAP * CE: elevated brain natriuretic peeptide (BNP)
91
CHF / P. Edema Treatment
* High flow oxygen therapy via non-rebreather , HFNC * place in Fowler's position * Hyperinfaltion therapy (IPPB, IPV) * Diuretics -furosemide * Positive inotropic agents - digitalis, dogoxin docutamine, dopamine * Analgesic - morphine (slow down breathing) * Preload reduction agens - nitroglycering, nitroprusside, morphine * CPAP - not for hypercapnia * Antidysrhytmic agents Atropine (brady), procainamide or metoprolol (tachy)
92
Positive inotropic agents for CHF
digitalis, dogoxin docutamine, dopamine
93
Analgesic for CHF
* Analgesic - morphine (slow down breathing)
94
Preload reduction agents for CHF? | and pulmonary edema
nitroglycering, nitroprusside, morphine
95
Antidysrhytjmic agents for CHF / P. edema
Bradycardia : atropine Tachycardia : procainamide, metoprolol
96
Arrhythmias etiology
Hopoxemia Ischemia Electrolyte imbalance conduction disorders
97
List a few medications for CHF
* Digitalis - to increase muscle contractility * Lasix to promote fluid excretion * Nipride (vasodialtor) to reduce impedance of blood flow
98
Do you give lasix for small or mild edema ?
no
99
Left heart failure
pulmonary edema
100
right heart failure
peripheral edema
101
what do you give for cardiogenic shock
* Anticoagulants (warfarin) and antiplatelets * Thrombolytics (activase) * Diuretics
102
Meds for P. edema
* Digitalis / dobutamine to increase cardiac output * Lasix for fluid excretion * Vasodilators - morphine and Nipride to decrease vascular resistance and improve cardiac output | If diuretics dont work, intubate and MV for acute ventilatory failure
103
treatment for Premature Ventricular Contraction | PVC
Treat with oxygen, lidocaine and consider causes
104
Treatment for Ventricular fibrillation and pulseless ventricular tachycardia ?
defibrillation
105
For Atrial flutter, fibrillation and ventricular tachycardia WITH pulse consider ...
synchronized cardioversion
106
What is a frequen complication of COPD and interstitial lung disease
Pulmonary hypertension
107
An increase in mean pulmonary artery pressure greater than 25mmHg at rest.
Pulmonary Hypertension
108
Pulm. Hypertension general appearance
anxious diaphoretic cyanotic peripheral edema jugular venous distension
109
Pulm. Hypertension Resp. pattern
* RP : dispnea, shortness of breath during routine activity tachypnea
110
Pulm. Hypertension * breath sounds * cough
* wheezing crackles pleural friction rub * cough : non-pruductive
111
Pulm. Hypertension Chest x-ray
underluing lung disease enlarged pulmonary arteries
112
Hemodynamics for Pulm. Hypertension
increased PAP
113
treatment for Pulm. Hypertension
* Diuretics to reduce fluid buildup * Blood thining meds * Inotropic agents (digitalis) * Warfarin (Coumadin) * O2 therapy * nitric oxide for severe cases
114
Pulm. Hypertension blood thining medications
1. Apixaban (Eliquis) 2. Fondaparinux (Arixtra) 3. Heparin (Levenox) 4. Rivaroxaban (Xarelto) 5. Warfarin (Coumadin)
115
Interruption of coronary blood flow for an extended period of time causing potentially irreversile damage to the heart muscle, potentially leading to sudden cardiac arrest
Myocardial Ischemia / Infarction
116
Myocardial Ischemia / Infarction * general appearance
diaphoretic, anxious c/o chest pain possible cyanosis
117
Myocardial Ischemia / Infarction *Diagnostic testing* * ABG * Electrolytes * electrocardiogram * Cardiac enzynes
* ABG: Hypoxemia * Electrolytes: Hyperkalemia or hypokalemia * Electrocardiogram: inverted T waves, elevated S-T segment * Cardiac enzymes: Elevated troponin level
118
Electrocardiogram for Myocardial Ishemia
Inverted T waves, elevated S-T segment
119
treatment for Myocardial Ischemia / Infarction
* 100% oxygen (priority) * Aspirin * Morphine * Anti-arrhythnmic agents as indicated (amiodarone, Procainamide, atropine) * Nitrates for chest pain * Maintain blood pressure with fluids or vasopressors (dopamine) * Defibrillate for pulseless ventricular tachycardia or venticular fibrillation
120
Blood clots develop in peripheral blood vessels becase of..
