Pathophysiology and Management Flashcards
What causes flash pulmonary edema?
It is most often precipitated by AMI or mitral regurgitation, can be caused by aortic regurgitation, heart failure, or almost any cause of elevated left ventricular filling pressures.
Signs and symptoms of flash pulmonary edema
Acute sudden onset of SOB
AMI or CPx
Pink frothy sputum
Wheezing and coughing
What is another term for cardiogenic pulmonary edema and what are some of the causes?
CHF Caused by (high pressure) dysfunction of either the R or L ventricle, chronic HTN or myocarditis.
What is non-cardiogenic pulmonary edema and what are some of the causes?
Occurs due to acute hypoxemia from toxin inhalation or drowning because fluid seeps into the lungs.
Recurring asthma attacks are usually due to what underlying condition?
Infection or continuous exposure to triggers
What is a severe prolonged asthma attack that does not respond to typical treatment?
Status asthmaticus
Another term for asthma
reactive airway disease
Why would a patient in static asthmatics become acidotic?
Due to CO2 retention
What is asthma sometimes referred to as?
Reactive airway disease
Why wil dehydration worsen asthma?
Causes thickening of mucus due to tachycardia and increases air trapping
What are the 3 most common pathologic conditions with asthma and what is the best treatment for each condition?
Bronchospasm- responds well to aerosol bronchodilators
Bronchial Edema- poor response to aerosol bronchodilators, does respond to corticosteroids
Excessive mucus secretions- improve hydration
2 pathologies of COPD
Emphysema and chronic bronchitis
Pathology of emphysema
Damage to terminal bronchioles and alveoli and trap air.
Pathology of chronic bronchitis
Chronic sputum production with hypercarbia and hypoxemia levels typically associated with right side heart failure (cor pulmonale)
S&Sy of COPD with pneumonia
Fever, signs of infection, colored thick sputum, localized crackles
S&Sy of COPD with right sided heart failure
Episode of CHF, pedal edema, JVD
S&Sy of COPD with left sided heart failure
AMI, left ventricular failure
Why can the hypoxic drive become the primary respiratory stimulus in COPD?
In chronic hypoventilation HCO3 ions migrate in the CSF thus increasing the pH causing the primary stimulus to breath to be low levels of O2
Acceptable O2 levels in a COPD pt
93%
What is auto-PEEP and why is it a concern in COPD pts?
Complete exhalation should occur prior to the next ventilation in order to prevent increasing thoracic pressure from causing a pneumothorax or from limiting venous return to the heart and leading to cardiac arrest.
Ventilate at 4-6 bpm if this is a concern.
Characteristics of pneumonia
Onset: hours-days
Productive cough, fever, crackles or diminished lung sounds due to consolidation usually in bases and unilateral, pleural friction rub in area of consolidation
If supine the good lung should be up to decrease ventilatory effort
Often dehydrated
Bronchial dilators typically ineffective
What is atelectasis?
Occurs when entire sections of alveoli collapse due to chronic under inflation (sedation)
Typically occurs to people who do not take deep breaths
What is hemoptysis?
Coughing up blood in the sputum
What is a pleural effusion?
Excessive accumulation of fluid in the lungs
Management of hemoptysis and pleural effusions in cancer patients?
Limited to supportive care
What is a build up of fluid in the air spaces of the lungs due to blood plasma migrating into the lung parenchyma?
Pulmonary edema
