Pulmonary Disorders Flashcards
cheyne stokes
periods of apnea
dying and neuro pateints
sign of pulmonary disorder in finger
clubbing
carboxyhemoglobin
number of carbon on hemoglobin
normal caroxhemoglobin
2 or less
- smokers 5-10
how to treat carbon monoxide posioning
high flow o2
DVT
- virchows triad
hypercoaguability
vessel trauma
venous statis
how can we get a PE
DVT breaks off
s/s of DVT
pain
swelling
warm
redness
doppler diagnosis
s/s of PE
shortness of breath
diagnosis of DVT
doppler
classification of PE
massive
submassive
low risk
massive PE
hypotension
submissive PE
right ventricular dysfunction or myocardial necrosis
low risk PE
no hypotension or right ventricle issues
why might PE have right ventricular failure
right ventricle has to work harder
how might CXR look in PE
normal
best way to diagnose a PE
CT
ABG of PE
hypoxemia with r alk
how to treat a PE
fibrinolytic therapy
right sided HF also might be caused by
pulmonary hypertension
atelectasis
collapse of the alveloi
how to treat atelectasis
incentive spirometer
deep breathing (in)
intunate
if we intubate atelectasis, what do we want increased
PEEP
s/s of atelectasis
tachypena
tachycardia
dyspnea
hypoxemia
decreased breath soundsc
crackles
fluid
emphysema blebs
air trapped pockets
caused of tension pneumothorax
truama
chest tube displacement
central line
pleural effusion
how will a tension pneumothorax look clinically
NO LUNG SOUNDS
TRACHEAL DEVIATION TO UNAFFECTED SIDE!!!!!!
what might we palpate for with pulmonary issues
subq emphysema
asthma is caused by
bronchoconstriction
what happens with mucus with asthma
increase
asthma V/Q mismatch
ventilation and circulation mismatch
no oxygenation but we have perfusion
S/S of asthma
wheezing
non productive cough
tachycardia
tachypena
accessory muscle use
why are we cautious of Co2 elevation in asthma
client chest
not moving in or out
impending death
r acid
know how to use inhaler
deep breath while pushing
hold breath
spacer
why do lungs failure to collapse in status asthmaticus
mucus plugs
why use peak flow
ensure meds are working
acute respiratory failure ABG
pao2 less than 60
pco2 greater than 50
what happens after placing ET tube
check lung sounds
CXR
what happens in right stem intubation
decreased L lung sounds
withdraw
where should the ET tube be at on the carina
4cm
intubated patient how often oral care
Q2
ET tube inflated to
20-25
why do we not want ET inflated higher than 20-25
necrosis
what to due with a GSC under 8
INTUBATE
tidal volume settings
6-8cc/kg (450-650)
rate 8-14
Fio2 lowest to prevent hypoxemia
when do we consider nutriton needs for an intubated patient
3rd day nourished
24 h malnourished
complications of intubation
VTE
GI bleeding
cardiac
pulmonary
what type of prohypatic for intubated patients
DVT and GI
- heparin and PPI
crepitus
subq emphysema
what do we need to monitor “psychiatric” for intubated patients
delerium
do all intubated patients need restraints
no
- ex: fully sedated, or decreased GCS
if there is increased intratoracici pressure what happens to CO
decreased
cardiac dysrythmais occur because of
sucioning
meds
hypoxemia
maintain HOB at
30
spontaneous breathing test
turn down mech ventilation every morning to see if pt can breath on own
twinkle in eye
look infuse that they are ready to be extubated
weaning intolerance
VITAL SIGNS
- SBP increase/decreased 20
- DBP greater than 100
-HR increase by 20
- RR over 30 or less than 10
- spo2 less than 90%
CXR with ARDS
completely normal
ARDS
- refractory hypoxemia
increase O2 but it stays low
ARDS tidal volume
lower
proning
promote lung expansion and then increase oxygenation
oscillation (fluctuation/swing) unexpected cessation
indicate blocked or kinked
air leak
intermittent bubbling
