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Pathophysiology > Exam 2 - Alterations Of Pulmonary Function > Flashcards

Exam 2 - Alterations Of Pulmonary Function Flashcards

1
Q

Uncomfortable breathing; shortness of breath

Spelling

A

Dyspnea

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2
Q

Difficulty breathing while laying down

Spelling

A

Orthopnea

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3
Q

Gasping for air at night

A

Paroxysmal nocturnal dyspnea

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4
Q

What is dyspnea?

A

Uncomfortable breathing; shortness of breath

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5
Q

What can cause dyspnea?

A
  • Anxiety
  • Rapid labored breathing
  • Obesity
    (Not necessicarily related to disease)
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6
Q

What is orthopnea?

A 
Horizontal dyspnea
(Trouble breathing while laying down)
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7
Q

What is paroxysmal nocturnal dyspnea?

A

Gasping for air at night

Must stand up for relief

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8
Q

What causes orthopnea?

A

Occurs during heart failure

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9
Q

What causes paroxysmal nocturnal dyspnea (PND)?

A

Left ventricular failure

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10
Q

What would you ask a patient who you suspect has PND?

A

“Do you wake up at night gasping for air?”

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11
Q

High CO2?

A

Hypercapnia

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12
Q

What actually wakes the patient up during PND?

A

Hypercapnia (not enough circulating oxygen)

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13
Q

How many breaths per minute is normal breathing?

A

8-16 breaths per minute

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14
Q

Increased ventilatory rate with no expiratory pause

A

Kussmauls

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15
Q

What induces Kussmauls?

A

Strenuous exercise

Metabolic acidosis

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16
Q

Altering periods of deep and shallow breathing, with apnea

A

Cheyene-Stokes

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17
Q

What causes Cheyne-Stokes?

A

Traumatic brain injury

Or any condition that slows blood flow to brain

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18
Q

Breathing pattern in someone with Kussmauls?

A

Increased rate, no expiratory pause

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19
Q

Breathing pattern of someone with Cheyne-Stokes?

A 
Altering periods of deep and shallow breathing
With apnea (apnea lasting 15-60 seconds)
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20
Q

WHEN does Cheyne-Stokes occur?

A

Right before death (body is trying to reset breathing)

Death rattle follows, then death

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21
Q

Inadequate gas exchange of alveoli

A

Hypoventilation

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22
Q

What is hypoventilation?

A

Inadequate gas exchange and alveolar level

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23
Q

What does hypoventilation result in?

A

Hypercapnia (that further decreases breathing)

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24
Q

How to help a patient with hypoventilation

A

Have them take deep breaths

This gets rid of some carbon dioxide

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25
Q

Alveolar ventilation that exceeds metabolic demands

A

Hyperventilation

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26
Q

When does hyperventilation commonly occur?

A

Severe anxiety
acute head injury
In conditions that cause hypoxemia

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27
Q

What does hyperventilation result in?

A

Hypocapnia (b/c breathing off CO2)

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28
Q

How does a person feel if they’re experiencing hyperventilation?

A

Light headed

Hands and feet can go numb

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29
Q

How should you help a hyperventilating patient?

A

Breathing into paper bag (breathe CO2 back in to get more)

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30
Q

What does coughing do?

A

Protective reflex

Cleanses the lower airways & removes inhaled particles

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31
Q

Couging up blood; bloody secretions

Spelling

A

Hemoptysis

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32
Q

What does hemoptysis indicate?

A

Localized infection or inflammation

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33
Q

What does normal speutum look like?

A

Clear and frothy

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34
Q

What does speutum look like in someone with hemoptysys?

A

Frothy speutum mixed with bright red blood

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35
Q

Bluish discoloration of the skin and mucous membranes?

A

Cyanosis

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36
Q

What is cyanosis caused by?

A

Increasing amounts of desaturated or reduced hemoglobin (lack of oxygen)

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37
Q

Types of cyanosis:

A

Central

Peripherial

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38
Q

Which type of cyanosis is more dangerous and why?

A

Central. Often means major circulatory problem

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39
Q

What should you do if you think you see cyanosis in your patient?

A
  • Check blood oxygen

- Check consciousness

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40
Q

Where does pain caused by pulmonary disorders originate?

