Chest And Lower Respi Tract Disorder Flashcards
Type of atelectasis that is not detected in chest xray
Macroatelectasis
Reduced alveolar ventilation or type of blockage that impedes the passage of air to & from the alveoli
Prob: closure or collapse alveoli
Cause: trauma & pulmonary embolism
ATELECTASIS
Type of atelectasis that is loss of segmental lobar or overall lung volume
Microatelectasis
Most common type of atelectasis in post op & immobilize people
Acute atelectasis
Rubbing of pleural & parietal space
Pleural pain
Most common management for atelectasis
Oxygenation
Using simple face mask & one way valve system that provides varying amount if expiratory resistance
-management for atelectasis
Positive Expiratory Pressure Therapy(PEP)
Inflammation of the lung parenchyma that is caused by a microbial agent
Pneumonia
One of the categories of pneumonia that occurs in community setting
COMMUNITY ACQUIRED PNEUMONIA(CAP)
3 most common causes of CAP
Streptococcal pneumonia-upper reapi tract
Mycoplasma pneumonia-children&young adults
Haemophilluz pneumonia-older people& co-morbid illness
2nd category of pneumonia that occurs after 24-48 hours after confinement
-aka NOSOCOMIAL PNEUMONIA
HOSPITAL ACQUIRED PNEUMONIA(HAP)
Type of HAP that is for debilitated patient(not moving)
Pseudomonal pneumonia
Type of HAP for inhalation of organism
Staphylococcal pneumonia
Type of HAP for the entry of substance in the lower airway
Aspiration pneumonia
Substantial portion of one or both living(type of HAP)
Lobar pneumonia
Distributed in patchy fashion originating in 1 or more localized areas w/in the bronchi extending to adjacent lung parenchyma
-most common type of HAP
Bronchopneumonia
Blood stream invasion of microorganism
- diagnostic findings for pneumonia
Bacteremia(blood culture)
5 medications for pneumonia
Antobiotics Antipyretic Antihistamines Nasal decongestants Antitussive
3 complications of pneumonia
Shock & respi failure
Atelectasis & pleural effusion
Superinfection- administration of large doses of antibiotics
Infectious disease that primarily affects the lung parenchyma
Through airborne transmission
From inhaling droplets
Pulmonary tuberculosis(PTb)
Diagnostic findings for PTb that is used to determine if the patient is exposed to the bacillus standard procedure
Mantoux test
Interpretation for 5mm wheel formed in duration of mantoux test if PPD( purified protein derivative) is given
- significant in HIV patients
- close contact w/ active case
- chest xray results consistent w/ Tb
Class 0 for Tb
No exposure no infection
Class 1
Expose no evidence of exposure
Class 2
Latent infection no disease
Class 3
Disease clinically active
Class 4
Disease not clinically active
Class 5
Suspected disease diagnosis pending
Chemotherapeutic antiTb drugs
INH, RIF, pyrazinamide, ethambutol & streptomycino
Potential complication of PTb
Malnutrition
May discolor contact lenses & urine ( red orange color)
Rifampicin
Disorder affecting the pleural space
Pleural conditions
Inflammation of both layers of the pleura
Pleurisy(pleuritis)
Severe sharp knifelike pain
Decrease as fluid develops
Pleuritic pain
Diagnostic findings for pleurisy
Pleural friction pub- using a steth Chest xray Sputum exam Thoracentecis Pleural biopsy
Nursing mgt. for pleurisy
Turn pt. frequently w/ the affected side to splint the chest wall
Use hands to splint the rib cage while coughing
Collection of fluid in the pleural space
Complication of heart failure, TB, pneumonia and pulmonary infections
Pleural effusion
Effusion could be:
Clear
Bloody
Purulent
Normal amt of fluid in the pleural space
5-15 ml
Pleural membrane is not disease
-Filtrates of plasma that move Across intact capillary wall
Transudate
Extravassation of fluid into tissue or cavity
- inflammation by bacterial products or tumors involving the pleural space
Exudate
Confirms the presence of fluid in the pleural space
Thoracentesis
2 medical mgt for pleural effusion
Thoracentesis
Pleurectomy
Position of chest tube insertion
Sitting or lying down w/ the affected side elevated
2nd intercoastal space to remove air
8th or 9th intercoastal space to drain fluid & flood
Abn accumulation of fluid in the lungs or alveolar space
- severe life threatening
Pulmonary edema
Accumulation of thick purulent fluid in the pleural space often w/ fibrin development & walled off area where infection is located
Empyema
Medical mgt for empyema if fluid is not too thick or purulent
Fluid drained
For patient w/ complicated pleural effusion
Tube thoracostomy
Opening of chest drainage to remove thickened pleura, pus & debris
Thoracotomy
Postural drainage, percussion and vibration
Chest physiotherapy(CPT)
Purpose is To remove air or fluid from pleural space
- to establish (-) pressure & reexpand the lungs
Closed chest drainage(thoracostomy tube)
Bottle serves as drainage bottle & water seal bottle
One way bottle system
Height of the bottle to allow drainage from the pleura by gravity
Atleast 2-3 ft below the level of the chest
Never raise the bottle above the level of the chest to prevent
Reflux of fluid
Assess for patency of the tube
Fluctuation of fluid along the tube
Intermittent bubbling of fluid
In the absence of fluctuation
Obstruction of the device- check for kinks, milk tubing towards the bottle
If no obstruction….
Consider lung reexpansion
1st bottle- drainage
2nd bottle- water seal
-observe for fluctuation of fluid along the tube & intermittent bubbling w/ each respiration
2 bottle system
1st bottle- drainage
2nd bottle- water seal
3rd bottle- suction
Three bottle system
Postion of removal of ctt
Semi fowler
Complications of cct
Subcutaneous emphysema & respi disease
Sudden & life threatening deterioration of the gas exchange functions of the lungs due to decrease respi drive, dysfunction of chest wall, dysfunction of lung parenchyma
Acute respiratory failure
Medical mgt for acute respi failure
Intubation & oxygenation
Due to sudden progressive edem, increasing bilateral infiltrates on chest xray & hypoxemia refractory to O2 supplementation & reduced lung compliance
Acute respiratory distresa syndrome
Aka ‘ADULT RESPIRATORY DISTRESS SYNDROME’
Nutrition for ARDS
No oral intake- enteral feeding only!
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
Pulmonary embolism
Phaacologic therapy for pulmonary embolism
Anticoagulant
Thrombolytic therapy
Surgical mgt for pulmonary embolism
Embolectomy
Post op nursing care for pulmonary embolism
Hemorrhage