6B: RLD II Flashcards
What are some toxins that can lead to reduced lung compliance and volume?
Silicosis, BPD, lung cancer, pulmonary fibrosis, inhalation injury, radiation therapy, lobectomy, asbestosis, TB, sarcoidosis
What is pleural effusion?
Inflammation and fluid accumulation in the pleural space
What are causes of pleural effusion?
Infection, trauma, CHF, cirrhosis, pericardial disease that alters V/Q mismatch
What is the pathophysiology of the effects of pleural effusion?
Fluid and inflammation put pressure on the lungs and decrease the ability to inflate
What happens to lung volumes with pleural effusion?
Decrease
What happens to activity tolerance with pleural effusion?
Decrease
Is there pain associated with pleural effusion?
May have pain with inspiration
What are the four symptoms of pleural effusion?
- SOB and difficulty with deep breathing
- Decreased expansion on x-ray
- Bronchial or decreased breath sounds
- Decreased activity tolerance
What are the five causes of pulmonary edema?
- Increased pulmonary capillary pressure
- Increased negativity or interstitial pressure
- Altered alveolar/capillary membrane permeability
- Lymphatic insufficiency
- Unknown
How does fluid build up and cause edema?
Factors cause fluid to leak from the pulmonary and lymphatic system interstitially and into the alveoli
What does the build up of interstitial fluid cause?
Creates a barrier that makes gas exchange between the capillaries and the alveoli difficult
What is the effect of pulmonary edema on the heart?
Heart has to work much harder to gain sufficient levels of oxygen
Are O2 or CO2 levels affected more by pulmonary edema, and why?
O2 levels because CO2 is more soluble
What are key symptoms of pulmonary edema?
- SOB
- Increased RR
- Decreased lung volumes
What happens to PaO2 with pulmonary edema?
Decreased due to the V/Q mismatch
What will you see on x-ray with pulmonary edema?
Fluid accumulation
What heart symptoms will someone with pulmonary edema present with?
Signs of CHF
When auscultating, what sounds might you hear if someone has pulmonary edema?
Crackles or rhonchi
ARDS is the result of what?
Trauma, aspiration, overdose, inhaled toxin, shock, metabolic reasons, severe infection
What happens with ARDS?
Fluid fills in the alveoli
What are the five pulmonary effects of ARDS?
- Decreased lung volume
- Increased work of breathing
- Decreased surfactant
- Decreased breath sounds
- Wheezes or rhonchi
What are the three pulmonary effects of COVID?
- Fluid leaks into alveoli
- Inflammation of bronchial walls
- Fluid blocks smaller airways
What are the pulmonary symptoms of COVID?
- SOB and difficulty breathing
- Fluid in lungs
- Dry cough and sore throat
What will a chest x-ray look like with COVID?
Ground glass
What would require intubation with COVID?
Severe presentation, cytokine storm
What is the effect of rib fractures on the pulmonary system?
- Decreased respiratory depth
- Muscular splinting
- Decreased chest wall motion
What is a lung contusion?
Localized damage causing RBC and plasma to move into the alveoli that results in V/Q mismatch
What are the three clinical sings of rib fractures?
- Decreased rib excursion and lung volumes
- Pain with inspiration, weak cough
- Decreased breath sounds and ventilation
What clinical signs indicate are present with lung contusion?
- Decreased lung volumes
- Decreased breath sounds
- Poor ventilation, possibly visible clotted area on x-ray
What are interventions for lung contusion?
- Ventilation
- Deep breathing and positioning to increase PO2
- Mobility
- Observation of fluid volumes
What is atelectasis?
Air sac collapse, partial lung collapse
What happens with V/Q in the lung segment with atelectasis?
Decreased
What are some causes of atelectasis?
Phrenic nerve injury, SCI, post-surgical, trauma, muscular and bony changes
What are the five signs of atelectasis?
- Decreased breath sounds
- Decreased lung ventilation
- SOB
- Decreased rib excursion
- Decreased activity tolerance
