Lower Respiratory Key Points Flashcards
What is acute bronchitis?
Inflammation of the bronchi characterized by a cough lasting up to 3 weeks.
Self-limiting Condition
Treatment is supportive
It is a self-limiting condition; treatment is supportive.
What is pertussis?
A highly contagious infection of the respiratory tract characterized by uncontrollable, violent coughing.
Treatment consists of macrolide antibiotics and supportive care.
Define pneumonia.
An acute infection of the lung.
Pathogens reach the lung via aspiration, inhalation, or hematogenous spread.
Pathogens can reach the lung via aspiration, inhalation, or hematogenous spread.
What is community-acquired pneumonia (CAP)?
An acute infection of the lung occurring in patients who have not been hospitalized or lived in a long-term care facility within 14 days of onset of symptoms.
Differentiate between hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP).
HAP begins 48 hours or longer after admission to a hospital and was not present at the time of admission.
What is aspiration pneumonia?
Sequelae occurring from abnormal entry of secretions or substances into the lower airway.
What is necrotizing pneumonia?
A complication of bacterial lung infection that may cause cavitation within the lung parenchyma.
What is opportunistic pneumonia?
Occurs in patients with altered immune responses who are highly susceptible to respiratory infections.
What is tuberculosis (TB)?
An infectious disease caused by Mycobacterium tuberculosis, typically spread by airborne droplets.
What are the types of tuberculosis?
- Primary TB infection
- Post-primary TB (reactivation TB)
- Latent TB infection (LTBI)
What is the treatment for active TB disease?
Drug therapy with 4 drugs for the initial 3-month phase or longer.
What is atypical mycobacteria?
Causes disease resembling TB, typically in immunosuppressed individuals or those with chronic pulmonary disease.
What are pulmonary fungal infections?
Infections caused by inhaling spores, often asymptomatic except in immunocompromised patients.
What is a lung abscess?
A necrotic lesion of the lung that contains pus.
Onset usually insidious.
What is atelectasis?
A condition characterized by collapsed, airless alveoli.
What is pleurisy?
Inflammation of the pleura, caused by infectious diseases, cancer, autoimmune disorders, and more.
Define pleural effusion.
A collection of fluid in the pleural space, classified as transudative or exudative.
What is idiopathic pulmonary fibrosis (IPF)?
A chronic, progressive disorder characterized by chronic inflammation and scar tissue formation in the lungs.
Risk factors include smoking, wood, and metal dust.
Lung transplantation may be considered.
What is sarcoidosis?
A chronic, multisystem granulomatous disease primarily affecting the lungs.
What are the manifestations of rib fractures?
Pain at the site, especially with inspiration and coughing.
Most commonly caused type of chest injury from blunt trauma.
What is flail chest?
Results from multiple rib fractures causing an unstable chest wall.
Must be 3 or more ribs in 2 or more locations.
Define pneumothorax.
Air in the pleural space resulting in partial or complete collapse of the lung. Can be non-penetrating (closed) or penetrating (open) chest trauma.
What is pulmonary edema?
An abnormal accumulation of fluid in the alveoli and interstitial spaces of the lungs.
Most commonly caused type cause is left-sided heart failure.
What is pulmonary embolism (PE)?
Blockage of pulmonary arteries by a thrombus, fat, air emboli, or tumor tissue.
Usually from thrombi in the deep veins of the legs.
What causes pulmonary hypertension?
Can occur as primary disease (idiopathic) or secondary complication from other disorders.
What is cor pulmonale?
Enlargement of the right ventricle caused by a primary disorder of the respiratory system.
Most commonly cause is COPD
What is pneumoconiosis?
A group of lung diseases caused by inhalation and retention of mineral or metal dust particles.
Examples: Asbestos, chemical pneumonia is, and hypersensitivity pneumonitis.
What are the types of lung transplantation?
- Single lung
- Bilateral lung
- Heart-lung
- Transplant of lobes from living related donor
What is the most important risk factor in the development of lung cancer?
Cigarette smoking.
What are the two broad subtypes of primary lung cancers?
- Non-small cell lung cancer (NSCLC)
- Small cell lung cancer (SCLC)
What is the treatment of choice for NSCLC stages I to IIIa?
Surgical resection.
What is the main treatment for SCLC?
Chemotherapy.
What is the overall goal of nursing management for lung cancer patients?
Ensure a patent and functional airway, effective breathing patterns, and adequate tissue oxygenation.
Pertussis Treatment
Macrolide Antibiotics and supportive care
Pneumonia Complications
Pleural effusion, abscess, and acute respiratory failure.
More common in those with underlying chronic conditions.
Pneumonia Diagnosis
Validated by patient history and chest x-ray.
Pneumonia Supportive Measures
Hydration, O2 therapy, chest physiotherapy, nutrition care, proper positioning, and management of fever and pain.
Primary TB Infection
Occurs when the bacteria are inhaled. Most people mount effective immune responses and do not develop TB. If the initial immune response is not adequate, the bacteria replicate and active TB disease results. When active disease develops within the first 2 years of infection, it is called primary TB.
Post-Primary of Reactivation TB
TB disease occurring 2 or more years after the initial infection. If the site of TB is pulmonary or laryngeal, the person is infectious and can transmit the disease to others
Latent TB Infection
LTBI
Occurs in a person who does not have active TB disease. People with LTBI have a positive skin test but are asymptomatic. They cannot transmit the TB bacteria to others but can develop active TB disease at some point
Anti-tubercular Drugs
TB Precautions
Airborne
HEPA or N95 Masks
Opportunistic Fungal Infections
Occur in immunocompromised patients and those with HIV/ cystic fibrosis
Fungal Infection Treatment
Amphotericin B
Clindamycin
First-line therapy for its effectiveness against Staphylococcus and anaerobic organisms. IV antibiotics are switched to oral antibiotics once the patient shows clinical and chest x-ray evidence of improvement.
Common Cause of Atelectasis
Airway obstruction resulting from retained exudates and secretions. Often seen is postoperative patients.
Exudative Effusion
Accumulation of protein-rich fluid and cells in an area of inflammation.
Empyema
A pleural effusion that contains pus
Thoracentesis
Determines type of pleural effusion through a procedure done to remove fluid from the pleural space.
Spontaneous Pneumothorax
Typically occurs due to the rupture of small blebs (airfilled sacs) on the surface of the lung. Blebs can occur in healthy, young persons or from lung disease, such as COPD, asthma, cystic fibrosis, and pneumonia.
Iatrogenic pneumothorax
Can occur due to laceration or puncture of the lung during medical procedures.
Tension pneumothorax
Occurs when there is a rapid accumulation of air in the pleural space, causing severely high intrapleural pressures, placing tension on the heart and great vessels.
Hemothorax
An accumulation of blood in the intrapleural space.
Chylothorax
Lymphatic fluid in the pleural space caused by a leak in the thoracic duct. Causes include trauma, surgical procedures, and cancer.
Most Common PE Risk Factors
Immobility, surgery within the last 3 months, history of DVT, and cancer.
PE Complications
Pulmonary infarction (death of lung tissue) and pulmonary hypertension.
PE Diagnosis
Spiral CT Scan
Pulmonary angiography or a VQ scan are also acceptable if first isn’t available.
PE Treatment
Immediate anticoagulation.
Administration of low-molecular-weight heparin for acute (LMWH).
Percutaneous interventional techniques, surgical embolectomy, ultrasound-guided thrombolysis and aspiration thrombectomy are newer, moderately invasive procedures for PE.
Lung Transplant Post Op Care
Tarcolimus, mycophenolate mofetil, and prednisone.
Lung Cancer Diagnosis
CT scanning is the single most effective noninvasive technique for evaluating lung cancer. Biopsy is required for a definitive diagnosis.
