Lower Respiratory Flashcards
Main difference between bronchitis and pneumonia?
no chest infiltrates or consolidation on chest xray with bronchitis
characteristic s/s of bronchitis?
clear, mucoid sputum; persistent cough
characteristic s//s of pertussis?
whooping cough for 6-10 weeks
Community-acquired pneumonia
onset in community or first 2 days of hospitalization
Hospital-acquired pnemonia:
occurs 48 hours or longer after hospital admission and not incubating at the time of hospitalization
ventilator-acquired pneumonia
48 hours after intubation
complications of pneumonia: (4)
pleurisy, pleural effusion, atelectasis, bacteremia
pneumonia: how much activity? how many liters of fluids a day?
limited activity; 2-3
therapeutic positioning for bilateral pneumonia:
“right lung down”
therapeutic positioning for unilateral pneumonia:
“good lung down”
pneumo vaccine q ___years
5
influenza vaccine q ____years
1
Tube and NG feedings: HOB @?
Residuals should be less than _____.
30-45 DEGREES
100. IF MORE, STOP FEEDING!!
Bronchoscopy: post-op
NPO until gag reflex returns
Mantoux:
no redness (induration) at site 48-72 hours after=negative; positive reaction occurs 2-12 weeks after exposure
late symptoms of lung cancer:
weight loss, fatiguw, N/V
absent breath sounds over affected area-sigh of what?
pneumothorax
which pneumothorax is a medical emergency?
tension
stable tension pneumothorax is treated how?
resolves on its own
unstable tension pneumothorax is treated how?
chest tube
flail chest results from?
multiple rib fractures
flail chest may require:
short-term intubation (until extent of injury can be determined)q
flail chest: what type of IV hydration solutions?
crystalloids
Placement of chest tube for air removal:
anteriorly through 2nd intercostal space
placement of chest tube for fluid/blood removal:
posteriorly through the eighth or ninth intercostal space
water seal chamber contains ____ cm of water
2
purpose of water seal chamber?
prevents backflow of air into the patient from the system
suction control chamber: -_____cm
20
when pts has chest tubes and pleural drainage systems, keep______ at the bedside
occlusive dressing
lobectomy
removal of one lobe of the lung
pneumonectomy
removal of entire lung
segmental resection:
removal of one or more lung segments
wedge resection:
removal of small, localized lesion that occupies only part of a segment
plerual effusion:
collection of fluid in pleural space
transudate (with pleural effusion)
protein-poor, cell-poor fluid, seen with noninflammatory conditions
transudate is what color?
pale yellow
2 causes of transudate pleural effusions: increased ______ _______ in heart failure, decreased oncotic pressure (__________-which occurs in chronic liver or renal disease)
hydrostatic pressure, hypoalbuminemia
exudative (with pleaural effusions)
inflammatory reaction; accumulation of fluids and cells, high protein content; dark yellow or amber in color
with pleural effusions, chest x ray will indicate fliud greater than _____ml
250
how much fluid can be pulled off in thoracentesis?
1000-1200
what is necessary post thoracentesis?
chest x ray to check for pneumothorax
pleurisy
inflammation of the pleura
pulm. edema
abnormal accumulation of fluid in alveoli and interstitial spaces of lungs
common cause of pulm. edema:
left-sided heart failure
diagnostic studies for PE:
VP lung scan, D-DIMER , venous ultrasound if D-dimer is elevated
normal d-dimer levels,
less than 250 ml
PEEP is set at _____cm H20 for ARDS
10-20
