Conditions and Treatments Flashcards
Ataxia
Describes poor muscle control that causes clumsy voluntary movements
- usually a result of trauma.
Pulsus paradox
is when systolic P drops more than 10 mmHg on inspiration
Lethargic
Sleepy, arouses easily
Responds to verbal/painful stimuli
Stuporous
Does not completely wake up.
- still responds to pain.
Chronic obstructive pulmonary disease [COPD]
A chronic inflammatory lung disease that causes obstructed airflow from the lungs
Pleural effusion
is the build-up of excess fluid between the layers of the pleura outside the lungs
Pneumonia
An infection that inflames the air sacs in one or both lungs
- The fluids filled in these areas are usually phlegm or pus.
Pneumothorax
A collapsed lung occurs when air escapes from the lung
Asthma
condition in which your airways narrow and swell and may produce extra mucus.
Jugular vein distention [JVD]
Occurs when there’s any kind of backup of blood in the superior vena cava or in the heart itself
Dyspnea
Perceived SOB or difficulty breathing
What is Orthopnea and what does it indicate?
- Inability to breathe when lying down
- associated with heart failure
Trepopnea
difficulty lying on one side
Platypnea
dyspnea in the upright position
Paroxysmal nocturnal dyspnea
Sudden onset,
occurs during sleep in the recumbent position, often associated with cough/heart failure
Atelectasis
A complete or partial collapse of the entire lung or area (lobe) of the lung
Bonus
- It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.
- Atelectasis is one of the most common breathing (respiratory) complications after surgery.
Tension pneumothorax
when a pneumothorax creates a one way valve that continuously pressurizes the pleural space
- Air cannot leave.
- **where intrapleural pressure exceeds intra alveolar pressure
- Check valve, air moves in but cannot move out -> emergent
Spontaneous pneumothorax
the sudden onset of a collapsed lung without any apparent cause
usually due to trauma injury or lung disease.
Hoover sign
Flattening of the diaphragm due to hyperinflation.
(seen in CF, COPD, Asthma)
Respiratory alternans
alternation of chest and stomach rising
another sign of respiratory fatigue
Emphysema
A lung condition that causes shortness of breath.
-It is a chronic condition.
Caused:
Alveoli are damaged/weakened
-causes large air spaces
Stenosis
Narrowing
Hemorrhage
An escape of blood from ruptured blood vessels
Ischemia
Condition in which the blood flow (and oxygen as a result) is restricted/reduced in a part of the body.
Abdominal paradox
sign of fatigue
When and why would does Cheyne Stokes occur?
Occurs with low cardiac output
CHF
low blood flow = lag in ventilatory response
When and why would Biots respiration occur
Occurs with increased intracranial pressure
why would apneustic breathing happen?
occurs with damage to the pons
(section of brain that handles manages inspiration)
Key differences between a Transudate and Exudate pleural effusion.
- Transudative effusions are caused by combinations of increased hydrostatic pressure and decreased plasma oncotic pressure.
- Exudative effusions result from increased capillary permeability, leading to leakage of protein, cells, and other serum constituents
Obstructive lung disease vs Restrictive lung disease
Obstructive = make it hard to exhale all the air in lungs.
Restrictive = difficulty fully expanding lungs with air.
Both share SOB with exertion.
Fluids that separate parietal from visceral pleura
Empyema
Chylothorax (fatty)
Hemothorax
Traits of a Transudative Pleural Effusion
Pleura remains intact.
Non-inflammatory pleural effusion seen from: CHF, Liver Cirrhosis (scarring), Nephrotic syndrome
Trats of a Exudative Pleural Effusion
Localized ruptures of blood vessels, lymphatic vessels, lung abscess, or esophagus.
Infections.
Associated with respiratory and metabolic acidosis.
Signs and Symptoms for: Pleural Effusion
Tachypnea and Tachycardia
Pleuritic chest pain
Hypertension
non-productive cough
diminished breath sounds
dull percussion notes
Treatment for pleural effusion
Thoracentesis or pleuronectids.
AKA PUNCTURE
Cardiogenic pulmonary edema
Leaking of fluid with each heart beat.
