Respiratory

Question 1

COPD

Answer 1

• not reversible
• destruction of alveoli and narrowing of bronchioles
• trapping of air resulting in loss of lung elasticity

-Causes:
smoking
pollution
age
dust

-Presentation:
dyspnea with wet cough
pursed-lip breathing
wheezing
crackles
barrel chest
respiratory ACIDOSIS
clubbed fingernails

Treatment:
- position upright
- frequent rest periods
- effective coughing techniques
- 2-3L of fluids per day
- high calorie diet
- smoking cessation

Types:
- Emphysema: destruction of alveoli and narrowing of bronchioles
- caused by smoking, age, chemicals
-Bronchitis: inflammation and hypersection of mucus in rhe bronchi and bronchioles caused by chronic exposure to irritants
- productive cough, hypoxemia, respiratory acidosis
- pulse ox is usually less than 90% (this is expected)

Question 2

Pneumonia

Answer 2

-inflammatory process in lungs that causes fluid build up in alveoli and is bacterial, viral, fungal, chemical

-causes:
age
no flu (last year) or pneumonia vaccine (5 years)
lung disease
mechanical ventilation
tobacco use
immunocompromised

-Presentation:
tachypnea
tachycardia
wet cough
elevated WBC
onset of chills and fever
COUGHING + COARSE CRACKLES

-Treatment:
encourage fluids (3L)
anti-infectives, antipyretics, bronchodilators, anti-inflammatories

Question 3

Oxygen Delivery Devices

Answer 3

1. Nasal Cannula: 1-6L/min
2. Venturi Mask: 4-8L/min
3. Simple Face Mask: 6-8L/min
4. Aerosol mask/face tent: 8-10L/min
5. Partial Rebreather Mask: 8-11L/min
6. T-piece: 8-10L/min
7. Nonrebreather Mask: 12L/min

(Nothing Very Simple Arises Partially To None)

Question 4

Hypoxia

Answer 4

Early signs:
- increased HR, BP, RR, confusion, dyspnea

Late Signs:
- decreased HR, cyanosis,

Question 5

Status Asthmaticus

Answer 5

• life threatening episode of airway obstruction that is unresponsive to treatment

Presentation:
- extreme wheezing
- labored breathing
- use of accessory muscles
- distended neck veins
- high risk for cardiac/respiratory arrest

Treatment:
- Place in high fowlers
- Prepare for emergency intubation
- administer oxygen, epinephrine, systemic steroid as prescribed
- provide emotional support