exam 1 med surg Flashcards
1
Q
Physiologically, what should you avoid to not get a respiratory infection?
A
avoid trappage in mucocilliary and phagocytosis by alveolar macrophages
2
Q
What is the only mode of transmission for a respiratory infection?
A
airborne transmission
3
Q
What population is most likely to contract tuberculosis?
A
Homeless/incarcerated populations and people with HIV/AIDS
4
Q
What is the mode of transmission for TB?
A
droplet
5
Q
What are normally the clinical manifestations for someone with TB?
A
asymptomatic and noninfectious
6
Q
What are clinical manifestations for someone who has symptomatic TB?
A
fatigue, weight loss, sweats, cough, bloody sputum
7
Q
What are complications of TB?
A
bronchopleural fistula, meningitis, pleural effusions, bone disease, liver/kidney failure
8
Q
What is the mode of transmission for influenza?
A
droplet transmission
9
Q
What are the clinical manifestations of influenza?
A
fever, headache, sore throat, cough
10
Q
What are the risk factors of pneumonia?
A
recent antibiotic therapy, immunosupression, chronic disease
11
Q
What is pneumonia?
A
inflammation of the lung parenchyma from bacterial, viral, or fungal infection
12
Q
What are the clinical manifestations of pneumonia?
A
altered mental status, >30 Resp, hypotension, >125 bpm, low/high temps, low pH, decreased Na
13
Q
What are the complications of pneumonia?
A
empyema, sepsis, pneumothorax, respiratory failure
14
Q
What are the diseases of the upper airway?
A
Rhinitis, obstructive sleep apnea, laryngeal trauma, rhinosinitis, laryngeal cancer
15
Q
What is rhinitis?
A
inflammation of mucous membrane of nose in response to irritant
16
Q
What are the clinical manifestations of Rhinitis?
A
itching, sneezing, congestion
17
Q
What happens during obstructive sleep apnea?
A
upper airway narrows/collapses; increased resistance to airflow; hypoxemia, hypercapnia
18
Q
What are risk factors for sleep apnea?
A
A-fib, type 2 diabetes, HF, men, obesity, smoking, alcohol, 40-65 y/o
19
Q
What are the clinical manifestations of obstructive sleep apnea?
A
loud snoring, gasping during sleep, waking up a lot
20
Q
Who is laryngeal trauma more common in?
A
men
21
Q
How does laryngeal trauma occur?
A
Through injuries; ingestion/inhalation of causative agent; pressure from prolonged intubation
22
Q
What is rhinosinitis?
A
Symptomatic inflammation of nasal/paranasal cavity; infection/inflammation of paranasal sinuses; nasal congestion, obstruction of airflow
23
Q
What are the clinical manifestations of rhinosinitis?
A
purulent nasal drainage, facial pain, nasal obstruction
24
Q
who is laryngeal cancer more common in?
A
men
25
What happens with your epithelial cells during laryngeal cancer?
Squamous cells line larynx, hypopharynx, and entrance to esophagus
26
What can cause cells to become more precancerous in laryngeal cancer?
irritants like alcohol and smoking
27
What are the clinical manifesations of laryngeal cancer?
hoarseness, change in voice, cough, sore throat, pain w/ swallowing, lump/mass in neck
28
What are the diseases of the lower respiratory airway?
asthma, cystic fibrosis, COPD, lung cancer
29
What do lower airway disease do?
negatively impact oxygenation, ventilation, and gas exchange
30
What is asthma?
reversible airway obstruction from inflammation
31
What happens to the muscles surrounding airways during asthma attacks?
they tighten
32
When the muscles tighten during an asthma attack what happens to those airways?
airway obstruction and hyper-responsiveness
33
What are the clinical manifestations of asthma?
Wheezing, dyspnea, coughing, increase in sputum, increase in respiratory rate
34
What is cystic fibrosis caused by?
Caused by defective gene carried by both parents
35
Cystic Fibrosis is a genetic disease of what glands?
exocrine glands
36
What is there a deficiency of with cystic fibrosis?
Protein
37
Because there is a deficiency in protein with cystic fibrosis, what occurs?
mucus build-up which blocks airways and GI as well as blocks pancreatic enzymes
38
What are the clinical manifestations of cystic fibrosis?
Cough, mucus, wheezing, lung infections, poor weight gain, blockage, constipation
39
What is the main issue with COPD?
airflow limitation that is progressive and not fully reversible
40
What is a disease that occurs in COPD?
emphysema (destruction of alveoli)
41
What are clinical manifestations of COPD?
increase work of breath, accessory muscle use, tripoding, skin change, cough, crackles, wheezing
42
What are risk factors for COPD?
smoking, occupational hazards, pollution
43
What is lung cancer?