* Venous stasis ( inactivity, prolonged bed rest or sitting) * Fat/ air emboli * Trauma, fractures * recent surgery * Obesity * Pregnancy / child birth
121
Pulmonary Embolism general appearance
* Anxious * diaphoretic * cyanotic * cool or clammy skin
122
Pulmonary Embolism respiratory pattern
shortness of breath, tachypnea
123
Pulmonary Embolism Breath sound: cough:
BS: wheezing, crackles, pleural friction rub cough: Possible hmoptysis
124
Pulmonary Embolism chest x-ray
increased density in infarcted area, dilation of pulmonary arteries, wedfe-sahped infiltrate
125
Pulmonary Embolism Hmodynamics
increase PAP
126
Pulmonary Embolism Capnography
PECO2 : decreasing PECO2 with normal PaCO2
127
Pulmonary Embolism Vd/Vt ratio | decrease or increased?
increased
128
Pulmonary Embolism treatment / Prevention
* Anticoagulants ( heparin ) * Anti-embolisn (compression) stockings * Pneumatic compression device * Early ambulation
129
Pulmonary Embolism management / treatment
* Oxygen therapy ( PaO2 >80 torr ) * Anticoagulants ( Heparin ) * Analgesics to relieve chest pain * Digitalis , digoxin to maintan circulation * Thrombolytic agent - urokinase, strephtokinase, tPA
130
Thrombolytic agents for PE
urokinase, streptokinase, tPA
131
consist of right ventricular enlargement (hypertrophy, dilation or both) and is secondary to pulmonary hypertension from disorders of the chest wall or lungs
Cor Pulmonare
132
increased right ventricular workload as a result of pulmonary hypertension causing hypertrophy of the right ventricle. Often caused by COPD
Cor Pulmonale
133
Cor Pulmonale physical appearance
distended neck veins, chest pain, peripheral edema
134
Cor Pulmonale appearance of the chest
increased AP diameter with obstructive lung disease
135
Cor Pulmonale hemodynamics
increased CVP, decreased QT with exercise
136
Chronic disorder of the neuromuscular junction that interferes with chemical transmission of acetylcholine
Myasthenia Gravis | Moves from Mind to Ground
137
Myasthenia Gravis general appearance
general weakness that improves with rest, drooping eyelids (ptosis), double vision (diplopia), difficulty swallowing (dysphagia)
138
drooping eyelids
ptosis
139
double vision
diplopia
140
dysphagia
difficulty swallowing
141
Myasthenia Gravis * respiratory pattern * Breath sounds
Rp: shallow breathing Bs: diminished with crackles
142
Specail test for Myasthenia Gravis
* Edophonium Test (Tensilon challenge test) * electromyography (muscles test movement) * Blood test for Ach recfeptor antibodies
143
If Vt,Vc MIP and weakness improve with Tensilon its reffered as ?
Myasthenic Crisis - more of this type of drug needs to be given * Maintenance drug therapy (anticholinesterase therapy, cholinesterase imhibitors ) including Pyridostigmine (Mestinon, Regonol ) and Prostigmine (Neostigmine)
144
what is a maintenance drug thearapy for Myasthenia Gravis
* anticholinesterase therapy cholinesterase inhibitorsincluding: Pyridostigmine (Mestinon, Regonol) and Prostigmine (Neostigmine)
145
If Vt, VC, MIP and weakness worsen with Tensilon, its referred as ?
