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NRSG 258 PATHO > Pulmonary Alterations > Flashcards

Pulmonary Alterations Flashcards

1
Q

hypovent

A

dec alveolar vent in relation to demand

min vol dec

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2
Q

hypervent

A 
ventil> demand
inc ph (repir alkal), dec po2 and pco2 (hypoxemia/ hypocapnia)
results- tissue ischem, coma, organ dysfunct
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3
Q

hypercapnia

A

inc CO2 in CSF
inc rate/ depth respir
dec pH (inc respir r)
causes- respir. acidosis/ depression nervo system, disease of medulla or spinal cord injury
results- cerbral vasodil = inc intracranial P

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4
Q

hypoxemia

A

dec O2 in blood
act. chemorecep
< 60 mmHg

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5
Q

O2Hb affinity- L and R shift

A 
ph- inc= inc affinity (lungs)
dec= dec aff (tissues)
temp- inc = dec aff tissue uploading
dec= inc aff- lung oxygenation
left shift= inc aff 
right shift= dec aff (O2 released)
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6
Q

hemoptysis

A

blood stained sputum

frm lungs, trach, larynx, bronchi

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7
Q

orthopnea

A

difficulty breathing when laying down

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8
Q

Kussmahl breathing

A

deep and labored, assoc w/ ketoacid. and renal failure

“hypervent”

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9
Q

ventilation perfusion inequality or mismatch

A

v/q
air in alveoli/ blood flow in cap
normal = 0.8-0.9

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10
Q

shunting

A

low v/q, dec vent to well perfused areas

results- dec o2 sat, dyspnea

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11
Q

alveolar dead space

A

high v/q, poor perfusion
cause- inc residual co2
inhaled air not participate in gas exchange= alv damage

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12
Q

hypoxemia

A

not enough o2 avaliable

cause- abnorm v/q, inc mem thickness, edema, dec surface area

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13
Q

zone 1 of lungs

A

alve P> arterial and venous

apex

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14
Q

zone 2 of lungs

A

arterial P > alveo P

venous P < alveo P

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15
Q

zone 3 of lungs

A

base

alveol P < arterial and venous P

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16
Q

acute respir failure

A

causes- lung / chest wall injury, spinal cord/ brain injury, pulm diseases, surgical complicat
inadeq gas exchange
po2> 50 mmHg= dec alveol vent
po2< 50 mmHg= dec exchan between alveol and cap

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17
Q

pleural effusion

A

fluid in pleural space (increases alvel. P but no collapse)
results- dyspnea, pleural pain (differen from chest wall pain w/ palpation!), compression atelectasis (lung collapse), muffled lung sounds

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18
Q

transductive effusion

A

(systemic)
from left heart failure
fluid comes from capil into pleural space

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19
Q

exudative (local)

A

from infection
fluid inc wbc and protein in pleural space
cause- infection, inflamm, cancer

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20
Q

hemothorax

A

blood in pleural cavity

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21
Q

empyema

A

pus in pleural space

common cause- pneumonia

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22
Q

pneumothorax

A

collection gas in pleural cav
results- atelectasis
symptoms- dependant on size, pain and speed

23
Q

primary pneumothorax

A

occurs idopathically

24
Q

pneumothorax- secondary

A

due to underlying dis.

