cardiopulmonary Diagnoses

Question 1

Congestive Heart Failure

Answer 1

• common etiologies contributing to CHF include arrhythmia, pulmonary embolism, hypertension, valvular heart disease, myocarditis, unstable angina, renal failure, and severe anemia
• Left-sided heart failure is generally associated with signs of pulmonary venous congestion; right-sided heart failure is associated with signs of systemic venous congestion
• Diminished cardiac output causes compensatory changes including an incr in blood volume, cardiac filling pressure, HR, and cardiac muscle mass

Question 2

Cystic Fibrosis`

Answer 2

• causes the exocrine glands to overproduce thick mucus which causes subsequent obstruction
• autosomal recessive genetic disorder located on the long arm of chromosome seven
• the most common cause of death is respiratory failure

Question 3

emphysema

Answer 3

• results from a long history of chronic bronchitis, recurrent alveolar inflammation or from genetic predisposition of a congenital alpha 1- antitrypsin deficiency
• clinical presnetation may include barrel chest appearance, incr subcostal angle, rounded shoulders secondary to tight pectorals, and rosy skin coloring
• symptoms of emphysema worsen with the progression of the disease and include a persistent cough, wheezing, difficulty breathing especially with expiration and an incr respiration rate

Question 4

Myocardial Infarction

Answer 4

• MI occurs when there is poor coronary artery perfusion, ischemia, and subsequent necrosis of teh cardiac tissue usually due to thrombus, arterial blockage or atherosclerosis
• risk factors include patient or family history of heart disease,smoking, physical inactivity, stress, hypertension, elevated cholesterol, DM, and obesity
• clinical presentation may include deep pain or pressure in the substernal area with or without pain radiating to the jaw or into the left arm or the back

Question 5

Peripheral vascular disease

Answer 5

• characterized by narrowing of the lumen of blood vessels causing a reduction in circulation usually secondary to atherosclerosis
• risk factors include phlebitis, injury or surgery, autoimmune disease, DM, smoking, hyperlipidemia, inactivity, hypertension, positive family history, incr age, and ibesity
• Pt education is paramount regarding the disease process, limb protection, foot and skin care, and risk factors reduction

Question 6

restrictive lung disease

Answer 6

• classification of diorders caused by a ulmonary or extrapulmonary restriction that produces impairment in lung expansion and an abnormal reduction in pulmonary ventilation
• pulmonary restriction of the lungs can be caused by tumor, interstitial pulmonary fibrosis, scarring within the lungs, pleural effusion, chest wall stiffness, structural abnormality, and respiratory muscle weakness
• pathogenesis includes a decr in lung and chest wall compliance, decr in lung volumes and an increase in the work of breathing

Question 7

Angina Pectoris

Answer 7

• Results from diminished myocardial perfusion, most commonly caused by narrowing of one or more of teh coronary arteries
• described as an uncomfortable or painful feeling of tightness, pressure, fullness or squeezing in the center of teh chest
• medical management varies greatly with symptom severity and type, focusing primarily on the underlying pathology

Question 8

Coronary artery disease

Answer 8

• occurs as a result of atherosclerotic plaque buildup within the coronary arteries; develops slowly, often going unnoticed for years before producing symptoms
• risk factors include HTN, DM , obesity, CKD, elevated cholesterol and triglyceride levels, and a family history of the condition
• Cardiac rehabilitation is recommended and upon completion, teh patient should possess self-management skills associated with symptoms recognition and reduction of risk factors

Question 9

Aneurysm

Answer 9

• abnormal balloon- like bulge in the wall of a blood vessel that occurs when the blood vessel becomes weakened and can no longer handle the pressure of teh blood
• symptoms will differ based on the site of the aneurysm and whether the aneurysm has ruptured or not
• symptoms include low back, abdominal or groin pain, nausea and vomiting, lightheadedness and a rapid HR; sympyoms of a thoracic aortic aneurysm include jaw, neck, back, or chest pain, coughing or hoarseness, and SOB

Question 10

atelectasis

Answer 10

• occurs when the alveoli within the lung become deflated, resulting in the complete or partial collapse of a lung and a reduction in gas exchange
• conditions that prevent coughing and deep bretahing increase the risk for atelectasis
• when large portions of the lung are affected, S/S include coughing , fast and shallow breathing, increased HR,,cyanosis, reduced oxygen sat levels and occasionally chest pain

Question 11

Chronic Venous Insufficiency

Answer 11

• typically affects the distal lower extremities and is characterized by venous incompetence and resyltant venous hypertension
• Symptoms include edema, feelings of heaviness tingling sensations, and dull, aching pain in the distal lower extremities
• Symptoms generally improve and may resolve fully with elevation, however, reappear once dependent positioning is resumed

