6C: RLD III Flashcards
What is a PE?
Thrombus from a clot travels through the vein system to the right side of the heart and then lodges in a pulmonary artery
What is the primary effect of PE?
Causes blockage of blood flow at an area of the lung so no perfusion or gas exchange can occur
What are other possible effects of PE?
- Edema and hemorrhage at site of blockage
- Edema triggers inflammatory process
- Alveolar collapse causing regional atelectasis
Why is the location of a PE significant?
Determines the severity of the impairment
What location of a PE is most severe?
In a more proximal artery due to larger area of ischemia
Is PE life threatening?
Yes if the clot is large enough, but only 10% result in death
What % of surgical deaths is the result of PE?
3%
What are the three clinical pulmonary signs of PE?
- Acute SOB
- Fatigue and malaise
- Decreased breath sounds, possibly wheezing
How will x-rays and labs look with a PE?
Normal
What non-pulmonary symptoms may a person with PE have?
- Syncope
- LE pain
- Chest pain (pleuritic)
How is PE diagnosed?
V/Q scan, pulmonary angio, spiral CT
What is pneumonia?
Acute inflammation of the lungs due to bacteria, virus, or fungus
How does pneumonia develop?
- Inflammatory process due to pathogen
- Increase in fluid for pathogen to multiply in
- Limits body’s ability to fight pathogen
Describe fluid that is infiltrating vs consolidating
Infiltrating: fluid accumulating in lung
Consolidation: when fluid fills an entire lung segment
What happens when an entire lung segment fills with fluid with pneumonia?
V/Q mismatch
What are risk factors of pneumonia?
- Age
- Immune or respiratory dysfunction
- Surgery, trauma to head/chest
- Increased exposure to pathogens
- Smoking
- Prolonged use of ventilator
What are the symptoms of pneumonia?
- Fever
- Productive cough with yellow or green infectious material
- Increased WBC
- Fatigue, dyspnea, weight loss, tachypnea
What is BPD?
Bronchopulmonary dysplasia
When does BPD develop?
Infants with respiratory distress syndrome, meconium aspiration
What infants are at risk for BPD?
On ventilator or long term O2
What is the pulmonary impact of BPD?
- Decreased surfactant, high surface tension leading to atelectasis
- Hypertrophy
- Fibrosis of airways
What clinical signs will you see with BPD?
- Increased RR
- Cyanosis
- Rales or grunting
What is Idiopathic Pulmonary Fibrosis (IPF)?
Progressive and irreversible inflammation that leads to scarring and fibrosis of the alveolar walls
What is the life expectancy with IPF?
Survival time of three years after diagnosis - will qualify for transplant
What are the signs of IPF?
- Decreased lung volumes
- Decreased surface for gas exchange
What other pathologies can cause decreased compliance and ventilatory capabilities?
Aging, ankylosing spondylitis, RA, SLE, scleraderma, polymyositis, pneumothorax, hemothorax
What happens with thermal injury?
Bronchospasm, problems with the mucociliary escalator, increased mucous production
What happens as CO2 bings to Hbg with thermal injury?
Less ability for O2 to bind
How can skin injury affect the pulmonary system?
Decreased extensibility to allow for proper thoracic excursion
What pulmonary symptoms can result from burns?
- SOB, may need ventilator
- Pulmonary edema
- Peripheral edema
- Decreased lung volumes
- Decreased rib excursion
- Increased body temp
What is the increased in body temp with burns significant?
Increased body temp leads to increases in O2 dissociation