Uncontrolled cell growth of abnormal cells
44
What are clinical manifestations of lung cancer?
cough, hemoptysis, SOB, Wheezing, hoarsness, chest pain
45
What is a pulmonary embolism?
blood clot in pulmonary artery
46
What happens with pulmonary embolisms?
high ventilation, low perfusion
47
What are risk factors for pulmonary embolisms?
obesity, smoking, fracture, trauma, heart disease, spinal cord injury
48
What are the clinical manifestations with pulmonary embolisms?
dyspnea, pleuritic chest pain, tachypnea
49
What are the 3 phases of acute respiratory distress syndrome?
1. Exudate phase (24-48hours) inflammation of alveolar membrane
2. proliferative phase
3. fibrotic phase
50
What are the risk factors for ARDS?
sepsis, severe trauma, aspiration, smoking, bypass, overdose, PE
51
What are clinical manifestations of ARDS?
tachypnea, tachycardia
52
What are the two types of acute respiratory failure?
hypoxemic respiratory failure
hypercapnic respiratory failure
53
What are risk factors for ARF?
pulmonary edema, pneumonia, PE, Asthma, narcotics
54
What are clinical manifestations of hypoxemic respiratory failure?
Changes in respirations, change in HR, Change in BP
55
What are clinical manifestations of hypercapnic respiratory failure?
Headache, confusion, decrease in consciousness
56
What are the two types of chest trauma?
blunt force trauma, penetrating trauma
57
What are clinical manifestations of chest trauma?
decrease in oxygen and ventilation, impaired gas exchange
58
What are complications with chest trauma?
Pneumothorax, cardiac tamponade
59
location of AV valves
between atria and ventricles
60
location of semilunar valve
between ventricle and pulmonary/body
61
PR interval
depolarize atria
62
QRS interval
depolarize ventricles
63
QT interval
ventricles depolarizing and repolarizing
64
What is the order of the conduction system?
SA node
AV Node
Bundle of HIS
R and L bundle branches
Purkinje fibers
65
Depolarization
opening of Na channels
66
Repolarization
closed Na channels and K out
67
What are cardiac lab values that are vital in knowing?
lipid pannel (cholesterol, lipid density, trigycerides), creatinine, troponin, myoglobin, natriuretic peptide
68
What is cardiac output?
HR x Stroke volume
69
preload
blood in ventricle at the end of diastole
70
afterload
resistance ventricle must overcome
71
diastole
ventricles relaxed
72
systole
ventricles contract
73
Highest risk factor of cardiac dysrhythmias?
age
74
Manifestations of cardiac dysrhythmias?
hypotension, sweating, shortness of breath, syncope
75
sinus bradycardia
<60 bpm
76
causes of sinus bradycardia
hypoxia, hypothermia
77
Treatment for sinus bradycardia
beta blockers, Ca channel blockers
78
Causes of arterial fibrillation
age, cardiomypathy, HTN, Pericarditis, obesity, diabetes
79
treatment for Afib
control HR, cardiac abrasion, cardioversion
80
atrial flutter
the heart's upper chambers (atria) beat too quickly
81
Causes of atrial flutter
acute MI, mitral valve disease, thyrotoxicosis, COPD
82
treatment for atrial flutter
beta blockers, Ca channel blockers, digoxin, cardioversion
83
ventricular tachycardia
the lower chamber of the heart beats too fast to pump well and the body doesn't receive enough oxygenated blood
84
What are the causes of ventricular tachycardia?
hypovolemia, hypoxia, acidosis, hyper/hypokalemia, hypoglycemia
85
treatments for ventricular tachycardia
antiarrythmatic meds, electrolytes, cardioversion, resuscitation
86
atrial fibrillation
an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart
87
ventricular fibrillation
disorganized heart signals cause the lower heart chambers (ventricles) to twitch (quiver) uselessly
88
causes of ventricular fibrillation
hypovolemia, hypoxia, acidosis, hyper/hypokalemia, hypoglycemia, MI, PE
89
treatment for ventricular fibrillation
chest compressions, defibrillation
90
idioventricular rhythm
SA and AV nodes fail
91
causes of idioventricular rhythms
MI, post cardiac arrest, drug toxicity, electrolyte imbalance, myocarditis, cardiomyopathy
92
What would you do during asystole
start CPR
93
asystole
heart stops beating
94
heart block
delay or block in conduction
95
causes of heart block
acute coronary syndrome, electrolyte imbalance, med toxicities
96
heart block can cause what
ischemia/death
97
treatment for heart block
monitor, pacing, treat cause
98
Risk factors for atherosclerosis
vessel damage, infammatory response, hard thickened vessels, plaque formation
99
What causes atherosclerosis?
high cholesterol, high triglycerides (LDL)
100
clinical manifestations of atherosclerosis
Mi, stroke, gangrene, cardiac death
101
Peripheral artery disease risk factors
atherosclerosis
102
What is peripheral artery disease?