When inadequate pump function increases pressure in pulmonary capillaries forcing fluid to leak into the space between capillaries and alveoli
Non-cardiogenic pulmonary edema
Massive fluid shift.
Results from injury to lungs and increases permeability. Causing fluid to overload and leak into alveoli (protein rich).
Interstitial edema is often seen in what?
Cardiogenic pulmonary edema.
Cardiac tamponade
pressure on the heart occurs when blood or fluid builds in the space between the heart muscle and the outer covering sac (pericardium) of the heart.
Signs and Symptoms of: Pulmonary Edema
Pink frothy sputum.
Wheezing + Crackles
Cyanosis
Cheyne-stokes respirations
hypertension
tachypnea + tachycardia
What are 2 main treatments for managing pulmonary edemas?
Preload reduction treatment
Afterload reduction treatment
Preload Afterload Treatment
Use diuretics (for fluid shift) and vasodilators
Afterload Reduction Treatment
To decrease pressures on heart.
- ACE inhibitors to reverse vasoconstriction
- Beta Blockers to reduce HR
- Oncotic agents like mannitol to pull fluid into circulation.
What are alternative/extra treatments for Pulmonary Edema?
Oxygen therapy
Non-invasive ventilation.
-NIV (CPAP is great for suction clearance)
What are the benefits to non-invasive ventilation?
Great for secretion clearance (CPAP)
Stents the airways open
Helps oxygenation intubation and ventilation
Difference between Pulmonary Edema and Effusion?
Location of fluid buildup
- Pulmonary edema is a condition where excess fluid accumulates in the air spaces and tissues of the lungs. This fluid buildup can make it difficult for the lungs to function properly and can lead to symptoms such as shortness of breath, coughing, and wheezing. Pulmonary edema can be caused by a variety of factors, including **heart failure, kidney failure, lung infections, **and exposure to certain toxins.
- Pulmonary effusion, on the other hand, is a condition where fluid accumulates in the pleural space, which is the space between the lungs and the chest wall. This fluid buildup can compress the lungs and make it difficult to breathe. Symptoms of pulmonary effusion can include chest pain, shortness of breath, and a cough.
How do NMBA’s reduce ICP?
- They help facilitate mech. ventilation and reduce O2 consumption, which in turn decreases cerebral metabolic demand and lowers ICP.
- Reducing agitation via paralyzing can also promote more effective ventilation.
What are 4 phenotypes of a Pulmonary embolism (PE)
- Thrombus
- Embolus
- Shower thrombi
- Saddle Emboli
What is the difference between a embolus and thrombus?
- Thrombus = clot in a vein
- Embolus = clot on the move
Why is a saddle emboli fatal?
The clot could Lodge at pulmonary artery bifurcation
What are consequences of a Shower Thrombi?
Right sided heart failure
- many clots could form
What are cause of pulmonary Embolisms (PE)?
- Fat, air, amniotic fluid, bone marrows, or tumors
- DVT
- Virchows triad
What is virchow triad?
- Venous stasis (slow venous flow)
- Hypercoagubility (clots on clots)
- Injury to vessel lining
How are Pulmonary Embolisms diagnosed?
- CxR and d dimer test
- CT or V/Q scan
- Pulmonary angiogram gold standard
What are treatments for pulmonary embolisms?
- O2
- Fast acting anticoagulants (heparin (note aPTT and monitor) followed by warfarin
- Thrombolytics
- Vein filter placement for recurring clots issues
What is the difference between a closed and open pneumothorax?
- Closed = air does not have access to atm aka stuck in chest lining
- Open air goes right to atm
What is a trauma pneumothorax?
Penetrating wound
- Sucking chest wound (open pneumo)
- Tension (closed pneumo)
What is a spontaneous pneumothorax?
Secondary to COPD, TB, tall/Scandinavian men
- May act like a tension pneumo
What is a latrogenic pneumothorax?
Occurs during a procedure (ie. cannulation of subclavian)
How is Cystic Fibrosis diagnosed?
Sweat test
- > 60 in kids
- > 80 in adults
What gene mutates causing Cystic fibrosis?
CFTR gene mutation
- Condon 508
Placental abruption vs Placental previa?
- Placental abruption = separation from placental implantation prior to deliver
(emergency) - Placental previa = placenta covers the cervix (c section required)
