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Nursing 115 > Chapter 19 Management of patients with chest and lower respiratory tract disorder > Flashcards

Chapter 19 Management of patients with chest and lower respiratory tract disorder Flashcards

1
Q

What is atelectasis?

A

Closure or collapse of alveoli
Is usually found during chest x-rays and clinical signs and symptoms

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2
Q

When does acute atelectasis occur the most?

A

Postoperative setting after thoracic and upper abdominal procedures or in people who are immobilized and have a shallow, monotonous breathing pattern

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3
Q

Explain obstructive atelectasis.

A

results from the reabsorption of gas and no air can enter the alveoli because of the bloackage and the alveoli collapse
trapped alveolar air is absorbed into the bloodstream

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4
Q

What are causes of atelectasis?

A

foreign body (tumor or growth)
altered breathing patterns
retained secretions
pain
alterations in small airway function
prolonged supine positioning
increased abdominal pressure
reduced lung volumes due to musculoskeletal or neurologic disorders
restrictive defects
specific surgical procedures

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5
Q

What is compressive atelectasis?

A

excessive pressure on the lung tissue and can be produced by pleural effusion( fluid within pleural space), pneumothorax (air in pleural space), hemothorax (blood in pleural space)
also pericardial effusion (pericardium distended with fluid) tumor growth in the thorax or elevated diaphragm

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6
Q

What are the signs of acute atelectasis?

A

Dyspnea (SOB), cough, sputum, tachycardia. tachypnea, pleural pain, central cyanosis, difficulty breathing in supine position, anxiety

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7
Q

What are the signs of chronic atelectasis?

A

Same as acute but also symptoms of pulmonary infection

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8
Q

What does ICOUGH mean?

A

Incentive spirometry
Coughing and deep breathing
Oral care
Understanding
Getting out of bed at least three times daily
Head of bed elevation

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9
Q

What is thoracentesis?

A

removal of the fluid by needle aspiration to decrease the compressions against the alveoli

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10
Q

What is pulmonary edema?

A

Abnormal accumulation of fluid in the lung tissue, the alveolar space, or both.
It is a severe, life threatening condition

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11
Q

How does noncardiogenic pulmonary edema occur?

A

Damage of the pulmonary capillary lining
May be due to direct injury to the lung ( chest trauma, aspiration, smoke inhalation)
Hematogenous injury to the lung (sepsis, pancreatitis, multiple transfusion, and cardiopulmonary bypass)
Injury plus elevated hydrostatic pressures

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12
Q

What is pulmonary embolism?

A

It is the obstruction of the pulmonary artery or one of its branches by a thrombus that originates somewhere in the venous system or in the right side of the heart.

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13
Q

What is deep vein thrombosis?

A

Refers to thrombus formation in the deep veins (calf or thigh sometimes in the arm)
Especially in patients with peripherally inserted central catheters

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14
Q

What is pulmonary hypertension?

A

Elevated pulmonary arterial pressure greater than 25mmHg at rest and greater than 30mmHg with exercise and secondary right heart ventricular failure

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15
Q

What is the main symptom in pulmonary hypertension?

A

Dyspnea
2nd common is substernal chest pains
others are weakness, fatigue, syncope, hemoptysis, signs of right-sided heart failure, anorexia, abdominal pain

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16
Q

When does a positive vasoreactivity test occue?

A

When there is a decrease of at least 10mmHg in pulmonary artery pressure with overall pressure that is less than 40mmHg in the presence of both an increase or unchanged cardiac output and a minimal decrease or unchanged systemic BP

17
Q

When is calcium channel blockers prescribed?

A

When the patient has a positive vasoreactivity test and who do not have right-sided heart failure

18
Q

What does prostanoids do?

A

They mimic the effect of the prostaglandin prostacyclin by relaxing vascular smooth muscle by stimulating the production of cyclic 3’, 5’-adenosine monophosphate and inhibits the growth of smooth muscle cells

19
Q

What long is the half-life of epoprostenol?

A

3 minutes and must be continuously given through an implanted central venous catheter using an infusion pump

20
Q

How is iloprostis taken?

A

Inhaled 6-9 times daily

21
Q

How is treprostinil taken?

A

First form would be taken parenterally but now has been approved in the inhaled formulation and they are working on a PO form
Subcut method hurts

22
Q

What is selexipag?

A

It is a prostanoid that is available in tablet taken twice a day but it cost a lot and not all insurance plans cover it

23
Q

What does endothelin receptor antagonist do?

A

They bind to vascular endothelin-1 receptors, blocking constriction of the pulmonary arteries and resulting in vasodilation. These are hepatotoxic

24
Q

What is included in endothelin receptors antagonist?

A

Bosentan, ambrisentan, and macitentan

25
Q

What medication is contraindicated in patients with liver or kidney disease?

A

Riociguat

26
Q

Explain atrial septostomy.

A

Results in shunting of blood from the right side of the heart to the left.
Decreasing the strain on the right side of the heart and maintaining left ventricular output

27
Q

What is acute tracheobronchitis?

A

inflammation of the mucous membranes of the trachea and bronchial tree
often follows infection of the upper respiratory tract as result of a viral infection

28
Q

What bacteria can cause tracheobronchitis?

A

Streptococcus pneumoniae, Haemophilus influenzae, and mycoplasma pneumoniae
fungal infection aspergillus may also cause

29
Q

What are the clinical manifestations of tracheobronchitis?

A

Dry irritating cough, scanty amount of mucoid sputum
Soreness from coughing, fever, chills, night sweats, headache, and general malaise
SOB, Stidor or wheeze, pus-filled sputum, or blood-streaked secretion

30
Q

What are the risk factors for penicillin-resistant and drug-resistant pneumococci?

A

Older than 65, alcoholism, beta-lactam therapy, HIV, exposure to child in a day care

31
Q

What are the risk factors for infection with enteric Gram-negative bacteria?

A

Live in long-term care, cardiopulmonary disease, and recent antibiotic therapy

32
Q

What are the risk factors with pseudomonas aeruginosa?

A

Structural lung disease, corticosteroid therapy, broad-spectrum antibiotic therapy, malnutrition

33
Q

What are clinical manifestations of TB?

A

Low-grade fever, cough, night sweats, fatigue, and weight loss, and hemoptysis

34
Q

What test is used for TB?

A

Mantoux test-skin
quantiferon-TB-blood
T-spot-blood
Sputum culture

35
Q

What are the first-line TB drugs?

A

Isoniazid, Rifampin, Rifebutin, Rifapentine, Pyrazinamide, Ethambutol, and combinations

36
Q

Which TB medication is a prophylactic?

A

Isoniazid 6-12months

Nursing 115 (3 decks)

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