M1 recap Flashcards
types of pain
acute,
chronic
intractable
neuropathic
Acute Pain:
- pain directly related to tissue injury, resolves when tissue heals
Chronic (Persistent) Pain:
- pain that persists beyond three months secondary to chronic disorders, or damaged nerves after healing is complete
Intractable Pain:
- A pain state that is usually severe in which there is no cure, after accepted medical treatments have been offered (i.e. Refractory Angina)
Neuropathic Pain:
- Pain that is related to malfunctioning or damaged nervous tissue
- Shingles, fibro
types of pain
nociceptive
somatic
visceral
pain threshold
phantom pain
Nociceptive
- caused by damage to somatic or visceral tissue
Somatic
- localized to areas such as bone, joint, muscle or skin
- Aching or throbbing
Visceral
- activation of nociceptors of the thoracic, pelvic, or abdominal viscera (organs).
Pain Threshold:
- The process of recognizing, defining, and responding to pain
Phantom Pain:
- Painful sensations experienced from a limb that has been removed (amputated)
Meds for scale of pain (1-10)
Medication for mild pain (1-3)
NSAIDs
nonopioid analgesics
Tylenol → acetaminophen
Advil → ibuprofen
Mild to moderate pain (4-6)
prescriptions for opioids are often combined with a nonopioid analgesic (tylenol 3 EG)
Moderate to severe pain (6-10)
Morphine is one of the opioids most commonly prescribed for moderate to severe pain, although fentanyl (Duragesic), hydromorphone (Dilaudid), methadone (Metadol), and oxycodone also are used extensively.
lung capacity
TV,IRV,ERV,VC
Lung Capacity (important)
- Tidal volume (TV or VT): air volume of each breath (500ml)
Inspiratory reserve volume (IRV):
- maximum volume that can be inhaled after a normal inhalation
Expiratory reserve volume (ERV):
- maximum volume exhaled after a normal exhalation
Vital capacity (VC):
- the maximum volume of air exhaled from a maximal inspiration, VC = TV + IRV + ERV (average is 6L)
restrictive vs obstructive PD
what causes a restictive PD
issue with Inflow of air
Decreased lung compliance and decreased lung expansion
Problem of volume rather than airflow (speed)
Caused by:
Decreased number of functioning alveoli
Lung tissue loss (lobectomy/tumour)
Hypoxemia – low oxygen in blood
Hypoxia – low oxygen in tissue
RPD
pneumonia
what is it? some S/S
Inflammation of lung tissue
Classic Signs and Symptoms
- Tachypnea
- Productive cough
- Fever
- Dyspnea
- Crackles, decreased breath sounds
- ABGs indicative of hypoxemia (o2 level and Co2 level)
RPD
classifications of Pneumonia
Classification often based on where acquired
- Ventilator-associated pneumonia (VAP)
- Health care-associated pneumonia (HCAP)
- Community AP: Streptococcus pneumoniae (gram +ve)
- Hospital AP: Pseudomonas (gram –ve, opportunistic)
Anti-infective tx
Penicillins (Oxacillin, Antipseudomonal)
Tetracyclines
Aminoglycosides
Cephalosporins (Ceftriaxone)
Macrolides (Clarithromycin)
Fluoroquinolones (Ciprofloxacin)
RPD
bronchitis
Chronic sputum production with a cough on a daily basis for a minimum of 3 months/year
Chronic hypoxemia/cor pulmonale (right sided HF)
Increased mucus production
Increased bronchial wall thickness (obstructs air flow)
Increased CO2 retention/acidemia
Reduced responsiveness (hypoxemia)
RPD
emphysema
Abnormal enlargement of the air spaces distal to the terminal alveolar walls
S/S
- Barrel chest // thin due to energy required to breathe
- dyspnea
- decreased gas exchange surface area
- Decreased capillary network
- increased O2 consumption
obstructive PD
Air flows readily into lungs, trapping occurs in aveoli
Causes prolonged expiratory phase
CO2 can get trapped if alveoli not empty prior to inhalation
hyperinflation with poor elastic recoil
Examples:
Asthma
status asthmaticuz
COPD
CF
OPD
status asthmaticus
what is it? physiological changes that occur? S/S
Life threatening due to airway obstruction
Physiologic Changes:
- Inflammation causing narrowing/ remodelling of the airway
- Hyper-responsiveness to irritants: bronchospasms and mucous plugging
Symptoms of Status Asthmaticus
- Pulsus paradixus of 25mm Hg or greater
- ABG showing hypoxemia with or without hypercapnia (++CO2)
- Reduced peak expiratory flow rate (30% or less of predicted value)
- dyspnea (Inability to speak or only 1 word phrases)
COPD
What is it? some causes?surgery? pharm?
resp disorder causing airflow limitation, associated with a chronic inflammatory response in the airways and the lung. (caused largely by smoking )
Surgery
lung volume reduction surgery
lung transplantation
pharm
- B2 Adremergic agonist (inhaled short acting or long acting)
- corticosteroids
OPD
TB
pharm
TB is caused by the Mycobacterium tuberculosis or the tubercle bacillus, an acid-fast organism, spread by airborne transmission.
pharm
- Isoniazid
- Pyridoxine
- Rifampin
- Pyrazinamide
OPD
CF
An autosomal recessive, cuased by altered function of the exocrine glands involving primarily the lungs, pancreas, and sweat glands
Abnormally thick, abundant secretions from mucous glands lead to a chronic, diffuse, obstructive pulmonary disorder in almost all patients.
Chronic fatal respiratory disease
The most common genetic disease
