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Medsurg > Respi p.2 > Flashcards

Respi p.2 Flashcards

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1
Q

closure / colapse of alveoli

A

atelectasis

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2
Q

causes of atelectasis

A

sx (thoracic or abdominal sx) result of anethesia
excess secretion of mucuos - blockage

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3
Q

Atelectasis obstructive

A

Blockage

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4
Q

atelectasis non obstructive

A

decrease ventilation

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5
Q

s/sx of atelectasis

A

Dyspnea / sputum prod / Cough / increase HR / increase RR / central cyanosis

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6
Q

when you auscultate atelectatis what sound will you heard?

A

crackles

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7
Q

when you chest xray pt. atelectasis what will you see

A

patchy infiltrates or consolidated areas

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8
Q

when you pulse ox patient with atelectasis what will you observe?

A

Decrease o2 saturation

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9
Q

Prevention of atelectasis?

A

Early ambulation
Turning
voluntary deep breathing every 2 hrs
used of incentive spirometry
coughing excercise
suctioning
CPT
Metered dose inhalers

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10
Q

goal of treatment of atelectasis

A

improve ventilation and remove secretion

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11
Q

inflam of the lung parenchoma

A

pneumonia

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12
Q

pneumonia cause

A

Bacteria / Virus / Fungi

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13
Q

4 types of pneumonia

A
  1. CAP - happen before 48 hrs / after 48hrs
    - S. pnemoniae / H. Influenza
  2. HCAP - Intial antibiotic Treatment should not be delayed
  3. HAP - 48 hrs or more after hospital
    - F. coli / H influenzae / Pseudomonas / Kles Pneumonae
  4. VAP - 48 hrs atleast
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14
Q

s/sx of pneumonia

A

fever / Increase RR / SOB / Sputum: purulent / rusty blood tinged sputum / crackels

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15
Q

dx of pneumonia

A

culture
cxr
sputum exam

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16
Q

Prevention of pneumonia

A

vaccination

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17
Q

Mngt of pneumonia

A

antibiotics
antipyretics
anti histamines
decongestant
02
hydration
bedrest
intubation
Warm moist inhalations