Cholinergic Crisis - overdose of anticholinesterase drugs * Administer Atropine to reverse Tensilon
146
rare autoimmune disorder that causes inflammation and deterioration of the patient's peripheral nervous system | Ground to Brain
Guillain-Barre Syndrome
147
Guillain-Barre Syndrome physical appearance
Acute weakness, especially in the legs, cyanosis
148
Guillain-Barre Syndrome Resp. pattern
shallow breathing
149
Guillain-Barre Syndrome spontaneous vent parameters
decreasing Vt, Vc, MIP
150
Chronic bronchitis cough assessment
cough: congested, productive or thick sputum
151
Guillain-Barre Syndrome Arterial Blood Gas watch for ...
ventilatory failure PaCO2 >45 torr
152
Guillain-Barre Syndrome Lumbar puncture
high protein level CSF (>500mg/dL)
153
Guillain-Barre Syndrome Special Test
* Lumbar puncture * abnormal electromyography * elevated IgM levels
154
Guillain-Barre Syndrome general management
* monitor and stabilzation of vitals * monitor SpO2, VC and MIP * Frequent ABG measurement (when there's a spirographic change) * hyperinflation therapy (IS, IPPB) * mechanical ventilation for impending or acute vent. failure
154
what type of therapy is effective with Guillain-Barre Syndrome
Plasmapheresis and intravenous immunoglobulin (IVIG) therapy
155
Drug Overdose patient assessment
* slow, shallow breathing * diminish breath sounds * altered level of consciousness, euphoria
156
Drug Overdose treatment/ management
1. airway maintenance 2. MV for ventilatory failure 3. Reversal agents * Naloxone (Narcan ) - for narcotics * Flumazenil (Romazicon) - for benzos * Acetlycystein - for acetaminophen
157
reverse agent for narcotic overdose
Naloxone (Narcan)
158
reversal agen for benzodiazepine overdose
Flumazenil (Romazicon)
159
reversal agents for acetaminophen
Acetylcysteine
160
Stroke / acute brain attack patent assessment | Cerebrovascular accident (CVA)
* motor and speech loss * bradypnea, cheyne- Stokes respiraotions * Hypertension, fever
161
Stroke / acute brain attack Medica history
* cebrebral thrombi or emboli * atherosclerosis * hypertension * transient ischemic attacks
162
Stroke / acute brain attack Diagnotic testing
* CT/MRI * cerebral angiogram * intracranial pressure monitoring - may be elevated
163
Stroke / acute brain attack drug therapy
* Anticoagulation therapy * Vasodilators * Thrombolytic therapy: tissue plasminogen factor (tPA)
164
Stroke / acute brain attack Management
* Drug therapy * Mechanical ventilation (hyperventilation may be helpful to reduce ICP) | avoid use of PEEP
165
For a Stroke / acute brain attack what do you avoid during MV?
PEEP (b/c it increases ICP)
166
What can help reduce ICP during MV? | intracranial pressure
Hyperventilation
167
An acute illness or injury to the lungs that results in reduced lung compliance, diffuse atelectasis and refractory hypoxemia
Acute Respiratory Distress Syndrome (ARDS)
168
ARDS etiology
* sepsis (most common cause) * Aspiration * Pneumonia * Severe trauma * Massive blood transfusion * drug abuse
169
ARDS breath sounds | Acute Respiratory Distress Syndrome
broncial, crackles
170
ARDS respiratory pattern
tachypnea, substernal or intercostal retractions
171
ARDS * general appearance * vital signs
* cyanotic * tachycardia, hypertension
172
ARDS chest percussion
Falt / dull note
173
ARDS chest x-ray
* increased opacity * diffuse alveolar inflitrates with honeycomb or ground glass
174
# chest x-ray * diffused alveolar infiltrates with a honeycomb or graound glass appearance
ARDS
175
Acute Respiratory Distress Syndrome Pulmonary function
Decreased volumes and capacities | Vt, RV, FRC and TLC
176
ARDS hemodynamics
elevated PAP with normal PCWP
177
ARDS Treatment / management
* treat underlying cause * O2 therapy * CPAP / PEEP (treat refractory hypoxemia) * monitor hemodynamics * hyperinfaltion therapy (SMI/IS, IPPB) for atelectais * Mechanical ventilaton
178
ARDS vent. settings | as indicated
1. VT 4-6mL/kg 2. plateau pressur < 30 cmH2O 3. initiate recruitment maneuvers 4. maintain PaO2 >55
179
ARDS Other alternative approaches to MV
1. inverse ratio ventilation (IRV) 2. Pressure Regulated Ventilation (APRV) 3. Pressure REgulatated Voulume (PRVC) 4. High Frequency Ventilation (HFV) 5. Permissive hypercapnia
180
Consider __ position to improve oxygenation for ARDS
Prone position
181
use inhaled nitric oxided (iNO) to treat ...
