respiratory system Flashcards
(98 cards)
1
Q
acute otitus media
A
infection that lasts for up to 6 weeks
2
Q
chronic otitus media
A
chronic tissue damage that has an irreversible pathology
3
Q
peak age of otitis media
A
6-18 months
4
Q
otitis media is the most common disease in children in under the age
A
of 5
5
Q
OM becomes bilateral how often?
A
50% of the time
6
Q
OM and effusion
A
OM can occur with or with out effusion
7
Q
OM can be infectious or it can be
A
non infectious
8
Q
common in children under 3 years old because
A
they have a wider straighter shorter eustatian tube
9
Q
OM can cause inflammation where?
A
surrounding lymphoid tissue (AKA adenoid lymphoid hypertrophy)
10
Q
there is obstruction the pharynx due to
A
enlargement and secretions
11
Q
risks of OM
A
infection
perforated tympanic membrane
hearing loss
disequilibrium
12
Q
common surgical interventions for OM
A
tympanoplasty (or reconstruction of the tympanic membrane)
13
Q
predisposing factors for OM
A
cleft pallate immune defficency allergic rhinitis sinititus down syndrome upper respiratory infections
14
Q
other risk factors for OM
A
passive smoking
poor feeding habits
day care
15
Q
20-40% of pediatric office visits have to do with what?
A
OM
16
Q
in acute otitis media a bacterial infection accompanies a
A
viral URI infection
17
Q
eustachian tube dysfunctions
A
secretions access middle ear via eustacian tube
18
Q
otorrhea
A
discharge from the ear = perforated tympanic membrane
19
Q
clinical manifestaions of OM
A
unilateral, bilateral in children otalgia (pain in ear) fever (often afebrile) nasal discharge cough irritable pulling at ear URI (upper respiratory infection) diahhrea, vomiting, anoxeria falls conductive hearing loss strep throat
20
Q
antibiotic treatments of OM
A
antibiotics amoxicilin cefaclor co-trimoxazole ciftriaoxone
21
Q
analgesics and antipyretics used for OM
A
acetaminophen
ibuprofen
22
Q
other treatments for OM
A
hydration
position on uneffected side
23
Q
surgical interventions for OM
A
Myringomectomy
incision in the tympanic membrane
24
Q
what is asthma?
A
chronic inflammation of the airways that causes airway hyper responsiveness mucosal edema and mucus production
25
inflammation leads to reccurent episodes of
cough
chest tightness
wheezing and dyspnea
26
unlike other COPD
asthma is reversible with or with out treatment (spontaneously sometimes)
27
does asthma lead to long term airway narrowing?
yes, due to changes causes by the chronic inflammation
28
Narrowing airway includes
bronchoconstriction, airway edema, airway remodling (causes by chronic inflammation, the airway changes its shape)
29
hypoxemia can occur
in asthma
30
three common symptoms of asthma
dysnpea
cough
wheezing
31
common triggers (allergins)
grass
trees
weeds and pollen
32
common triggers (pereninnal)
mold
dust
roaches
animal dander
33
common triggers for asthma
```
air pollutants
cold
heat
weather changes
strong odors/ perfumes
smoke
exercise
viral infections
stress
medications
occupational exposure (nuts and shellfish)
```
34
treatment of asthma
antiinflammatory medications
35
short acting treatments of asthma
relax smooth muscles
| relieve acute symptoms onset by stress and exercise
36
Long acting treatments of asthma
corticosteroids
most potent and effective treatment of asthma
use with a spacer and patient should rinse their mouths to prevent thrush
37
commonly used long acting treatments
corticosteroids
theophylline- mild bronchodiolator
Salmeterol and Formoterol
38
commonly used short acting treatments
```
beta-andergenic agonists
Albuterol
Proventil
Ventolin
Levalbuterol
Pirbuterol
```
39
thrush
fungal infection on skin or mucus membranes
40
what is croup?
an acute infection of the upper and lower respiratory tract that occurs in children 3mo-3yrs after an URI
41
croup is characterized by
hoarseness
irriability
fever
brassy cough, dysnpea, and tachynpea, resulting from the obstruction of the larynx
cyanosis and pallor occurs in severe cases
42
interventions for croup
bed rest
fluid intake
allevation of airway obstruction to ensure adequate respiratory exchange
provide humidity and monitor for signs of distress
43
what is tonsillitis?
inflammation of the tonsils usually due to an URI
44
Acute tonsillitis can be confused with
pharyngitis
45
chronic tonsillitis can be mistake for other disorders such as
allergy
asthma
rhinosinitus
46
tonsillitis can occur where?
adenoid or pharyngeal tonsils
47
why does tonsillitis occur after a Uri
because the bacteria is inhaled and can get into the tonsils
48
symptoms of acute tonsilitis
sore throat
fever
snoring
difficulty swallowing
49
enlarged adenoids causes
```
mouth breathing
ear ache
draining in ear
frequent head colds
bronchitis
foul smelling breath
voice impairment
noisy respiration
```
50
why does tonsilitus present this way?
