Respiratory Flashcards
Pharynx and larynx issues
Acute pharyngitis: Inflammation of pharyngeal walls(tonsils, palate, uvula)
Peritonsillar abscess: Group A Strep
Laryngeal polyps: On vocal cords- overuse and abuse
Acute bronchitis
Mainly viral cause
Can also be irritants in air, asthma
Usual assessment: Cough
Mangement: symptom relief, prevent pneumonia
High Fowler’s or whatever position is comfortable
Pneumonia
Infection that inflames alveoli- may fill with liquid
Risk factors: over 65, bedrest/immobility, debilitating illness, chronic disease.
Prevention: immunization over 65\
HAP, CAP, necrotizing, aspiration, opportunistic
Viral most common
Complications: ARDS, septic shock, atelectasis
ARDS
Acute Respiratory Distress Syndrome
Widespread rapid infection of lungs- commonly caused by sepsis/systemic inflammation
Shortness of breath, tachypnea, cyanosis
alveoli collapse
Tuberculosis
Primary: Bacteria inhaled, get infected, inflammatory reaction
Reactivation: 2+ yrs. after initial infection
Latent: Positive skin test, asymptomatic
Assessment: Dry cough leads to productive cough, fatigue, anorexia, weight loss, night sweats.
12 dose regimen for latent tb infection
Once weekly for 12 weeks
Directly observed therapy
Directly observed therapy
Intensive phase: 2-3months
Medication taken under direct supervision of staff
Continuation phase: 4-6 months: blisterpack given, first dose taken under supervision
Rib fracture treatment
Pain meds
Deep breathing
Coughing when you can
Tension pneumothorax
Poke with needle
Chest tube
PT will be short of breath, blue and low 02 sat
Flail chest treatment
Splint w/pillow on flail side
Assessment of chest tubes
FOCA
Fluctuation of water seal chamber
Output
Color
Air leak
Chest tube troubleshooting
DOPE
Dislodgement
Obstruction
Pneumothorax
Equipment
Pleural drainage w/chest tubes
Tidal bubbling expected w/pneumothorax
Check connections for leaks
5th intercostal space, mid axillary line.
Sterile technique
Pulmonary edema
Most common cause L side HF
Hear crackles-can have sudden onset
Low spO2
Dyspnea
Asthma
Assessment:
Wheezing, anxiety
Risks: allergens, respiratory infection, air pollution
Asthma triad
beta blockers can trigger->bronchospasm
ACE inhibitors can cause cough
Sulfites can trigger (can be in fruits, beer, wine, vegetables)
Watch for silent chest
Asthma triad
Nasal polyps
Asthma
Sensitivity to NSAIDS and aspirin
Silent chest
If pt was wheezing, then sudden absence of wheeze- very bad, cannot breathe.
Life threatening, may need mechanical ventilation
Status asthmaticus
Most extreme asthma attack
Hypoxia, hypercapnia, acute respiratory failure.
Unresponsive to corticosteroids and bronchodilators
Must be immediately intubated, mechanical ventilation.
Asthma treatment
Main: short acting beta adrenergic (SABA- rescue drugs) bronchodilators- albuterol
Moderate to severe attack: ipratroprium (atrovent) w/SABA: AKA combivent
Frequent attacks also have to be on long term med: Inhaled corticosteroid (ICS)
Combivent
SABA and irpratroprium combined.
What asthma meds are quick relief
SABA, anticholinergic (ipratroprium)
Long term asthma meds
Corticosteroids
Inhaled (fluticasone)
Singulair
Xolair
Which asthma med is easiest to use and most effective
Nebulizers transfer more meds than MDI w/spacer
Easy to use
ex. albuterol, ipratroprium
COPD
Chronic inflammation of lungs and airway.
Chronic bronchitis
Couch and sputum production for at least 3 months/year in 2 consecutive years
Emphysema
Destruction of alveoli w/o fibrosis.
Mucus hypersecretion
Air becomes trapped on inspiration=barrel shape (hyperinflation of lungs)
Pulmonary HTN
Long acting beta agonist bronchodilators
Symbicort(combo w/corticosteroid)
Salmeterol
Anticholinergic bronchodilators
Short acting:
Ipratroprium
Long acting:
Tiotropium
Anti inflammatory corticosteroids
LONG TERM:
Beclomethasone
Budesonide
Fluticasone
If you have meds to give for airway clearance which do you give first?
Bronchodilator first
THEN
Corticosteroid etc.
Cant work if they can’t get into lungs.
Leukotriene modifiers
Montelukast
Not for acute attack
Cystic Fibrosis
Assessments/findings:
Cough w/thick sputum
Complications: resp failure, pneumothorax
Management: Mobilize mucous, Chest physical therapy, postural drainage, nebulized saline.
Cor pulmonale
Pulmonary HTN from lung disease->alveoli shrivel, blood doesnt flow to them->backs up, too much volume causes HTN
Pulmonary HTN leads to R side cardiac hypertrophy due to it being harder to push.