pulmonary artery pressure
182
An infectious inflammatory process that primarily affects the gas exchange area of the lung causing capillary fluid to pur into the alveoli.
Infectious disease / Pneumonia
183
This process leads to inflammation of the alveoli, alveolar consolidation and atelectasis
Infectious disease / Pneumonia
184
Infectious disease / Pneumonia | Past medical hx
initially mimics a cold or flu, signs and symptoms may develop quickly, may have chest pain
185
Infectious disease / Pneumonia patient assessment
* SOB (may be present) * productive cough - yellow/green sputum * decreased chest expansion, increased tactile and vocal fremitus * cyanosis * Diaphoretic
186
Infectious disease / Pneumonia chest percussion
Flat or dull note
187
Infectious disease / Pneumonia breath sounds
Crackles, bronchial, whispered pectoriloquy
188
Infectious disease / Pneumonia vital signs
increased HR, BP,QT, temperature
189
Infectious disease / Pneumonia chest x-ray
increased density from consolidation and atelectasis, air bronchograms , possible pleural effusion
190
Infectious disease / Pneumonia CBC
increased WBC with bacterial infection, decreased WBC with viral infection
191
Infectious disease / Pneumonia special test
* CT scan * Acid fast stain for tuberculosis * ELISA test for HIV
192
ELISA test is done to detect ...
HIV
193
Infectious disease / Pneumonia Treatment / management
* oxygen therapy * pulmonary hygiene therapy * Hyperinfaltion therapy * Mechanical ventilation * VAP protocol for intubated pt * drug therapy ( antibiotics, antipyretics, analgesics, cough suppressants ) * thoracentesis for pleural effusion
194
Drug therapy for Infectious disease / Pneumonia
* Antibiotics * Antipyretics (control fever) * Analgesics (pain)
195
Immunocompropmise medical conditions can be cuased by ?
HIV cancer diabetes, malnutrition certain genetic disorders
196
signs and symptos of Immunocompropmise
* Frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections * inflammation and infection of interna organs * blood disorders (low platelet count or anemia)
197
Pneumocystis carinii/ jirovecii infections can be treated with..
aerosolized pentamidine
198
Failure of the cardiovascular system to adequately perfuse tissues that results in widespread impairment of cellular metabolism; a reduction in blood flow to the tissues that is inadequate to sustain life.
