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Respiratory Emergencies > Respiratory Diseases and Disorders > Flashcards

Respiratory Diseases and Disorders Flashcards

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1
Q

Disorders of Obstruction

A
  • Asthma
  • Status asthmaticus
  • COPD (chronic bronchitis, Emphysema)
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2
Q

Pulmonary Disorders

A
  • Acute Respiratory failure
  • Adult Respiratory distress syndrome
  • Aspiration
  • Hypo/hyperventilation
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3
Q

Respiratory Tract Infections

A
  • Pneumonia
  • Pleurisy
  • Pleural Effusion
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4
Q

Pulmonary Vascular Disease

A
  • Pulmonary edema
  • Pulmonary embolism
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5
Q

Chronic inflammatory disorder of the lower airways. Obstruction increases resistance to flow

A

Asthma

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6
Q

2 Types of Asthma

A
  1. Intrinsic
  2. Extrinsic
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7
Q

Not associated with specific antigen-antibody reaction

A

Intrinsic Asthma

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8
Q

Specific antigen-anitbody reaction (common in children)

A

Extrinsic Asthma

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9
Q

Common Triggers of Asthma

A
  • External or environmental factors (pollen, dust, feathers, foo, drugs)
  • Infections
  • Cold air
  • Chemical irritants
  • Tobacco smoke
  • Exercise
  • Emotional stress
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10
Q

Progression of Asthma

A
  1. Antigen is inhaled to lower airway
  2. Sensitized IgE antibodies trigger mast-cell degranulation in submucosa
  3. Mast-cell membrane ruptures releasing
    - Histamine
    - Leukotrienes
    - Prostaglandins
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11
Q

Phase 1 of Asthma

A

Within minutes of exposure
1. Bronchial smooth muscle contraction (Bronchoconstriction)
2. Fluid leakage from peribronchial capillaries (bronchial edema)

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12
Q

Phase 2 of Asthma

A

~3-4 hours later cells of the immune system invade respiratory submucosa, resulting in:
1. Sustained bronchiole inflammation
2. Increased mucous production
3. Bronchial edema

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13
Q

Classifications of Asthma Severity

A
  1. Mild Intermittent
  2. Mild persistant
  3. Moderate persistant
  4. Severe persistant
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14
Q

Treatment for Asthma

A
  1. Correct hypoxia (O2)
  2. Reverse Bronchoconstriction
  3. treat inflammation and edema
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15
Q

Severe prolonged attack that cannot be broken by bronchodilators

A

Status Asthmaticus

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16
Q

Signs and Symptoms of Status Asthamticus

A
  • Similar to asthma, however bronchodilators don’t help
  • Greatly diminished breather sounds
  • Imminent Respiratory Arrest
  • Pulsus paradoxus (systolic drop 10 mmHg or more)
  • Pneumothorax may occur due to air trapping and pressures
  • Silent chest with PCO2 > 70 mmHg
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17
Q

Treatment for Status Asthmaticus

A
  • Rapid transport is imperative
  • Administer high-concentration oxygen
  • Anticipate need for intubation and aggressive ventilatory support
  • Dehydrated common so IV fluid administration may be required
  • Closely monitor the patient’s respiratory status
  • Continuous bronchodilator therapy may be ordered
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18
Q

Hypersecretion of mucous and chronic productive cough that continues for at least 3 months/year or 2 consecutive years

A

Chronic Bronchitis

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19
Q

Blue Bloaters

A

Chronic Bronchitis

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20
Q

History for Chronic Bronchitis

A
  • Frequent respiratory infections
  • Productive cough
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21
Q

Inspection findings for Chronic Bronchitis

A
  • Often Overweight
  • Pursed-Lip Breathing
  • JVD
  • Ankle Edema
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22
Q

Lung sound for Chronic Bronchitis

A

Rhonchi

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23
Q

Management of Chronic Bronchitis

A
  • Relieve hypoxia (seated semi-fowlers, O2 prn to maintain SpO2> 90%, IV NS TKVO)
  • Reverse bronchoconstriction (bronchodilator nebulized)
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24
Q

Destruction of the alveolar walls distal to the terminal bronchioles that causes abnormal enlargement of gas exchange airways and loss of elastic recoil. Decrease in diffusion.

