Exam 2 - Alterations Of Pulmonary Function Flashcards
1
Q
Uncomfortable breathing; shortness of breath
Spelling
A
Dyspnea
2
Q
Difficulty breathing while laying down
Spelling
A
Orthopnea
3
Q
Gasping for air at night
A
Paroxysmal nocturnal dyspnea
4
Q
What is dyspnea?
A
Uncomfortable breathing; shortness of breath
5
Q
What can cause dyspnea?
A
- Anxiety
- Rapid labored breathing
- Obesity
(Not necessicarily related to disease)
6
Q
What is orthopnea?
A
Horizontal dyspnea (Trouble breathing while laying down)
7
Q
What is paroxysmal nocturnal dyspnea?
A
Gasping for air at night
Must stand up for relief
8
Q
What causes orthopnea?
A
Occurs during heart failure
9
Q
What causes paroxysmal nocturnal dyspnea (PND)?
A
Left ventricular failure
10
Q
What would you ask a patient who you suspect has PND?
A
“Do you wake up at night gasping for air?”
11
Q
High CO2?
A
Hypercapnia
12
Q
What actually wakes the patient up during PND?
A
Hypercapnia (not enough circulating oxygen)
13
Q
How many breaths per minute is normal breathing?
A
8-16 breaths per minute
14
Q
Increased ventilatory rate with no expiratory pause
A
Kussmauls
15
Q
What induces Kussmauls?
A
Strenuous exercise
Metabolic acidosis
16
Q
Altering periods of deep and shallow breathing, with apnea
A
Cheyene-Stokes
17
Q
What causes Cheyne-Stokes?
A
Traumatic brain injury
Or any condition that slows blood flow to brain
18
Q
Breathing pattern in someone with Kussmauls?
A
Increased rate, no expiratory pause
19
Q
Breathing pattern of someone with Cheyne-Stokes?
A
Altering periods of deep and shallow breathing With apnea (apnea lasting 15-60 seconds)
20
Q
WHEN does Cheyne-Stokes occur?
A
Right before death (body is trying to reset breathing)
Death rattle follows, then death
21
Q
Inadequate gas exchange of alveoli
A
Hypoventilation
22
Q
What is hypoventilation?
A
Inadequate gas exchange and alveolar level
23
Q
What does hypoventilation result in?
A
Hypercapnia (that further decreases breathing)
24
Q
How to help a patient with hypoventilation
A
Have them take deep breaths
This gets rid of some carbon dioxide
25
Alveolar ventilation that exceeds metabolic demands
Hyperventilation
26
When does hyperventilation commonly occur?
Severe anxiety
acute head injury
In conditions that cause hypoxemia
27
What does hyperventilation result in?
Hypocapnia (b/c breathing off CO2)
28
How does a person feel if they’re experiencing hyperventilation?
Light headed
| Hands and feet can go numb
29
How should you help a hyperventilating patient?
Breathing into paper bag (breathe CO2 back in to get more)
30
What does coughing do?
Protective reflex
| Cleanses the lower airways & removes inhaled particles
31
Couging up blood; bloody secretions
| Spelling
Hemoptysis
32
What does hemoptysis indicate?
Localized infection or inflammation
33
What does normal speutum look like?
Clear and frothy
34
What does speutum look like in someone with hemoptysys?
Frothy speutum mixed with bright red blood
35
Bluish discoloration of the skin and mucous membranes?
Cyanosis
36
What is cyanosis caused by?
Increasing amounts of desaturated or reduced hemoglobin (lack of oxygen)
37
Types of cyanosis:
Central
| Peripherial
38
Which type of cyanosis is more dangerous and why?
Central. Often means major circulatory problem
39
What should you do if you think you see cyanosis in your patient?
- Check blood oxygen
| - Check consciousness
40
Where does pain caused by pulmonary disorders originate?
```
In pleurae (inflammation and infection)
Airways
Chest wall (excessive coughing)
```
41
Most common cause of pain in pulmonary disorders
Pain that originates in pleurae
42
Why is documentation about abnormal sputum important?
- Provides info about disease progression
| - Shows effectiveness of therapy
43
What should you document about a patient’s sputum?
```
Appearance
Odor
Consistancy
Thickness
Color
```
44
Word for high CO2
Hypercapnea
45
What is hypercapnea?
Increased carbon dioxide in arterial blood
46
What causes hypercapnea?
Hypoventilation of alveoli (less oxygen in alveoli)
47
Reduced oxygenation of arterial blood
Hypoxemia
48
What causes hypoxemia?
Respiratory alterations
49
What does hypoxemia lead to?
Hypoxia
50
What is hypoxia?
Reduced oxygenation of cells in tissues
51
How can high CO2 be lowered?
Increase respirations to breathe the CO2 off
| Adding O2 doesn’t help because need to breathe the CO2 off first
52
What does a SpO2 monitor for?
