Pulmonary Disorders Flashcards
How do you calculate pack years?
of packs smoked per day x # of years smoked
What is the biggest contributor to respiratory illness?
smoking
What are the common symptoms of pulmonary issues?
dyspnea, cough, sputum production, chest pain, wheezing, and hemoptysis
What is dyspnea?
shortness of breath
What causes a cough?
inflammation of mucous membranes in the respiratory tract
What are common causes of a cough?
asthma, GERD, infection, medication side effects
What should be noted about sputum?
the color, consistency, and odor
Referred chest pain can present where?
neck, back, and abdomen
Chest pain may occur with what conditions?
pneumonia, pulmonary emboli, pleurisy, and lung cancer
high-pitched, continuous, musical sound in the lungs
wheezing
What does wheezing on expiration indicate? Inspiration?
expiration = asthma
inspiration = bronchitis
What is hemoptysis?
coughing up blood
What are the common causes of hemoptysis?
pulmonary infection, lung cancer, PE, vessel and artery abnormalities
Clubbing of the fingers can be a sign of what conditions?
chronic hypoxic conditions, chronic lung infections, lung cancer
Cyanosis is a late symptom of what condition?
hypoxia
non-musical, discontinuous sounds on inspiration
crackles
What may crackles indicate?
HF, pulmonary fibrosis, obstructive pulmonary disease
What causes crackles?
fluid in the airway
What are wheezes caused by?
changes in airway diameter
What may cause wheezing?
bronchospasm, asthma, chronic bronchitis
discontinuous, low-pitched, rubbing sounds heard on inspiration and expiration
friction rub
What causes friction rub?
loss of lubricating pleural fluid
continuous, high-pitched, musical sound heard over the neck
stridor
What causes stridor?
airway narrowing
Which of the adventitious sounds is considered an emergent situation?
stridor - pt may need to be intubated
evaluates lung mechanics, gas exchange, and acid-base disturbance
Pulmonary Function Test (PFT)
What should be held prior to a pt undergoing a PFT?
bronchodilators
decreased pH, decreased bicarb
metabolic acidosis
increased pH, increased bicarb
metabolic alkalosis
decreased pH, increased bicarb
respiratory acidosis
increased pH, decreased bicarb
respiratory alkalosis
assess the ability of the lungs to provide adequate oxygenation, remove CO2, and maintain and normal pH
Arterial Blood Gas (ABG)
When should cultures be obtained?
prior to starting antibiotic therapy
aspiration of fluid and air from pleural space
Thoracentesis
tube inserted down the throat to view the lungs
bronchoscopy
infection and inflammatory reaction of the lungs
pneumonia
pneumonia acquired from a community setting or within 48 hours post-hospitalization
Community-Acquired Pneumonia
pneumonia in a non-hospitalized pt that has extensive contact with various healthcare things (i.e., long term care facility, dialysis patient, etc.)
OR pt that was in the hospital for 2+ days in the last 90 days of infection
Healthcare-Associated Pneumonia
pneumonia in a hospitalized patient that develops 48 hours or more after admission
Hospital-Acquired Pneumonia
pneumonia that develops 48 hours or more after endotracheal intubation
Ventilator-Associated Pneumonia
How can ventilator-associated pneumonia be prevented?
- Elevating HOB to at least 30 degrees
- Oral care with chlorhexidine daily
- Daily sedation vacations
- Peptic ulcer disease prophylaxis
- DVT prophylaxis
What are some underlying disorders that put people at higher risk for pneumonia?
heart failure, diabetes, alcoholism, COPD, AIDS, cancer, influenza, cystic fibrosis
What are some risk factors of pneumonia?
smoking, neutropenia, prolonged immobility, depressed cough reflex, ET tube, intoxication, sedation, advanced age, URI
What are common clinical manifestations of pneumonia?
fever, chills, pleuritic chest pain, tachypnea, SOB, accessory muscle use, HA, cough, fatigue
What is a risk factor older adults will display with pneumonia?
change in mental staus
What are the V/S classifications for being “hemodynamically” unstable?
- Temp > 100
- HR > 100
- RR > 24
- SBP < 90
- O2 Sat < 90%
What are the nursing interventions for the removal of secretions in pneumonia patients?
hydration, humidification, turning/positioning, and deep breathing/coughing
systemic response to infection
sepsis
signs of sepsis
- Temp > 100.4
- HR > 90
- RR > 20
- WBC > 12,000
circulatory imbalances occur and are profound
septic shock
What is the best way for older adults to prevent pneumonia?
receiving both the influenza vaccine and pneumococcal (PPSV) vaccine
inhalation of foreign substance into the lung
aspiration pneumonia
chronic inflammation and hypersecretion of mucus, narrowing of airways occurs
COPD
presence of cough and sputum production for at least three months in each of 2 consecutive years
chronic bronchitis
impaired O2 and CO2 exchange resulting from destruction of walls of over distended alveoli
emphysema
What is the cause of most COPD and emphysema cases?
tobacco use
What are the three primary symptoms of COPD?
chronic cough, sputum production, and dyspnea
What is a physical assessment finding in COPD?
barrel chest
What adventitious sound is found in COPD?
expiratory wheeze
What are two major complications of COPD?
respiratory insufficiency and respiratory failure
What are the possible acute exacerbations of chronic COPD?
severe bronchospasm and pneumonia
abnormal enlargement of the right side of the heart as a result of disease of the lungs
cor pulmonale
What are the pharmacological therapy options for COPD management?
bronchodilators and corticosteroids, oxygen therapy may also become necessary
What is the breathing pattern of a patient with COPD?
shallow, rapid, and inefficient
What breathing exercise is recommended for COPD patients?
diaphragmatic breathing
What breathing exercise is recommended for emphysema pts?
pursed lip breathing
How does pursed lip breathing work?
prolongs exhalation and prevents the collapse of small bronchioles
chronic inflammatory disease of the airways
asthma
common causes of asthma
airway hyperresponsiveness, mucosal edema, and excessive mucus production
common seasonal allergies
grass, tree, weed pollens
common perennial allergies
mold, dust, animal dander
Major complications of asthma
status asthmaticus, respiratory failure, pneumonia, and hypoxemia
Quick relief meds for asthma treatment
beta-2 adrenergic agonists and anticholinergics
Long-acting medications for asthma treatment
corticosteroids, long-acting beta-2 adrenergic agonists, leukotriene modifiers
What should be done after administering inhaled medications?
mouth should be rinsed to prevent thrush
