Pulmonary Disorders Flashcards
Pneumonia
Inflamm of lung parenchyma d/t bacterial, viral, fungal infection
Pneumonia risk factors
- Advanced age
- Long-term care residents
- Smoking
- Chronic resp disease
- Immunocompromised
- Prolonged immobility
- Aspiration of stomach content (AMS can cause this)
- Prolonged NPO status
- Diminished consciousness, gag reflex, swallow reflex
- *Hospitalization longer than 48 hrs
- Recent abx therapy
Pneumonia clinical manifestations
- *Fever
- Tachypnea
- *Chills
- Cough, non-prod/prod
- *Pleuritic chest pain
- *Fatigue
- *Myalgias, arthralgias
Severe: purulent/blood tinged sputum, hypotension, dysrhythmia
Types of pneumonia
- Community-acquired
- MRSA community-acquired
- Hospital-acquired (occurs 48 hrs after admission)
Pneumonia labs
- Elevated WBC (>10, 500)
- Elevated C-reactive Protein (>1)
- Elevated bands (>5%)
Pneumonia nursing action
- Administer *humidifed O2 as ordered
- Administer meds: antibiotics
- *Pulmonary hygiene: incentive spirometer, ambulation, make sure pt coughing up secretions
- Pt positioning
- *Monitor intake & output
- *Ensure adequate nutritional support (most pts tired so don’t wanna eat + difficulty breathing)
- Activity
Pneumonia pt teaching
- *Hand hygiene
- Adequate rest, nutrition, fluid intake
- *Understand S&S of worsening resp status
- Pneumonia vaccine
Obstructive sleep apnea
Muscle tone relaxes during sleep –> can’t overcome increase in resistance –> airway collapse
- Hypoxia
- Hypercapnia
- Apnea
OSA risk factors
- Male
- *Obesity
- Smoking
- Alc use
- *Age 40-45
- Craniofacial or upper airway abnormalities
Other:
- Menopause
- Atrial fibrillation
- Nocturnal dysrhythmia
- Type 2 DM
- HF
- Pulm hypertension
OSA clinical manifestations
- Loud snoring
- Snorting
- Witnessed apnea
- Recurrent waking during sleep
- Choking
OSA risks what?
Increased risk of CV disease bc excessive inflamm process d/t decreased blood flow. Also cause scarring.
OSA treatment (supportive)
- CPAP (pressure keeps airway open)
- Nonsupine sleeping
- No alc or sedative before bed
- Oral appliance to forward tongue to keep airway open
OSA treatment (surgery)
- Tonsillectomy
- Adenoidectomy
- Uvulopalatopharyngoplasty
- Septoplasty
- Nasal polypectomy
- Tongue reduction
- Epiglottoplasty
- Bariatric surgery (reduce weight)
OSA pt teaching
- Disease process
- Instruct pt on CPAP + meds
- Instruct pt on weight reduction
Asthma
- Affect bronchial airways, resulting in airway obstruction & bronchial hyperresponsive
- Cause bronchospasm or contraction of small airways –> inflamm
- Triggered by exposure to inhaled irritants
Asthma clinical manifestations
- Chest tightness
- Wheezing (concern when on inspiration & expiration)
- Dyspnea
- Coughing
- Increased sputum
- *Inability to speak in full sentences bc not getting enough air
- Tachycardia, increased RR
Asthma medications
- Inhaled corticosteroids (Flovent, Pulmicort) = long term
- Bronchodilator (Albuterol) = rescue
- Anticholinergics (Sprivia - tiotropium)
- Leukotriene receptor antagonist (Montelukast)
Inhaled corticosteroid action
Anti-inflammatory
Decrease mucuous prod & swelling, airways becomes less sensitive to triggers
Bronchodilator action
Eg. beta-2 adrenergic agonist
Relax bronchial smooth muscle leading to open airways & less obstruct
Anticholinergic action
Relax muscle around larger airway
Leukotriene receptor antagonist action
Block leukotriene
COPD
Results in airflow limitations that are progressive and not fully reversible.
Types of COPD
- Emphysema
- Chronic bronchitis
Emphysema
- Alveolar destruction
- CO2 can’t leave and O2 can’t enter: ineffective gas exchange
- Loss of lung elasticity causes air trapping and distension in alveolar