A 
In pleurae (inflammation and infection)
Airways
Chest wall (excessive coughing)
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41
Q

Most common cause of pain in pulmonary disorders

A

Pain that originates in pleurae

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42
Q

Why is documentation about abnormal sputum important?

A
  • Provides info about disease progression

- Shows effectiveness of therapy

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43
Q

What should you document about a patient’s sputum?

A 
Appearance
Odor
Consistancy
Thickness
Color
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44
Q

Word for high CO2

A

Hypercapnea

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45
Q

What is hypercapnea?

A

Increased carbon dioxide in arterial blood

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46
Q

What causes hypercapnea?

A

Hypoventilation of alveoli (less oxygen in alveoli)

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47
Q

Reduced oxygenation of arterial blood

A

Hypoxemia

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48
Q

What causes hypoxemia?

A

Respiratory alterations

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49
Q

What does hypoxemia lead to?

A

Hypoxia

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50
Q

What is hypoxia?

A

Reduced oxygenation of cells in tissues

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51
Q

How can high CO2 be lowered?

A

Increase respirations to breathe the CO2 off

Adding O2 doesn’t help because need to breathe the CO2 off first

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52
Q

What does a SpO2 monitor for?

A

Hypoxia and hypoxemia

because if a patient has hypoxia (at tissue level) they also have hypoxemia because hypoxemia leads to hypoxia

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53
Q

What causes acute respiratory distress?

A

Inadequate gas exchange

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54
Q

Values that define acute respiratory distress

A

PaO2 <50 (oxygen)
PaCO2 >50 (carbon dioxide)
PH <7.25 (power of hydrogen)

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55
Q

Symptoms of someone in acute respiratory distress

A

Dyspnea
Tachypnea
Low SpO2

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56
Q

How do we help someone in acute respiratory distress?

A

Know that if oxygen is low, CO2 is high, need to slow breathing down

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57
Q

Passage of fluid and solid particles into the lung

A

Aspiration pneumonia

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58
Q

What does aspiration tend to occur due to?

A

Impairment of swallowing mechanism and cough reflex

Due to decreased level of consciousnes or CNS abnormalities

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59
Q

Which patients tend to have a high rate of aspiration?

A

Pts being tube fed becuase of tube not being in the right place and it didn’t get caught

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60
Q

Excess water in the lung

A

Pulmonary edema

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61
Q

Most common cause of pulmonary edema

A

Heart disease or valve issues

62
Q

What does pulmonary edema sound like?

A

Fluid in the lungs so it sounds like crackles

63
Q

How is pulmonary edema treated?

A

Diuretic

Cannot be relieved by coughing

64
Q

What is flash pulmonary edema?

A

Pulmonary edema that occurs very rapidly

65
Q

What does a patient’s sputum look like when they have flash pulmonary edema?

A

Pink, frothy

66
Q

What would be done to help a patient who has flash pulmonary edema?

A

Emergency diurretics

67
Q

What is ateletasis?

A

Collapse of lung tissue

68
Q

What are the two types of atelectasis?

A

Compression

Absorption

69
Q

What is Compression Atelectasis caused by?

A

External pressure

70
Q

What is absorption atelectasis caused by?

A

removal of air from obstructed or hypoventilated alveoli

or from inhalation of concentrated oxygen or anesthetic agents

71
Q

Most common cause of absorption atelectasis

A

Inhilation of anesthetic agents

72
Q

How to treat compression atelectasis?

A

Chest tube

73
Q

How to treat absorption atelectasis

A

Chest tube, but sometimes pt can live with it if it’s only in base of alveoli and they’re handing it ok
(Can detect with xray)

74
Q

What is bronchiectasis?

A

Persistent abnormal dilation of the bronchi

75
Q

What is bronchiolitis

A

Inflammatory obstruction of small airways

76
Q

Which pulmonary disease is most common in children?

A

Bronchiolitis

77
Q

If bronchiolitis occurs in adults, what is it due to?

A

Chronic bronchitis
Viral infection
Inhalation of toxic gases

78
Q

*Symotoms of bronchiolitis?

