Pulmonology Disorders Flashcards
ARDS
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.
ARDS- signs and symptoms
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
ARDS- treatment
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
COPD
Chronic Obstructive Pulmonary Disease
Usually a combination of COPD and Chronic Bronchitis
COPD- signs and symptoms
Abnormal ventilations
Excess mucus, which is difficult to clear.
Barrel Chest
Often skinny
Emphysema
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.
Emphysema- signs and symptoms
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
Emphysema- treatments
Same as Chronic Bronchitis
Chronic Bronchitis
Increased number of goblet (mucus producing) cells.
Chronic Bronchitis- signs and symptoms
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.
Chronic Bronchitis- treatments
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
Asthma
Chronic inflammatory disorder of the airway. Inflammation is usually triggered by some inflammatory trigger.
Asthma- Signs and symptoms
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
Asthma- treatment
Oxygen IV line EKG monitoring Albuterol Ipratropium Support ventilations Prepare to intubate should respiratory arrest occur.
Pneumonia
Bacterial and or viral infection of the lungs. Sometimes it is fungal based.
Pneumonia- Signs and Symptoms
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
Pneumonia- treatment
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
SARS
Sever Acute Respiratory Syndrome (SARS)- Upper Respiratory Infection
SARS- signs and symptoms
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
SARS- treatment
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
Lung Cancer
Several different types.
Lung Cancer- signs and symptoms
Altered mental status One-to-two-word dyspnea Cyanosis Hemoptysis Hypoxia Hoarseness Vague Chest Pain
Lung Cancer- treatment
Oxygen
IV access
Bronchodilators/ corticosteroids
Intubate if necessary
Toxic Inhalation
Upper airway obstruction due to edema and laryngospasms