A

Emphysema

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25
Pink Puffers
Emphysema
26
History for Emphysema
- Recent weight loss - Dyspnea with exertion - Cigarette and tobacco usage common - Lack of cough except in the AM
27
Inspection finding for emphysema
- Thin - Barrel chest - Pink skin due to extra red cell production (Polycythemia) - Hypertrophy of accessory muscles
28
Percussion finding with Emphysema
Hyperresonance
29
Lung sounds for emphysema
- Wheezes and rhonchi - Prolonged expiration
30
Emphysema management
- STOP SMOKING - Relive hypoxia (semi-fowlers, O2 prn to maintain SpO2 >90%, IV NS TKVO) - Reverse Bronchocontriction (Anticholinergic inhaled/nebulized, B2-adrenic agonist inhaled/nebulized)
31
Form of pulmonary edema that is caused by fluid accumulation in the interstitial space within the lungs
ARDS
32
Precipitating factors of ARDS
- Sepsis - Aspiration - Pneumonia - Pulmonary injury - Burns/inhalation injury - Oxygen toxicity - Drugs - High altitude - Hypothermia - Near-drowning syndrome - Head injury - Pulmonary Emboli - Tumor Destruction - Pancreatitis - Invasive procedures - Bypass, hemodialysis - Hypoxia, hypotension, or cardiac arrest
33
Pathophysiology of ARDS
- Disruption of the alveolar-capillary membrane - Affects interstitial fluid
34
Treatment of ARDS
- Manage underlying condition - High-concentration O2 (CPAP, PEEP) - IV access - Pulse oximetry, ECG - RApid transport - Use of pharmacological agents
35
Passage of fluid and solid particles into lungs
Aspiration
36
Signs and Symptoms of Aspiration
- Decreased LOC or CNS causing cough reflex - abnormal swallowing mechanism
37
Predisposing Factors for Aspiration
- Substance abuse - Sedation - Anesthesia - Seizure disorder - CVA - Myasthenia gravis (neuro disorder) - Guillain-Barr's syndrome (inflammation of nerves)
38
History taking for Aspiration
- Sudden onset of choking - May be fever, dyspnea, wheezing
39
Aspiration Management
- Prevention - Standard dyspnea treatment pre-hospitally - ??PEEP - ??Antibiotic
40
Ventilation that exceeds metabolic demands
Hyperventilation Syndrome
41
Common Causes of Hyperventilation Syndrome
- Anxiety - Hypoxia - Pulmonary disease - Cardiovascular disorders - Drugs - Fever - Infection - Pain - Pregnancy
42
Signs and Symptoms of Hyperventilation Syndrome
- Dyspnea with rapid breathing and high minute volume - Chest pain - Circumoral tingling - Carpopedal spasm - Other assessment findings will vary, based on the cause of the syndrome
43
Infection of the lower respiratory tract
Pneumonia
44
Types of Pneumonia
- Bacterial - Viral - Aspiration
45
- Hospital acquired vs community acquired - Inhalation of microorganisms - Infection can spread throughout lungs - Alveoli may collapse, resulting in ventilation disorder
Bacterial and Viral Pneumonia
46
History Assessment for Pneumonia
- Generally, appear ill with generalized weakness and malaise - Recent Hx of fever and chills - Deep, productive cough (yellow to brownish sputum)
47
Inspection finding for Pneumonia
Pleuritic chest pain (sharp, tearing pain)
48
Auscultation finding for Pneumonia
- Inspiratory crackles with decreased air movement in involved segment - Egophony
49
Management of Pneumonia
- Adequate ventilation and oxygenation (semi-fowlers, O2 prn to maintain SpO2 > 90%, IV NS TKVO) - Reverse Bronchospasm prn (symptomatic relief) (B2-adrenergic agonist inhaled/nebulized) - In-hosptal: - X-ray/lab confirmation - Antibiotic therapy (bacterial)
50
Inflammation of the pleura
Pleurisy
51
Pleurisy Pathology
Frequently preceded by upper respiratory infection
52
History finding for Pleurisy
- Chills - Fever
53
Inspection finding for Pleurisy
- Pleuritic chest pain (sharp, tearing) on inspiration - Pain may also be referred to shoulder
54
Auscultation findings for Pleurisy
Pleural friction rub may be heard over affected area
55
Pleurisy Management
- Adequate ventilation and oxygenation (semi-fowlers, O2 prn to maintain SpO2 > 90%) - ECG - IV NS TKVO - If unsure of cause of chest pain, treat according to chest pain protocol
56
Presence of fluid in the pleural space
Pleural Effusion
57
Sources of fluid in Pleural Effusion
- Blood vessels - Lymph nodes - Abscess - Inflammation of tissue - CHF
58
History Findings for Pleural Effusion
- Chills - Fever
59
Inspection finding for Pleural Effusion
- Pleuritic chest pain (sharp, tearing pain) on inspiration - Pain may also be referred to shoulder
60
Auscultation findings for Pleural Effusion
Pleural friction rub may be heard over affected area
61
Management of Pleural Effusion
- Adequate ventilation and oxygenation (semi-fowlers, O2 prn to maintain SpO2 > 90%) - ECG - IV NS TKVO - if unsure of cause of chest pain, treat for chest pain protocol
62
A condition characterized by an abnormal collection of fluid in the lungs
Pulmonary Edema
63
Assessment for Pulmonary Edema
Diaphoresis, pallor and pitting edema are commonly found
64
Lungs Sounds for Pulmonary Edema
- Mild to moderate presents with crackles in bases of lungs upon inspiration - Moderate to Severe produce coarse crackles heard throughout all lungs lobes during both inspiration and expiration - Tactile fremitus may also be present, palpating abnormal chest wall vibrations as a patient speak
65
Management of Pulmonary Edema
- High flow O2 - If SpO2 < 85% despite basic O2 therapy, advanced airway management with PEEP may be indicated - Rapid transport
66
Occlusion of a portion of the pulmonary vascular bed by an embolus
Pulmonary Embolism
67
What can cause a Pulmonary Embolism
- Thrombus - Tissue fragment - Lipids - Air embolus
68
History findings for Pulmonary Embolism
- Sudden onset of dyspnea - Pleuritic chest pain - Unproductive cough (rare hemoptysis) - Recent Hx immobilization (trauma, inactivity)
69
Inspection findings of Pulmonary Embolism
- Laboured breathing - Tachypnea, tachycardia - S&S of right sided failure (JVD, hypotension)
70
Auscultation of Pulmonary Embolism
- Usually unremarkable - Occasionally crackles, wheezes may be noted
71
Assessment findings for Pulmonary Embolism
- Check extremities for S&S of deep vein thrombosis (DVT) (warm, swollen extremity, thick cord palpated along medial thigh, pain on palp or calf extension) - Extreme S&S include: confusion, cyanosis, hypotension, cardiac arrest, petachiae)
72
Pulmonary Embolism Management
- Maintain airway - Support breathing - IV NS TKVO - Monitor vitals - Transport in position of comfort - Definitive care requires hospitalization and thrombolytic or heparin therapy - Prepare for cardiac arrest

Respiratory Emergencies (7 decks)

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