Lower Respiratory Disorders: Inflammatory and Infectious Disorders Flashcards
atelectasis
disease process
closure of alveoli
atelectasis
common causes
shallow breathing
S/P anesthesia from surgery
pain
impaired cough
excess secretions
mucus plugs (block bronchiole)
COPD
atelectasis
prevention
early mobilization
deep breathing
pain meds
IS (incentive spiro)
positioning
atelectasis
positioning
high fowlers
atelectasis
why is pain a risk factor
patient don’t want to get up and move or cough
atelectasis
stroke/anestheisa
impaired cough/gag
atelectasis
increase secretions
mucus plug
how often do we want patients to cough and deep breath
10x hour
pain medication
stay on top of pain
hard to get pain down from a 9-10
atelectasis
manifesations
increase HR
RR
decreased ability to oxygenate
diminished lung sounds
focused respiratory assessment occurs of what
plus ox
lung sounds
respirations
cyanotic
cough
sputum
work of breathing
accessory muscles
depth and rate
pneumonia
causes
bacteria
virus
fungi (normal immune system should be able to fight off fungi so this is seen in immunocompromised individuals)
pneumonia can be a complication of _________
atelectasis
4 types of pneumonia and which ones are never events
community acquired pneumonia (CAP)
health care acquired pneumonia (HCAP)
hospital acquired pneumonia (HAP) NEVER
ventilator acquired pneumonia (VAP) NEVER
pneumonia
manifestations
change in temp, pulse
secretions (color, consistency, amount)
cough
tachypnea
shortness of breath
crackles on auscultation
pneumonia
manifestations ELDERLY
mental status change
fatigue
do not get fever as easily
why do we want sputum and urine cultures
sputum for the organism and possible antibiotics
urine to rule out UTI
pneumonia
risk factors
long term care (spreads quickly)
immunosuppression (chemo, steroids, HIV/AIDS)
smoking
prolonged immobility (espcially in elderly, they will rapidly decline)
depressed cough reflex
NPO
supine positioning (increase risk for atelectasis)
alcohol (inhibits airway protection)
transmission from healthcare providers
pneumonia
order of priority
- culture
- antibiotic administration with in 60 min
pneumonia
diagnosis
history
CXR, CBC, blood, urine, sputum culture
pneumonia
supportive treatment
fluids (concern about FVE, especially in elderly)
oxygen for hypoxia
antipyretics (aches)
antitussives (cough sup)
decongestants
antihistamines
when are antibiotics used for a viral infection
not indicated for vital but used for secondary bacterial infection
pneumonia
improving airway clearance
encourage hydration: 2-3L a day (as tolerated by cardiovascular to thin secretions)
humidification (loose secretions)
coughing techniques (splint)
chest physiotherapy (pulmonary toilet)
pneumonia
nutrition
provide nutritionally enriched foods and fluids
aspiration
defintion
inhalation of foreign material (oropharyngeal or stomach)
aspiration
clinical presentation
tachycardia
dyspnea
hypotension
hypertension
central cyanosis
ultimately death
aspiration
prevention
tube feeding-placement verification
swallow assessment
HOB elevated
pulmonary tuberculosis
risk factors
poverty
poor housing
malnutrition
immunocompromised
forgein travel
immigration
exposure
pulmonary tuberculosis
signs and symptoms
persistent cough
weight loss
anorexia
night sweats
hemoptysis
shortness of breath
fever/chills
rust colored sputum
what is the only way we can confirm pulmonary tuberculosis
sputum culture of M. tuberculosis
what is the QuantiFERON
blood test, tells us exposure only
not affected by BCG vaccine
Mantoux test sight
intradermally in the forearm
Mantoux test reading
48-72 hours later
Mantoux test
exposure in person with normal immunity
10mm
Mantoux test
exposure in person who is high risk (HIV/immunocompromised)
5mm
does the Mantoux test prove exposure or confirmation
exposure
latent TB
exposed immune system able to suppress it
no signs and symptoms, might have ghon focus (walled off bacteria)
how do we confirm if a patient is no longer infectious
negative sputum culture x3
tuberculosis
health teaching
follow exact drug regimen
- empty stomach
- 1 hour prior to meals
avoid wine, tuna, alcohol, aged cheese
proper nutrition and reverse weight loss
pleurisy
inflammation of both layers of pleurae
pleurisy are at risk for
atelectasis
why are pleurisy at risk for atelectasis
inflamed surfaces rub together with respirations cause sharp pain intensified with inspirations
pleural effusion
collection fluid in the pleural space usually secondary to another disease
pleural effusion
manifestations
dyspnea
diminished or absent sound over lungs
empyema
accumulation of thick purulent fluid in pleural space
pulmonary edema
accumulation of fluid in the lung tissue, alveolar space or both
pulmonary edema
non cardiogenic causes
chest trauma
aspiration
smoke inhalation
sepsis
pancreatitis
multiple transfusion
cardiopulmonary bypass
pulmonary edema
mainfesations
increase in RR
shortness of breath
decrease pulse ox
crackles
when provided oxygen they continue to remain hypoxemia, frothy sputum
acute respiratory failure
sudden and life threatining deterioration
acute respiratory failure
ABG
PO2 less than 50
PCO2 greater than 50
pH less than 7.35
acute respiratory failure
manifestations
early, late, and turning point
restlessness (early)
dyspnea
air hunger
confusion/lethargy (turning point)
tachycardia and tachypnea
diaphoresis
cyanosis (late)
respiratory arrest (LATE)
what does actor respiratory failure require
intubation and mechanical ventilation
