Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Complex Care Exam 1 > Pulmonary Disorders > Flashcards

Pulmonary Disorders Flashcards

1
Q

Intrapulmonary Shunting

A
  • The amnt of blood tht flows to the lungs w/out being oxygenated bc of nonfunctioning alveoli
    > blood not going where its suppose to
    > alveolar collapse secondary to ateletctasis
    > alveolar flooding w/ pus, blood, or fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PaO2/FiO2

aka P/F ratio

A
  • Measurement of efficiency of oxygenation
  • Measurement of intrapulm shunting
  • Normal: greater than 286
    > the lower the value, the worse the lung function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute Lung Failure (ALF)

A
  • A clinical condition in which the pulmonary system fails to maintain adequate gas exchange
  • Usually occurs secondary to another disorder tht has altered the normal function of pulm system
    > conditions tht dcr func: vent drive, muscle strength, chest wall elasticity, the lung’s capacity for gas exchange
    > conditions tht inr func: airway resistance, metabolic oxygen requirements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute Lung Failure (ALF) - CMs

A
  • Hypoxemia
    > low oxygen in blood
  • Hypercapnia
    > high CO2
  • Acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute Lung Failure (ALF) - Medical Management

A
  • Treat underlying cause
  • Promote adequate gas exchange
    > supplemental oxygen
    > if an intrapulmonary shunt (low I/F ratio) is present, pt will require positive pressure
  • Correct acidosis
  • Initiate nutrition support
  • Prevent complications
    > ischemic-anoxic encephalopathy
    > cardiac dysrhythmias
    > VTE
    > gastrointestinal bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acute Lung Failure (ALF) - Nursing Management

A
  • Optimize oxygenation & ventilation
  • Position
    > healthy lung down
    > elevate HOB
    > reposition
  • Prevent desat
    > perform only necessary procedures
    > hyperoxygenate before suctioning
    > provide adequate rest & recovery time btwn procedures
    > minimize oxygen consumption: limit physical activity, admin sedation to control anxiety & maintain normothermia
  • Promote secretions clearance
    > humidify
    > suction
  • Maintain surveillance for comps
  • Educate pt & fam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute Respiratory Distress Syndrome (ARDS)

A
  • Noncardiac pulmonary edema & disruption of the alveolar-capillary membrane as a result of injury to the pulm vasculature or airways
    > the hallmark of ARDS is refractory hypoxemia
    > w/in a week of no clinical injury
    > bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules
    > origin of edema: lungs (not from HF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute Respiratory Distress Syndrome (ARDS) - Oxygenation

A
  • Mild: P/F ratio: 200-300 mmHg WITH PEEP or CPAP greater than, equal 5 cm H2O
  • Moderate: P/F ratio: 100-200 mmHg WITH PEEP greater than, equal to 5 cm H2O
  • Severe: P/F ratio: less than 100 mmHg WITH PEEP greater than, equal to 5 cm H2O
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acute Respiratory Distress Syndrome (ARDS) - CMs

A
  • Exudative Phase: tachypnea, restlessness, apprehension, & moderate incr in accessory muscle use
  • FIBROPROLIFERATIVE PHASE: pt’s s/s progress to agitation, dyspnea, fatigue, excessive accessory muscle use, & fine cracles as resp failure develops
    > poor end perfusion
  • ABGs: low PaO2, despite incrs in supp ox admin (refractory hypoxemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute Respiratory Distress Syndrome (ARDS) - why is PaCO2 initially low?

A

Fast breathing early on; breathing off CO2 gets fatigued; retaining CO2 (incrs lvls)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute Respiratory Distress Syndrome (ARDS) - why is the pH high?

A

Acidotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acute Respiratory Distress Syndrome (ARDS) - Fibroproliferative Phase

A
  • Destruction of type II alveolar cells
  • Gas exchange compromised
  • Incrd peak inspiratory pressure
  • Dcrd compliance
    > static & dynamic
  • Refractory hypoxemia
    > intraalveolar atelectasis
    > incrd shunt fraction
    > dcrd diffusion
  • Dcrd functional residual capacity
  • Interstitial fibrosis
  • Incrd dead space ventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acute Respiratory Distress Syndrome (ARDS) - Fibroproliferative Phase Physical Examination

A
  • Elevated pulm artery pressures
  • Incrd workload on right ventricle
  • Incrd use of accessory muscles
  • Fine crackles
  • Incring agitation r/t hypoxia
  • CXR: interstitial or alveolar infiltrates; elevated diaphragm
  • Hyperventilation; hypercapnia
  • Widening alveolar-arterial gradient
  • Incrd work of breathing
  • Worsening hypercarbia & hypoxemia
  • Lactic acidosis (r/t aerobic metabolism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute Respiratory Distress Syndrome (ARDS) - Fibroproliferative Phase Physical Examination: Alteration in Perfusion

A
  • Incrd HR
  • Dcrd BP
  • Change in skin temp & color
  • Dcrd cap filling
  • End-organ dysfunction
    > Brain: change in mentation, agitation, hallucinations
    > Heart: dcrd CO -> angina, HF, papillary muscle dysfunc, dysrhythmias, MI
    > Renal: dcrd urinary or GFR
    > Skin: mottled, ischemic
    > Liver: elevated SGOT, bilirubin, alkaline phosphatase, PT/PTT; dcrd albumin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute Respiratory Distress Syndrome (ARDS) - Medical Management

A
  • Treat underlying cause
  • Ventilation
    > Mechanical Ventilation modes: pressure control ventilation & inverse ratio ventilation
    > complications to assess for: pneumothorax
  • Oxygenation therapy
    > admin O2 at lowest lvl to support tissue oxygenation
    > PEEP > 5 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the purpose of adding PEEP to vent settings

A

Open alveoli space for lung oxygen exchange

17
Q

When would ECMO be considered?

A

High PEEP, not perfusing

18
Q

Acute Respiratory Distress Syndrome (ARDS) - Nursing Management

A
  • Optimize oxygenation & ventilation
    > position, prevent desat, promote secretion clearance
  • Prone position
    > ARDS: to promote posterior surface of lungs
  • Comfort & emotional support
  • Maintain surveillance for comps
19
Q

Pneumonia

A
  • An acute inflammation of the lung parenchyma caused by an infectious agent tht can lead to alveolar consolidation & can be classified as community acquired or hosp acquired
  • Dyspnea, fever, cough (productive or non)
20
Q

Pneumonia - Medical Management

A
  • Focus on initiation of antibiotic therapy
  • Admin oxygen
  • Mech vent
  • Management of fluids & nutrition support
  • Treat comps
21
Q

Pneumonia - Nursing Actions

A
  • Optimize oxygenation & ventilation
  • Prevent spread of infection
  • Provide comfort & emotional support
  • Maintain surveillance for comps

Complex Care Exam 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions