lower respiratory (exam 1) Flashcards
what is the closure or collapse of alveoli
atelectasis
is atelectasis total or partial?
could be either
what kind of atelectasis is marked by distress, tachycardia, tachypnea, pleural pain, and cyanosis
acute
what kind of atelectasis is marked by increased infections distal to obstruction
chronic
risk factors for atelectasis?
-surgery
-immobile
-older
what is a late sign of atelectasis?
cyanosis
what are preventative interventions of atelectasis?
-early mobilization
-turns
-suction
-incentive spirometry
-deep breathe
-fluids
what is inflammation of the lung parenchyma caused by microorganisms
pneumonia
what is inflammation of 1 lung
pneumonitis
what is one of the most common causes of death in the US
pneumonia
what kind of pneumonia is acquired less than or equal to 48 hours after admission to the hospital
community acquired pneumonia
what kind of pneumonia is in non-hospital patients that have excessive healthcare contact
health care associated pneumonia
what kind of pneumonia is greater than or equal to 48 hours after admission to the hospital
hospital acquired pneumonia
what kind of pneumonia is greater than or equal to 48 hours after intubation
ventilator associated pneumonia
what kind of immunocompromised patients are at risk for pneumonia?
cancer, HIV, auto-immune, transplant, immuno-suppressed
what kind of pneumonia is when something from the outside gets in the airways
aspiration pneumonia
what are s/sx of pneumonia
-hypoxia
-fever
-orthopnea
-tired easily
-sputum
how to diagnose pneumonia
-clinical assessment
-sputum
-CXR
-bronchoscopy
-biopsy
treatment of pneumonia
antimicrobials
what are important prevention measures for pneumonia?
-influenza vaccine
-avoid pollutants/hazards
-MAINTAIN HYDRATION
-isolate infected persons
-WASH HANDS
what test tells us if theres clots
D-dimer
COVID-19 has _____ transmission
viral
COVID-19 has ___ WBCs, ___ lymphocytes, and ___ CRP and D-dimer
low, low, high
what are some complications from COVID-19?
pneumonia
-resp failure
-sepsis
-organ failure
-cardiac injury
-clots
-inflammation
what is a chronic and infectious
pulmonary tuberculosis
what other tissues can pulmonary tuberculosis spread to?
-meninges
-kidneys
-bones
-lymph nodes
what population is susceptible to mycobacterium tuberculosis
homeless
where should patients with TB be placed
-negative pressure room
-wear N95
some risk factors for TB
-close contact
-immunocompromised
-immigrating/traveling to/from places woth high TB
-overcrowded pop
-inadequate therapy/treatment
s/sx of TB
low grade fever
cough
night sweats
-fatigue
weight loss
how to tell if someone has TB
-being sus
-history
-rust colored sputum
-sputum culture
-CXR
-TB blood test
the mantoux TB test is an intradermal injection of ____
PPD (purified protein derivative)
a mantoux skin test is read ____ hours after injection
48-72
a positive mantoux skin test is____
hard (induration)
what do the measurements of TB skin tests mean?
10mm is if recent immigration, IV drug user, resident of high risk, or children
5mm if immunocompromised, HIV/AIDS, close contact, CXR backed
what prophylactic TB med prevents neuritis (neuropathy)
isoniazid
what are the 4 combo drugs to treat TB
INH, rifampin, pyrazinamide, ethambutol
what combo TB med is hard on the liver, causes polyneuropathy, and can develop drug induced hepatitis
INH
which combo TB drug causes red/orange secretion, need to monitor liver and drug-drug interactions
rifampin
what combo TB med can cause joint pain, hyperuricemia, and hepatotoxicity, monitor uric acid/liver
pyrazinamide
what combo TB med is very hard on the eyes, monitor vision, optic neuritis
ethambutol
for TB, continue 2 drugs (_________ and _________) for _____ weeks
(INH and rifampin) for 4-7 weeks
what is when the 2 lung linings stick, sharp pain, and sheering of lining
pleurisy
what is when there’s extra fluid in the lung space, cant expand, and resp distress
pleural effusion
how to treat pleural effusion
thoracentesis
occurs when pleural space is exposed to positive pressure
pneumothorax
air in the thoracic cavity from a pleural lining rip
pneumothorax
what are the 2 causes of pneumothorax
-spontaneous/simple
-traumatic
what are the 2 kinds of spontaneous/simple pneumothorax
primary (w/o underlying disease)
secondary (w/ underlying disease)
what does traumatic pneumothorax come from
trauma and complications from procedures
symptoms of pneumothorax
-SOB
-acute CP
-dec BP
-dec O2
-inc HR
treatment of pneumothroax
needle decompression / chest tube
creation of a surgical opening into the thoracic cavity
thoracotomy
indications of a thoracotomy
-dx lung/chest disease
-obtain biopsy
what is a wedge resection
used for diagnosis, taking a piece out to look
what is the term for removal of a lung lobe
lobectomy
what is the term for removal of a lung
pneumonectomy
what is the removal of scar tissue
decortication
what is important to assess before thoracic surgery
functional reserve
what is placed in the pleural space to drain fluid, air, or blood
chest tubes
chest tubes are placed in the ______ airway for air removal and the ______ airway for fluid or blood removal
upper, lower
keep chest tubes _______ level of chest
below
section _____ of the drainage system is the suction chamber with constant gentle bubbling
A
how high is the water in section A of a drainage system
20 cm
sections ___ and ___ should not bubble, when inhaling the water goes up, when exhaling the water goes down (THE WATER SEAL)
B and C
section ___ of the drainage system is the drainage chamber
D
complication from chest tubes?
-atelectasis
-infection
-air in pleural space
what is the leading cause of cancer death and 2nd most common cancer in both men and women?
lung cancer
____% of all new cancers are lung cancer
10-15
lung cancer has _____ survival rates and no early diagnosis
low
what are the 2 classifications of lung cancer
-small cell (SCLC)
-non-small cell large cell (NSCLC)
___% of lung cancer is small cell and ____% is non small cell large cell
10-15
80-85
what are the 2 types of non small cell large cell lung cancers
-squamous
-adenocarcinoma (most)
risks for lung cancer
-cigarettes
-genetic
-environmental (gas, 2nd hand smoke, asbestos, workplace)
dx of lung cancer
-CXR
-CT
-PET
-MRI
-biopsy
90% of lung cancer starts at the _________
bronchial epithelium
treatment for cure/palliation of lung cancer symptoms
-radiation
-surgery
-chemo
-palliative
complication from lung cancer treatment
-resp failure
-vent dependency
-scarring
-pericarditis
-myelitis
-cor pulmonale (R sided HF)
obstruction of the pulmonary artery or a branch by a clot from the venous system
pulmonary embolism (PE)
what is associated with PEs
trauma, surgery, pregnancy, HF, immobility
s/sx of PE
-dyspnea
-CP
-sudden pleuritic stabbing pain
-hemoptysis (blood cough)
-fear/anxiety
dx of PE
-early rec
-assessment
-CXR
-ECG
-SpO2/ABGs
treatment of PE
thinners, aPTT, INR
what thinner affects aPTT
heparin
what thinner affects INR
warfarin
