respiratory

Question 1

idiopathic pulmonary fibrosis causes

Answer 1

• older w hx of smoking, chronic exposure to inhaled irritants, drugs amiodarone (Cordarone) or ambrisentan
• excessive wound healing w loss of cellular regulation-honeycomb

Question 2

idopathic pulmonary fibrosis treatment

Answer 2

• focus on slowing fibrotic process and control dyspnea
• corticosteroids and immunosuppressants
• cyclophosphamide (Cytoxan, Neosar), azithioprine (Imuran), chlorambucil (Leukeran), methotrexate (Folex)
• oxygen and morphine

Question 3

IV infusion of prostacyclin therapy

Answer 3

• specific dilation of pulmonary arteries
• continuous, dedicated line, don’t flush, right brand, use pt
• epoprostenol (Flolan, Veletri), trepostinil (Remodulin)

Question 4

Sarcoidosis information

Answer 4

• cough, dyspnea, and abnormal abdominal chest xray but otherwise asymptomatic
• rule out infection/cancer
• staged based on xray findings
• can lead to pulmonary htn

Question 5

sarcoidosis pt care

Answer 5

• focus to reduce manifestations and prevent fibrosis
• no symptoms-no tx
• corticosteroids
• assess symptom severity, pulm funct studies, chest xray, cbc, cr, ca, urinalysis
• educate steroid side effects, avoid infection, energy conservation

Question 6

sarcoidosis indicators for tx-5

Answer 6

decreased total lung capacity, diffusing capacity, or forced vital capacity, involvement of other organs, hypercalcemia

Question 7

paraneoplastic syndrome-5

Answer 7

• hormones secreted by tumor cells
  1. adrenocorticotropic hormone (ACTH)- Cushing’s syndrome
  2. antidiuretic hormone- syndrome of inappropriate antidiuretic hormone (SIADH), weight gain, general edema, dilution of serum electrolytes
  3. follicule stimulating hormone (FSH)- gynocomastia
  4. parathyroid hormone- hypercalcemia
  5. ectopic insulin- hypoglycemia

Question 8

warning signs of lung cancer

Answer 8

• hoarseness, change in resp pattern/ cough/wheeze/dyspnea, sputum-blood/rust/purulent
• pain-chest/shoulder/arm
• recurring episodes of pleural effusion, pneumonia, bronchitis
• fever, wt loss, clubbing

Question 9

nicotine replacement risks

Answer 9

smokinh while on nicotine can put to much in system and lead to stroke or heart attack

Question 10

tobacco screening

Answer 10

• past or current
• how many a day, duration, age when started
• pack years (ppd x years)
• secondhand and thirdhand smoke, social smoker
• hooka, waterpipe, ecig

Question 11

impaired gas exchange

Answer 11

takes place in lung tissue between alveoli and capillaries, not the airways
-right bronchus- bad intubation and foreign objects

Question 12

aging changes in resp-alveoli

Answer 12

decrease-surface area, diffusion, elastic recoil, ability to cough
-encourage turn, cough, deep breathe, incentive spirometry, upright position

Question 13

aging changes in resp-lungs

Answer 13

• residual vol increases, vital cap, O2 and CO2 exchange, elasticity decrease
• include inspection, palpation, percussion, and auscultation, abnormal breathing patterns in assessment, encourage activity and frequent oral hygiene

Question 14

aging changes in resp- pharynx and larynx

Answer 14

muscle, vocal cords, cartilage atrophy

-face to face convo

Question 15

aging changes in resp-pulmonary vasculature

Answer 15

assess LOC and cognition

Question 16

capnography readings- increase

Answer 16

• amt of CO@ in exhaled air
• normal 20-40
• detect hypoxia before pulse oximetry
• increase indicate impaired gas exchange-> hypoventillation, partial airway obstruction, rebreathing exhaled air
• cellular metabolism-fever, acidosis, heavy exercise

Question 17

capnography readings-decrease

Answer 17

• poor pulm ventilation

- pulm embolism, apnea, total airway obstruction, tracheal extubation, hyperventilation

Question 18

Pt education for pulm function tests

Answer 18

1. don’t smoke 6-8 hrs prior
2. bronchodilator drugs may be withheld for 4-6 hrs
3. reduce anxiety by explaining procedure