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Pathophys > Lung Parenchyma Disorders > Flashcards

Lung Parenchyma Disorders Flashcards

1
Q

When does pulmonary edema occur?

A
  1. the pulmonary vasculature fills with fluid that leaks into the IS spaces
  2. the vasculature becomes very leaky allowing fluid to escape into the IS space
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2
Q

What is the effect of pulmonary edema on gas exchange?

A

Fluid moves in alveolar spaces decreasing the space available for gas exchange

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3
Q

Pulmonary edema develops as a result of what?

A
  1. Fluid overload
  2. Decreased albumin
  3. Lymphatic obstruction
  4. Increase capillary permeability (tissue injury or excessive immune response)
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4
Q

What are the s&s of pulmonary edema in the early stages?

A
  1. Persistent cough
  2. Slight dyspnea
  3. Diaphoresis (sweating)
  4. Intolerance to exercise
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5
Q

As fluid continues to fill the pulmonary interstitial spaces because of pulmonary edema, what are the s&S?

A
  1. More acute dyspnea
  2. Respirations increase in rate
  3. Audible wheezing
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6
Q

As pulmonary edema worsens, what are the S&S?

A

Cough becomes productive-frothy sputum tinged with blood (pinkish hue)

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7
Q

Prognosis of pulmonary edema dependent on what?

A

Prognosis depends on the underlying condition

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8
Q

T/F Presence of pulmonary edema is not a medical emergency.

A

False, presence of pulmonary edema is a medical emergency

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9
Q

Treatment of pulmonary edema aimed at what?

A
  1. Enhancing gas exchange
  2. Reducing fluid overload
  3. Strengthening/slowing HR
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10
Q

What is used to removed excess alveolar fluid in patients with pulmonary edema?

A
  1. Oxygen by mask or through ventilatory support
  2. Diuretics
  3. Diet
  4. Fluid restrictions
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11
Q

What is acute respiratory distress syndrome (ARDS)?

A

A condition that causes fluid to leak into your lungs, limiting movement of air into the alveoli -> hypoxemia

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12
Q

Most people who get ARDS are already in the hospital for something else. What?

A
  1. sepsis
  2. Accidents
  3. Pulmonary toxic molecules
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13
Q

How does acute respiratory distress syndrome (ARDS) occur?

A
  • widespread inflammation in lungs

- Impaired gas exchange within lungs at level of alveoli

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14
Q

S&S of acute respiratory distress syndrome (ARDS)?

A

Rapidly progressing dyspnea, tachypnea & hypoxemia

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15
Q

High mortality rate of acute respiratory distress syndrome (ARDS) of 20-50% associated with what risk factors?

A
  1. severity
  2. patient age
  3. comorbidities
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16
Q

acute respiratory distress syndrome (ARDS) complications:

Atelectasis -

A

Atelectasis: Collapse of part of one’s lung

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17
Q

acute respiratory distress syndrome (ARDS) complications:

Pneumothorax -

A

Pneumothorax: Accumulation of air in the pleural space

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18
Q

Other complications of ARDS?

A
  1. Widespread organ damage or failure
  2. Kidney failure
  3. Cardiogenic shock
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19
Q

Long term complications of ARDS?

A
  1. Scarred lungs

2. ICU acquired muscle weakness

20
Q

Treatment of ARDS -

A

supportive and includes mechanical ventilation

21
Q

Atelectasis -

A

collapse of normally expanded and aerated lung tissue at any structural level (parenchyma, alveoli, pleura, chest wall, bronchi)

22
Q

What are the 3 categories of atelectasis?

A
  1. obstructive-absorptive
  2. non-obstructive
  3. compressive
23
Q

What is the primary cause of obstructive-absorptive atelectasis?

A
  • obstruction of the bronchus serving the affected area
    1. Between alveoli and trachea obstructed
    2. Air in alveoli not replaced
    3. Air diffuses into the blood
    4. alveoli collapse
24
Q

What is non-obstructive atelectasis?

A

Interference with the natural forces that drive lung expansion

25
Q

What can cause non-obstructive atelectasis?

A
  1. Hypoventilation associated with decreased pulmonary motion [paralysis, pleural disease, diaphragmatic disease, mass]
  2. Failure to breathe deeply postoperatively because of pain leading to muscle guarding and splinting
  3. Oversedation, coma, immobility
  4. Loss of surfactant
26
Q

What can cause compressive atelectasis?

A
  1. Pneumothorax
  2. hemothorax (blood)
  3. fluid (hydrothorax) in the pleural cavity
  4. Abdominal distension (push up into lung)
27
Q

Implications for therapist working with patient with atelectasis:

A
  • Frequent gentle position changes
  • deep breathing
  • coughing
  • ambulation sooner rather than later
28
Q

PT promoting what with interventions?

A
  1. ciliary clearance
  2. mucus clearance (drainage)
  3. enhance lung expansion
  4. permits collateral ventilation of the alveoli (Kohn pores)
29
Q

What is pneumothorax?

A
  • Abnormal collection of air in the pleural space

- can only develop if air is allowed to enter the pleural, through damage to the chest wall or damage to the lung itself

30
Q

Is pneumothorax typically unilateral or bilateral?

A

Unilateral

31
Q

T/F Small spontaneous pneumothorax will typically resolve without treatment

A

True

32
Q

How can air be removed from a patient with pneumothorax?

A

The air may be removed with a syringe or a chest tube

33
Q

What are the two major types of lung cancer?

A
  1. Small cell lung cancer (SCLC)

2. Non-small cell lung cancer (NSCLC)

34
Q

T/F If lung cancer has characteristics of both types of small/non-small, it is called mixed small cell/large cell although it is uncommon.

A

True

35
Q

What is small cell lung cancer (SCLC)?

A

Cells become so dense that there is almost no cytoplasm present and the cells are compressed into an ovoid mass

36
Q

Where does small cell lung cancer (SCLC) tend to be located?

A

Centrally, most often near hilum of the lung

37
Q

What are usually present at the time of diagnosis of small cell lung cancer (SCLC)?

A

Lymphatic and distant metastases

38
Q

T/F Small cell lung cancer (SCLC) most frequently in smokers.

A

True

39
Q

T/F small cell lung cancer (SCLC) progresses slowly.

A

False, Very aggressive; typically metastasizes before diagnosed

40
Q

What is non-small cell lung carcinoma?

A
  • Spread of primary cancer to other locations (brain, bone, liver)
  • Involves lymph and blood vessels
  • 85% of all lung cancers
41
Q

non-small cell lung Carcinomas of the kidney, breast, pancreas, colon, and uterus are likely to metastasize where?

A

To the lung

42
Q

Most lung cancers are detected on what?

A

routine chest X-ray taken for unrelated issues

43
Q

Clinical manifestations of lung cancer?

A
  1. Productive cough with hemoptysis, sputum production
  2. Dyspnea
  3. Anorexia, fatigue, weakness
  4. Recurring bronchitis or pneumonia
  5. Wheezing
  6. poorly defined persistent chest pain
  7. Difficulty swallowing
  8. Cardiac and esophageal compression
44
Q

Treatment of lung cancer:

A
  1. Surgical resection of tumor (not usually option for SCLC because of location)
  2. Radiation
  3. Chemo
45
Q

T/F The smaller the number (I-IV) the more sever the disease

A

False, The larger the number (I-IV) the more severe the disease

Pathophys (16 decks)

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