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18
Q

inflamation of the both layers of the pleurae

A

pleurisy

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19
Q

s/sx of pleurisy

A

Pleuritic pain / when deep breathing / coughing / sneezing worsing the pain

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20
Q

what finding when you ausculte patiet with pleurisy

A

pleural effeusion

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21
Q

mngt of pleurisy

A

discover cause / relieve pain
- analgesic / nsaid / Intercostal nerve block

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22
Q

nx Intervention Pleurisy

A

Splinting / turning frequently on affected side

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23
Q

Collection of fluid in the pleural space

A

Pleural effusion

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24
Q

normal pleural space

A

5-15 ml

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25
s/sx of pleural effusion
dyspnea / difficulty of breathing
26
when assessing pleural effusion what should you assess?
auscultation: Decrease breath sound Percusstion: Premitus Inspection: Tracheal Deviation CAR / VT scan : (+) presence of fluid
27
dx and treatment of choice of pleural effusion
thoracentesis
28
guidance of thoracentesis
UTZ ; avoid puncture of the lungs
29
when you repeat thoracentesis what happen to you?
can cause depletion of protein and electrolytes
30
obliterate the pleural space
chemical pleurodesis
31
use of agent that in chemical pleurodesis and instilled in??
Prevent accumulation of fluids that instilled into the pleural space with the use of chest tube using thorascopic approach / aerosolized
32
Pleural effusion clamped: for? time and change position??
tube for 60-90 mins ; Side side then unclamped
33
consist of 2 cath. that connects a pump chamber containing 2 one valves
pleuroperitoneal shunt
34
oleuroperitoneal shunt used
fluid moves from pleural cavity to peritoneal cavity
35
nx Intervention of pleural effusion
Position: sitting leaning forward Fluid : recorded Pain mngt: Analgesic frequent movement
36
sudden and life threatening deteroration of gas exchange fxn
Acutre respiratory failure
37
Define acute respiratory failure
Hypoxemia: decrease 60 mmhg or 02 Hypercapnia: Decrease 50 mmhg of Co2 with acidosis : Ph decrease 7.35
38
s/sx of acute respiratory failure
Restlessness / fatigue / HA / Dyspnea / Air Hunger / Tachycardia / Increase BP / Progression of hypoxemia : earlyy : restless ness increase HR and RR / Late: Cyanosis / Decrease RR
39
mngt of Acute respiratory failure and how to do it and define
1. ET intubation Insection: Aid by laryngoscope Positioned: 2cnm above the carina Balloon: Iflated Cuffe pressure: 20-25 mmhg Can be used no longer than 14-21 day - increase - tracheostomy 2. Mech vent -* Increase alarm : for the tubes for kinks * decrease alaram: For connections : Detach to reconnect
40
extubation of acute respiratory failure
Ambu bag and 02 at bedside
41
Pathophy of acute respiratory distress syndrome
severe inflam - process - diffuse alveolar damaged - sudden progressive pulmo edema / increase bilateral infiltrates / hypoxemia - unresponsive to oxygen supplementation
42
causes of acute respiratory distress syndrome
Aspiration / covid 19 pneumonia / drug overdose / fat embolism / hematologic disorder / infection / major surgeries / metabolic disorder / sepsis / shock / trauma
43
physical assessment of acute repisratory distress syndrome
Intercostal retractions Auscultate: Crackles
44
PEEP improves?
O2 - keep the alveoli open to prevent collapse improve arterial oxygenation
45
acute respiratory distress syndrome has no pharmacologic syndrome
true
46
what position when having acute respiratory distress syndrome?
prone
47
mech vent in acutre respiratory distress syndrome decrease what?
anxiety : sedation
48
if peep cannot be maintained despite the use of sedatives what to do?
neuromuscular blocking agents
49
Abnormal accumulation of fluid in the lung tissue
Pulmonary edema
50
pulmonary edema damage of pulmonary capillary edema
pulmonary edema
51
what increase in pulmonary edema
hydrostatic pressure
52
mngt pulmonary edema
02 / diuretics / antihypertensives / inotropes / airway / intubation / morphine / positioning / cardiac monitoring / fluid restriction
53
obstruction of the pulmo artery
pulmonary embolismcau
54
causes of pulmonary embolism
DVT / Atrial fibrial / air bubbles / fat embolism
55
s/sx of pulmonary emblism
SOB / chest pain / fainting / lightheadedness / bloody streaked mucus / dizziness / cold clammy skin / cyanosis
56
mngt for pulmonary embolism
anticoagulant thrombolytics vena cava filter Pulmonary embolectomy
57
Slow progressive respiratory disease of airflow obstruction involving airways
chronic obstructive pulmonary disease
58
presence cough and sputum production for atleast 3 months in each of 2 consecutive years
chronic bronchitis
59
hypersecretion of mucus
mucus plug
60
impaired gas exchange result from obstruction of the walls of over distended alveoli
emphysema
61
emphysema chest
barrel chest
62
chronic airway inflammation leads to?
astma airway hyperresponsiveness - mucosal edema - mucus production - cough / chest tightness / wheezing / dyspnea
63
is the key to asthma care
knowledge
64
complication of asthma
status asthamaticus / respi failure / pneumonia / atelectasis
65
mngt of asthma
pulmonary treatment focus: prevent impairment of lung function - decrease surgeries - prevent exacerbation
66
medications of asthma
- short acting beta 2 adrenergic agonist - albuterol - bronchodilation - anticholinergic - ipratoprium - decrease secretion - corticostroids - prednisone - decrease inflam - long acting - @night ; 12 hrs - leukotrine modifiers - montelukast
67
best manage by early treatment and education
astma exacerbation
68
Nx interventions of asthma
assess airyway for the first 12-24 hrs - increase oral fluid intake 3-4 L /dday - avoid irritants
69
more common than penetrating
blunt trauma
70
common cause of blunt trauma
vehicular accident
71

Medsurg (6 decks)

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