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Medsurg > Respi p.2 > Flashcards

Respi p.2 Flashcards

1
Q

closure / colapse of alveoli

A

atelectasis

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2
Q

causes of atelectasis

A

sx (thoracic or abdominal sx) result of anethesia
excess secretion of mucuos - blockage

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3
Q

Atelectasis obstructive

A

Blockage

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4
Q

atelectasis non obstructive

A

decrease ventilation

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5
Q

s/sx of atelectasis

A

Dyspnea / sputum prod / Cough / increase HR / increase RR / central cyanosis

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6
Q

when you auscultate atelectatis what sound will you heard?

A

crackles

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7
Q

when you chest xray pt. atelectasis what will you see

A

patchy infiltrates or consolidated areas

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8
Q

when you pulse ox patient with atelectasis what will you observe?

A

Decrease o2 saturation

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9
Q

Prevention of atelectasis?

A

Early ambulation
Turning
voluntary deep breathing every 2 hrs
used of incentive spirometry
coughing excercise
suctioning
CPT
Metered dose inhalers

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10
Q

goal of treatment of atelectasis

A

improve ventilation and remove secretion

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11
Q

inflam of the lung parenchoma

A

pneumonia

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12
Q

pneumonia cause

A

Bacteria / Virus / Fungi

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13
Q

4 types of pneumonia

A
  1. CAP - happen before 48 hrs / after 48hrs
    - S. pnemoniae / H. Influenza
  2. HCAP - Intial antibiotic Treatment should not be delayed
  3. HAP - 48 hrs or more after hospital
    - F. coli / H influenzae / Pseudomonas / Kles Pneumonae
  4. VAP - 48 hrs atleast
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14
Q

s/sx of pneumonia

A

fever / Increase RR / SOB / Sputum: purulent / rusty blood tinged sputum / crackels

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15
Q

dx of pneumonia

A

culture
cxr
sputum exam

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16
Q

Prevention of pneumonia

A

vaccination

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17
Q

Mngt of pneumonia

A

antibiotics
antipyretics
anti histamines
decongestant
02
hydration
bedrest
intubation
Warm moist inhalations

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18
Q

inflamation of the both layers of the pleurae

A

pleurisy

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19
Q

s/sx of pleurisy

A

Pleuritic pain / when deep breathing / coughing / sneezing worsing the pain

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20
Q

what finding when you ausculte patiet with pleurisy

A

pleural effeusion

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21
Q

mngt of pleurisy

A

discover cause / relieve pain
- analgesic / nsaid / Intercostal nerve block

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22
Q

nx Intervention Pleurisy

A

Splinting / turning frequently on affected side

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23
Q

Collection of fluid in the pleural space

A

Pleural effusion

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24
Q

normal pleural space

A

5-15 ml

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25
Q

s/sx of pleural effusion

A

dyspnea / difficulty of breathing

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26
Q

when assessing pleural effusion what should you assess?

A

auscultation: Decrease breath sound
Percusstion: Premitus
Inspection: Tracheal Deviation
CAR / VT scan : (+) presence of fluid

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27
Q

dx and treatment of choice of pleural effusion

A

thoracentesis

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28
Q

guidance of thoracentesis

A

UTZ ; avoid puncture of the lungs

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29
Q

when you repeat thoracentesis what happen to you?

A

can cause depletion of protein and electrolytes

30
Q

obliterate the pleural space

A

chemical pleurodesis

31
Q

use of agent that in chemical pleurodesis and instilled in??

A

Prevent accumulation of fluids that instilled into the pleural space with the use of chest tube using thorascopic approach / aerosolized

32
Q

Pleural effusion clamped: for? time and change position??

A

tube for 60-90 mins ; Side side then unclamped

33
Q

consist of 2 cath. that connects a pump chamber containing 2 one valves

A

pleuroperitoneal shunt

34
Q

oleuroperitoneal shunt used

A

fluid moves from pleural cavity to peritoneal cavity

35
Q

nx Intervention of pleural effusion

A

Position: sitting leaning forward
Fluid : recorded
Pain mngt: Analgesic frequent movement

36
Q

sudden and life threatening deteroration of gas exchange fxn

A

Acutre respiratory failure

37
Q

Define acute respiratory failure

A

Hypoxemia: decrease 60 mmhg or 02
Hypercapnia: Decrease 50 mmhg of Co2
with acidosis : Ph decrease 7.35

