respiratory conditions Flashcards
What systems need examining in surgical patients?
Respiratory system
Digestive system
Renal system
CNS
Cardiovascular system
what is the impact of anaesthesia on the respiratory system?
Dead space where tube is connected so patient may not be receiving perceived oxygen.
What is a CABG surgery
Coronary artery bypass graft
Harvest a vein from leg normally
Graft to outside of heart to improve perfusion
Are put on by pass in the surgery
Involves a sternotomy
What are possible post-operative pulmonary complications?
Temperature >38 degrees
WCC >11.2
Pneumonia / chest infection
X-ray of atelectasis / consolidation
Production of purulent sputum different from preoperative sputum
Positive results sputum microbiology
SpO2 <90% on room air
Re-admission or prolonged stay
Why might thoracic surgery causes complications?
Surgery impairs post op respiratory function resulting in a relatively high risk of developing postop pulmonary complications incidence is much higher following upper surgery than abdominal surgery
What is a hemicolectomy
Removal of a segment of the colon either due to damage or cancer
Can be done open or laparoscopically
Recovery can be longer when open
Uses a middle incision
Why might a patient need a hemicolectomy?
Bowel/colon cancer
ulcerative colitis
Crohn’s disease
polyps
diverticulitis
What is an anterior resection?
An anterior resection ileostomy is where a diseased portion of bowel is removed
Traditionally performed through a middle incision or now laparoscopically.
Last portion of large intestine before rectum is removed.
If anastomosis needs time to heal an ileostomy may be formed created stoma (temporary).
What are possible risks presented by an anterior resection ileostomy?
Chest infection
Blood clots in legs or lungs.
Anaesthesia
Bleeding
Higher risk of complications if overweight, smoke or have other medical issues.
What are possible complications from an anterior resection specifically around the abdomen?
Leakage
Pelvic nerve damage
Increased risk of infection
Bowel stopping working
What is cystic fibrosis
Genetic disorder
affects the lungs, pancreas, liver and kidneys
Affects the CFTR gene which controls the production of mucus.
What are the clinical features of CF?
Productive cough,
shortness of breath,
mucopurulent sputum
What are treatmetns for CF
Clearance techniques such as side lying, percussion, autogenic drainage and ACBT
Medical management may include DNASE, hypotonic saline, IV antibiotics
What is COPD?
Refers to emphysema and chronic bronchitis. Chronic obstructive pulmonary disease.
What is emphysema?
Destruction of alveoli
This reduces surface area for gase exchange and impaired lung function
What is chronic bronchitis?
Inflammation and irritation of bronchial tubes.
Airways become swollen and excess mucus is produced obstructing airways.
What are symptoms of COPD?
Dyspnoea
Cough
Wheezing
Chest tightness
What are the contraindications for exercise in COPD?
Sever hypoxia
Recent MI 3-6 months
Unstable angina
Recent exacerbation of COPD requiring hospitalisation
Infection
Severe hypotension
What is asthma?
A long-term inflammatory disease of the airways of the lungs.
Will have variable and recurring symptoms linked to reversible airflow obstruction and easily triggered bronchospasm such as due to exercise or allergies.
What are symptoms of asthma?
Wheezing
Coughing
Chest tightness
Shortness of breath
What is the treatment for asthma?
Inhalers - preventative inhalers often contain some level of steroids and relievers such as salbutamol
May need steroid tablets
Sometimes surgery
Physiotherapy for breathing exercises and clearance techniques
What do preventative inhalers and reliever inhalers do?
Relievers help to eleviate immediate symptoms
Preventers help to reduce sensitivity of airways and reduce inflammation
Can have combination inhalers
What is pneumonia?
Pneumonia is an inflammatory condition of the lung that mainly affects the alveoli that is usually caused by infection.
What are symptoms of pneumonia?
Dry cough
chest pain
Fever
Difficulty breathing
What is the treatment for pneumonia?
Clearance techniques to help move secretions
Breathing techniques
Antibiotics
Can be vaccinated against
