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Med Surg III > Respiratory > Flashcards

Respiratory Flashcards

Test #3

1
Q

Structure of respiratory system

A
  • Larynx
  • Trachea
  • Cartilage
  • Bronchus
  • Bronchioles
  • Alveoli
  • Diaphragm
  • Intercostal muscles (between ribs)
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2
Q

Inspiration (1/3 of resp cycle)

A

contraction of diaphragm (floor moves down) and external intercostal muscles increases space in the chamber

-Lowered intrathoracic pressure causes air to enter through airways and inflate lungs

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3
Q

Expiration (2/3 of resp cycle)

A

relaxation of diaphragm (floor moves up) and intrathoracic pressure increases

  • Increased pressure pushes air out of lungs
  • Requires elastic recoil of lungs
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4
Q

Chronic Obstructive Pulmonary Disease (COPD)

A

Chronic inflammatory lung disease causing obstructed airflow-chronic bronchitis and emphysema

Not reversible-Treatable but not curable

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5
Q

What other disorder can coexist with COPD?

A

asthma

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6
Q

What is chronic bronchitis?

A

inflammation of lining of bronchial tubes, causing increased mucous and coughing

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7
Q

What is Emphysema?

A

Alveoli at the end of the bronchioles are destroyed.

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8
Q

Risk factors of COPD

A

environmental exposures and host factors

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9
Q

Primary symptoms of COPD

A

S/S don’t typically appear until a lot of damage has already occurred. Gets worse with time.

cough
wheezing
sputum production
dyspnea

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10
Q

Etiology of COPD

A
  • *Smoking causes 80-90% of cases
  • passive smoking

Occupational exposure

Ambient air pollution

Infection-Pneumonia

  • *Genetic Abnormalities
  • Alpha 1-antirypsin deficiency

Age
-35-40 before symptoms, but probably already have problem

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11
Q

Pathophysiology of COPD

A

Inflammatory response causes changes in pulmonary vasculature-definitely changes the walls.

COPD causes bronchial tubes and alveoli (used to force air out of lungs and body) to lose elasticity and over expand, leaves air trapped in lungs when exhalation, damaging alveoli.

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12
Q

Airflow limitation

A

during forced exhalation due to loss of elastic recoil

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13
Q

Airflow obstruction

A

due to mucous hyper-secretion, mucosal edema, and bronchospasms

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14
Q

Diagnostic tests of COPD

A

PFT

ABG-take from arteries! MUST put pressure for 5 min

Sputum tests-Pneumonia, TB

Chest X-ray, CT, MRI

Fluoroscopic studies and angiography

Radioisotope procedures (lung scans)

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15
Q

Arterial Blood Gases (ABG)

A

Measurement of arterial O2 and CO2 levels

Used to assess adequacy of alveolar ventilation and ability of lungs to provide O2 and remove CO2

Assess acid-base balance (7.35-7.45 pH)
**If on O2 all the time, look for resp acidosis (under 7.35)

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16
Q

Prevention of COPD

A

Stop smoking
Avoid irritants
Yearly flu shots
Pneumonia shots q5years

17
Q

Therapies for COPD

A

O2-usually 2L
-If O2 given too much, they lose drive to breathe

Pulmonary rehab

18
Q

Meds for COPD

A

Bronchodilators

Inhaled/oral steroids-CHECK CBG

Combo inhalers-rinse mouth

Phoshodiesterase 4 inhibitors-reduce inflammation
-causes diarrhea

Theophylline-tremors, tachycardia

Antibiotics

19
Q

Bronchoscopy

A

Look in lungs with scope

Numb throat, NPO until gag reflex-could aspirate

20
Q

When would you put a non-rebreather on?

A

When a patient is struggling for air and needs increased percentage of air

21
Q

Ways to break up mucous

A
  • Pulmonary toilet
  • High frequency compression device
  • Nebulizers
  • Acapella airway-breathe in, ball vibrates
  • Flutter device
22
Q

Surgical management of COPD

A

Bullectomy-removal of expanded alveoli

Lung volume reduction surgery-gets rid of lung tissue that isn’t functioning

Lung Transplantation

23
Q

Nitrate foods

A

Bologna

Bacon

24
Q

Why can’t patients with COPD have gassy foods?

A

They could aspirate when they burp

25
Q

Sulfites food

A

meats and salad bars

26
Q

Chronic Bronchitis Symptoms

Blue Bloater

A

Usually heavy smoker
Will lead to Right Sided Heart Failure

  • Hypoxic=Low O2 and High CO2
  • Cyanotic-fingertips and nose
  • Cough with thick sputum
  • Hypercapnia (High pCO2)
  • Resp acidosis
  • High Hgb
  • Club fingers
  • Cardiac enlargement
  • Hard time sucking in & out
  • Skinny
  • Increased respiration rate
  • Dyspnea-exertion, then at rest
  • coarse rhonci and wheezes-high-pitched snoring sound
27
Q

Emphysema

Pink Puffer

A

Tripod breathing-leaning forward to open more room for lungs.

  • Sucks in everywhere to breathe-pursed lips
  • High CO2 (pink)
  • CO2 poisoning-cherry red lips
  • Dyspnea
  • Barrel chest but thin appearance
  • anorexia, weight loss-increase calories
  • Leads to right sided HF (cor pulmonale)
  • minimal cough and mucous
  • long time to breathe out
  • decreased breath sounds
28
Q

Other lung diseases

A

Pneumonia
TB
Occupational Lung

29
Q

Atelectasis

A

Going into pneumonia

Collapse/airless condition of the alveoli

Postop patients are high risk

30
Q

Symptoms of Atelectasis

A

cough, sputum production, low-grade fever

If area is large-respiratory distress, anxiety, hypoxia

31
Q

Prevention of Atelectasis

A

Frequent turning and immobilization

Deep breathing every 2 hours

coughing exercises, suctioning, aerosol therapy, chest physiotherapy

32
Q

Treatment for Atelectasis

A

Strategies to improve ventilation

Remove secretions

33
Q

Pneumonia types

A
  • Aspiration-food
  • Inhalation-chemicals, fumes
  • Hematogenrous-carried by blood
  • bacterial
  • viral
  • fungal-bird poop
  • parasites
  • Opportunistic-HIV
  • Pneumocyctic carni pneumonia (PCP)
  • Lesionares-cooling towers and fountains
  • winter-inside, not outside
34
Q

Pneumonia

A
  • Obstruction of bronchioles
  • Decreased gas exchange
  • Increased Exudate
  • Cough
  • fever
  • tachycardia/tachypynea
  • dyspnea-resp distress
  • pleural pain
  • decreased breath sounds-crackles, snoring, wheezing
  • dull percussion
35
Q

Pus

A

WBC eating bacteria

36
Q

Pneumonia etiology

A

Variety of aspirated organisms

-Organism dependent on whether community acquired in previously healthy pt (more likely streptococcus)

37
Q

Community acquired pneumonia

A

in pt with depressed pulmonary defenses such as chronic bronchitis (more likely Klebsiella or Pseudomonas spps)

38
Q

Hospital acquired pneumonia

A

Within 2 days of adult community acquired.

After 2 days=hospital acquired

Med Surg III (9 decks)

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