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NURS 347 EXAM 2 > Lower Respiratory tract > Flashcards

Lower Respiratory tract Flashcards

1
Q

Anything that’s in lower respiratory tract is from what?

A

Trachea down

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2
Q

How many lobes on right and left?

A

3 right
2 left

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3
Q

What is atelectais ?

A

Collapsed, airless alveoli

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4
Q

Atelectasis is what? Sounds like and percussion like?

A

Decreased or absent breath sounds
Dullness on percussion

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5
Q

When the alveoli are collapsed we can’t perform what? And means?

A

Gas exchange
We aren’t getting enough perfusion in the body

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6
Q

What causes Atelectasis?

A

Secretions obstructing small airways

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7
Q

Who are at high risk of Atelectasis? (2)

A

Bedridden
Post op abdominal & chest surgery

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8
Q

What is the prevention & treatment (3)

A

Encourage them deep breathing incentive spirometers
Early mobility

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9
Q

The reason why we want our patient to get up and start moving is after getting aceletasis because it lowers the risk of ?

A

pneumonia

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10
Q

What is acute bronchitis?
And usually caused by?

A

Self limiting inflammation of bronchi
Caused by viruses

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11
Q

What are some other triggers of acute bronchitis? (5)

A

Pollution
Chemical inhalation
Smoking
Chronic sinusitis
Asthma

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12
Q

What are the symptoms of acute bronchitis? (7)

A

Cough
Clear/purulent sputum (pus)
Headache
Fever
Malaise
Dyspnea
Chest pain

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13
Q

What is the acute bronchitis diagnosis? (3)

A

It depends on the assessment of breath sounds
Crackles or wheezes

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14
Q

Do we give antibiotics to acute bronchitis? Why?

A

No
Because it’s mainly a virus that causes this

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15
Q

What is the treatment goal for acute bronchitis? (3)

A

Symptom relief
Prevent pneumonia
( supportive care )

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16
Q

What are some treatments we are going to perform on the patient with acute bronchitis? (5) and provide description of each

A

Cough suppressant, oral fluid, humidifier
B2 agnosit inhaler for wheezing or underlying pulmonary condition
Avoid irritants
Flu shot
Or see HCP ( healthcare professional ) if symptoms last longer than 4 weeks

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17
Q

What is the bacteria name for pertussis?

A

Bordetella pertussis

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18
Q

Bordetella pertussis is a what type of bacteria?

A

Gram negative

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19
Q

The gram negative Bordetella pertussis attaches to what and releases what? And results in what? (3)

A

Attached to cilia ( nose hair )
Releases toxins
Results in inflammation

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20
Q

Pertussis is highly what?

A

Contagious

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21
Q

How do we help prevent pertussis? What do we do? And when do we give it?

A

TDaP vaccine
At 11 years old

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22
Q

What are the 3 manifestations of pertussis?

A

Stage 1
Stage 2
Stage 3

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23
Q

What is stage 1 manifestations for pertussis (5)
How long too?

A

1 to 2 weeks
Low grade fever
Runny nose
Watery eyes
General malaise
Mild nonproductive cough

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24
Q

What is state 2 manifestations pertussis?
How long?

A

2 to 10 weeks
Paroxysms of cough
( hallmark ) whooping

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25
Q

What is stage 3 pertussis? And how long ? (2)

A

2-3 weeks
Less severe cough
Weak

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26
Q

What are the 3 hallmark characteristic of pertussis?

A

Uncontrollable
Violent
Cough with whooping sound

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27
Q

What is diagnosis pertussis (3)
What are we gonna do to diagnosis it

A

Nasopharyngeal cultures
PCR of nasopharyngeal secretions
Serology testing

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28
Q

What is main treatment of pertussis?
And 4 examples?

A

Macrolides
Erythromycin
Clarithromycin
Azithromycin
Trimethoprimsulfamethoxazole

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29
Q

Pertussis treatment can also be for what type of exposure other than already having it?

A

Close contact exposure

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30
Q

Pertussis have what two precautions?

A

Routine and droplet

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31
Q

For childern what vaccine do we give for pertussis?

A

DTaP

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32
Q

Why do we give pregnant women Tdap vaccine ?

A

In order to prevent anything to the baby

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33
Q

What is pneumonia?
Which can’t?
And can be from ?

A

Secretions or thick fluid in alveoli
And can’t gas exchange
And can be from atelectasis

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34
Q

Pneumonia is an acute ?

A

Infection of lung parenchyma

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35
Q

Pneumonia is associated with significant ? (2)

A

Morbidity and mortality rates

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36
Q

Pneumonia and influenza are the what leading cause of death in US?

A

8th

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37
Q

What are the common pneumonia symptoms that All pneumonia type share? (14)

A

Fever
Difficulty breathing !!
Sweating
Cough
Chest pain
Fast heartbeat
Shortness of breath
Loss of appetite
Nausea
Vomiting
Diarrhea
Low energy
Muscle pain
Shaking/chills

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38
Q

How do you tell the differences between each pneumonia?

A

By collecting a sputum sample

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39
Q

Pneumonia can start off acutely however it’s mainly found how?

A

When patients already have an illness and it gets progressively worse
And get a secondary increase in temp

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40
Q

What are the normal defense mechanisms for pneumonia? (8)

A

Air filtration
Epiglottis closure over trachea
Cough reflex
Mucociliary escalator
Reflex bronchoconstriction
IGA
IGG
alveolar macrophages

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41
Q

Defense mechanism become what for pneumonia ? (2)

A

Incompetent or overwhelmed

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42
Q

How do defense mechanisms become Incompetent or overwhelmed by pneumonia? (7)

A

Aspiration
Tracheal intubation
Air pollution
Smoking
Viral URI
Aging
Chronic diseases

43
Q

What are the 3 ways organisms reach lungs of pneumonia?

A
  1. Aspiration of normal flora from nasopharynx or oropharynx
  2. Inhalation of microbes present in air
  3. Hematogenous spread from primary infection elsewhere in body
44
Q

What are the 2 most effective classification of pneumonia? And names?

A

CAP community acquired pneumonia
HAP hospital acquired pneumonia

45
Q

How does HAP or nosocomial pneumonia happen?

A

Occurs 48 hours after hospitalization and not present at time of admission

46
Q

How does VAP happened and stand for?

A

Ventilator associated pneumonia
Occurs 48 hours after endotracheal intubation

47
Q

When a patient has crackles or wheezes or other fluid in the lungs and their ferbile , not looking great and having trouble breathing, what can we do?

A

Provide
Empiric treatment

48
Q

What empiric antibiotic therapy means? (3)

A

You don’t know what is causing the pneumonia
All you know is that the patient has pneumonia
Therefore you can select an antibiotic to treat them with

49
Q

Will empiric treatment be effective on an virus pneumonia? Why?

A

No because it’s giving antibiotics

50
Q

When do you want to start empiric antibiotic treatment for pneumonias? After what diagnosis (6)?

A

Risk factors
Early vs late onset
Presentation
Underlying medial conditions
Hemodynamic stability
Most likely causative organism

51
Q

What are 2 medication examples of empirc treatment for pneumonia?

A

Amoxicillin & Doxycycline

52
Q

What are the 6 types of pneumonia?

A

Viral
Bacterial - extreme unwell & hospital
Mycoplasma - bacterial & virus ( atypical )
Aspiration
Necrotizing
Opportunistic

53
Q

What’s the most common pneumonia to get?

A

Viral

54
Q

What is aspiration pneumonia?
And triggers what?

A

Abnormal entry of oral or gastric material into lower airway

Inflammatory response

55
Q

What are the Major risk factors of aspiration pneumonia? (5)
( look at how many A’s there is )

A

Decreased level of consciousness
Depressed cough
Depressed gag reflex!!!
Difficulty swallowing
Insertion of nasogastric tube with or without tube feeding

56
Q

Aspiration pneumonia is the primary bacterial infection? True or false?

A

Yes

57
Q

Aspiration of ____ causes gastric pneumonia and results in what? And hours?

A

Acid Gastric contents
Possible bacterial infection
24-72 hours

58
Q

What is necrotizing pneumonia?
What type of infection?
And results from what?

A

Thick/liquid mass
Destruction of the lung
Bacterial
CAP

59
Q

What are the 3 signs of necrotizing pneumonia?

A

Immediate respiratory insufficiency/failure
Leukopenia - low WBC
Bleeding into airways

60
Q

where do we see necrotizing pneumonia? (2) what type of treatment patients get

A

Radiation
Chemotherapy

61
Q

What is the treatment of necrotizing pneumonia?(2)

A

Long term antibiotics
Possible surgery

62
Q

Necrotizing pneumonia, we can see what type of edema ??

A

Pulmonary edema

63
Q

What is opportunistic pneumonia?

A

Immunocompromised patients
Usually has already existing infection and pneumonia comes along

64
Q

Who are at risk at getting opportunistic pneumonia? (4)
( like they are like severely what?)

A

Severe protein calorie malnutrition
Immunodeficiencies
Chemotherapy/ radiation
Immunosuppression therapy
(Long term corticosteroid therapy)

65
Q

What is opporynitistic pneumonia caused by? (3)
( think literally, it can be from??)

A

Bacterial
Virus
Microorganism

66
Q

What is pneumocystis jiroveci pneumonia?
What infection and most common in?

A

Fungal infection
HIV patients

67
Q

____is a fungus ball that colonized in a healed lung scar or abscess from a previous disease

A

Aspergilloma

68
Q

Pneumocystis Jiroveci pneumonia (PJP) has what type of symptoms?

A

Slow onset

69
Q

What is the slow onset for PJP? (6)

A

Fever
Tachycardia
Tachypnea
Dyspnea
Nonproductive cough
Hypoxemia

70
Q

PFP can be life threatening how or more so cause what?

A

Respiratory failure

71
Q

PFP can do what to other organs?

A

Spread
( cause it’s a fungus )

72
Q

Does antifungal medication work on PFP?

A

No

73
Q

What’s the treatment of PJP? (2)

A

Trimethoprim
Sulfamethoxazole

74
Q

What is cytomegalovirus (CMV) pneumonia?

A

Herpes virus

75
Q

What will we see in patients who have CMV pneumonia? Symptoms (2)

A

Asymptomatic/mild
To severe

76
Q

Why do we see asymptomatic in CMV pneumonia?

A

Because of their impaired immunity from the herpes

77
Q

In who does CMV pneumonia effect?

A

HIV and AIDS patients

78
Q

What’s the treatment of CMV pneumonia? (2)

&
#1 complication of Hematopoietic stem cell transplantation is CMV

A

Anti viral medications
High dose immunoglobulin

79
Q

What’s the 5 steps of pathophysiology of pneumonia?

A

Inflammatory response
( white blood cells attraction )
Alveoli fill with fluid
( consolidation )
Decreased production of mucus
( airway obstruction )
Decreased gas exchange
Resolution of infection
( gas exchange back to normal )

80
Q

What’s the most common manifestations of pneumonia ?
(7)

A

Cough : productive(pus) or nonproductive(nothing comes out)
Green, yellow, or rust color sputum
Fever
Chills
Dyspnea
Tachypnea
Pleurtic chest pain

81
Q

What will we see in older or debilitated patients of manifestations of pneumonia? (3)

A

Confusion
Stupor
Hypothermia

82
Q

What’s the physical examination manifestations? (5)
( what are we doing to the person )

A

Fine/coarse crackles
Consolidation ( fluid in lungs )
Bronchial breath sounds
Egophony
Increased fremitus
( pleural effusion - fluid of pleural cavity )
Dullness percussion

83
Q

What is Egophony?

A

E to A sound

84
Q

What does bronchial breath sounds mean?

A

You’ll hear more “breath” sounds on the midline of chest than on the side of the lung

85
Q

What is fremits pneumonia ?

A

Increased or decreased vibrations

86
Q

What are the complication of pneumonia and means?

A

MDR
multi drug resistant pathogens

Whatever antibiotics we have, the pneumonia is resistant to it

87
Q

What are the risk factors of MDR? (4)

A

Age
Immunosuppression
History of antibiotic use
Prolonged mechanical ventilation

88
Q

What are the diagnostic studies for pneumonia? (8)

A

History and physical exam
Chest X ray
Thoracentisis & Bronchiscopy
Pulse oximetry
Arterial blood gases
Sputum gram stain, culture, sensitivity
Blood culture
CBC with differential

89
Q

What’s a thoracentesis?

A

Needle into the fluid in the back
Into a bag

90
Q

What’s a bronchoscopy?

A

Looking with a camera down the nose into the bronchi

91
Q

What interprocessional care can we give for pneumonia?
And names ?

A

Pneumococcal vaccine
prevnar 13 & pneumovax 23

92
Q

Inter professional care of pneumonia
We want to prompt treatment with___ which response generally occurs within 48-72 hours
And results in 3
Then you ready chest X ray in what weeks

A

Antibiotics
Decreased temp
Improved breathing
Decreased chest discomfort
6-8 weeks

93
Q

We may also want to give supportive care to viral pneumonia by doing 5 things?
( like what treatments can we give for like hypoxemia?)

A

Oxygen for hypoxemia
Analgesics for chest pain
Antipyretics for fever
Adjuvant drugs
Rest & acitivity

94
Q

What type of nutrition do we want for a pneumonia patient? (4)

A

Small
Frequent
High calorie
Nutritious meals

95
Q

What’s the most important thing for nutritional therapy for pneumonia?

A

Hydration!!!

96
Q

We also have to monitor weight for patient of pneumonia why?

A

Because they can get dehydrated and lose weight

97
Q

What’s some subjective data for pneumonia? Nursing assessment

A

Past health history
Medications
Surgery
Tube feeding
Intubation
Health perception
Nutrition
Activity
Cognitive

98
Q

What is objective data for pneumonia?

A

What we see on patient
Like labs, respiratory etc

99
Q

What’s the nursing goal/ plan for pneumonia?

A

Good breath sound
Normal breathing patterns
Normal chest x ray
Abscesses of complications

100
Q

Nursing implementation for pneumonia
Health promption includes?

A

Teach hygiene
Nutrition
Rest
Regular excerise
No smoking
Risk facts
Influenza & pneumonia vaccine

101
Q

What’s acute care for nursing implementation pneumonia? (6)

A

Oxygen
Hydration
Nutrition
Breathing exercises
Early ambulatory
Positioning

102
Q

Prevent aspiration pneumonia how?
Acute care (7)

A

Elevate head of bed 30^
Assist with eating.drinking.meds
Assess for gag reflex!!
Monitor reflex and gastric residual
Early mobilization
Cough & deep breathe
Twice day oral hygiene

103
Q

Last acute care, what’s the best way to reduce infections? Like medical asepsis?

A

Hand hygiene !!!

NURS 347 EXAM 2 (7 decks)

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