enlargement of the tonsils causes filling behind the nares, making it difficult for air to travel from the nose to the throat resulting in nasal obstruction. the infection can also travel through the eustain tubes causing acute otitis media which can lead to tympanic rupture
51
medical treatment of tonsilitis
```
increase fluid intake
salt water gargles
rest
anaglesics
bacterial infections are treated with penicillin (or cephalosporins)
```
52
post op position for tonsilectomy
prone to allow draniage from the phayrnx and mouth (with head turned to the side)
53
pt may not return to a normal position and oral airway must not be removed until
gag reflex has returned
54
risk of hemorrhage mean that
there is risk for damage to the patients airway
55
bleeding is common however
excess bleeding needs to be reported
56
teach patient that
bleeding may occur up till 8 days after surgery
sore throat
stiff neck
minor ear pain
vomiting
all may occur in the first 24hrs after surgery
57
encourage what? after tonsillectomy
ice chips, soft foods and liquids
58
apply what? after tonsillectomy
ice collar
59
pulmonary perfusion
blood flow through the respiratory system
60
goal of oxygen therapy
provide adequate transportation of oxygen in the blood while decreasing the work of breathing and reducing the stress on the myocarduim
61
oxygen transport is dependent on
cardiac output
hemoglobin
arterial oxygen content
metabolic requirements
62
hypoxemia
decrease in the arterial oxygen saturation (low o2 in blood)
63
manifestation of hypoxemia
changes in mental status
impaired judgement
agitation, confusion, disorientation, confusion, lethargy, increased BP, changes in HR, dysrythmias, central cyanosis, disphoresis, cool extremities
64
hypoxemia leads to
hypoxia
65
what is hypoxia?
decrease in oxygen saturation of tissues severe hypoxia is life threatening
66
rapidly occuring hypoxia leads to changes in what?
central nervous system
lack of coordination or impaired judgement
fatigue, drowsiness, apathy, inattentiveness, delayed reaction
67
hypoxia can occur in patients with
COPD, CHF
68
hypoxia is assessed by
ABGS, pulse ox, clinical evaluation
69
hypoxia is the leading cause of
post op mortality and morbidity
70
indicators of poor respiratory status
```
confusion
restlessness
diaphoresis
pallor
tachycardia
tachypnea
hypertension
```
71
preoperative risk factors
```
preexisiting
medications
life style
weight
age
```
72
intraoperative risk factors
location of incision
horizontal vs vertical
anesthia
duration of anesthia
73
when pt coughs
have them hold a pillow over their chest
74
post op risk factors
having an NG tube in longer that 24hrs
immobilization
pain
75
hypoventalion causes
decreased o2 transfer
mild hypoxemia
moderate hypoxemia
respiratory acidosis
76
causes of post op hypoventilation
```
residual paralysis
airway resistance
increased tissue resistance
lung and chest compliance
obesity
abdominal distension
dressings and casts
```
77
what is atelectasis?
incomplete expansion of the lung or part of the lung
78
Microatelectasis
involves the collapse of aveoli
79
macroatelectasis
collapse of a lobe or lung, normally not bilateral
80
atelectisis can is caused by
intrinsic obstruction
extrinsic airway obstruction
lung tissue may be compressed
aveoli may be incompletely and eventually collapse
81
acute atelectisis
closure or collapse or airless condition of the aveoli caused by hypoventilation or obstruction of the airway
82
chronic atelectisis
with out enough surfactant lungs may collapse
83
acute atelectasis is usually a
post operative complication
84
clinical manifestations of atelectasis
```
insidious
cough
sputum
acute marked distress
chronic, similar to acute
pt may be anxious
```
85
universal sign of atelectasis
low grade fever
86
nursing diagnosis for atelectasis
```
ineffective airway
ineffective gas exchange
infection
activity intolerance
altered mobilization
```
87
nursing interventions for atelectasis
```
education
auscultation
pulse ox
t and p
cough/deep breathe
incentive spirometry
suctioning
ambulation
chest physiology
thoracentesis
mechanical ventilation
bronchodialators
```
88
thoracentesis
procedure that removes the fluid from the pleural space
89
what is pneumonia?
lower respiratory infection
most common cause of death from infectious disease, at all ages
8th leading cause of death
treated inpatient and outpatient
caused by bacteria, myobacteria, fungi, parasites, viruses
90
community acquired pneumonia
```
common cause strep pneunomia
all ages in children- URI
acute symptoms
Gold standard CXR
treatment 10-14 days of antibiotics
fluids and rest
occurs in community or 48hrs after hospitalization
```
91
hospital acquired pneumonia
```
nosocomial
common causes- staph, strep, psuedomonas, MRSA
CBC, CXR, blood culture, sputum culture
colonized by multiple organisms
occurs 48 hours after admission
```
92
immunocompromised pneumonia
caused when a pt is immunocompromised and cannot fight of the infection
93
aspiration pneumonia
inhalation of gastric content
regurgitation is silent
chemical irritation and pneumonia
signs and symptoms depends on severity
prevention and reduction of complications
can cause tachycardia, dysnpea, cyanoisis, hyper or hypotension, death
94
clinical manifestations of pneumonia
```
depends on extent and location
depends on cause
depends on patients condition
predominant symptoms
low grade fever, cough, myaglia plueratic pain, mucoid sputum
```
95
inoculum
introduction of microorganisms or pathogens into the body
96
gold standard cxr
review of cxr by 3 radiologists
97
ventilation associated pneumonia
type of pneumonia that occurs >48hrs after ventilation
98
causes of aspiration pneumonia
brain injury, decreased LOC, drug or alchohol, intoxication, seiziure activity, flat body positioning, stroke, swallowing disorders,v
