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MedSurg > Management of Pts w/ Chest & LRT Disorders > Flashcards

Management of Pts w/ Chest & LRT Disorders Flashcards

1
Q
  • Refers to closure or collapse of alveoli
  • Acute or chronic

*Acute is the most common (post-op/immobilized)

Excess secretions or mucous

  • Chronic (e.g. tumor)
A

ATELECTASIS

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2
Q

*Occurs either in the community setting
or within the first 48 hours after
hospitalization or institutionalization.

A

Community-Acquired Pneumonia

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2
Q
  • Inflammation of the lung
    parenchyma
  • Caused by bacteria,
    mycobacteria, fungi, and
    viruses.
A

Pneumonia

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3
Q

pneumonia

low risk = w/ symptoms but no xray findings
moderate = may symptoms and findings sa xray
high risk = in pts with HPN, commatose, decrease sensorium (needs intubation)

A

–

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3
Q

Pneumonia in the Immunocompromised Host

common virus cause __
*Occurs with use of corticosteroids,
chemotherapy, nutritional depletion
* Antimicrobial agents, AIDS, genetic immune
disorders, mechanical ventilation

A

“Pneumocystis pneumonia”

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4
Q

*Onset of pneumonia symptoms more than 48
hours after admission in patients with no
evidence of infection at the time of admission.

  • Ventilator-associated pneumonia is considered a
    type of nosocomial pneumonia

*Impaired host defenses

A

Hospital-Acquired Pneumonia

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5
Q

Distribution of lung
involvement in bronchial
and lobar pneumonia

(left), patchy areas of
consolidation occur.

A

bronchopneumonia

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5
Q
  • Refers to the pulmonary consequences resulting
    from entry of endogenous or exogenous
    substances into the lower airway
  • Most common is bacterial infection from aspiration
    of bacteria that normally reside in the upper
    airways
  • Gastric contents, exogenous chemical contents, or
    irritating gases
A

Aspiration pneumonia

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6
Q

Distribution of lung
involvement in bronchial
and lobar pneumonia

(right), an entire lobe is
consolidated.

A

lobar pneumonia

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7
Q
  • Aspiration of stomach contents into the lungs
    *It can occur when the protective airway reflexes
    are decreased or absent
  • Can result in tachycardia, dyspnea, central
    cyanosis, hypertension, hypotension, and finally
    death.
A

Aspiration

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7
Q

Vaccination against pneumococcal infection is
advised for the following:
* People 65 years of age or older
* People with functional or anatomic asplenia
* People living in environments or social settings in
which the risk of disease is high
* Immunocompromised people at high risk for
infection

A

Vaccination against pneumococcal infection is
advised for the following:
* People 65 years of age or older
* People with functional or anatomic asplenia
* People living in environments or social settings in
which the risk of disease is high
* Immunocompromised people at high risk for
infection

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7
Q

*Occurs unobserved

*If untreated, massive inhalation of gastric
contents develops in a period of several hours.

A

Silent aspiration

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8
Q
  • Caused by a coronavirus
  • Transmitted via respiratory droplets
  • Close contact with a person who has been diagnosed with
    the disease or a history of travel or residence in an area
    with known cases
  • May also be spread when a person touches a surface
    contaminated by the droplets and then touches his or
    her mucous membranes.
A

Severe acute respiratory syndrome (SARS)

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8
Q
  • Primarily affects the lung parenchyma
    *It also may be transmitted to the meninges,
    kidneys, bones, and lymph nodes.
  • Associated with poverty, malnutrition, overcrowding, substandard housing, and inadequate health care
A

Tuberculosis (TB)

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9
Q

treatment for SARS

A

oseltamivir / tami flue

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9
Q

transmission mode of TB

A

Airborne and droplets transmission

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9
Q

cause of tb

A

Mycobacterium tuberculosis

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10
Q

mantoux test
* A reaction of 5 mm or greater may be significant in people who are considered to be at risk

*An induration of 10 mm or greater is usually considered significant in people who have normal or
mildly impaired immunity.

A
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11
Q

Pulmonary TB is treated primarily with antituberculosis agents for ___ months

A

6 to 12 months

11
Q

BGC vaccine is given to protect from what kind of TB?

A

CNS

11
Q

Prophylactic taking daily doses for 6 to 12 months
* Household family members of patients with active disease
* HIV infection – 5mm or more induration

  • Old TB detected on CXR – 5mm or more induration
  • Patients whose current PPD test results show a change from former test
    results.
  • Users of IV/injection drugs – 10mm or more induration
  • High-risk comorbid conditions – 10mm or more induration
A

==

12
Q
  • Accumulation of thick, purulent fluid within the
    pleural space
  • Complications of bacterial pneumonia or lung
    abscess.
  • At first the pleural fluid is thin, with a low
    leukocyte count but progresses to a
    fibropurulent stage to loculated empyema
A

Empyema

12
Q

is necrosis of the
pulmonary parenchyma
* It is generally caused by aspiration
of anaerobic bacteria.

A

lung abscess

12
Q

*Inflammation of both layers of the pleurae
(parietal and visceral).
* May develop with URTI, trauma, PE, CA and
after thoracotomy.

A

Pleurisy (Pleuritis)

12
Q
  • Collection of fluid in the pleural space
  • Complication of heart failure, nephrotic syndrome, PE
  • TB, pneumonia, neoplastic tumors
  • Most common is bronchogenic carcinoma
A

Pleural Effusion

13
Q

Medical Management of EMPYEMA

*Drain the pleural cavity and achieve complete
expansion of the lung
* The fluid is drained, and appropriate antibiotics
* Sterilization of the cavity requires 4 to 6 weeks
of antibiotics.

A

–

14
Q

*Needle aspiration with a thin percutaneous
catheter, if the volume is small and the fluid is
not too purulent or too thick

A

Thoracentesis

15
Q
  • Chest drainage using a large
    diameter intercostal tube
    attached to water-seal
A

Tube thoracostomy

16
Q
  • Abnormal accumulation of fluid in the lung tissue, the alveolar space, or both.
  • Severe, life-threatening condition.
A

Pulmonary Edema

16
Q
  • Sudden and life-threatening deterioration of the
    gas exchange function of the lung
  • Failure of the lungs to provide adequate
    oxygenation for the blood.
A

Acute Respiratory Failure

16
Q

Type of Acute Respiratory Failure

  • Decrease in arterial oxygen tension
    (PaO2) to less than 50 mm Hg (hypoxemia)
A

TYPE 1

17
Q

is a critical part of the treatment of ARDS.

improves oxygenation, but it does not influence the
natural history of the syndrome
* helps increase functional residual capacity (FRC) and
reverse alveolar collapse by keeping the alveoli open,
resulting in improved arterial oxygenation

A

PEEP

17
Q

Type of Acute Respiratory Failure

  • Increase in arterial carbon dioxide tension (PaCO2) to greater than 50 mm Hg(hypercapnia), with an arterial pH of less than 7.35.
A

TYPE 2

17
Q
  • Severe form of acute lung injury.
  • Characterized by a sudden and progressive
    pulmonary edema
    *Increasing bilateral infiltrates on chest x-ray,
    *Hypoxemia unresponsive to oxygen
    supplementation
A

Acute Respiratory Distress Syndrome(ARDS)

18
Q
  • deterioration in the gas exchange function that has
    persisted for a long period after an episode of
    acute respiratory failure
  • Develop a tolerance to the gradually worsening
    hypoxemia and hypercapnia.
A

Chronic respiratory failure

19
Q
  • Most frequent cause of Cor Pulmonale is severe COPD
  • Any disease affecting the lungs and accompanied by
    hypoxemia may result in cor pulmonale
A

–

19
Q
  • Exists when the mean pulmonary artery
    pressure exceeds 25 mmHg with a pulmonary
    capillary wedge pressure of less than 15 mmHg
  • Must be measured directly during right-sided
    heart catheterization.

*Not clinically evident until late in its
progression.

A

Pulmonary Arterial Hypertension

20
Q
  • Condition in which the right ventricle of the
    heart enlarges
  • Type of pulmonary arterial hypertension due to
    a known cause.
A

Pulmonary Heart Disease
(Cor Pulmonale)

21
Q

Refers to the obstruction of the
pulmonary artery or one of its branches by a thrombus

Venous thromboembolism (VTE) is a term that includes both DVT and PE.

Associated with trauma, surgery,
pregnancy, heart failure, older than 50 years, hypercoagulable states, and
prolonged immobility.

A

Pulmonary
Embolism

22
Q

*Death from Pulmonary
Embolism commonly occurs within 1 hour after the onset of symptoms

A
22
Q
  • considered the best method to diagnose PE
  • allows for direct visualization arterial obstruction
A

Pulmonary angiography

23
Q

*If the patient has suffered massive embolism and is hypotensive, an indwelling urinary catheter is inserted to monitor urinary output.

  • Small doses of IV morphine or sedatives are administered to relieve patient anxiety
A

–

24
Q
  • Resolves the thrombi or emboli quickly
  • Used in treating PE, particularly in patients who are
    severely compromised
  • Bleeding is a significant side effect
A

Thrombolytic Therapy

24
Q
  • Removal of the actual clot on
    cardiopulmonary bypass.
  • Very risky
A

surgical embolectomy

25
Q
  • A vacuum-cupped catheter is introduced
    transvenously
  • Suction is applied to the end of the embolus,
    and the embolus is aspirated into the cup.
  • Catheters are available that pulverize the clot
    with high-velocity jets of normal saline solution.
A

Transvenous catheter embolectomy

26
Q

*Inserted through the internal jugular
vein or common femoral vein

  • The perforated umbrella permits the
    passage of blood but prevents the
    passage of large thrombi.
A

Greenfield filter

MedSurg (11 decks)

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