PCP Expansion - Respiratory (Common Diseases) Flashcards
When should an MDI be used over nebulizing medication?
In patients with a fever and a history of respiratory illness.
Define croup
Laryngotracheitis or croup is an inflammation of the larynx and trachea, specifically sub-glottic structures, located around and below the vocal cords
What population is most likely to contract croup?
Children around 6 months to 3 years old of age
When does croup mostly occur?
During the fall and winter
What percentage of croup cases are mild?
85% of the cases are mild
What symptoms would appear at the onset of croup?
- Cold-like symptoms
- Runny nose and congestion
What symptoms are present during croup?
- Hoarseness
- Stridor
- Fever
- Intercostal and supraclavicular retractions
- Barking or seal-like cough
What treatments can be given for croup
EMR
- Administer oxygen
- Transport early
- Ask for PCP or ACP help
PCP
- Administer EPINEPHrine via nebulizer
- Administer dexamethasone if there is NO IMPROVEMENT from EPINEPHrine
(Requires clinicall consultation)
ACP
- Consider the need for invasive airway management
- Consider the need for antipyresis with acetaminophen
What are the most common causes of pulmonary edema?
- Congestive heart failure (CHF): from MI or difficulty contracting from increased afterload
- Valve failure: blood does flow correctly and back up to pulmonary circulation
- Dysrhythmia: atrial fibrillation
What are the less common causes of pulmonary edema?
- Trauma
- Liver disease
- Use of drugs
- Pneumonia
- Drowning
- Sepsis
- Cancer
What mechanisms contribute to pulmonary edema?
- Hydrostatic pressure
- -
How does hydrostatic pressure contribute to pulmonary edema?
- Build up of pressure in the capillaries
- An increase in volume causes increase in pressure
- Fluid gets pushed out into the capillaries causing pulmonary edema
- As pressure builds up, fluid gets pushed outside the capillaries, into the interstitial space, and into the alveoli
How do osmotic effects contribute to pulmonary edema?
- Water moves from an area of low solute concentration to an area of high solute concentration
- Example: Liver Failure
- Low albumin causes decreased solute in the blood
- H20 moves into the interstitial space because of low solute (in this case albumin) in the blood
How does poor lymphatic drainage contribute to pulmonary edema?
- Normally, H20 in the interstitial space is drained by the lymphatic system
- Lymphatic drainage can be caused by cancer, asthma, smoking, lung disease, etc
How does poor capillary permeability contribute to pulmonary edema?
- Capillary damage can occur in pneumonia and sepsis
- Capillaries are more “leaky” and fluid escapes more readily
