week 5 module 14 respiratory abnml

Question 1

HPI cough

Answer 1

onset
nature: dry or moist 
sputum production
sputum characteristics
pattern
severity
associated s/s
efforts to treat
postural influence
quality

Question 2

sputum characteristics of bacterial infection

Answer 2

yellow
green
rust
clear
transparent
purulent
blood streaked
sticky

Question 3

sputum characteristics of viral infection

Answer 3

blood streaked (not- common)

Question 4

sputum characteristics of chronic infectious disease

Answer 4

particularly abundant in the early morning
slight, intermittent blood streaking
occasional large amounts of blood

Question 5

sputum characteristics cancer

Answer 5

slight
persistent
intermittent blood streaking

Question 6

sputum characteristics infarction

Answer 6

blood clotted

large amounts of blood

Question 7

sputum characteristics TB

Answer 7

occasional large amounts of blood

Question 8

chest pain

Answer 8

onset and duration
- trauma, coughing, lower resp infection, recent surgery, hx thrombosis, prolonged immobilization
Associated symptoms
efforts to treat: heat, splinting, meds

Question 9

chest pain does not originate in heart when

Answer 9

constant ache that lasts all day
does not radiate
made worse by pressing on chest wall
fleeting, needle-like jab that last a few seconds
situated in shoulders or between the shoulder blades

Question 10

asthma patho

Answer 10

small airway obstruction due to inflammtation within the airways

• triggered by allergens anxiety, cold, exercise, URI, cigarette smoke
• > mucosal edema, inc. secretions, bronchoconstriction with inc. airway resistance

Question 11

asthma subjective

Answer 11

episodes of paroxysmal dyspnea
chest pain and tightness
may last for minutes, hours or days
may be asymptomatic between episodes

Question 12

asthma objective data

Answer 12

tachypnea and paroxysmal coughing with wheezing on expiration and inspiration
prolonged expiration
labored breathing
fatigue
anxious with inc. airway resistance
hypoxemia
dec. peak expiratory flow rate

Question 13

atelectasis patho

Answer 13

incomplete expansion of the lung at birth or the collapse of the lung
- caused by compression from outside or resorption of gas from the alveoli in the presence of airway obstruction

Question 14

atelectasis subjective

Answer 14

freq. seen in the postoperative setting

Question 15

atelectasis objective

Answer 15

auscultation dampened or muted in the involved area

XR: consolidation assoc. with postobstructive pneumonia

Question 16

bronchitis patho

Answer 16

inflammation of the large airways

-> inc. mucus secretions

Question 17

bronchitis subjective

Answer 17

acute: fever and chest pain possible

chronic bronchitis: cough may be productive

Question 18

bronchitis objective

Answer 18

hacking nonproductive cough
- minimal auscultation findings with no resp distress
wheezing or dampened auscultation when worsened

Question 19

pleurisy patho

Answer 19

inflammatory process involving the visceral and parietal pleura

Question 20

pleurisy subjective

Answer 20

sudden onset with chest pain when taking a breath
rubbing of the pleural surfaces can be felt by pt
pain referred to ipsilateral shoulder

Question 21

pleurisy objective

Answer 21

resp. are rapid and shallow with diminished breath sounds
pleural friction rub auscultated
fever possible

Question 22

pleural effusion patho

Answer 22

excessive nonpurulent fluid in the pleural space

Question 23

pleural effusion subjective

Answer 23

cough with progressive dyspnea

pleuritic chest pain w/ inflammatory effusion

Question 24

pleural effusion objective

Answer 24

auscultation and percussion vary with the amount of fluid present and position of patient
dullness and decreased tactile fremitus
- hyperresonant in area above.
mobile fluid with gravitate to dependent position
breath sounds muted in affected area

