Pulmonology Disorders Flashcards

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1
Q

ARDS

A

A condition that may exist in the patient with pneumonia in which an area of the lung fills with fluid (in interstitial space) and cellular debris.

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2
Q

ARDS- signs and symptoms

A
Gradual decline in respiratory status unless it is High Altitude  Pulmonary Edema in which onset would be rapid.
Dyspnea
Agitation
Confusion
Tachypnea 
Tachycardia
Crackles in both lungs
Wheezing
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3
Q

ARDS- treatment

A

Oxygen
IV access- only give fluids if hypovolemic
Cardiac monitoring
Suctioning
CPAP
Bag mask and intubation with resp. failure
Drugs to use: Diuretics, nitrates, and possibly corticosteroids

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4
Q

COPD

A

Chronic Obstructive Pulmonary Disease

Usually a combination of COPD and Chronic Bronchitis

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5
Q

COPD- signs and symptoms

A

Abnormal ventilations
Excess mucus, which is difficult to clear.
Barrel Chest
Often skinny

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6
Q

Emphysema

A

Destruction of the walls of the alveoli- thus decreasing surface area for gas exchange to occur.
Lungs cannot recoil because of this, which causes air trapping.
Polycythemia is common in these patients.

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7
Q

Emphysema- signs and symptoms

A

Report recent weight loss, trouble breathing, and progressive limitation of physical activity.
Barrel chest
Breathing through pursed lips
Rapid resting respiratory rate
Thin
Pink in color due to polycythemia
Rarely associated with cough, except in the morning
Wheezing and Rhonchi
Right-sided heart failure may encourage jugular distension and peripheral edema

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8
Q

Emphysema- treatments

A

Same as Chronic Bronchitis

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9
Q

Chronic Bronchitis

A

Increased number of goblet (mucus producing) cells.

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10
Q

Chronic Bronchitis- signs and symptoms

A

Productive Cough
Copious Sputum
Rhonchi due to occlusion of larger airways with mucus plugs.
Signs of right-sided heart failure such as JVD and ankle edema.

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11
Q

Chronic Bronchitis- treatments

A
Establish Airway
Place in semi-seated position
Oximeter to check O2 lever
Oxygen
CPAP
IV line
Albuterol, ipratropium, corticosteroids.
Prepare to intubate if PT gets tired of breathing
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12
Q

Asthma

A

Chronic inflammatory disorder of the airway. Inflammation is usually triggered by some inflammatory trigger.

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13
Q

Asthma- Signs and symptoms

A
Dyspnea, wheezing, and cough. Later signs are tachypnea and hyper-inflammation of the chest.
Sever asthma-
 one-to-two-word dyspnea
 pulsus paradoxus
 tachydardia
 decreased oxygen saturation
 agitate and anxious
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14
Q

Asthma- treatment

A
Oxygen
IV line
EKG monitoring
Albuterol
Ipratropium
Support ventilations
Prepare to intubate should respiratory arrest occur.
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15
Q

Pneumonia

A

Bacterial and or viral infection of the lungs. Sometimes it is fungal based.

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16
Q

Pneumonia- Signs and Symptoms

A
Recent history of fever and chills
Generalized weakness and malaise
Deep productive cough- may expel yellow to brown sputum, often streaked with blood.
Pleuritic chest pain
Tachypnea
Tachycardia
Cough
Crackles (rales)
Wheezes or rhonchi may be heard
17
Q

Pneumonia- treatment

A

Place in position of comfort
High-flow oxygen
Oximeter
Ventilatory support in severe cases
IV access- and fluid resuscitation based on PT hydration status
Antipyretic agents like ibuprofen, or acetaminophen

18
Q

SARS

A

Sever Acute Respiratory Syndrome (SARS)- Upper Respiratory Infection

19
Q

SARS- signs and symptoms

A
Altered mental status
One-to-two-word dyspnea
Cough
Cyanosis
Hypoxia
Sore throat
Rhinorrhea
Chills
Myaglias (muscle aches)
Headache
Diarrhea
Wheezing
As disease progresses:
Cough
Sputum production
Respiratory distress
Respiratory Failure
20
Q

SARS- treatment

A
Place in position of comfort
High-flow oxygen
Oxygen
IV access
Albuterol- if wheezing
Bag valve mask if vent assistance needed
Intubation in sever cases
21
Q

Lung Cancer

A

Several different types.

22
Q

Lung Cancer- signs and symptoms

A
Altered mental status
One-to-two-word dyspnea
Cyanosis
Hemoptysis
Hypoxia
Hoarseness
Vague Chest Pain
23
Q

Lung Cancer- treatment

A

Oxygen
IV access
Bronchodilators/ corticosteroids
Intubate if necessary

24
Q

Toxic Inhalation

A

Upper airway obstruction due to edema and laryngospasms

25
Q

Toxic Inhalation- Signs and Symptoms

A

Loss of consciousness
Burns/ particulate matter around face, mouth, and throat
Wheezes
Crackles

26
Q

Toxic Inhalation- treatment

A

High-flow humidified oxygen
IV line
Prepare to intubate if necessary

27
Q

Carbon Monoxide Inhalation

A

Hypoxia on the cellular level and eventually metabolic acidosis because carbon monoxide is bound to hemoglobin leaving no room for oxygen to bind to it.

28
Q

Carbon Monoxide Inhalation- Signs and symptoms

A
Headache
Nausea
Vomiting
Confusion
Agitation
Loss of coordination
Chest pain
Loss of consciousness
Seizures
Peripheral cyanosis
29
Q

Carbon Monoxide - Treatment

A

High Flow oxygen with tight fitting mask

Maintain airway

30
Q

Pulmonary Embolism

A

A blood clot or other particle that lodges in a pulmonary artery, effectively blocking blood flow through that vessel.

31
Q

Pulmonary Embolism- Signs and symptoms

A

Right sided heart failure inducing JVD
Peripheral edema
Ventilation-perfusion mismatch
Often times occurs after long period of inactivity- sometimes following surgery

32
Q

Pulmonary Embolism- Treatment

A
Establish and maintain airway
Prepare for CPR if necessary
Assist ventilations if necessary
Highest possible flow of oxygen
IV at "to keep open" rate
Quick transport
Prepare to intubate if necessary
33
Q

Spontaneous Pneumothorax

A

Pneumothorax that occurs in the absence of blunt of penetrating trauma. Where air escapes the lung into the pleural space, 15-20% pneumothorax is generally well tolerated in the absence of other lung complications.

34
Q

Spontaneous Pneumothorax- signs and symptoms

A
Sudden onset of sharp, pleuritic chest or shoulder pain- ---------------Often following lifting or cough
Decreased breathing sounds on effected side
Tachypnea
Tachycardia
Diaphoresis
Pallor
Occasionally:
Cyanosis, and subcutaneous emphysema
35
Q

Spontaneous Pneumothorax- Treatment

A
Most case only require supplementary oxygen
Place in position of comfort
Be careful if CPAP is required. If required watch for:
Difficulty ventilating
Hypoxia
JVD
Tracheal Deviation
Hypotension
Cyanosis
Tachycardia