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Med-Surg Spring 2024 > Chapter 31 - Obs. Pulmonary Dis - Exam 2 > Flashcards

Chapter 31 - Obs. Pulmonary Dis - Exam 2 Flashcards

1
Q

what is bronchiectasis

A

chronic condition characterized by abnormal widening and inflammtion fo the airways in the lungs known as bronchi

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2
Q

symptoms of bronchiectasis

A

chronic cough, large amounts of mucus, shortness of breath, chest pain, fatigue

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3
Q

treatment of bronchiectasis

A

managing symptoms, preventing complications

chest physiotherapy: postural drainage, percussion, and vibration help loosen and clear secretions from the airways

pnemonia vaccine

surgery to remove affected lung

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4
Q

what is cystic fibrosis

A

genetic disease affecting many organs, lethally impairing pulmonary function

mucus plugs up glands causing atrophy and organ dysfunction

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5
Q

pathology of cystic fibrosis

A

mutation of CFTR gene. when this gene is defective or absent it results in thick sticky mucus buildup in various organs, leading to a range of symptoms and compliations

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6
Q

pathology of cystic fibrosis to the lungs

A

thick mucus accumulates in the airways, obstructing airflow and trapping bacteria. this environmet promotes recurrent lung infections inflamaton and progressive lung damage

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7
Q

cystic fibrosis can lead to

A

bronchiectasis

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8
Q

cystic fibrosis is characterized by

A

abnormal mucus production, respiratory symptoms including chronic cough, frequent lung infections,wheezing, shortness of breath pancreatic insufficiency, digestive issues, SALTY SKIN, infertility

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9
Q

patients with CF will have __________enzyme deficiency

A

pancreatic

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10
Q

sweat chloride analysis can test for

A

CF

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11
Q

nurses role pt w/ CF

A

education, support, monitor resp status, nutritional status, VS, oxygen levels, lung function tests, meds

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12
Q

nurse: medical management of CF

A

mucolytics
pancreatic enzyme replacement
etc

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13
Q

preventive/maintenance therapy of CF

A

chest physiotherapy
exercise

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14
Q

COPD is a term that describes

A

a term that can be used to describe a range of pulmonary conditions including chronic bronchitis, emphyema, irreversible asthma

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15
Q

what is asthma

A

chronic inflammatory disease of the airway that causes intermittent hyper responsiveness, mucosal edema and mucus

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16
Q

patho asthma

A

when an allergen activates a mast cell it releases histamine and other chemicals and creat inflammation leading to inc blood flow, smooth muscle contraction and bronchoconstriction

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17
Q

asthma is characterized by

A

chest tightness, wheeze, increased RR, SOB, inc cough, use of accessory muscles, barrel chest, long breathing cycle, cyanosis, hypoxemia

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18
Q

what is an asthma action plan

A

personalized asthma action plans that outline specific steps to take based on asthma symptoms, peak flow measurements, meds

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19
Q

what is a meter dose inhaler

A

commonly used to deliver bronchodilators to relieve acute asthma symptoms or rescue meds during asthma attacks

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20
Q

what is a dry powder inhaler

A

unlike metered-dose inhalers, which deliver meds in the form ofa pressurized aerosol spray, DPIs deliver meds in the form of a dry powder

commonly used to deliver bronchodilators and corticosteroids for long term control of asthma and copd symtoms

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21
Q

what is a nebulizer

A

delivers meds such as bronchodilators or corticosteroids in the form of a fine mist, used for a range of conditions.

easy to use, can deliver large volume of meds over extended periods

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22
Q

what is status asthmaticus

A

severe and potentially life threatening form of asthma exacerbation that doesnt respond adequately to standard asthma treatments such as bronchdilatros and corticosteroids

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23
Q

characteristics of status asthmaticus

A

wheezing coughing chest tightness SOB which can rapidly escalate to resp failure if not treated promply and aggressively

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24
Q

nurse role: status asthmaticus

A

immediate intervention to address airway obstruction and improve oxy

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25
Q

treatment of status asthmaticus

A

short acting beta adrenergic agonist nebulizzer, steroids

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26
Q

what is chronic bronchitis

A

type of copd, inflammation and irritation of the brochia tubes leading to persistent cough and excessive mucus production

risks include smoking

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27
Q

symptoms of chronic bronchitis

A

persistent productive cough 3 month to 2 years, excessive mucus production, airway inflammation

