Pulmonary

Question 1

Gas exchanges occurs here

Answer 1

Alveolocapillary membrane

Question 2

Pneumocytes

Answer 2

Type 1.
Line the alveolar surface
Type 2.
Secretes surfactant to keep alveoli open

Question 3

S/Sx of Pulmonary disease

Answer 3

Cyanosis:
O2 SAT below 85%

Dyspnea:

• flaring of nose
• use of accessory muscles
• dyspnea on exertion (DOE)
• proximal nocturnal dyspnea (PND)
• orthopnea (TRIPOD POSITION)

Question 4

Orthopnea

Answer 4

Difficulty breathing laying down

Question 5

Atelectasis

Answer 5

Collapse of lung tissue

Question 6

Compression Atelectasis

Answer 6

Caused by tumor, fluid or air the pleural space

If compression at the base of the lungs, ABD distention is present

Question 7

Absorption Atelectasis

Answer 7

HYPOventilated alveoli or inhalation of concentrated oxygen or anesthesia

Question 8

When can Absorption Atelectasis occur?

Answer 8

Usually post-op. Secretions pool in the lungs, pt. will have shallow breaths

Question 9

S/SX of Atelectasis

Answer 9

• Leukocytosis - increase in WBC
• Dyspnea
• Cough and fever

Question 10

What is encouraged to prevent Atelectasis?

Answer 10

• Cough and deep breath

- Using Incentive Spirometer

Question 11

What does the Incentive Spirometer do?

Answer 11

Expand the lungs and redistributes surfactant to stabilize the alveoli. It also promotes clearance of secretions and opens up the PORES OF KOHN.

Question 12

PORES OF KOHN

Answer 12

These pores open up ONLY during deep breathing. It allows air to move from an open alveoli to an obstructed alveoli = prevents collapse and helps removal of obstruction

Question 13

What does Pulmonary Edema look like on an X-Ray?

Answer 13

Looks like BAT WINGS

Question 14

Pulmonary Edema

Answer 14

Excess water in the lungs. Normal lung space contains little water

Question 15

What causes Pulmonary Edema?

Answer 15

Hydrostatic pressure - pulmonary vessels force fluid into lungs
Inflammation of the epithelium also causes permeability

Question 16

What are the 2 main disease processes that causes Pulmonary Edema?

Answer 16

ARDS - Acute Respiratory Distress Syndrome

Left Sides Heart Failure

Question 17

What is Pneumonia (PNA)?

Answer 17

Infection of the lower respiratory tract

Question 18

What is the most common cause of Septic Shock?

Answer 18

Pneumonia

Question 19

What has the highest mortality rate than any other HAI?

Answer 19

hospital Acquired Pneumonia

Question 20

What influences the pt.’s s/sx of PNA?

Answer 20

The type or organism

Question 21

Streptococcus pneumoniae, mycoplasma, influenza, RSV (pediatrics), legionella are common in which PNA?

Answer 21

Community acquired PNA ( the most common PNA)

Question 22

Staphylococcus aureus and pseudomonas are common in which PNA?

Answer 22

Non-socomial PNA

Question 23

Mycobacterial, fungi, pneumocyst jiroveci are common in which PNA?

Answer 23

HIV

Question 24

Explain the Pathophysiology of PNA

Answer 24

1. Aspiration of secretions from and URI (upper respiratory infection):
2. Inhalation of organism occurs from cough, sneeze, talking to an infected person or from a respiratory equipment
3. Bacteria multiply and spread through blood vessels of lungs

Question 25

Name some normal defenses of the human body against PNA

Answer 25

1. The upper respiratory tract usually eliminates pathogens by coughing and utilizing the ciliary mechanism to expel microorganisms.
2. Alveolar macrophages also work to kill pathogens that enter the lung space.
   REMEMBER: large amount of macrophages = inflammation (cellular infiltration)

Question 26

In PNA, what causes the V/Q mismatch?

Answer 26

When bronchioles will with exudate

Question 27

What is V/Q and the V/Q ratio?

Answer 27

V = Ventilation
the amount of air reaching the alveoli
normally 4 LPM
Q = Perfusion 
the amount of blood reaching the alveoli
normally 5 LPM

Ratio 4:5 or 0.8

Question 28

What is Shunting?

Answer 28

Decrease amount of available air to the alveoli in PNA