Common Pulmonary Disorders Flashcards
What causes Atelectasis and how does it present?
Caused by:
Blockage of airway
Compression
Presentation:
Diminished breath sounds, crackles
Opacity on chest film
Fever?
How to maximize ventilation for Atelectasis?
Positioning, deep breathing, mobilization
What is Pneumonia and how does it present?
PNA or lung infection is when there is fluid accumulating in the alveoli
Presentation:
Cough, pleuritic pan, rapid shallow breathing, fever, malaise, tachycardia
Diminished breath sounds, crackles
Plus transmitted vocalizations
Opacity on chest film
What is Pulmonary Edema caused by and how does it present?
Caused by:
Increased hydrostatic pressure
Increased vascular permeability
Dyspnea, tachypnea, shallow breathing, dry/frothy cough
Crackles on auscultation
Orthopnea, paroxysmal nocturnal dyspnea
How do you improve gas exchange with someone how has pneumonia?
Positioning, breathing, mobilization
Minimize effects of inactivity
Airway clearance
What can help Pulmonary Edema?
Diuretics
Oxygen
Combat inactivity
What are the three types of Pulmonary Embolisms (PE)?
Small (60–80%)
Often unrecognized
Medium
Pleuritic pain, dyspnea, slight fever, tachycardia
Massive (five percent)
Chest pain, pallor, hypotension, tachycardia
Sudden hemodynamic collapse, shock
What is the management of PE?
Management depends on severity:
Respiratory support
Hemodynamic support
Anticoagulation
Recognize and refer to medical team
What is A cute Respiratory Distress Syndrome (ARDS)?
Rapid onset of life-threatening respiratory insufficiency, cyanosis, severe hypoxemia
Severe hemorrhagic pulmonary edema, loss of surfactant, decrease lung compliance, alveolar collapse
What is the medical management of ARDS?
Respiratory, cardiovascular support
Corticosteroids, antibiotics if indicated
Combat immobility
Improve gas exchange with prone positioning
What are the three ways and airway can be blocked?
Secretions
Thickened airway (Inflammation, hypertrophy)
Loss of radial traction
How do Obstructions impact airway resistance?
Obstruction increases resistance to airflow
- Requires greater pressure gradient
- Increased work of breathing
Affects expiration more than inspiration
(That’s why FEV1 is more decreased than FVC)
How does obstruction create hyperinflation?
Alveolar wall destruction along enlarged alveolar air space due to damage to elastic fibers creates more residual volume and a flattened diaphragm — increased work of breathing
What three factors cause COPD?
Emphysema - Alveolar wall destruction, Hyperinflation
Chronic Bronchitis - Productive cough, Airway inflammation
Asthma - Bronchial hyper-responsiveness
How does COPD present?
Shortness of breath, chronic cough, poor exercise tolerance
Periodic exacerbations due to infection
Extra-pulmonary effects
- Weight loss (cachexia)
- Skeletal muscle dysfunction
- Increased risk of heart disease, respiratory infection, depression, diabetes, lung cancer
COPD Risk Factors?
Non-modifiable:
Genetic: alpha-1 antitrypsin deficiency
Increasing age
Male sex
History of infections
Modifiable
Tobacco smoke
Pack years: number of packs/day * years smoked Exposure to occupational dusts/particles, air pollution
What are the two types of COPD presentations?
Emphysema and Chronic Bronchitis
How does Emphysema presentation present?
Progressive shortness of breath
Weight loss
Chest hyperinflation
Decreased breath sounds
Moderate hypoxemia
Hyperventilation with prolonged exhalation
“Pink puffers”
How does Chronic Bronchitis Presentation present?
Persistent cough with excessive sputum production
Recurrent infections
Fluid retention (crackles)
Severe hypoxemia
“Blue bloater”
PT goals for COPD
Breathing and positioning to manage dyspnea
Exercise training to maintain/improve functional capacity
Energy conservation
Airway clearance if indicated
What is Asthma and how does it present?
Airway hypersensitivity
Episodes of bronchoconstriction and inflammation
Wheezing, breathlessness, chest tightness, cough
How is asthma diagnosed?
Flow volume loops before and after vasodilators
If % can improve then it is consider asthma (“reversible”)
What are the types of asthmas and what are they triggered by?
Atopic results from hypersensitivity response to specific allergen
Non-atopic results from chronic exposure to airway irritants
Acute severe/status asthmaticus is prolonged, refractory
Treated with short- and long-acting
bronchodilators, anti-inflammatory agents
What is Cystic Fibrosis (CF) and how does it present?
Excessive, tenacious secretions
- Mucus plugging that blocks respiratory passages, chronic infections
Productive cough, decreased activity tolerance, chronic hypoxemia