obstruction of blood flow through large peripheral arteries, partial or total occlusion
103
clinical manifestations of peripheral artery disease
diminished lower extremity pulses
104
treatment for peripheral artery disease
anti-platelets, statins, angioplasty, atherectomy
105
risk factors for aortic artery disease
men, family history
106
What occurs with aortic artery disease
middle layer artery is weakened, stretching of inner layer, artery widens, tension increases
107
clinical manifestations of aortic artery disease
asymptomatic till burst, thoracic or abdominal
108
treatment for aortic artery disease
by controlling hypertension and repair or graft
109
risk factors for hypertension
race, gender, socioeconomic status
110
What does Na do with hypertension?
increases
111
What happens to veins during hypertension?
vasoconstriction
112
What does aldosterone do to cause hypertension?
increase stroke volume and blood pressure
113
What does the SNS do during Hypertension?
promotes vasoconstriction
114
what are the clinical manifestations of hypertension?
headache, chest pain, vision changes
115
treatment for hypertension
lifestyle changes, diuretics, antihypertensives
116
risk factors for carotid artery disease
smoking, hypertension, obesity
117
What happens with carotid artery disease?
vessel wall thickening, plaque formation occluding coronary artery
118
clinical manifestations of carotid artery disease
impaired profusion, stroke or TIA
119
carotid artery disease usually does not present symptoms which means the patient is...
asymptomatic
120
treatment for carotid artery disease
carotid endocardectomy, stenting
121
risk factors for deep vein thrombosis
old age, cancer, varicose veins, pregnancy
122
what happens to the rate of bloodflow with DVT
decreases
123
deep vein thrombosis causes damage to what?
the vessel walls
124
DVT increases the chances of a...
blood clot
125
clinical manifestations of DVT
pain, swelling, redness, warmth
126
what kind of monitoring can a nurse perform for cardiovascular dysfunctions?
hemodynamic monitoring
127
what are ways to perform hemodynamic moniotring?
arterial catheter (BP), central venous catheter (R arterial pressure), pulmonary artery catheter (R heart function)
128
What is cardiogenic shock
heart cannot contract, decrease in cardiac output
129
what are the clinical manifestations of cardiogenic shock
chest pain, diaphoresis, nausea, vomiting
130
treatment for cardiogenic shock
increase BP and CO, intra-aortic balloon, heart transplant mechanical support
131
What is a myocardial infraction
destruction of heart muscle from lack of oxygenated blood supply
132
what are clinical manifestations of MI
chest, shoulder, and arm pain
133
what is a cardiomypathy?
structural changes to heart (weak, enlarged, thick or rigid), decrease in heart muscle function
134
clinical manifestations fo MI
chest pain, dizziness, indigestion, nausea
135
treatment for MI
Ace inhibitors, beta blockers, diuretics, pacemaker intervention (surgery)
136
modifiable risk factors of coronary artery disease
high cholesterol, HTN, diabetes, obesity, smoking, activity
137
non-modifiable risk factors of coronary artery disease
gender, race, heredity, age
138
What process occurs during CAD that forms and occludes the coronary arteries?
atherosclerosis
139
With CAD, what can occur if left untreated?
unstable angina, MI, sudden cardiac death
140
What happens to blood flow as a result of CAD?
reduced blood flow and ischemic problems
141
What are risk factors for myocarditis?
being a young men
142
What happens during myocarditis?
damage to myocardium, virus is causative agent
143
What are clinical manifestations of myocarditis?
heart failure, shock, angina, dyspnea, syncope
144
Treatments for myocarditis
manage HF, dysrhythmias, immunsupressants
145
What occurs with heart failure?
myocardial cell dysfunction, heart cannot meet bodys needs
146
What are clinical manifestations of HF?
fatigue, weight gain, tachycardia, HTN/hypotension, murmur
147
Complications with HF?
pulmonary edema (pink frothy sputum), renal failure
148
Treatment for HF
beta blockers, diuretics, ace inhibitors, Ca channel blockers, digoxin, defibrillator
149
What are risk factors for infective endocarditis?
age, immunodeficiency, drug use, diabetes, heart defect
150
What happens with infective endocarditis?
infection of endocardium affecting heart valve (usually bacterial)
151
Clinical manifestations of infective endocarditis
oslers nodes, janeway lesions, splinter hemorrhage, murmur, fever
152
treatment for infective endocarditis
IV therapy, valve replacement/repair
153
risk factors of pericarditis
non-ischemic chest pain, post MI
154
what is pericarditis
inflammation of the pericardium
155
clinical manifestations fo pericarditis
pleural chest pain, pericardial effusion, EKG changes, fever
156
treatment for pericarditis
aspirin, NSAIDs, antiinflammatories
157
What happens with valvular disease?
regurgitation, left or right sided heart failure
158
clinical manifestations of valvular disease
murmur, SOB, crackles, angina, syncope, fatigue, edema
159
treatment for valvular disease
ace inhibitors, diuretics, valve repair/replacement
160
sinus tachycardia rate
>100 bpm
161
causes of sinus tachycardia
fever, anemia, hypovolemia, hypotension, PE, MI
162
treatment for sinus tachycardia
beta blockers, Ca channel blockers
