Gas Exchange Flashcards
infectious disease caused by mycobacterium tuberculosis
tuberculosis
tuberculosis most commonly infects the
lungs
what are the risk factors for tuberculosis
homeless, residents of inner city neighborhoods, foreign-born, living or working in institutions, IV injecting drug users, poverty, immunosuppression, asian descent
when does multi drug resistant tuberculosis occurs
when a strain develops resistance to two of the most potent first line anti TB drugs
what is one of the main causes for resistance to the drug to occur
not finishing treatment
how is tuberculosis spread
via airborne droplets
how long can the tuberculosis droplets be suspended in the air and why
minutes to hours because the droplet itself is so tiny
tuberculosis is NOT spread by
touching, sharing food utensils, kissing, or physical contact
once tuberculosis droplet is inhaled it lodges in bronchiole and alveolus and develops into a
granuloma
when the granuloma develops the infection becomes
walled off and typically stops further spreading
why does tuburculosis the lungs
its aerophilic (oxygen loving)
develops active infection within the first 2 years of being exposed is
primary infection
activated 2 years AFTER exposure is
latent TB infection
Tb comes back when immunocompromised
reactivation TB
where is the grandulome/TB found
upper to mid lungs
what does TB usually start with
dry cough that then becomes productive and frequent
what is a late sign of TB
coughing up blood and SOB
large numbers of organism spread via the bloodstream to distant organs
milary TB
fluid in the pleura space and causes inflammation
pleural TB
for the PPD what indicated that you have been exposed to TB (antibodies)
the presence of induration at injection site
low risk of TB at injection site is an induration of
> 15
high risk of TB at injection site is an induration of
> 10
immunocompromised will have an induration at injection site of
> 5
If there is an induration at injection site what is the next steps
chest xray and then sputum test (first thing in the morning)
what is the gold standard for testing tuberculosis
sputum
instead of getting a skin test every year if positive for TB you will get an
xray yearly
when do you prefer to obtain sputum culture
before placed on antibiotics
a TB patient is usually infectious the
first 2 weeks after starting treatment (if sputum +)
why should you report TB patient to health dept
so they can get in touch with people pt has been in contact with
what precaution will the TB pt be on
airborne precaution with negative pressure room
what PPE should you wear when bathing the pt
Gown, goggles, mask (n95) and gloves
what are S/S of tuberculosis
progressive fatigue, malaise, anorexia, weightloss, chronic cough, night sweats, hemoptysis, low grade fever, pleuritic chest pain
what is the treatment for TB
TB meds for 6 most of longer, isolation until - sputum results
what are the dx of Tb
Tb skin test, chest x ray then sputum (3 specimens collected on different days)
acute infection of the lung parenchyma
pneumonia
what could cause pneumonia
pollution, smoking, upper respiratory infections, tracheal intubation, aging
what are 3 ways organisms reach lungs
aspiration, inhalation of microbes in the air, hematogenous spread form primary infection elsewhere in the body
occurs in patients who have been hospitalized or resided in a long term care facility within 14 days of the onset of symptoms
community acquired pneumonia
occuring 48 hours or longer after admission and not incubating at time of hospitalization
Hospital acquired pneumonia
what is the #1 cause of pneumonia
streptococcal pneumonia
what causes HAP
not washing hands
what are major problems in treating HCAP
multidrug resistant organisms
what does aspiration pneumonia result from
abnormal entry of secretions into lower airway
why would you perform a sputum culture BEFORE antibiotics are given
antibiotics could give abnormal results
what are symptoms of pneumonia
cough, fever, dyspnea, pleuritic chest pain, rhonchi and crackles
what are a few complications of pneumonia
pleural effusion, atelectasis, bacteremia, meningitis, sepsis
what is the gold standard for dx pneumonia
chest xray
collaborative care for pneumonia would be
pneumococcal vaccine, antibiotic therapy, oxygen for hypoxemia, analgesics for chest pain
what is the minimum days for antibiotic therapy (pneumonia)
5 days
what should the pts nutritional therapy be for pneumonia
adequate hydration, hi calorie, small frequent meals
COPD includes
chronic bronchitis, emphysema
airflow limitation that is not fully reversible and is generally progressive
COPD
what are symptoms of a COPD patient
easily fatigued, frequent respiratory infections, use of accessory muscles to breathe, orthopneic, dysrhythmias, thin in appearance, wheezing, purse lipped breathing, chronic cough, digital clubbing
clubbing is a chronic sign of
hypoxia as well as cyanosis
presence of cough and sputum production for at least 3 months in each of 2 consecutive years
chronic bronchitis
for pt with chronic bronchitis the alveoli become _____
damaged
what are some clinical signs of a chronic bronchitis pt
frequent cough with foul smelling sputum
pulmonary infecitons, blue bloater appearance, dyspnea and activity intolerance
what are S/S of a blue bloater
frequent productive cough (3mx2yr) digital clubbing barrel chest easily fatigued smoke dyspnea leans forwatd to breath easier uses accessory muscles needs O2 easily fatigued lots of respiratory infection
where is it best to locate cyanosis
lips, mucous membranes and fingers
what is the progressive destruction of alveoli
emphysema
emphysema _______ surface area of respiratory bronchioles, alveoli, and alveolar ducts
decreases
emphysema is the _______ of lung tissue and _______ your elasticity
destruction;lose
what are clinical manifestations of emphysema
chronic cough exertional dyspnea sputum production persistent tachycardia diminished breath sounds "pink puffer" "barrel chest"
why do emphysema patients not eat
because its hard to breath while eating and they would rather have oxygen
what are S/S of pink puffer
speaks in short jerky sentences, purse-lip breathing, barrel chest, destruction of alveoli walls, wheezing, smoke, permanent damage, frequent URIs, bronchi collapse on expiration, prolonged expiratory time, thin appearance, loss of lung elasticity, no cyanosis, anxious, easily fatigues
what does it mean when a person doesn’t have enough endurance
shortness of breath while resting or with activity
what are assessment and dx findings for emphysema
pulmonary function tests, spirometry
ABGs
what is the gold standard for emphysema
spirometry
what are risk factors for emphysema
smoking
occupational exposure
air pollution
genetic abnormalities
what is the genetic risk factor for COPD
antitrypsin deficiency
what is an autosomal recessive disorder
AAT
some degree of emphysema is common because of physiological changes due to
aging
what are signs of severity for COPD exacerbationss
use of accessory muscles and central cyanosis
what are COPD exacerbation treatmens
short acting bronchodilators
coticosterioids
antibiotics supplemental oxygen therapy