Shock
199
# Types / causes of Shock Cardiogenic | cause?
heart failure
200
# Types / causes of Shock Neurogenic or Vasogenic | cause?
Alterations in vascular smooth muscle tone
201
# Types / causes of Shock Anaphylactic | cause?
Hypersensitivity / allergic reaction
202
# Types / causes of Shock Septic | cause?
Infection
203
# Types / causes of Shock Hypovolemic | cause?
Insuffiencent intravascular fluid volume
204
# Types / causes of Shock Traumatic | cause?
Components of hypovolemc and septic shock
205
# Patient assessment Shock general appearance
Pale or cyanotic cold clammy lethargic unresponsive diaphoretic poor capillary refill
206
# patient assessment shock res. pattern
Tachypnea, shortness of breath
207
Shock | hemodynamics
decreased CVP, PAP, PCWP, QT
208
Shock dianostic testing | ABG? Hemo? Urin output
* ABG : hypoxemia * Hemo : decreased CVP, PAP, PCWP, Qt * urine output : decreased
209
Shock Treatment/ management
* mechanica ventilation fro vent failure * Vasopressors for wasogenic shock (dopamine, dobutamine) * Inotropic agents for heart filure (digitalis, dogoxin * Antibiotics for infection * Treat hypovolemia with IV fluids
210
Vasopressors for vasogenic shock
dopamine dobutamine
211
# Shock Inotropic agents for heart fialure
digitalis digoxin
212
treat hypovolemia with ..?
IV fluids
213
a medical specialty which deals with the cause, prevention and treatment of obesity | BMI >30 kg/m2
Bariatrics
214
common risk of obes pt :
* difficult to proved ventilation via manual resuscitation bag * difficult intubation (bull neck - mallampati >3) * Atelectasis * hemodynamic instability * DVT and pulmonary embolism
215
# Bariatric condiation s Obstructive sleep apnea is prevalent leading to :
* Obesity Hypoventilation Syndrome / Pickwickian Syndrome * Compensated respiratory acidosis * Cor pulmonale
216
# Bariatric condiations guidelines for mechanical ventilation
1. Vt at 6mL/kg of IBW 2. PEEP, helful to offset weight of chest wall 3. Elevated head of bed to prevent aspiration and VAP 4. Early extubation if on CPAP
217
surgical removal of the larynx
Laryngectomy
218
Laryngectomy treatment / management
* use meticulous suctioning technique * watch fro bleeding / clots * Cool aerosol will help keep secretions thin in the ealry post-op period * Monitor basic laboratory test
219
Head Trauma / Surgery etiology
* Traumatic brain injury * Tumors * Aneurysms * Cerebrovascular accidents * Seizures
220
Head Trauma / Surgery Resp. pattern
irregular rhythm, Cheyne-Stokes or Biot's breathing
221
Head Trauma / Surgery Patient assessment | RR, level of consciousness, and pupillary response
1. Resp.rate irregular, Cheyne - Stokes or Biot's breathing 2. Level of consciousness: altered level of consciousness (increased risk of aspiration 3. pupillary response: abnormal
222
Head Trauma / Surgery treatment
* airway protection * O2 therapy - maintain PaO2 100 torr * MV (minimize mean airway pressure, low PEEP and pip * Benzo or propofol for sedation * Treat acute ICP >20mmHg ( heperventilation, hob elevated, Mannitol ) * Dilantin for seizures
223
Intracranial pressure
5-10 mmHg
224
how to treat acute elveations in ICP ? | >20 mmHg
* hyperventilation * keep head of bed elevated * Mannitol
225
use dilantin for
seizures
226
decreased renal function secondary to diabetes mellitus or renal insufficiency
Diabetes / renal failure
227
Diabetes / renal failure resp. pattern
may exhibit Kussmaul breathing
228
Diabetes / renal failure physical appearance
Alert lethargic confused comatose unresponsive pedal edema
229
Diabetes / renal failure secondary assessment | ABG, urine output, blood glucose level
* abg: metabolic acidosis * urine ouput: decreased (<500mL/day) * blood glucose level: >160 mg (diabetic)
230
Diabetes / renal failure primary assessment | hx, Resp.pattern, BS, appearance
* hx: diabetes mellitus, renal disease * Resp. pattern: may exhibit Kussmaul breathing * BS: rales if CHF is present * appearance : alert,lethargic, confused, comatose, unresponsive, pedal edema
231
Hypothermia hx: appearance :
* hx: near drowning or cold exposure, indigent, homeless or elderly persons * app: shivering, confusedm poor coordiantion, cyanosis, peripheral vasoconstriction
232
Hypothermia vital signs
decreased HR,RR Qt, temperature
233
If pt has a temp < 37, how would their ABG actual values differ? | PH, PCO2, PO2
* pH - increased * Pco2 - decreased * PO2 - decreased
234
Near drowning assessment | cough, color, Resp pattern
* cough - frothy pink stable bubbles * cyanosis * BS- crackles and rhonchi
235
Near drowning * physical appearance * vital signs
* Pa - confused, unconscious, comatose * VS- increased HR, BP, Qt, hypothermia
236
Near drowning Chest x ray
initially can be normal, fluffly infiltrates, pulmonary edema
237
Near drowning treatment / management
* 100% oxygen * Intubate with PEEP * Inotropic agent * Diuretics * Warming * ECMO for severe cases
238
If neck injury is suspected after near drowning, you should?