Question 25

empyema patho

Answer 25

purulent exudative fluid collected in the pleural space | - non-free flowing

Question 26

empyema subjective

Answer 26

``` often febrile and tachypneic cough and chest pain pt appears ill progressive dyspnea cough may produce blood or sputum ```

Question 27

empyema objective

Answer 27

breath sounds are distant or absent in affected area percussion is dull vocal fremitus is absent

Question 28

lung abscess patho

Answer 28

well-defined, circumscribed, inflammatory, and purulent mass that can develop central necrosis - aspiration of food or infected material

Question 29

lung abscess subjective

Answer 29

malaise fever SOB

Question 30

lung abscess objective

Answer 30

percussion is dull breath sounds distant or absent over affected area pleural friction rub may be present cough my produce purulent, foul-smelling sputum

Question 31

pneumonia patho

Answer 31

inflammatory response of the bronchioles and alveoli to an infective agent

Question 32

pneumonia subjective

Answer 32

``` bacterial infections can be rapid onset of - cough, pleuritic chest pain, dyspnea mycobacterial, fungal, atypical - onset of symptoms more insidious sputum production chills, fever, rigors N/V ```

Question 33

pneumonia objective

Answer 33

``` febrile tachypnea tachycardia crackles and rhonchi diminished breath sounds egophony, bronchophony, and whispered pectorioguy dull to percussion inc. fremitus over area of consolidation ```

Question 34

influenza patho

Answer 34

viral infection of the lung -> leaves pt more susceptible to secondary bacterial infection Entire respiratory tract may be overwhelmed by interstitial inflammation and necrosis

Question 35

influenza subjective

Answer 35

``` cough fever malaise HA ST common cold ```

Question 36

influenza objective

Answer 36

crackles wheezes rhonchi tachypnea

Question 37

tuberculosis patho

Answer 37

chronic infectious disease most often begins in the lung but may have widespread manifestations - inhaled from infected person

Question 38

TB subjuective

Answer 38

latent period - asymptomatic, some regional lymph nodes involved Active: - fever, cough, wt. loss, night sweats Hx of travel to region with endemic TB or close contact with infected person

Question 39

TB objective

Answer 39

latent: no findings active: - consolidation and/or pleural effusion may develop with corresponding findings - cough with blood streaked sputum

Question 40

pneumothorax patho

Answer 40

presence of air or gas in the pleural cavity | - may result from trauma or occur spontaneously

Question 41

pneumothorax subjective

Answer 41

minimal collections of air may be without s/s | larger: dyspnea and chest pain

Question 42

pneumothorax objective

Answer 42

breath sounds over pneumothorax are distant mediastinal shift with tracheal deviation can be seen unexplained but persistent tachycardia may be a clue to minimal pneumothorax

Question 43

hemothorax patho

Answer 43

presence of blood in the pleural cavity | - may be the result of trauma or invasive medical procedures

Question 44

hemothorax subjective

Answer 44

dyspnea lightheadedness decreased pulmonay function

Question 45

hemothorax objective

Answer 45

breath sounds distant or absent percussion dull fremitus and decreased tachycardia and hypotension with large blood loss

Question 46

lung cancer patho

Answer 46

bronchogenic carcinoma, malignant tumor - tobacco smoke - asbestos - ionizing radiation - inhaled carcinogenic agents

Question 47

lung cancer subjective

Answer 47

may cause cough, wheezing, hemoptysis | peripheral tumors w/out obstruction may be asymptomatic

Question 48

lung cancer objective

Answer 48

airway obstruction: postobstructive pneumonia can develop | malignant pleural effusion may develop

Question 49

pulmonary embolism patho

Answer 49

``` embolic occlusion of pulmonary arteries risks: - older than 40 - hx venous thromboembolism - surgery with anesthesia longer than 30 min - heart disease - CA - fx of pelvis or leg bones - obesity - acquired or genetic thrombophilia ```

Question 50

pulmonary embolism subjective

Answer 50

pleuritic chest pain with or without dyspnea

Question 51

pulmonary embolism objective

Answer 51

``` possible low grade fever or isolated tachycardia hypoxia dull to percussion decreased fremitus if there is effusion pleural friction rub possible ```

Question 52

epiglottitis patho

Answer 52

acute, life-threatening infection involving the epiglottis and surrounding tissues - Hib - strep

Question 53

epiglottitis subjective

Answer 53

begins suddenly and progresses rapidly without cough painful sore throat difficulty swallowing muffled voice

Question 54

epiglottitis objective

Answer 54

``` pt sits straight up with neck extended and head forward anxious and ill appearing unable to swallow -> drooling no cough high fever beefy red epiglottis ```