Acute Lung Problems

Question 1

Excess fluid in the lungs resulting from inflammatory process (causes atelectasis and hypoxemia)

Answer 1

Pneumonia

Question 2

Causes of pneumonia

Answer 2

infectious organisms (strep and staph are most common)

inhalation of irritants

Question 3

Physical assessment findings of pneumonia

Answer 3

adventitious breath sounds: rales/crackles, rhonchi, or wheezing

Might have diminished breath sounds

dyspnea, increased RR, hypoxemia

Question 4

Risk factors for pneumonia

Answer 4

age, smoking, comorbidities (COPD), anything that would decrease immune system (DM, HIV, lung cancer)

Question 5

Ways to prevent ventilator-associated pneumonia (VAP)

Answer 5

mouth care: decreases bacteria in the mouth and risk for infection

Raise HOB and turn frequently: Keeps secretions moving

Protonix: decreases acid reflux and risk for aspiration

Hand hygiene

Question 6

Caused by the coronavirus

Triggers inflammatory response in the respiratory tract

Answer 6

severe acute respiratory syndrome (SARS)

Question 7

Diseases that require a N95 mask (airborne)

Answer 7

corona virus, TB, anthrax

Question 8

Clinical manifestations of TB

Answer 8

Low-grade fever, night sweats, cough, nausea, anorexia, fatigue

Question 9

Diagnostics for TB

Answer 9

Tuberculin (Mantoux) test - PPD induration of 10 mm or greater = positive for exposure but doesn’t mean you have the disease

Sputum culture - gold standard dx (negative culture means they aren’t infectious)

Question 10

Interventions for TB

Answer 10

Meds: Isoniazid and Rifampin (antibiotics)

Education is priority so that they don’t expose other people and know how to take meds appropriately

Follow up visits: can’t take 9 months to eradicate TB

Question 11

Localized area of lung destruction caused by liquefaction necrosis usually r/t bacteria

Answer 11

lung abscess

Question 12

Interventions for lung abscess

Answer 12

drain abscess, antibiotics, frequent mouth care for Candida albicans (fungal infection from antibiotic use)

Question 13

Bacterial infection from contaminated soil/livestock

Answer 13

Anthrax (Bacillus anthraces)

Progresses from flu like symptoms to respiratory collapse and septic shock

Question 14

Collection of pus in pleural space

Answer 14

Pulmonary empyema

Caused by pulmonary infection, lung abscess, and infected pleural effusion

Question 15

Interventions for pulmonary empyema

Answer 15

Drain it w/ thoracentesis, re-expand lung, control infection w/ antibiotics

Question 16

Where are chest tubes placed?

Answer 16

pleural space

Question 17

What do you do if you see continuous bubbling in the water-seal chamber?

Answer 17

Suspect an air leak in the system and check connections

Do not milk, strip, or clamp the chest tube

Question 18

What do you if a chest tube disconnects from the chamber?

Disconnects from the patient?

Answer 18

Put the end of the tube in a cup of sterile water

petroleum gauze taped on three sides

Question 19

Pulmonary Contusion

Answer 19

asymptomatic at first but can develop into respiratory failure

reduced lung movement and area for gas exchange leads to hypoxemia

Question 20

Complications of rib fractures

Answer 20

pulmonary contusion, pneumothorax, hemothorax

Question 21

Pneumothorax

Answer 21

chest injury that allows air to enter the pleural space and causes a collapsed lung

Question 22

S/S of pneumothorax

Answer 22

reduced breath sounds, pleuritic chest pain, tachypnea, subcutaneous emphysema

Question 23

Diagnosis of pneumothorax

Answer 23

Chest xray

Question 24

Tx of pneumothorax

Answer 24

Chest tubes

Question 25

Tension pneumothorax

Answer 25

air leaking into the chest wall can’t get out

Question 26

Tx of tension pneumothorax

Answer 26

needle thoracotomy