Pulmonary dysfunction Flashcards
what is different about bacterial vs viral PNA?
bacterial has :
- chest pain
- tachypnea
- increased WBCs
- productive cough
how is aspiration PNA caused?
aspirated material causes an acute inflammatory reaction within the lungs
TB is spread via..
aerosolized droplets from an untreated infected host
how many weeks must the host be on anti TB drugs to be rendered noninfectious?
2 weeks
DURING THE INFECTION STAGE of TB, what must be the precautions?
pt isolated in a NEG PRESSURE ROOM
- anyone entering must wear a MASK
- IF the pt leaves the room, must wear a mask
PCP (pneumocystis pneumonis) is ..
pulmonary infection caused by a fungus in immunocompromised hosts (ie post transplant/HIV +)
-involves SOB, crackles, weakness, fever, CXR shows infiltrates
SARS blood counts will be..
decr WBCs/platelets/lymphocytes
-INCR LIVER FXN TESTS
what happens to the chest wall during COPD?
AP diameter increases
what is asthma?
increased REACTIVITY of the trachea and bronchi to various stim
-involves widespread narrowing of the airways due to inflammation, smooth ms constriction, and incr secretions
what is the PaCO2 level in an asthmatic?
HYPOcapnea - increased RR so not enough O2 or CO2
is CF obstructive or restrictive?
-what is involved?
could be EITHER or mixed
-thickening of secretions of ALL exocrine glands
what is bronchiectasis?
can be congenital or acquired
-abnormal dilation of the bronchi AND excessive sputum production
what is respiratory distress syndrome?
occurs in PREMIES
- collapse of alveoli 2/2 lack of surfectant
- MUST CAREFULLY WEIGH BENEFITS OF PT VS INCREASED BREATHING EFFORT CAUSED BY HANDLING PREMIE*
What is a common result of RDS?
bronchopulmonary dysplasia
-obstructive; 2/2 high pressures of MV or high fractions of FiO2 and/or infections
LUNGS show: pulmonary immaturity and dysfxn 2/2 HYPERINFLATION
there are 3 reasons for restrictive pulmonary disease:
alterations in :
- bony thorax
- neuroms apparatus
- lung parenchyma & pleura
arthrogryposis may result in what type of respiratory disease ? and why?
RESTRICTIVE - 2/2 restricted motion of chest wall/motion of bony thorax
what aspects of PFTs are affected in restrictive disease 2/2 neuroms apparatus alterations?
reduced vital capacity & TLC
if a patient has bronchogenic carcinoma, where is the tumor? and what are the PT considerations for this?
tumor in the bronchial mucosa
- PNA that develops behind a COMPLETELY OBSTRUCTED BRONCHUS CANNOT BE TREATED W PT TECHNIQUES; HOLD tx until palliative tx shrinks tumor
- could also have increased risk of FX 2/2 thoracic bone metastasis w chest compressive maneuvers/coughing
pneumothorax means..
air in pleaural space
where does the trachea/mediastinal shift in a pneumothorax?
AWAY from the injured side
hemothorax means..
blood in pleural space
how can you determine hemo vs pneurmothorax via physical exam?
pneumothorax has tymphany with medial percussion
if someone suffers blunt trauma to the chest and experiences hemoptysis, you can suspect..
possible LUNG CONTUSION with or without rib fx
if pulmonary edema is cardiogenic, what will they present like?
peripheral edema will be present
If a pt has a PE, their Ve/Q ratio..
will be HIGH Ve»_space; Q b/c perfusion low
what is a pleural effusion?
excessive fluid b/t the visceral and parietal pleura (incr pleural permeability to protein )
3 indications for postural drainage =
- incr pulmonary secretions
- aspiration
- atelectasis / collapse
how long can you keep someone in ONE postural drainage position?
20 minutes (max)
what is the trendelenburg position?
head of bed tipped down 15 - 18 deg
what is the precaution when doing percussion/postural drainage with a pregnant woman?
supine or trendelenburg compresses vena cava
how long should percussions last?
3-5 minutes PER position
how many shaking exhalations should be done?
5-10 (>10 risks hyperventilation)
why is suctioning of secretions done intermittently? and how long should suctioning typically last/
intermittently to NOT damage trachea
-suction 10-15 seconds
