Chapter 4 - Respiratory Distress Flashcards
What is pneumonia?
Inflammation of the lung parenchyma resulting from either infectious or non-infectious causes.
What are infectious organisms?
Bacteria
Viruses
Fungi
Protozoa
Common extrinsic factors for asthma:
Smoking Exercise Dust mites Pet hair Pollen
Intrinsic factors for asthma:
Aspirin
Beta-blockers
Viral infections
Emotional distress
Diaphoretic-
Sweaty
Febrile
High temperature
Tachycardia
Increased heart rate
Tachypnoeic
Increased reap rate
ABG’s
A test of gases and pH in arterial blood
Coarse rales -
A series of short low popping sounds, also called crackles
Haemoptysis
Coughing bloody sputum
Working out Fi02%
4 x 02 rate (6L/min) + 20
Pneumonia affects gas exchange in which structures of the lungs?
Alveoli
Assessment of patient with pneumonia includes-
White cell count Mental status FBC/Serum electrolytes Breath sounds ?Purse lip breathing Use or accessory muscles
A person with pneumonia is likely to display which lung sound on auscultation?
Rales (Crackles)
The body’s respiratory centre is primarily stimulated by:
A rise in blood carbon dioxide
Common causes for low arterial oxygen levels (hypoxaemia).
Hypoxia Hypoventilation Ventilation Perfusion mismatch Diffusion abnormalities
Inflammation of pneumonia is most likely to cause an alteration in:
Diffusion of gases
When dealing with a very breathless patient ask what kind of questions?
Yes / No
Closed ended
Groups of people most likely affected by pneumonia:
Elderly
Alcoholics
Immunocompromised
Chronic illness
Pleural effusion
Build up of fluid in the space between the lung and chest wall
Empyema
Pockets of pus that form in the space between lung and chest wall
Productive cough
Sputum material coughed up from the lungs
Lung abscess
Pockets of pus that form in the lung itself
Secondary infection due to medication
Secondary bacterial lung infection after a viral infection
Bacteraemia or septicaemia
Bacteria in the bloodstream or throughout the body
Dyspnoea
Clinical sign of hypoxia, manifested by a feeling of breathlessness
Fatigue
Subjective sensation of a patient reporting loss of endurance
Malaise
Generalised feeling of being unwell
Normal Pa02 for a healthy 30yom would be between:
80-100
Normal PaC02 for a 30yom would be between:
35-45
A normal pH for a 30yom would be between:
7.35 - 7.45
When someone has a fever due to pneumonia, what would you expect in this instance?
Haemoglobin would release oxygen more readily and bind it less readily
Most important cue cluster for a patient with pneumonia:
Tachypnea Fever Purulent sputum A cough Coarse rales Oxygen saturation lower than normal
Early signs of hypoxia include:
Tachypnoea or bradypnoea Tachycardia or bradycardia Pa02 50-60mmHg PaC02 59-60mmHg Confusion
Late signs of hypoxia include:
Tachypnoea or bradypnoea Cyanosis Unresponsiveness to verbal command Tachycardia or bradycardia Pa02 <50mmHg PaC02 > 60mmHg Sp02 <90%
Nasal prongs flow rate:
2-4 litres
Fi02 - 0.24 - 0.36
Hudson mask flow rate:
6-15 litres per minute
Fi02 - 0.4-0.6
Non-rebreather mask flow rate:
10-15 litres per minute
Fi02 0.6-0.9
High flowers position will:
Assist in lung expansion
Wheezes are caused by:
Narrowed airways
An asthma attack is caused by substances released from mast cells which cause:
Broncho-constriction and inflammation
Peak exploratory flow rate can be defined as:
The maximum amount of air that a person is capable of expiring during forced expiration.
Expiration occurs when:
The intercostal muscles and diaphragm relax.
The most characteristic alteration in lung volume that is caused by air trapping in asthma is:
Functional residual capacity
Reversibility of airflow obstruction is necessary to -
Diagnose asthma
What breath sound is not suggestive of asthma?
Stridor
Characteristics of asthma include:
SOB
Cough
Chest tightness
Wheeze
Side effects of bronchodilators include:
Palpitations and tremors
Interventions for long term management of asthma include:
1- provide written/verbal instructions for future reference
2- teach the correct use of PEFR meter(peak flow)
3- Implement strategies to decrease anxiety
4 - Discuss lifestyle changes such as warming up slowly before exercising in cold weather