Question 12

Cor Pulmonale

Answer 12

• Occurs when the right ventricle is unable to effectively pump blood due to the prolonged presence of pulmonary hypertension and increased right ventricular afterload
• initially, symptoms are primarily associated with the underlying pulmonary pathology; as the condition advances, symptoms may include peripheral pitting edema and jugular vein distention
• Most commonly diagnosed by means of clinical findings, medical history, echocardiogram, labral test, chest x-ray, and electrocardiography

Question 13

Pericarditis

Answer 13

• Characterized by swelling and irritation of the pericardium that is often caused by viral infections
• symptoms include a sharp chest pain that can radiate to the neck or shoulder pain that intensifies with coughing, lying down or inhaling deeply, SOB, heart palpitations, weakness and fatigue , fever and a cough
• pericardial rub is the sound heard during auscultation when the pericardial layers rub against one another

Question 14

Pleural effusion

Answer 14

• occurs when excess fluid accumulates in the pleural cavity secondary to medical conditions that result in increased fluid production or decr fluid absoprtion
• Pt with a large effusion may experience SOB, chest pain, cough and fever
• Common tests used to identify the condition include chest x-ray, computed tomography, and US imaging

Question 15

Pneumothorax

Answer 15

• Occurs when air accumulates in the pleural cavity and causes a collapsed lung
• Symptoms vary widely depending on the type and size of the pneumothorax, but may include chest pain, SOB, hypoxemia cyanosis and hypotension
• Tension pneumothorax is a specific type of pneumothorax that results in large increases in pressure in the pleural cavity and is considered a medical emergency

Question 16

Pulmonary Edema

Answer 16

• Characterized by excess fluid in the lungs that often occurs when the left ventricle is unable to adequately pump blood to the systemic circulation
• acute pulmonary edema is considered a medical emergency and is characterized by extreme SOB, wheezing or gasping, anxiety a cough that produces frothy sputum, chest pain and palpitations
• a chest x-ray is the primary imaging study to confirm the presence of fluid in the lungs

Question 17

Pulmonary embolism

Answer 17

• Occurs most commonly as a result of venous thrombi that have detached and traveled from elsewhere in the body before lodging in a pulmonary artery
• Symptoms include a sudden onset of dyspnea, coughing, hypoxia, and chest pain which may mimic myocardial infarction
• pulmonary angiogram is the most conclusive means of identifying a pulmonary embolism, however, complication risks are high and so it is used only when other diagnostic methods are inconclusive

Question 18

Respiratory Acidosis

Answer 18

• Refers to a state in which the pH of body fluids is abnormally low indicating acidemia
  0 Hypoventilation prevents adequate removal of CO2 from teh body causing hypercapnia and as a result, bicarbonate HCO3- levels decrease altering the body’s acid-base balance
• initial symptoms are often vague and more closely related to the underlying pathology; as the condition worsens, symptoms include lethargy, confusion, AMS, and cyanosis

Question 19

Respiratory alkalosis

Answer 19

• Refers to a state in which the pH of body fluids is abnormally high indicating alkalemia
• hyperventilation removes more CO2 from the body that can be produced causing hypocapnia and as a result, hydrogen (H+) levels decrease altering the body’s acid-base balance
• Initial symptoms are often vague and more closely related to the underlying pathology, however, tachypnea, tachycardia, hyperventilation and dizziness are commonly observed

Question 20

Sarcoidosis

Answer 20

• a condition characterized by the growth of small, abnormal collections of inflammatory cells, known as granulomas, within the body’s organs
• the cause of sarcoidosis is not known, though it is thought to be the result of an abnormal immune system response to a foreign substance
• symptoms will vary based on what organs are affected, most commonly the lungs, lymph nodes, and skin

Question 21

tuberculosis

Answer 21

• highly contagious infectious disease spread via airborne transmission primarily caused by the mycobacterium tuberculosis bacteria
• actively TB typically presents with generalized symptoms of infection including fever, chills, fatigue, weight loss, decreased appetite, and night sweats; left untreated can be fatal
• diagnosed based on a skin test where a small amount of teh substance tuberculin is injected at a forearm, site with the skin’s reaction then assessed 48-72 hours later

Question 22

VEnous thrombosis

Answer 22

• the formation of a blood clot within a vein, most commonly occurring in the deep veins of the lower extremities
• signs and symptoms include swelling, redness, warmth and pain in the affected leg, though it can occur without any noticeable symptoms
• US imaging is most commonly used to identify the presence of a venous thrombus