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28
Q

treatment of chronic bronchitis

A

relieving symptoms, improving lung function, preventing exacerbations, reducing complications

quit smoking
inhaled corticosteroids, pulmonary rehab, oxygen therapy

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29
Q

what is emphysema

A

irreversible tissue damage, loss of lung elasticity and hyperinflation of the lung, overstretchingand enlargement of alveoli, collapse of small airways bonchioles

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30
Q

symptoms of emphysema

A

dyspnea, wheezing, chronic cough, sputum, symptoms worsen overtime

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30
Q

what is panlobular emphysema

A

uniform enlargement of airspaces aka the alveoli throughout the entire lung lobule

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31
Q

what is centrilobular emphysema

A

primarily affects the upper lobes of the lungs and is associate with smoking

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32
Q

what is a bullectomy

A

procedure to remove abnormally large air spaces or air filled sacs that develop within the lung tissue r/t emphysema or COPD

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33
Q

what is lung volume reduction surgery

A

treat severe emphysema
traditionally performed by making incision in chest to access the lungs, damaged areas of lung tissue are removed. aims to improve lung function by reducing hyperinflation and improve respiratory mechanics

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34
Q

what is chest physiotherapy

A

set of techniques aimed at improving lung function and clearing mucus or secretions from airways
chest percussion
chest vibration
postural drainge
breathing exercises

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35
Q

complications of oxygen therapy

A

oxygen toxicity
absorption atelectasis
fire hazard
drying of mucus membranes
oxygen induced hypoventilation

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36
Q

low flow oxygen therapy

A

flow rate of oxy is lower than the patient’s peak inspiratory flow rate. continuous or intermittent supply of oxy

  1. nasal cannula
  2. simple face mask

patients may have COPD, congestive heart failure, pneumona

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37
Q

the flow rate of oxygen delivered via nasal cannula is

A

1 to 6 liters per minute

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38
Q

the flow rate of oxygen via face mask is

A

5 to 10 liters per minute

the mask delivers a higher concentration of oxygen compared to nasal cannula

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39
Q

nursing responsiblity r/t oxygen therapy

A

monitored closely for signs of oxygen toxicity, hypoventilation, etc

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40
Q

high flow oxygen therapy is

A

therapy that delivers a high flow rate of heated and humidified oxygen to patient with respiratory insufficiency.

unlike low flow which delivers a variable oxygen concentration depending on the patient’s breathing pattern, high flow oxy therapy delivers a constant and controlled concentration of oxygen, regardless of patient’s inspiratory flow rate

typically delivered through a “high-flow nasal cannula”

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41
Q

high-flow oxygen therapy flow raes

A

20 to 60 liters per minute or higher

42
Q

heated and humidified oxygen

A

the oxygen delivered through a high flow nasal cannula is heated and humidified to minimize drying and patient comfort

43
Q

what is a non-invasive positive pressure ventilation

A

type of ventilatory support that delivers mechanical ventilation to the lungs without the need for invasive procedures. it is typically delivered thru a mask or nasal interface providing continuous positive airway pressure CPAP or BIPAP to support breathing

44
Q

low-flow nasal cannula flow rate

A

1 to 6 L/min

45
Q

low-flow simple face mask flow rate

A

5 to 10 L/min

46
Q

low-flow partial rebreather mask flow rate

A

8 to 15 L/min

47
Q

low flow non-rebreather mask flow rate

A

10 to 15 L/min

48
Q

high-flow venturi-mask flow rate

A

4 to 15 L/min

49
Q

high-flow trach collar O2 and T tube flow rate

A

10 to 15 L/min

50
Q

high-glow nasal cannula flow rate

A

20 to 60 L/min

51
Q

trach care assessment

A

tube inspection, skin, stoma, respiratory rate/effort/oxy sat levels, secretions management

52
Q

trach - preventing aspiration

A

positioning, food/liquid consistency, monitoring

53
Q
A
54
Q

what is the hallmark characteristic of bronchiectasis

A

Ectasis” is a term derived from the Greek word “ektasis,” which means expansion or dilation. In medical terminology, it is used to describe the abnormal enlargement or dilation of a tubular structure in the body, such as blood vessels or hollow organ

thus,

permanent abnormal dilation of medium-sized bronchi

55
Q

why doses it matter if the bronchi are over dilated?

A

inflammatory changes weaken the bronchial wall, therefor airway damage, the walls can develop colonies of microorganisims leading to infection
when the walls of the bronchi are injured, the mucociliary mechanisim is damaged (that escalator thing) and again this leads to infection

56
Q

the main points of bronchiectasis

A

the bronchi are over dilated leading to mucus/bacteria/infection accumulation that is nearly impossible to cough out

there is no cure

57
Q

cystic fibrosis is a type of

A

bronchiectasis

58
Q

main points of cystic fibrosis

A

-genetic disease
- increased abnormally thick, sticky mucus production
- GI, pancreas issues
- recurrent resp infections, persistent cough
-

59
Q

what is the gold standard for diagnosing CF

A

the sweat chloride test

60
Q

main points of asthma patho

A
  • reversible airflow obstruction, usually temporary attacks
  • chronic inflammatory disease
  • bronchoconstriction, mucus, edema
  • bronchial hyperreactivity
61
Q

what are the risk factors for asthma

A

genetics and environment

62
Q

what is “silent chest”

A

if the patient with asthma has been wheezing, followed by sudden absence of a wheeze and the patient is struggling to breathe this is a life threatening emergency

63
Q

drug therapy for asthma can be complex. usually divided in to two types what are they

A
  1. short term “rescue” inhaler
  2. preferred reliever agents
64
Q

where as asthma is reversible and temporary, COPD is progressive and _______ airflow limitation

A

persistent

65
Q

copd patho main points

A
  • chronic inflammation of lungs
  • airflow limitation not fully reversible during forced exhalation
  • main cause is the loss of elastic recoil and airflow obstruction from mucus hypersecretion, mucosal edema, and bronchospasm
66
Q

true or false: status asthmaticus is a mild form of asthma

A

false!
this is a life threatening emergency, most extreme form of asthma
s/s hypoxia, hypercapnia
patient is unresponsive to treatment with bronchodilators and corticosteroids
patient will most likely need immediate mechanical ventilation

67
Q

main points chronic bronchitits

A
  • inflammation of bronchi caused by chronic exposure to irritants such as cigarette smoke
  • constant irritants produce mucus
  • bronchial walls become thickened, and lumen narrow
    -irreversible tissue damage
68
Q

main points emphysema

A

-destruction of alveoli, lungs loose elasticity and alveoli hyperinflate
- overstretching and enlargement of alveoli into bullae

69
Q

there are 2 types of emphysema what are panlobular and centrilobular what is the difference

A

panlobular - uniform destruction of functional unit of the resp system where gas exchange occurs; bronchioles, alveolar ducts and alveoli

centrilobular - primarily affects the upper lobes of the lungs

70
Q

what is a bullectomy

A

1 or more very large bullae are removed. this help WOB.

71
Q

what is lung volume reduction

A

surgery that reduces the size of the lungs by removing some of the diseased tissue so that remaining healthy tissue can thrive

72
Q

oxygen therapy is a common treatment for

A

hypoxemia and hypoxia

73
Q

we classify O2 delivery systems as low flow or high flow. Low flow delivery devices are appropriate for patients who are ____,____,_____

A

awake, alert, and spontaneously breathing with a stable intact respiratory drive

74
Q

high flow o2 delivery devices differ because they deliver a _____O2 concentration independent of the patients respiratory rate or pattern

A

fixed

75
Q

high flow systems provide O2 that ____ or _____ the patient’s resp demand

A

meet, exceed

76
Q

patients requiring high flow therapy are also awake, alert, and spontaneously breathing but have _____o2 requirements that low flow devices cannot meet

A

higher

77
Q

examples of low flow devices include

A

nasal prongs, simple masks, non rebreather maskse

78
Q

examples of high flow masks include

A

venturi mask and high flow nasal cannula

79
Q

we all know what a god damn nasal cannula (low flow) is but tell me about it anyway

A

most commonly used
used for patients requiring low o2 concentrations
achieves o2 concentrations of 1 L/min to 6 L/min

80
Q

Okay, main points of partial and non-rebreather masks

A

used for short term therapy for patients with higher O2 needs
achieves o2 concentrations of 10-15 L/min
o2 flows into reservoir bag and mask during inhalation
bag allows patient to rebreathe 1/3 of oxygen rich air
- vents stay open on mask

81
Q

high flow venturi mask main points

A
  • mask can deliver precise, high flow rates of o2
    low, constant o2 concentrations, used for COPD patients
82
Q

true or false: smoking is recommended around o2 cannisters

A

false that shit will blow up

83
Q

what the hell is O2 toxicity

A

prolonged exposure to a high level of o2, can result in severe inflammatory response which can lead to pulmonary edema, shunting of blood, hypoxemia, pulmonary edema

84
Q

the alveoli contain many different gases, including o2, co2, and nitrogen. Nitrogen helps maintain the size, shape and structure of the alveolus.
if the brochial tubes become obstructed (mucus) the exchange of co2 and o2 cant occur.
nitrogen will eventually move out of the alveolus and into the bloodstream
this is called “nitrogen washout”
as a result, the alveoulus collapses, and absorption atelectasis occurs.

what does this result in?

A

absorption atelectasis

85
Q

______ helps maintain the size, shape, and structure of the alveolus

A

nitrogen

86
Q

okay we are almost there,
clean the o2 device. why would we clean it?

A

because a bunch of bacteria will grow on it and lead to infection

87
Q

okay,
chemo receptors control the drive to breathe. They respond to co2 and o2 concentrations in the blood. as we know, normally an increase in co2 in the blood is a major stimulant of the resp center

however, patient with COPD develop a TOLERANCE for higher co2 levels. as a result the resp loses it sensitivitey to high co2 levels.
For these patients a major drive to breathe is hypoxemia (low oxygen in the blood). If we are giving a bunch of oxygen and its getting in the patient blood then we have some problems.
as a result, there is a concern about the dangers of giving o2 to a copd patient and reducing their stimulus or drive to breathe

what is this called

A

oxygen induced hypoventilation
or co2 narcosis

88
Q

co2 retention is also known as

A

hypercapnia

89
Q

what is hypercapnia

how can it happen

A

abnormally high level of CO2 in the blood, the body is unable to eliminate co2 efficiently leading to its accumulation in the blood stream

COPD, CNS disorders, meds, severe anemia

90
Q

nasal cannula flow rate

(low flow)

A

1 L/min to 6 L/min

91
Q

simple face mask flow rate

(low flow)

A

6 -12 L/min

92
Q

partial rebreather flow rate

(low flow)

A

10 to 15 L/min

93
Q

non rebreather flow rate

low flow

A

10-15 L/min

94
Q

tell me again about a high flow venturi mask. who would find it beneficial?

A

mask can deliver precise high flow rate of o2
low, constant o2 concentration for copd patients
can be humidified
its uncomfortable

95
Q

tell me about a tracheostomy collar, how does it work, who would use this?

A

collar attaches to neck, delivers humidity and o2, needs to be cleaned q4hr and prn to prevent aspirtation

96
Q

high flow nasal cannula flow rate

A

up to 60L/min!

97
Q

the endotracheal tube is a long flexible plastic tube that secures a patients airway when they need mechanical ventilation. An ET consists of a standard adaptor, cuff, pilot balloon along the length of the tube

the cuff pressure needs to be checked every 8 hours
what should the pressure be?

A

15-22 mmHG

98
Q
A
99
Q

which condition may develop if severe pneumonia is left untreated?
a. atelectasis
b. hemoptysis
c. bronchiectasis
d. chronic bronchitis

A

c. bronchiectasis

100
Q

_______ is a complication of asthma due to hyperinflation of the lungs and increased dead space

A

atelectasis

101
Q

what is the primary cause of brochiectasis

A

untreated or delayed treatment of bacterial lung infections

102
Q

which diagnostic test will help to determine the condition of a patient that has a productive cough, perfuse sweating, local hypoxia, and arteriolar vasoconstriciton?

a. sweat chloride test
b. spirometry
c. tomography
d. hemoglobin test

A

a. sweat chloride test

this person may have CF

103
Q
A

Med-Surg Spring 2024 (12 decks)

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