A
  • rapid ventilatory rate
  • marked use of accessory muscles
  • low-grade fever
  • dry, unproductive cough
  • hyperinflated chest
79
Q

Treatment of bronchiolitis

A
  • anti-viral medications (to treat underlying cause)
  • steroids (to calm inflammatory process)
  • help control pt’s breathing
  • help pt cough stuff up, if necessary (turn pt on side, massage lung tissue)
80
Q

Technical term for deflated lung

A

Pneumothorax

81
Q

What is a pneumothorax?

A

Presence of air or gas in pleural space

82
Q

What causes a pneumothorax?

A

Rupture in visceral pleura (surrounds lungs) or parietal plura and chest wall

83
Q

Types of pneumothorax

A

Open pneumothorax
Tension pneumothorax
Spontaneous pneumothorax
Secondary (traumatic) pneumothorax

84
Q

What is an open pneumothorax?

A
  • Air pressure in pleural space equals barometric pressure (due to hole in pleural space)
85
Q

What is a tension pneumothorax?

A
  • Site of pleural rupture acts as a one-way valve
86
Q

What happens to air with an open pneumothorax?

A

Air that is drawn in during inspiration is forced back out during expiration

87
Q

What happens to air with a tension pneumothorax?

A

Air can enter through site of rupture, but it prevents air from escaping by closing up during expiration

88
Q

Treatment for pneumothorax

A

Chest tube

89
Q

What is a spontaneous pneumothorax?

A

A spontaneous rupture of blebs on the visceral plura that occurs unexpectedly in healthy individuals

90
Q

Who is more likely to get a spontaneous pneumothorax?

A

Usually men, 20-40 years old (usually from coughing)

91
Q

What is a secondary pneumothorax caused by?

A

Chest trauma

92
Q

*Signs and symptoms of a pneumothorax

A
  • shortness of breath
  • pain
  • tachypnea
  • dry cough
    • trachial deviation (shifts away from affected lung)
93
Q

Classic symptom of pneumothorax?

A

Trachial deviation

94
Q

Presence of fluid in the pleural space

A

Pleural effusion

95
Q

How does pleural effusion happen?

A

Migration of fluids and other blood components through the walls of intact capillaries bordering the pleura
AKA
Increased permeability at capillary wall and fluids shift

96
Q

Pus in the pleural space

A

Empyema

97
Q

How does empyema happen?

A

Blocked pulmonary lymphatics

98
Q

Between pleural effusion and empyema, which is more common, and which is more serious?

A

More common: pleural effusion

More serous: empyema

99
Q

Treatments for pleural effusion

A

Antidurretics
Steroids
Antibiotics

100
Q

How can you detect pleural effusion in a patient?

A

May not hear, but may hear diminished lung sounds

Will most commonly notice on xray - sporradic fluid in lung space

101
Q

Treatment for empyema

A

Can be drained

102
Q

What is flail chest?

A

Instability of a portion of the chest wall

Causing abnormal movement of the chest when breathing

103
Q

What causes flail chest?

A

Usual cause: Fracture of several consecutive ribs in more than one place

Or the fracture of the sternum plus several consecutive ribs

104
Q

What are inhalation disorders?

Not on blue print

A

Irritants cause significant respiratory dysfunction

105
Q

What causes inhalation disorders?

Not on blue print

A

Smoke, ammonia, hydrogen chloride, sulfur dioxide, chlorine, phosgene, and nitrogen dioxide

All of these cause damage over time

106
Q

Patho of inhalation disorders

Not on blue print

A

Sever inflammation of the airways, alveolar and capillary damage and pulmonary edema

107
Q

Clinical symptoms of inhalation disorders

Not on blue print

A 
Burning of the eyes, nose, and throat
Coughing
Chest tightness
Dyspnea
Hypoxemia is common
108
Q

Airway obstructions that are worse with expiration

A

Asthma
Chronic Obstructive Pulmonary Disease (COPD)
- Chronic bronchitis
- Emphysema

109
Q

What is asthma?’

Not on blue print

A

Chronic disorder of airways with episodes

Usually reversible

110
Q

What do episodes of asthma look like?

Not on blue print

A 
Hyperresponsiveness of airways and bronchospasms
Airway obstruction (caused by spasms)
Airway inflammation (from inflammatory process)
111
Q

Patho of asthma

Not on blue print

A

Genetic predisposition or environmental factors

112
Q

Casual contributors of asthma

Not on blue print

A

Allergens
RTI (respiratory tract infection)
Exercise
Drugs/chemicals

113
Q

How is asthma diagnosed?

Not on blue print

A

Careful H&P, laboratory findings, pulmonary function tests (look at compliance of lung tissue, tidal volume, amount of air on expiration)

114
Q

What does casual contributors of something mean?

Not on blue print

A

They come and go

115
Q

Clinical manifestations of asthma

Not on blue print

A
  • Asymptomatic btw attacks
  • Chest constriction
  • Expiratory wheezing
  • Dyspnea
  • Nonproductive cough (worse at night and early am)
  • Prolonged expiration
  • Tachycardia
  • Tachypnea
  • Pulsus paradoxus
116
Q

What does expiratory wheezing in a patient with asthma sound like?
Not on blue print

A

High pitched musical sound, due to constriction

117
Q

Why does a patient with asthma have tachycardia?

Not on blue print

A

Probably due to anxiety, but also from the inflammatory process

118
Q

Explain prolonged expiration in someone with asthma

Not on blue print

A

Lasts longer than inspiration because of constriction

119
Q

What is COPD?

A

A group of disorders characterized by chronic or recurrent obstruction of airflow (progressive)

120
Q

Leading cause of morbidity and mortality worldwide

A

COPD

121
Q

How many Americans are estimated to have COPD?

A

14 million

122
Q

Risk factors of COPD

A

Host - smoking
Inherited
Environmental - asthma (allergy related)

123
Q

Predominate risk factor of COPD

A

Host - smoking

124
Q

Two types of COPD

A

Emphysema

Chronic obstructive bronchitis

125
Q

Most common type of respiratory tract infection

A

Pneumonia

126
Q

What is pneumonia?

A

Acute infection of lower respiratory tract

127
Q

Causes of pneumonia

A 
Bacteria
Viruses
Fungi
Protozoa
Parasites
128
Q

Mortality rates of pneumonia are highest among?

A

Elderly (if other predisposing factors)

129
Q

Risk factors for pneumonia

A 
Advanced age
Immobolization
Immunocompromised
Malnutrition
Alcoholism
Smoking
Underlying lung disease
Altered consciousness
Endotracheal intubation
130
Q

Name for being on a ventilator

A

Endotracheal intubation

131
Q

How can endotracheal intubation cause pneumonia?

A

Caused by ventilator not being cared for properly

132
Q

Three types of pneumonia

A

Community-acquired pneumonia
Nosocomial
Immunocompromised individual

133
Q

What is the difference between community-acquired and nosocomial pneumonia?

A

Community-acquired = person cought pneumonia outside of hospital, in community

Nosocomial = person caught pneumonia in the hospital

134
Q

Type of bacterial that leads to pneumonia

A

S. pneumoniae

135
Q

Examples of what could cause the pressure in Compression atelectasis?

A

(Exerted by tumor, fluid, air in pleural space, abdominal distension)

136
Q

What causes absorption atelectasis?

A
  • removal of air from obstructed or hypoventilated alveoli

- inhalation of concentrated oxygen or anesthetic agents

137
Q

Genetics

A

High blood pressure

CAD

138
Q

Family history

A

Hypertension

CAD

139
Q

Obesity

A

Hypertension

CAD

140
Q

Sedentary lifestyle

A

Hypertension

CAD

141
Q

Smoking

A

Hypertension
CAD
Atherosclerosis

142
Q

Hypernatremia

A

Hypertension

143
Q

Low potassium

A

Hypertension

144
Q

Alcohol

A

Hypertension

CAD

145
Q

Stress/Personality

A

Hypertension

CAD

146
Q

Estrogen deficiency

A

CAD

147
Q

Hyperlipidemia

A

CAD

Atherosclerosis

148
Q

Diabetes

A

CAD

Atherosclerosis

149
Q

Autoimmune phenomenon

A

Atherosclerosis

150
Q

Infection

A

Atherosclerosis

Pathophysiology (14 decks)

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