38
Q

s/sx of acute respiratory failure

A

Restlessness / fatigue / HA / Dyspnea / Air Hunger / Tachycardia / Increase BP / Progression of hypoxemia : earlyy : restless ness increase HR and RR / Late: Cyanosis / Decrease RR

39
Q

mngt of Acute respiratory failure and how to do it and define

A
  1. ET intubation
    Insection: Aid by laryngoscope
    Positioned: 2cnm above the carina
    Balloon: Iflated
    Cuffe pressure: 20-25 mmhg
    Can be used no longer than 14-21 day - increase - tracheostomy
  2. Mech vent
    -* Increase alarm : for the tubes for kinks
    * decrease alaram: For connections : Detach to reconnect
40
Q

extubation of acute respiratory failure

A

Ambu bag and 02 at bedside

41
Q

Pathophy of acute respiratory distress syndrome

A

severe inflam - process - diffuse alveolar damaged - sudden progressive pulmo edema / increase bilateral infiltrates / hypoxemia - unresponsive to oxygen supplementation

42
Q

causes of acute respiratory distress syndrome

A

Aspiration / covid 19 pneumonia / drug overdose / fat embolism / hematologic disorder / infection / major surgeries / metabolic disorder / sepsis / shock / trauma

43
Q

physical assessment of acute repisratory distress syndrome

A

Intercostal retractions
Auscultate: Crackles

44
Q

PEEP improves?

A

O2 - keep the alveoli open to prevent collapse
improve arterial oxygenation

45
Q

acute respiratory distress syndrome has no pharmacologic syndrome

A

true

46
Q

what position when having acute respiratory distress syndrome?

A

prone

47
Q

mech vent in acutre respiratory distress syndrome decrease what?

A

anxiety : sedation

48
Q

if peep cannot be maintained despite the use of sedatives what to do?

A

neuromuscular blocking agents

49
Q

Abnormal accumulation of fluid in the lung tissue

A

Pulmonary edema

50
Q

pulmonary edema damage of pulmonary capillary edema

A

pulmonary edema

51
Q

what increase in pulmonary edema

A

hydrostatic pressure

52
Q

mngt pulmonary edema

A

02 / diuretics / antihypertensives / inotropes / airway / intubation / morphine / positioning / cardiac monitoring / fluid restriction

53
Q

obstruction of the pulmo artery

A

pulmonary embolismcau

54
Q

causes of pulmonary embolism

A

DVT / Atrial fibrial / air bubbles / fat embolism

55
Q

s/sx of pulmonary emblism

A

SOB / chest pain / fainting / lightheadedness / bloody streaked mucus / dizziness / cold clammy skin / cyanosis

56
Q

mngt for pulmonary embolism

A

anticoagulant
thrombolytics
vena cava filter
Pulmonary embolectomy

57
Q

Slow progressive respiratory disease of airflow obstruction involving airways

A

chronic obstructive pulmonary disease

58
Q

presence cough and sputum production for atleast 3 months in each of 2 consecutive years

A

chronic bronchitis

59
Q

hypersecretion of mucus

A

mucus plug

60
Q

impaired gas exchange result from obstruction of the walls of over distended alveoli

A

emphysema

61
Q

emphysema chest

A

barrel chest

62
Q

chronic airway inflammation leads to?

A

astma

airway hyperresponsiveness - mucosal edema - mucus production - cough / chest tightness / wheezing / dyspnea

63
Q

is the key to asthma care

A

knowledge

64
Q

complication of asthma

A

status asthamaticus / respi failure / pneumonia / atelectasis

65
Q

mngt of asthma

A

pulmonary treatment focus: prevent impairment of lung function
- decrease surgeries
- prevent exacerbation

66
Q

medications of asthma

A
  • short acting beta 2 adrenergic agonist - albuterol - bronchodilation
  • anticholinergic - ipratoprium - decrease secretion
  • corticostroids - prednisone - decrease inflam
  • long acting - @night ; 12 hrs
  • leukotrine modifiers - montelukast
67
Q

best manage by early treatment and education

A

astma exacerbation

68
Q

Nx interventions of asthma

A

assess airyway for the first 12-24 hrs
- increase oral fluid intake 3-4 L /dday
- avoid irritants

69
Q

more common than penetrating

A

blunt trauma

70
Q

common cause of blunt trauma

A

vehicular accident

71
Q
A

Medsurg (5 decks)

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