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Clients with Health Challenges - N3600 > Course Intro - Problems of Oxygenation > Flashcards

Course Intro - Problems of Oxygenation Flashcards

1
Q

What is the designation neonate held for?

A

Babies in the first month of life

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2
Q

Bronchitis:
- inflammation of the ______, may be acute or chronic
- Causes?
What are the common signs and symptoms?

A

inflammation of the bronchi
Cause is viral or bacterial
Persistent and productive cough, rhinitis, pharyngitis

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3
Q

Describe bronchitis pathophysiology.

A

Inflammation of the bronchi causing mucus to be produced.

mucus clogs the airway, making breathing difficult.

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4
Q

Most cases of bronchitis are?

A

Bacterial

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5
Q

Describe the typical treatment of bronchitis.

A

Usually a self-limiting condition
Treatment is usually fluids, rest, anti-inflammatory agents, anti-expectorants, or bronchodilators
Antibiotics are reserved for those with chronic chest issues (e.g. smokers or COPD patients)

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6
Q

Why are antibiotics limited to smokers or COPD patients?

A

Because they already have large areas of the lung fields compromised and may go into respiratory arrest

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7
Q

When does bronchitis become critical?

A

The acute on chronic (AECB - acute exacerbation of chronic bronchitis)

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8
Q

What is the treatment for AECB? Why?

A

Broad-spectrum antibiotics
Evidence suggests early initiation of antibiotic treatment in patients with COPD results in a decrease in relapses and a decrease in hospital admissions

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9
Q

What is the number one killer worldwide?

A

TB

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10
Q

How is vancomycin administered?

A

given by IV - need central or picc (peripherally inserted central catheter) line to administer

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11
Q

Acute inflammation of lung parenchyma.

A

Pneumonia

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12
Q

What is the cause of pneumonia?

A

Microbial (bacteria, virus, mycoplasma, fungi, parasite), or chemical agent

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13
Q

How can agents causing pneumonia be acquired?

A

Aspiration - from nsaopharynx or oropharynx
Inhalation
Hematogenous spread - primary infection elsewhere in the body

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14
Q

How is the causative agent of pneumonia identified?

What is the treatment?

A

Take a sputum sample to identify the causative agent.

Treatment is lots of bed rest, lots of fluid to water down secretions so that they can be coughed out.

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15
Q

What is the most common way that younger individuals get bacteria into their lungs?
Describe precautions here for compromised patients.

A

Through our bloodstream after a procedure - especially after the dentist.
For more compromised patients, often given antibiotics to prevent complications such as pneumonia, pericarditis, endocarditis.

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16
Q

What are the different types of pneumonia?

A 
Community acquired (CAP)
Hospital acquired (HAP)
Fungal
Opportunistic
Aspiration
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17
Q

What is an important predisposing factor for pneumonia?

A

Altered level of consciousness - cannot clear their own pathways, cannot cough, clear throat/remove secretions.

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18
Q

Tremulous vibration heard or felt over posterior thorax. Heard when the tissue is fluid filled.

A

Fremitus

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19
Q

Pain in a muscle or group of muscles.

A

Myalgia

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20
Q

Myalgia without a traumatic history is often due to what?

A

viral infections

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21
Q

What is the usual sign that brings people to the doctor when they have pneumonia?

A

Fever and chills

22
Q

What is the point at which we need to treat elevated temperature?

A

38.5+

23
Q

Pain on inspiration, dagger-like pain when taking a breath in

A

Pleuritic chest pain

24
Q

Describe pulmonary consolidation in pneumonia.

A

On X-ray, can see the fluid-filled regions of the lungs

25
Q

How do we assess tactile fremitis?

A

Put hands on posterior thorax and have patient say 99

26
Q

If a person has muscle pain along with respiratory symptoms, what is often the diagnosis?

A

Viral pneumonia (walking pneumonia - layman term)

27
Q

How can confusion/stupor occur in pneumonia?

A

CO2 may not be exhaled, leading to respiratory acidosis.

28
Q

Inflammation of the parietal pleura.

A

Pleurisy

29
Q

Fluid in the interstitial & air spaces of the lungs

A

Pleural effusion

30
Q

Collapse of lung tissue

A

Atelectasis

31
Q

Pus in the pleural space

A

Empyema

32
Q

Describe purulence in pneumonia.

A

Green colour; means that bacteria are attacking healthy cell proteins
(normal breakdown of proteins is yellow in colour)

33
Q

inflammation of the fibro serous sac that surrounds the heart

A

pericarditis (fibro-serous sac surrounding the heart is the pericardium)

34
Q

Any inflammation condition of the joints

A

arthritis

35
Q

Any infection or inflammation of the membranes covering the brain and spinal cord

A

Meningitis

36
Q

Inflammation of the heart valves.

A

Endocarditis

37
Q

For pneumonia collaborative care:

  • Fluid intake should be increased to what? Why?
  • Describe the diet
A

3L/day to liquify secretions
1500cal/day at least, small frequent meals
- high protein, high calorie food
DO NOT GIVE MILK or other dairy products - will thicken secretions

38
Q

What is given to treat pain on inspiration?

Why is _____ not given?

A

Analgesics

Codeine/morphine is not given as this may cause constipation, and make the person drowsy and at risk for aspiration

39
Q

Describe what must be added when you write you will monitor something.

A

When you write monitor, MUST provide frequency

40
Q

Why would a spirometer be used?

A

To help with DB & C.

41
Q

When a person doesn’t have the strength to cough normally, what are they taught?

A

To huff cough

42
Q

The pneumococcal vaccine is indicated for these individuals.

A

Those with:

  • chronic illness, heart or lung disease, or diabetes
  • are recovering from a severe illness
  • are 65+
  • Live in a LTC facility
43
Q

Describe the time frame of immunity for the pneumococcal vaccine.

A

One vaccine good for life for most individuals

Given every 5 years to high risk individuals (HIV, transplant, renal failure)

44
Q

SARS:
- Cause - type of ________
- first appeared in _____
Treatment?

A

Caused by a certain type of coronavirus
First appeared in China (Canadian outbreak in March 2003)
Treatment - no vaccine or cure, no specific diagnostic tests either. Treatment is identical to that of viral pneumonia, including oxygen therapy and antiviral drugs
Proper hand hygiene is essential!!

45
Q

What was the cause of spread of SARS?

A

Poor hand hygiene (hand washing for 20 seconds needed to kill the virus)

46
Q

Describe the spread of SARS and when it becomes infectious.

A

Spread via close contact, respiratory secretions and bodily fluids
Ten days to show symptoms, then become contagious

47
Q

What is a very important symptom of SARS?

A

Fever - Temperature above 38C

48
Q

TB:

  • Cause
  • spread?
  • organ(s) involved
  • seen more often in these populations
  • Triad of common symptoms?
A

Mycobacterium tuberculosis
Spread via airborne droplets
Involves the lungs, but may also be extra-pulmonary (LKBALM - larynx, kidneys, bones, adrenal glands, lymph nodes, meninges)
Seen more often in the poor, underserved and minorities (6x higher in Canadian Aboriginal peoples)
Triad of common symptoms: hemoptysis, low-grade fever, night-sweats

49
Q

TB:
- Diagnosis?
– Diagnosis in the immunocompromised?
Who is always screened for TB?

A

Diagnosis:
- TB skin test (Mantoux) - 10 mm induration after 24-72hrs is positive
- chest X-ray, or sputum/smear culture can also be used
for the immunocompromised an induration reaction larger than 5mm is considered positive

HCPs are always screened and those admitted to LTC or chronic care facilities

50
Q

TB:

  • treatment?
  • vaccine?
A

Treatment:

  • Long-term treatment with oral antimicrobial drugs (6-9 months) - isoniazid or rifampin (liver test required)
  • Vaccine - BCG vaccine given in high-prevalence areas of the world

Clients with Health Challenges - N3600 (22 decks)

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