Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

adults > management of patients with chest and lower resp > Flashcards

management of patients with chest and lower resp Flashcards

1
Q

name some inflammatory and infectious pulmonary disorders

A
  • atelestasis
  • tracheobronchitis
  • pneumonia
  • covid-19
  • aspiration
  • pulmonary tuberculosis
  • lung abcess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

name some noninvasive respiratory therapies

A
  • incentive spirometer
  • small volume nebulizers
  • chest physiotherapy (postural drainage, percussion/vibration, pulmonary rehab)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is atelectasis

A

closure or collapse of alveoli, can be acute or chronic

acute = take care of it quickly
chronic = maintenance therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe the pathophysiology of atelectasis

A

reduced ventilation or obstruction of air to and from alveoli -> alveoli unable to absorb air dut to blockage and collapse ->
alveolar air absorbed into blood stream->
air can no lnger get into alvoli ->
lung become airless->
alveoli collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are some risk factors for atelectasis

A
  • surgical patients (immobilized, intubation, pain)
  • immobilized patients
  • increased age (osetoporotic changes, muscles weaker and cartilage stiffens)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are some clinical manifestaions of atelectasis

A
  • increasing dyspnea
  • cough
  • sputum production
  • resp distress
  • tachycardia/tachypnea
  • central cyanosis (late sign, theyre probs getting intubated)

usually given breathing tx, assess pulse ox b4 and after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are some prevention interventions for atelectasis

A
  • early mobilization
  • frequent turns
  • manage secretions (suction and fluids)
  • incentive spirometry
  • deep breathing
  • fluids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is pneumonia

A

inflammation of lung parenchyma caused by microorganisms

can be viral, fungal, or caused by bacteria

one of the most common causes of death in the US -> work on prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name some different types of pneumonia and describe them

A
  • community acquired pneumonia (CAP): get while out in public, signs and symptoms occured before being admitted
  • health care associated pneumonia (HCAP): nonhospital areas, acquired in another healthcare setting
  • hospital acquired pneumonia (HAP): occurs more than 48hrs after being admitted
  • ventilator associated pneumonia (VAP): occurs 48hrs after intubation
  • pneumonia in the immunocompromised host: host is at higher risk for it
  • aspiration pneumonia: sucked water into lungs and can’t get it out, stroke patients at risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe the pathophysiology of pneumonia

A

presence of pathogen or foreign subatance in the lung ->
causes inflammation in lung tissues (alveoli)->
affects ventilation and diffusion ->
decrease in alveolar oxygen tension mismatched ventilation/perfusion->
arterial hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are some risk factors for pneumonia

A
  • age
  • exposure
  • immune state
  • nutritional state/impaired swallowing
  • prolonged immobility
  • smoking
  • CA, COPD, cystic fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some signs and symptoms of pneumonia

A

they vary based on type and where its at
- hypoxia
- fever (increased WBC and decreased Hgb)
- orthopnea
- tires easily
- sputum production (green or blood tinged)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do you diagnose pneumonia

A
  • clinical assessment
  • sputum culture
  • chest xray
  • bronchoscpy
  • tissue biobsy
  • CT (check kidney labs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

whats included in the treatment of pneumonia

A
  • antimicrobials
  • check cultures (before drugs) (sputum culture)
  • start broad spectrum
  • change drug as needed
  • usually oral/IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe prevention of pneumonia

A
  • influenza vaccine give yearly (quality measure for hospitals)
  • pneumococcal vaccine may give booster
  • avoid pollutants
  • avoid infectious situations
  • maintain adequate hydration and nutrition
  • balance activity and rest activities
  • isolate infectious persons
  • wash hands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe covid and what complications may occur

A
  • sars-cov-2 virus
  • viral transmission
  • various levels of infection
  • repidly mutates
  • complications: shock, resp failure, pleural effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe the spread of covid

A
  • spreads person-person through resp droplets
  • close contact less than 6 feet apart
  • community spread
  • no evidence spread through food
  • possible spread by touching contaminated surfaces
  • unsure of weather effects on virus
  • symptoms may occur 2-14 days after exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe prevention of covid

A
  • wash hands
  • avoid touching eyes, nose, and mouth
  • avoid large crowds/close contact
  • wear mask in public
  • cover coughs and sneezes
  • clean and disinfect
  • monitor health daily
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does a chest xray look like for a covid patient

A

looks like glass shards in that bitch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how will viruses affect WBC count

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how will infection affect WBC count

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are some high risk populations for covid

A
  • older adults
  • nursing home and LTC facilities
  • underlying medical conditions
  • racial/ethnis minority groups
  • pregnancy and breastfeeding
  • disabilities
  • developmental and behavioral disorders
  • substance abusers
  • homelessness
  • group homes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are some symptoms of covid

A
  • fever
  • chills
  • cough
  • SOB
  • fatigue
  • body aches
  • HA
  • new loss of taste or smell
  • sore throat congestion/runny nose
  • nausea/vonmiting
  • diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are some complications that may occur due to covid

A
  • pneumonia
  • resp failure
  • acute respiratory distress syndrome (fluid in the lungs)
  • sepsis
  • multipl organ failure
  • cardiac injury
  • inflammation of the heart, brain, or muscles
  • secondary baceterial infections
  • blood clots in veins and arteries of lungs, heart, legs, or brain
  • multisystem inflammatory syndrom in children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

describe pulmonary tuberculosis

A
  • chronic and infectious disease of the lungs
  • can spread to other tissues like meninges, kidneys, bones, and lymph nodes
  • mycobacterium tuberculosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

describe how pulmonary tuberculosis is a wroldwide health prob

A
  • associated with poverty, malnutrition, overcorwding, substandard housing, inadequate health care
  • highly contagious via inhaled organisms
  • spread from person to person by airborne transmission
  • droplet nuclei
  • talking, coughing, sneexing, laughing, or singing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are some risk factors for pulmonary TB

A
  • close contact with an infected person
  • immunocompromised
  • substance abuse
  • pre-existing medical conditions
  • immigration from countries with TB rates
  • overcrowded population
  • patient not identified or isolated adequately
  • inadequate therapy (med coverage)
  • inadequate ventilation of room
  • isolation room not negative pressure airflow
  • patient not masked when out of room (duck bill mask)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are some signs and symptoms of pulmonary TB

A
  • low grade fever
  • cough
  • night sweats
  • fatigue
  • weight loss
  • rust colored sputum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how is TB diagnosis made

A
  • being suspicious
  • history
  • “rust” colored sputum
  • acid fast bacillus smear (contains mycobateria)
  • sputum culture
  • skin testing
  • chest xray (lesions in upper lobe)
  • TB blood tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

which test is preferred to diagnose TB

A

quanterferon gold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

describe mantoux testing

A
  • skin testing for TB
  • indtredermal injection of PPD
  • relies on antibody results (read 48-72 hours after injection)
  • positive = induration (hardening at site)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what drug is given as prophylaxis for contacts/converters/high risk individuals for TB

A

isoniazid (INH)
B6 given with it bc it can cause polyneuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what 4 drug combination is used in the initial treatment of TB

A
  • INH
  • rifampin
  • pyrazinamide (PZA)
  • ethambutol

for 8 weeks

34
Q

what drugs are used as continuation of TB treatment

A

2 drugs for 4-7months (INH and rifampin)

risk of transmission decreases after 2-3 weeks of therapy

35
Q

what are the side effects of INH

A

neuropathy, hard on liver (monitor function)

36
Q

what are the side effects of rifampin

A

turns urine orange, can stain clothes, contacts, and skin

monitor liver function

37
Q

what are the side effects of ethambutol

A

optic neuritis

monitor renal and liver function

38
Q

what are the side effects of PZA

A

joint pain and hyperuricemia

monitor uric acid and monitor liver function

39
Q

what are some patient education things to include for tb treatment

A

no alcohol bc of liver shit
need to be compliant

40
Q

describe pleurisy

A

inflammation of lung linings, not enough surfactant, lining tears

sharp stabbing pain on inspiration

41
Q

describe pleural effusion

A

too much fluid in pleural space

thoracentesis is done

42
Q

what is a pneumothorax

A

occurs when the pleural space is exposed to positive atmospheric pressure

air in the thoracic cavity, can cause tracheal devation and pressure on the heart

43
Q

name and describe the different types of pneumothorax

A
  • spontaneous (simple)
  • trauma (blunt: rib fracture, penetrating: stab wound/GSW)
  • post surgical (chest surgery, central line placement)
    -tension pneumothorax (air enters cavity and cant escape -> pressure builds and lung collapses -> shifts organs)
44
Q

is pneumothorax an emergency?

A

yep, patients condition can decline quickly

45
Q

what are some symptoms of pneumothorax

A
  • acute distress
  • pain - sudden, pleuritic
  • tachypnea
  • resp discomfort
  • absent breath sounds
  • anxiety, agitation
  • instant central cyanosis
  • air hunger
  • inscreased HR
  • diaphroesis
46
Q

what is the treatment of pneumothorax

A
  • chest tube
  • oxygen if tension pneumothorax
47
Q

what is a thoracotomy

A

creation of a surgical opening into the thoracic cavity

48
Q

what are soem indications for a thoracotomy

A
  • diagnose lung disease
  • diagnose chest disease
  • obtain biopsy
49
Q

name some thoracic surgeries and describe em a little

A
  • wedge resection (for diagnosis, just take a little and it comes back)
  • lobectomy (take a lobe outta there)
  • pneumonectomy (take the whole fuckin lung)
  • decortication (removing scar tissue)

done to diagnose, cure, and treat

50
Q

describe pre op for thoracic surgery

A
  • assess functional reserve (can the other lung take over?)
  • determine liklihood of recovery and survival
  • ensure optimal condition for surgery
  • determine baseline labs
  • pre op testing
51
Q

describe post op mamanegment of thoracic surgery

A
  • may be on vent/may have chest tube
  • promote airway clearance
  • manage pain
  • maintain fluid volume
  • monitor for complications
52
Q

what are some possible complications of thoracic surgery

A
  • immobility - atelectasis
  • bleeding
  • pneumothorax
  • infection
  • resp and/or heart failure
  • fistula formation (opening between airway and other structure)
53
Q

what are chest tubes

A

placed in pleural space to drain fluid, blood, and air

54
Q

where is the chest tube placed to remove air

A

upper

55
Q

where is the chest tube placed to remove fluid or blood

A

lower

56
Q

describe nursing management of chest tubes

A
  • must be one way system to allow air or fluid out of cavity and none back in
  • keep below the level of the chest (40cm or more)
  • pain management
  • site assessment: check for redness or drainage, check integrity of dressing, subQ emphysema)
57
Q

what are some possible complications of chest tubes

A
  • atelectasis
  • infection
  • re-accumulation of air in pleural space
58
Q

what should the nurse know about the chest tube?

A
  • know the purpose of tube for the patient
  • assess and maintain for patency (DO NOT rely on bubbling)
  • use caution before clamping (may be vent for thoracic cavity)
  • assess and manage pain
  • drainage from tube should be sanguinous when new then transitons to serous and amount should decrease over time
59
Q

the first chamber (A) on the chest tube drainage system is…

A

the suction chamber, should see gently bubbling

60
Q

the B chamber on the chest tube drainage system is….

A

the water seal chamber

should see tidaling when patient breathes in

61
Q

the C chamber on the chest tube drainage system is…

A

it has water in it and you should not see bubbling

62
Q

what can it indicate if there is bubbling in the C chamber

A

there is a leak in the system

63
Q

what is the D chamber of the chest tube drainage system

A

where the drainage goes

64
Q

the ocean system is for draining…

A

fluid

65
Q

the oasis system is for draining…

A

air

66
Q

what is the leading cause of cancer death in both men and women?

A

lung cancer

has low survival rates bc theres no ealy diagnosis and 70% spread at diagnosis

67
Q

what are some different classifcations of lung cancer

A
  • small cell (SCLC) 10-15%
  • non small cell large cell (NSCLC) 80-85% (squamous and adenocarcinoma)

adenocarcinoma is the most prevalent

68
Q

what are some risk factors of lung cancer

A
  • cigarette smoking (90%)
  • genetic
  • envirnmental exposures: radon gas, second hand smoke, asbestos, work place cancer causing agents
69
Q

what are some symptoms fo lung cancer

A
  • depends on the location of the tumor
  • degree of obstruction
  • existence of metastases
  • cough, voice changes, hemoptysis
  • dyspnea, weight loss, pain
70
Q

what is used to diagnose lung cancer

A
  • CXR
  • CT scan
  • PET scan
  • MRI
  • biopsy - must have cytology/tissue sample to identify cells
71
Q

where do 90% of lung cancers start

A

bronchial epithelium

72
Q

treatment of lung cancer depends on…

A
  • tumor cell type
  • stage of disease
  • overalll status
73
Q

whats included in treatment for cure or palliation of symptoms for lung cancer

A
  • radiation
  • surgery
  • chemotherapy
  • palliative
74
Q

what are some treatment related complications of lung cancer

A
  • respiratory failure
  • vent dependency
  • pulmonary fibrosis (lungs get scarred)
  • pericarditis (heart cant beat)
  • myelitis
  • cor pulmonale (right sided HF)
  • pulmonary toxicty
  • pneumonitis

need max psychosocial support and education about disease

75
Q

what is pulmonary embolism

A

obstruction of the pulmonary artery or one of its branches by a clot from the venous system (like DVT)

common disorder

76
Q

pulmonary embolism is associated with…

A
  • trauma
  • surgery
  • pregnancy
  • HF
  • > 50 years
  • hypercoagulable states
  • prolonged immobility
77
Q

symptoms of pulmonary embolism depend on…

A

size of clot and area affected

78
Q

what are some symtpoms of pulmonary embolism

A
  • dyspnea
  • CP
  • sudden/pleuritic
  • anxiety
  • fear
  • apprehension
  • diaphoresis
  • hemoptysis
  • syncope
  • tachypnea
  • sudden death
79
Q

what are some diagnostics used for pulmonary embolism

A
  • early recognition is important (death can occur within 1hr of onset of symptoms)
  • clinical assessment of risk factors
  • chest xray
  • EKG
  • pulse ox
  • ABGs
  • V/Q scan
  • spiral CT
  • D-dimer assay
  • ultrasound (check for DVT)
  • pulmonary angiogram
  • MRI
80
Q

describe prevention of pulmonary embolism

A
  • active leg exercises
  • early ambulation
  • antiembolism stockings/SCDs
81
Q

describe treatment of pulmonary embolism

A

meds:
-blood thinners (heparin, warfarin, apixaban)
-thrombolytics (tPA)

surgical procedures:
- clot removal
- vein filters

oxygen therpy and active IV lines

adults (51 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions