Resp Complications and Septic Shock Flashcards
Effusion
collection of fluids in hallow or in-between spaces in the body
Pleural Effusion
collection of fluid in the pleural space due to the imbalance of equilibrium of membranes. Symptom of disease, but not a disease on their own
Transudative Pleural Effusion
non-inflammatory normal fluid in the pleural space that is just in excess, decreased protein, typically from an increase in hydrostatic pressure
Empyema Pleural Effusion
puss, lots of WBC filling the space
Exudative Effusion
albumin in the spaces that have increased protein, inflammation, and increased capillary permeability causes the effusion
S&S of Pleural Effusion
SOB Chest pain protrusion of the chest pain that increases with breathing and can reach the shoulder and the arm cough fever and chills nightmares and night swears anroexia/weight loss
Daignosis of Pleural Effusion
the normal bitches CT chest X ray venous/ABGs ultrasound thoracentesis focused resp exam
TX of Pleural Effusion
admin of O2 chest tube for drainage surgery to drain relaxation starts for reducing anxiety pain meds implement interventions related to the root cause of the effusion
Pneumothorax
collection of air in the pleural space that can be closed, spontaneous, or open that results in partial or full collapse of the lungs
Closed Pneumothorax
typically in COPD or male smokers that is an unknown cause of the air filling in the pleural space. That one TikTok sound “how’d that get in here?”
Open Pneumothorax
air enters through the hole in the wall, can also come from bulbs bursting within the body that we can’t see from the outside
Hemothorax
collection of blood in the pleural space
Pneumo-Hemothorax
air and blood in the pleural space for a double whammy
Chylothorax
lymphatic fluid in the pleural space
S&S for Small Pneumothorax
mild tachy
SOB
Enlarged chest
S&S for Large Pneumothorax
angina barrel chest tracheal deviation cyanosis distended neck veins crunchy heart increased RR SOB severe pain when breathing air hunger low O2 Sat decreased breath sounds frothing at the mouth narrowed pulse pressure restlessness
Early Findings of Pneumothorax
tachypnea
hyperresponsiveness of the chest wall
decreased tactile fremitus
lower pitch booming sounds with breathing
Tension Pneumothorax
air accumulation quickly cannot escape that increases intra-thorax pressure and lung collapse that also has the mediastinal shift towards the unaffected side which can lead to the compression
S&S of Tension Pneumothorax
decreased CO, venous return and LDC aorta and vena cava compressed absent breath sounds tracheal clinician hypotension neck vein distension
TX of Pneumothorax
emergent needle decompression chest tube clearing entryway IV of fluids and antibiotics covering the chest wounds thoracentesis
Pneumonia
acute inflammation of lung parenchyma caused by the microbial organism
Community-Acquired Pneumonia
from the hospital or another person <48h post-exposure that can be from streptococcus pneumonia, legionella, mycoplasma and chlamydia
Hospital-Acquired Pneumonia
> 48 post-hospital stays that can result from is typically from compromised resp therapy equipment that is caused by the same as a community, Pseudomonas, enterobacter, MRSA, and methicillin-resistant
Fungal Pneumonia
fungi in the resp tract
Aspiration Pneumonia
fluids and materials aspirated from the stomach is introduced into the resp tract
Red Hospitalization Pneumonia
massive dilation of the capillaries in the lungs filling with immune response resulting in the red appearance of the lungs and granulous
Grey Hospitalization Pneumonia
decreased blood flow and consolidate in the affected area of the lung making it look grey
Stages of Pneumonia
Stage I shift of fluid in the affected area from alveoli where the organism spreads and multiplies
Stage II continuation and now massive dilation of the capillaries that have alveoli fill with the organism, blood and fibrin
Stage III decreased blood flow to affected areas and bad cap refill instead which makes lungs look grey
Stage IV is healing, exudate lysed and processed by macrophages and restoration of the lungs
Risk Factors of Pneumonia
DM Leukemia alcoholism LOC weakened immune system smoking immunosuppressants malnutrition intubation
S&S of Pneumonia
sudden onset of fever and chills pleuritic chest pain changes in vital signs confusion/delirium fremitus bronchial breath sounds myalgias necrosis sore throat diarrhea productive cough crackles in the lungs imbalance of CO2 and O2 nausea and vomiting
Complications of Pneumonia
pleural effusion pleurisy pericarditis autocisosis delayed resolution emphysema meningitis endocarditis
TX of Pneumonia
antibiotics targeting the main cause of the pneumonia
increased fluids
pain relief meds
O2 Sat to be >95%
high fowler’s position
pneumonia vax if this is more than the first one and severe
antipyretics and increased caloric intake
Sepsis/Septic Shock
life-threatening organ dysfunction and system inflammatory response to an infection
S&S of Sepsis
altered mental status a high score on the organ failure score tachypnea hypotension GSC<15 hyperventilation hypoperfusion organ failure
Diagnostics of Sepsis
usual suspects liver enzyme creatine level organ failure status bilirubin levels
TX of Sepsis
measurement of fluids and maintain them antibiotics vasopressors 30mg/kg crystalline or lactate ringers R&R pneumococcal vaccine multiple drug therapies increased nutritional status
