Respiratory 5 Flashcards
what can you develop if you have COPD
right sided HF
what are the causes of COPD
Smoking, chronic URI, air pollution, allergies
describe emphysema
cannot recoil
describe bronchitis
swollen bronchiole tubes
findings in COPD pt
- Tachycardia, tachypnea, barrel chest, cachectic, cough with sputum
- Prolonged expiratory phase, crackles, rhonchi
- ABG’s have < pO2, >paCO2
- Hgb elevated
- Acidodic
When would you call for help with a COPD patient?
Call for help when pO2 gets <60s (will be intubated)
treatment for COPD
-Oxygen supplements,
-May need ETT and ventilation if pO2 less than 60
-Inhaled bronchodilators, like albuterol or ephinephrine
I-V corticosteroids, like solu-medrol to decrease inflammation
-Diuretics to decrease edema
-Antibiotics if infection
-Chest tube if pneumohorax
what to rememeber about oxygen supplementation for COPD pt
remember the patient responds to higher than normal paCO2 levels to breathe
next to HF, _____ is the most common hospital admission
-COPD is the most common admission
(go back in the hospital often for pneumonia)
-cannot get fluid to exchange
pneumonia pt presents with
- Fatigue (very tired), painful cough, rapid RR, pleuritic pain and fever
- Sputum may be yellow, green or rust colored
- Lungs may have crackles, wheeze and dullness over the infected lung
describe the process from pneumonia to atelectasis
Bacterial infection triggers alveolar inflammation and edema, capillaries engorge with blood, causing stasis, edema and blood atelectasis
what needs to be done once pneumonia is dx
Need sputum culture to determine what they are carrying
And blood culture to see if bacteria is in blood stream
who is most at risk for pneumonia
Older patients are at greater risk because of weak chest musculature, can not clear secretions
what are the community acquired pneumonias
strep, mycoplasma, Hemophilus influenza, viral, Legionnaires
what are the hospital acquired pneumonias
*Pseudomonas, Staphylococcal, Klebsiella
bacterial vs viral infections development (pneumonia)
Bacterial infections only take a few weeks to develop
Viral infections can take months to develop
describe strep pneumonia
Dark reddish/dry sputum: strep (d/t URI that is not treated)
Fever, URI, rust sputum, consolidation on Xray
describe mycoplama pneumonia
- Sore throat, ear pain, headache, pain, rash, myalgia
- can be chronic and stay in system
describe Hemophilus influenza pneumonia
- URI, settles in lungs and stays there(develops over a long period), transmitted through droplet
- URI 2-6 wks earlier, chills, dyspnea, cough
describe viral pneumonia
typically type A (can be deadly)
describe Legionnaires pneumonia
spread through dirty water vapor (can be found in airplanes)
Flulike symptoms, malaise, headache within 24 hours,
number 1 hospital acquired infection
Pseudomonas pneumonia
describe pseudomonas pneumonia
- (bright green sputum)
- brought on by water vapor, anaerobic bacteria
- chills and fever, forms at base of lungs, large consolidation (not ventilated well)
describe stap pneumonia
Cough, chills, high fever, pain, bloody sputum, hypoxemia. Lung abscess
describe Klebsiella pneumonia
Fever, chills, rust, bloody sputum, cyanosis of lips and nails, shallow grunting respirations, pleuritic pain, consolidation
symptoms of aspiration pneumonia
Fever, crackles, dyspnea, hypotension, tachycardia, cyanosis
pneumonia treatment
Oxygen supplement, put HOB up, pulse ox Ventilation if needed Antibiotics Bronchodilator therapy Antitussive for cough High calorie diet and fluid Bed rest Analgesics for chest pain Cardiac monitoring
pneumonia pts need to _____
cough! get junk out of lungs
can only cough things out if hydrated (Fluids, High protein, antitussive)
describe pneumothorax
- Accumulation of air in the pleural cavity and leads to lung collapse
- Spontaneous or traumatic
describe tension penumothorax
is when venous return to the heart is impeded