intubaate with flexible bronchoscope
239
what type of bronchoscope do you use to intubate someone that has neck injury?
felxible bronchoscope
240
# PEDIATRIC DISEASES Asthma (Reversible Airway Obstruction) clinical presentation/ mdiagnosis
dyspnea cough increased production of secretions accessory muscle use increased respiratory rate and expiratory wheezing
241
# PEDIATRIC DISEASES Asthma (Reversible Airway Obstruction) Children may complain of ..?
stomach ache
242
Asthma (Reversible Airway Obstruction) chest x-ray
may show hyperinflation, flattened diaphragms and infiltrates
243
# PEDIATRIC DISEASES Asthma (Reversible Airway Obstruction) improved air movement in the lungs | auscultation
decreased bs (silent chest) and then increased wheezing indicates improved air movement
244
Asthma (Reversible Airway Obstruction) Helpful diagnostic test
* Pulmonary function testing (spirometry) * Exhaled nitric oxide testing helpful in monitoring airway inflammation * Bronchoprovocation challenges with methacholine or exercise
245
# PEDIATRIC DISEASES Asthma (Reversible Airway Obstruction) control medications
1. LABA: salmeterol, formoterol, argormeterol 2. Inhaled corticosteroids: beclomethasone, budesonide, fluticasone 3. Leukotriene modifiers: motelukast, zileuton 4. Immunomodulators: Omalizumab, palivizumab
246
# Asthma (Reversible Airway Obstruction) LABA control medication
* Salmeterol * formoterol * arfomoterol
247
# Asthma (Reversible Airway Obstruction) Inhaled corticosteroids
* beclomethasone * budesonide * fluticasone
248
# Asthma (Reversible Airway Obstruction) Leukotriene modifiers
* omalizumab * zileuton
249
# Asthma (Reversible Airway Obstruction) Immunomodulators
omalizumab palivizumab
250
# PEDIATRIC DISEASES Asthma (Reversible Airway Obstruction) Quick relief medication
* SABA :albuterol, levalnuterol * Anticholinergics : ipratropium * Systemic corticosteroids: prednisone, methylprednisolone
251
# PEDIATRIC DISEASES Asthma (Reversible Airway Obstruction) EMERGENCY ROOM CARE
* start with O2 * Inhaled SABA agents : 3 treatments/hour * Inhaled anticholinergics * systemic corticosteroids
252
acute episode that fails to respond to usual bronchodilator treatment
Status asthmaticus
253
# PEDIATRIC DISEASES Asthma (Reversible Airway Obstruction) ADDITIONAL TREATMETN
* continuous aerosol bronchodilator * subcutaneous epinephrine * intravenous steroids * Magnesium sulfate * He/O2 therapy * inhaled anesthetics (isoflurane, sevoflurane, halothane)
254
# Asthma recommend comprehensive astham management program which includes
* patient and parent education * identification and avoidance/ management of triggers * peak flow monitoring * recognizing signs and symptoms of episodes * Asthma action plan
255
most common type of Pediatric Pneumonia?
Viral Pneumonia
256
most common cause of viral pneumonia
Respiratory suncytial virus
257

RRT (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions