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Pathopharm Exam 3 > Module 8: Part 1 > Flashcards

Module 8: Part 1 Flashcards

1
Q

S&S pulmonary disease (9)

A

Dyspnea and cough
Altered breathing patterns
Hyperventilation
Hypoventilation
Hemoptysis
Abnormal sputum
Cyanosis
Chest pain
Clubbing

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2
Q

Subjective sensation of uncomfortable breathing

A

dyspnea

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3
Q

s/s severe dyspnea (3)

A

Flaring of the nostrils
Use of accessory muscles of respiration
Retraction of the intercostal spaces

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4
Q

dyspnea on exertion

A

Shortness of breath with activity

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5
Q

orthopnea

A

Dyspnea when lying down

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6
Q

Paroxysmal nocturnal dyspnea

A

Awaking at night and gasping for air; must sit up or stand up

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7
Q

what is a cough

A

Protective reflex that helps clear the airways by an explosive expiration

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8
Q

chronic cough

A

lasts more than 3 weeks

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9
Q

acute cough resolves

A

within 2-3 weeks

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10
Q

abnormal sputum

A

Changes in amount, consistency, color, and odor provide information about the progression of disease and the effectiveness of therapy.

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11
Q

hemoptysis

A

Coughing up blood or bloody secretions

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12
Q

eupnea

A

Normal breathing pattern

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13
Q

function of abnormal respirations

A

Adjustments made by the body to minimize the work of the respiratory muscles

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14
Q

Kussmaul respirations (hyperpnea)

A
  • Slightly increased ventilatory rate,
  • very large tidal volume
  • no expiratory pause
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15
Q

when is Kussmaul commonly seen

A

in severe acidosis (e.g.: diabetic acidosis)

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16
Q

labored breathing

A

↑ WOB

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17
Q

Restricted breathing

A

Disorders that stiffen the lungs or chest wall and decrease compliance

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18
Q

Biot’s Respirations

A

Periods of variable apnea and shallow respirations
Typically caused by damage to pons or stroke
A sign of deterioration and poor prognosis

biot = ‘bouta meet Jesus

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19
Q

Cheyne-Stokes respirations

A
  • Alternating periods of deep and shallow breathing
  • apnea lasting 15-60 seconds
  • followed by ventilations that increase in volume until a peak is reached
  • then decreases again to apnea
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20
Q

Normal, Biot’s, Kussmaul, Cheyne-Stokes patterns (diagram)

A
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21
Q

Alveolar ventilation is inadequate in relationship to the metabolic demands.

A

hypoventilation

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22
Q

leads to respiratory acidosis from hypercapnia

A

hypoventilation

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23
Q

Is caused by airway obstruction, chest wall restriction, or altered neurologic control of breathing.

A

hypoventilation

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24
Q

Alveolar ventilation exceeds the metabolic demands.

A

hyperventilation

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25
Q

Leads to respiratory alkalosis from hypocapnia.

A

hyperventilation

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26
Q

Is caused by anxiety, head injury, or severe hypoxemia.

A

hyperventilation

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27
Q

Bluish discoloration of the skin and mucous membranes

A

cyanosis

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28
Q

when does cyanosis develop

A

when 5 g/dl of hemoglobin is desaturated, regardless of concentration

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29
Q

peripheral cyanosis is most often caused by

A

poor circulation

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30
Q

where is peripheral cyanosis best observed

A

in the nail beds

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31
Q

central cyanosis is caused by

A
  • decreased arterial oxygenation
  • low PaO2 (partial pressure of oxygen)
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32
Q

where is central cyanosis best observed

A

in buccal mucous membranes and lips

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33
Q

clubbing

A

don’t really understand the cause, know that its very low O2 to periphery, nails round over

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34
Q

most common pain caused by pulmonary diseases

A

pleural pain

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35
Q

pleural pain characteristics

A

is usually sharp or stabbing in character

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36
Q

Infection and inflammation of the parietal pleura (pleuritis or pleurisy) can cause pain when

A

the pleura stretch during inspiration and are accompanied by a pleural friction rub.

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37
Q

chest wall pain may be from

A

airways, muscle, or rib pain

38
Q

hypercapnea

A

↑ CO2 in the arterial blood

39
Q

hypercapnia occurs from

A

decreased drive to breathe or an inadequate ability to respond to ventilatory stimulation

40
Q

most common cause of hypoxemia

A

ventilation-perfusion abnormalities

41
Q

shunting

A

low V/Q
seen in asthma and atelectasis

42
Q

alveolar dead space

A

Area where alveoli are ventilated but not perfused

43
Q

high V/Q example

A

pulmonary embolism

44
Q

hypoxia vs hypoxemia

A

hypoxemia is loss of O2 in the blood

45
Q

V:Q abnormalities diagram

A
46
Q

In acute respiratory failure, gas exchange is…

A

inadequate (hypoxemia)

47
Q

acute respiratory failure Pa O2

A

is < or equal to 50 mmHg

48
Q

what is the partial pressure of Co2 in hypercapnia

A

> or equal to 50 mmHg

49
Q

what is pH in ARF

A

< or equal to 7.25

50
Q

ARF requires what kind of treatment

A

ventilatory support, oxygen, or both.

51
Q

chest wall restriction

A

Chest wall is deformed, traumatized, immobilized, or made heavy by fat; work of breathing is increased, and ventilation may be compromised because of a decrease in tidal volume.

52
Q

impaired respiratory muscle function is caused by

A

neuromuscular disease

53
Q

flail chest

A

Is the instability of a portion of the chest wall from rib or sternal fractures.

54
Q

flail chest causes

A

paradoxical movement of the chest with breathing.

55
Q

pneumothorax

A

Presence of air or gas in the pleural space

56
Q

primary/spontaneous pneumothorax

A

Occurs unexpectedly in healthy individuals.

57
Q

secondary pneumothorax

A

Is caused by disease, trauma, injury, or condition

58
Q

iatrogenic pneumothorax

A

Is caused by medical treatments, especially transthoracic needle aspiration.

59
Q

open pneumothorax

A

Air pressure in the pleural space equals barometric pressure, because air that is drawn into the pleural space during inspiration is forced back out during expiration.

60
Q

tension pneumothorax

A
  • Site of pleural rupture acts as a one-way valve
  • air can enter on inspiration but cannot escape d/t it closing up during expiration
61
Q

what pneumothorax is life threatening?

A

tension

62
Q

what does a tension pneumo look like? (diagram)

A
63
Q

clinical manifestations of pneumo

A
  • Sudden pleural pain
  • tachypnea
  • possible mild dyspnea
64
Q

clinical manifestations of tension pneumo

A
  • Severe hypoxemia
  • tracheal deviation away from the affected lung
  • hypotension
65
Q

treatment of pneumo

A

Chest tube

66
Q

if persistent air leak with pneumo, treatment is…

A
  • Surgery
  • pleurodesis (instill caustic substance, talc, into the pleural space)
  • thoracoscopic surgical techniques
67
Q

pleural effusion

A

Presence of fluid in the pleural space

68
Q

transudative effusion

A

Is watery and diffuses out of the capillaries.

69
Q

exudative effusion

A

Is less watery and contains high concentrations of white blood cells and plasma proteins.

transudative: watery; from capillaries

70
Q

chylothorax

A

Chyle exudate (lymph from blocked thoracic duct)

71
Q

hemothorax

A

blood exudate

72
Q

clinical manifestations of pleural effusion

A

Dyspnea and pleural pain

73
Q

treatment of pleural effusion

A

Thoracentesis, chest tube, and surgery

74
Q

empyema

A

infected pleural effusion, pus in the pleural space

75
Q

manifestations of empyema

A
  • Cyanosis
  • fever
  • tachycardia
  • cough
  • pleural pain
76
Q

treatment of empyema

A

Administration of antimicrobial medications

Drainage of the pleural space with a chest tube

77
Q

treatment of severe cases of empyema

A
  • Ultrasound-guided pleural drainage
  • inject fibrinolytics or deoxyribonuclease (DNase) into pleural space
78
Q

restrictive lung disorders (9)

A
  • Aspiration
  • Atelectasis
  • Bronchiectasis, bronchiolitis
  • Pulmonary fibrosis
  • Inhalational disorders
  • Pneumoconiosis
  • Allergic alveolitis
  • Pulmonary edema
  • Acute respiratory distress syndrome
79
Q

aspiration

A

Passage of fluid and solid particles into the lungs

80
Q

most frequent site of aspiration

A

Right lower lobe: Is the most frequent site.

81
Q

clinical manifestations of aspiration

A

Both choking and intractable cough have a sudden onset

82
Q

non-pharm treatment of aspiration

A
  • Supplemental O2
  • may require mechanical ventilation with PEEP
  • Restrict fluids (decrease blood volume & minimize pulmonary edema)
83
Q

pharmacologic treatment of aspiration (2)

A

Administer steroids during the first 72 hours after aspiration.

May need broad-spectrum antibiotics.

84
Q

atelectasis

A

collapse of lung tissue

85
Q

compression atelectasis

A

External compression on the lung

86
Q

absorption atelectasis

A

Gradual absorption of air from obstructed or hypoventilated alveoli, volatile/gaseous anesthesia

87
Q

surfactant impairment

A

Decreased production or inactivation of surfactant

88
Q

clinical manifestations of atelectasis

A

Dyspnea, cough, fever, and leukocytosis

89
Q

treatment of atelectasis

A

PREVENTION aka deep breathing

90
Q

bronchiectasis

A

Persistent abnormal dilation of the bronchi

can be cylindrical, saccular, and varicose

91
Q

clinical manifestations of bronchiectasis

A

Chronic productive cough

92
Q
A

Pathopharm Exam 3 (18 decks)

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