Hypoxia and hypoxemia
because if a patient has hypoxia (at tissue level) they also have hypoxemia because hypoxemia leads to hypoxia
53
What causes acute respiratory distress?
Inadequate gas exchange
54
Values that define acute respiratory distress
PaO2 <50 (oxygen)
PaCO2 >50 (carbon dioxide)
PH <7.25 (power of hydrogen)
55
Symptoms of someone in acute respiratory distress
Dyspnea
Tachypnea
Low SpO2
56
How do we help someone in acute respiratory distress?
Know that if oxygen is low, CO2 is high, need to slow breathing down
57
Passage of fluid and solid particles into the lung
Aspiration pneumonia
58
What does aspiration tend to occur due to?
Impairment of swallowing mechanism and cough reflex
| Due to decreased level of consciousnes or CNS abnormalities
59
Which patients tend to have a high rate of aspiration?
Pts being tube fed becuase of tube not being in the right place and it didn’t get caught
60
Excess water in the lung
Pulmonary edema
61
Most common cause of pulmonary edema
Heart disease or valve issues
62
What does pulmonary edema sound like?
Fluid in the lungs so it sounds like crackles
63
How is pulmonary edema treated?
Diuretic
| Cannot be relieved by coughing
64
What is flash pulmonary edema?
Pulmonary edema that occurs very rapidly
65
What does a patient’s sputum look like when they have flash pulmonary edema?
Pink, frothy
66
What would be done to help a patient who has flash pulmonary edema?
Emergency diurretics
67
What is ateletasis?
Collapse of lung tissue
68
What are the two types of atelectasis?
Compression
| Absorption
69
What is Compression Atelectasis caused by?
External pressure
70
What is absorption atelectasis caused by?
removal of air from obstructed or hypoventilated alveoli
| or from inhalation of concentrated oxygen or anesthetic agents
71
Most common cause of absorption atelectasis
Inhilation of anesthetic agents
72
How to treat compression atelectasis?
Chest tube
73
How to treat absorption atelectasis
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
What is bronchiectasis?
Persistent abnormal dilation of the bronchi
75
What is bronchiolitis
Inflammatory obstruction of small airways
76
Which pulmonary disease is most common in children?
Bronchiolitis
77
If bronchiolitis occurs in adults, what is it due to?
Chronic bronchitis
Viral infection
Inhalation of toxic gases
78
*Symotoms of bronchiolitis?
- rapid ventilatory rate
- marked use of accessory muscles
- low-grade fever
- dry, unproductive cough
- hyperinflated chest
79
Treatment of bronchiolitis
- 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
Technical term for deflated lung
Pneumothorax
81
What is a pneumothorax?
Presence of air or gas in pleural space
82
What causes a pneumothorax?
Rupture in visceral pleura (surrounds lungs) or parietal plura and chest wall
83
Types of pneumothorax
Open pneumothorax
Tension pneumothorax
Spontaneous pneumothorax
Secondary (traumatic) pneumothorax
84
What is an open pneumothorax?
- Air pressure in pleural space equals barometric pressure (due to hole in pleural space)
85
What is a tension pneumothorax?
- Site of pleural rupture acts as a one-way valve
86
What happens to air with an open pneumothorax?
Air that is drawn in during inspiration is forced back out during expiration
87
What happens to air with a tension pneumothorax?
Air can enter through site of rupture, but it prevents air from escaping by closing up during expiration
88
Treatment for pneumothorax
Chest tube
89
What is a spontaneous pneumothorax?
A spontaneous rupture of blebs on the visceral plura that occurs unexpectedly in healthy individuals
90
Who is more likely to get a spontaneous pneumothorax?
Usually men, 20-40 years old (usually from coughing)
91
What is a secondary pneumothorax caused by?
Chest trauma
92
*Signs and symptoms of a pneumothorax
- shortness of breath
- pain
- tachypnea
- dry cough
* - trachial deviation (shifts away from affected lung)
93
Classic symptom of pneumothorax?
Trachial deviation
94
Presence of fluid in the pleural space
Pleural effusion
95
How does pleural effusion happen?
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
Pus in the pleural space
Empyema
97
How does empyema happen?
Blocked pulmonary lymphatics
98
Between pleural effusion and empyema, which is more common, and which is more serious?
More common: pleural effusion
| More serous: empyema
99
Treatments for pleural effusion
Antidurretics
Steroids
Antibiotics
100
How can you detect pleural effusion in a patient?
May not hear, but may hear diminished lung sounds
| Will most commonly notice on xray - sporradic fluid in lung space
101
Treatment for empyema
Can be drained
102
What is flail chest?
Instability of a portion of the chest wall
| Causing abnormal movement of the chest when breathing
103
What causes flail chest?
Usual cause: Fracture of several consecutive ribs in more than one place
Or the fracture of the sternum plus several consecutive ribs
104
What are inhalation disorders?
| Not on blue print
Irritants cause significant respiratory dysfunction
105
What causes inhalation disorders?
| Not on blue print
Smoke, ammonia, hydrogen chloride, sulfur dioxide, chlorine, phosgene, and nitrogen dioxide
All of these cause damage over time
106
Patho of inhalation disorders
| Not on blue print
Sever inflammation of the airways, alveolar and capillary damage and pulmonary edema
107
Clinical symptoms of inhalation disorders
| Not on blue print
```
Burning of the eyes, nose, and throat
Coughing
Chest tightness
Dyspnea
Hypoxemia is common
```
108
Airway obstructions that are worse with expiration
Asthma
Chronic Obstructive Pulmonary Disease (COPD)
- Chronic bronchitis
- Emphysema
109
What is asthma?’
| Not on blue print
Chronic disorder of airways with episodes
| Usually reversible
110
What do episodes of asthma look like?
| Not on blue print
```
Hyperresponsiveness of airways and bronchospasms
Airway obstruction (caused by spasms)
Airway inflammation (from inflammatory process)
```
111
Patho of asthma
| Not on blue print
Genetic predisposition or environmental factors
112
Casual contributors of asthma
| Not on blue print
Allergens
RTI (respiratory tract infection)
Exercise
Drugs/chemicals
113
How is asthma diagnosed?
| Not on blue print
Careful H&P, laboratory findings, pulmonary function tests (look at compliance of lung tissue, tidal volume, amount of air on expiration)
114
What does casual contributors of something mean?
| Not on blue print
They come and go
115
Clinical manifestations of asthma
| Not on blue print
- Asymptomatic btw attacks
- Chest constriction
- Expiratory wheezing
- Dyspnea
- Nonproductive cough (worse at night and early am)
- Prolonged expiration
- Tachycardia
- Tachypnea
- Pulsus paradoxus
116
What does expiratory wheezing in a patient with asthma sound like?
Not on blue print
High pitched musical sound, due to constriction
117
Why does a patient with asthma have tachycardia?
| Not on blue print
Probably due to anxiety, but also from the inflammatory process
118
Explain prolonged expiration in someone with asthma
| Not on blue print
Lasts longer than inspiration because of constriction
119
What is COPD?
A group of disorders characterized by chronic or recurrent obstruction of airflow (progressive)
120
Leading cause of morbidity and mortality worldwide
COPD
121
How many Americans are estimated to have COPD?
14 million
122
Risk factors of COPD
Host - smoking
Inherited
Environmental - asthma (allergy related)
123
Predominate risk factor of COPD
Host - smoking
124
Two types of COPD
Emphysema
| Chronic obstructive bronchitis
125
Most common type of respiratory tract infection
Pneumonia
126
What is pneumonia?
Acute infection of lower respiratory tract
127
Causes of pneumonia
```
Bacteria
Viruses
Fungi
Protozoa
Parasites
```
128
Mortality rates of pneumonia are highest among?
Elderly (if other predisposing factors)
129
Risk factors for pneumonia
```
Advanced age
Immobolization
Immunocompromised
Malnutrition
Alcoholism
Smoking
Underlying lung disease
Altered consciousness
Endotracheal intubation
```
130
Name for being on a ventilator
Endotracheal intubation
131
How can endotracheal intubation cause pneumonia?
Caused by ventilator not being cared for properly
132
Three types of pneumonia
Community-acquired pneumonia
Nosocomial
Immunocompromised individual
133
What is the difference between community-acquired and nosocomial pneumonia?
Community-acquired = person cought pneumonia outside of hospital, in community
Nosocomial = person caught pneumonia in the hospital
134
Type of bacterial that leads to pneumonia
S. pneumoniae
135
Examples of what could cause the pressure in Compression atelectasis?
(Exerted by tumor, fluid, air in pleural space, abdominal distension)
136
What causes absorption atelectasis?
- removal of air from obstructed or hypoventilated alveoli
| - inhalation of concentrated oxygen or anesthetic agents
137
Genetics
High blood pressure
| CAD
138
Family history
Hypertension
| CAD
139
Obesity
Hypertension
| CAD
140
Sedentary lifestyle
Hypertension
| CAD
141
Smoking
Hypertension
CAD
Atherosclerosis
142
Hypernatremia
Hypertension
143
Low potassium
Hypertension
144
Alcohol
Hypertension
| CAD
145
Stress/Personality
Hypertension
| CAD
146
Estrogen deficiency
CAD
147
Hyperlipidemia
CAD
| Atherosclerosis
148
Diabetes
CAD
| Atherosclerosis
149
Autoimmune phenomenon
Atherosclerosis
150
Infection
Atherosclerosis