25
pneumothorax-open
air in w/ inspiration, forced out w/ expir. "sucking wound" opening in chest wall
26
pneumothorax- closed
no hole in chest wall | secondary
27
charac of restrictive lung dis
dec lung compliance inc effort expand lungs during inspir inc respir r and dec tidal vol ex- pulm fibrosis or pulm edema
28
charact of obstructive lung dis
``` air obstruction worsens w/ expriation inc effort during expir symptoms- dyspnea and wheezing ex.- emphysema and asthma dec FEV forced expiratory vol results- v/q mismatch, respir failure, cor pulmonae ```
29
pulm edema
excess fluid in lungs restrictive causes- L sided heart failure, toxic gas inhal, ARDS results- dyspnea, inc effort breathing, inspir crackles, hypoxemia, pink frothy sputum
30
acute respir distress syndrome (full) ARDS
restrictive alveolar injury causes- trauma, sepsis treatment- mechanical vent progession- hypervent, respir alkalosis, dyspnea, metab acidosis, repir acidosis, hypoxemia, hypotension, dec cardiac o, death treatment- maintain o2 and vent, prevent infection, steroids, supportive therapy
31
classic ards-manifes
dyspnea, inspir crackles, dec lung complian, hypoxemia (unrespon to suppor. O2) respir alkalosis
32
progessive ARDS- manifes
dec tissue perfu, organ dysfun, metab acidosis, inc effort breathing, dec tidal vol, hypovent, respir acidosis, hyoxemia, hypotension, dec cardiac O, death
33
COPD chronic obstructive pulmon disease
obstructive inc inflam, dec elasticity air trapping- bronchial walls collapse (thickens or covered w/ mucus) v/q mismatch, hypoxemia, alveo collpase
34
chronic bronchitis- criteria and irritants
criteria- 3 mon/year and 2 consecut years hypersecret mucus and chronic productiv cough normal inc size and number endothelial cells, edema, thickening bronchial walls, impaired cilliary function= inc susceptibility to infection results- bronchospasms w/ dyspnea
35
chronic bronchitis- manifes, trtment, management
treatment- bronchodial, antib manifest- productive cough, tachypnea, dyspnea, thick secretions, hypoxia, cyanosis, hypercapnia, polycythemia, weight loss management- education (dec exposure irritants), treat infection, vacc for prophylaxis, expectorants (breakdown mucus), bronchodial (prevent bronchospasms, dec o2 flow
36
emphysema
brkdn alveol wall dec sa for gas exchange, loss pulm cap, loss elasticity, altered v/q causes- fribrosis progression- dec expiration = overinflation (air trapping), barrel chest, rib fixation, flattened diaph progession (advanc)- loss tissue, hypercap, infections, damaged alv = lrg air spaces, pneumothorax (air in pleural cav), weight loss, fatigue, clubbed fingers treatment- hydration, good nutr, lung reduction surgery
37
asthma
obstruc symptom- dysp, wheezing, tight chest cause- inflam response, vasodil, cap perm, edema, muscus production, thickened airway, broncial sm musc spasms (hyperresponsiveness) treatmnt- steroids results- hypervent, airway obstruct, hypoxemia, dec expiration, respir acidosis
38
asthma atopic v non-atopic
atopic caused by allergies
39
laryngotracheobronchitis (CROUP)
triggered w/ acute infection upper airway risk- 6 mon-5yrs, boys, late fall/winter symptoms- chest wall indrawing, throat swelling, barkin cough, fever *worse at night management- cool moist air, corticosteroids, nebulized epinephrine
40
pneumonia
lwr respir tract infection lung inflamm alveol filled w/ fluid (bac, viral, fungi or parasites) caused- inhal organism, act inflamm response
41
pneumonia- community-acquired
viral or bac | affects healthy and immunocomp
42
pneumonia- nosocomial (hospital-acquired)
bac gram - Pseudomonas does not infect healthy ppl treatment- antib, incentive spir, C+DB cough and deep breath, movement
43
pneumonia- lobar
``` bac- streptococcus (gram+) localized or systemic (1+ lobe) common young adults "walking pneum" droplet transm = inflamm response sympt- fever, cough, fatigue ```
44
pneumonia- fungal
risk- immunocomp caused- Histoplasma capsulatum id w/ specfic lobe effected
45
pneumonia- parasitic
enter through skin or swallowed, travel to lungs dec o2 transport attract eosinoph common antigen- toxoplasma gondii and ascarisis
46
pneumonia- viral
common causes- influenza, rsv (repir syncytial virus) leads to secondary infection bronchial epith sloughs manifesti- fever, chills, productive or dry cough, pleural pain, dyspnea, hemoptysis (coughing up blood)
47
tuberculosis
antigen- mycobacterium tuberculosis airborne droplet transm lodge in upper lobe= act inflam response symptoms- fever, cough, bloody sputum, weight loss, night sweats treatment- antib bac can become dormant = latent infection dev scar tissue around tubercle (caseous necrosis)
48
pulmonary embolism (PE)
bloackage main artery/ branch lung caused by thrombus or emboli (DVT) obstruction reaches lungs= inc right vent P risks- hypercoagulability, endoth vessel wall injury, venous stasis (slow blood flow) trtmnt- filter into vena cava, mech vent, embolectomy, admin heparin or streptokinase (anticoag)
49
pulmonary embolism (PE)- small emboli
manifes- cough, dyspnea, transient chest pain
50
pulmonary embolism (PE)- large emboli
inc chest pain, dyspnea, coughing, hempytisis, fever, hypoxia, anxiety, tachyc, restlessness, cyanosis, dec o2, pallor
51
pulmonary embolism (PE)- massive emboli
hypotension, severe chest pain, rapid-weak pulse, palpitations, loss of consiousness, shock
52
cystic fibrosis
CF scarring/ cyst formation in pancreas bc- gene mutation with CFTR messes w/ sweat, NaCl balance, digestive juices and mucus risks- caucasian can be diag before birth progression- need lung transplant, require protein, diet management (nutrients not absorbed, bc bile not excreted)
53
SIDS sudden infant death syndrome
risks- <1yr peaks at 2-4 month, more common males usually happens when sleeping inc risk- immunocomp or those exposed to environ stressors
54
pulmonary system aging
dec chest wall compliance and elasticity (recoil) dec ventilatory reserve dec SA gas exchange and cap perfusion dec exercise capacity

NRSG 258 PATHO (3 decks)

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