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Respiratory Emergencies > Respiratory Diseases and Disorders > Flashcards

Respiratory Diseases and Disorders Flashcards

1
Q

Disorders of Obstruction

A
  • Asthma
  • Status asthmaticus
  • COPD (chronic bronchitis, Emphysema)
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2
Q

Pulmonary Disorders

A
  • Acute Respiratory failure
  • Adult Respiratory distress syndrome
  • Aspiration
  • Hypo/hyperventilation
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3
Q

Respiratory Tract Infections

A
  • Pneumonia
  • Pleurisy
  • Pleural Effusion
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4
Q

Pulmonary Vascular Disease

A
  • Pulmonary edema
  • Pulmonary embolism
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5
Q

Chronic inflammatory disorder of the lower airways. Obstruction increases resistance to flow

A

Asthma

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6
Q

2 Types of Asthma

A
  1. Intrinsic
  2. Extrinsic
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7
Q

Not associated with specific antigen-antibody reaction

A

Intrinsic Asthma

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8
Q

Specific antigen-anitbody reaction (common in children)

A

Extrinsic Asthma

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9
Q

Common Triggers of Asthma

A
  • External or environmental factors (pollen, dust, feathers, foo, drugs)
  • Infections
  • Cold air
  • Chemical irritants
  • Tobacco smoke
  • Exercise
  • Emotional stress
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10
Q

Progression of Asthma

A
  1. Antigen is inhaled to lower airway
  2. Sensitized IgE antibodies trigger mast-cell degranulation in submucosa
  3. Mast-cell membrane ruptures releasing
    - Histamine
    - Leukotrienes
    - Prostaglandins
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11
Q

Phase 1 of Asthma

A

Within minutes of exposure
1. Bronchial smooth muscle contraction (Bronchoconstriction)
2. Fluid leakage from peribronchial capillaries (bronchial edema)

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12
Q

Phase 2 of Asthma

A

~3-4 hours later cells of the immune system invade respiratory submucosa, resulting in:
1. Sustained bronchiole inflammation
2. Increased mucous production
3. Bronchial edema

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13
Q

Classifications of Asthma Severity

A
  1. Mild Intermittent
  2. Mild persistant
  3. Moderate persistant
  4. Severe persistant
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14
Q

Treatment for Asthma

A
  1. Correct hypoxia (O2)
  2. Reverse Bronchoconstriction
  3. treat inflammation and edema
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15
Q

Severe prolonged attack that cannot be broken by bronchodilators

A

Status Asthmaticus

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16
Q

Signs and Symptoms of Status Asthamticus

A
  • Similar to asthma, however bronchodilators don’t help
  • Greatly diminished breather sounds
  • Imminent Respiratory Arrest
  • Pulsus paradoxus (systolic drop 10 mmHg or more)
  • Pneumothorax may occur due to air trapping and pressures
  • Silent chest with PCO2 > 70 mmHg
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17
Q

Treatment for Status Asthmaticus

A
  • Rapid transport is imperative
  • Administer high-concentration oxygen
  • Anticipate need for intubation and aggressive ventilatory support
  • Dehydrated common so IV fluid administration may be required
  • Closely monitor the patient’s respiratory status
  • Continuous bronchodilator therapy may be ordered
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18
Q

Hypersecretion of mucous and chronic productive cough that continues for at least 3 months/year or 2 consecutive years

A

Chronic Bronchitis

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19
Q

Blue Bloaters

A

Chronic Bronchitis

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20
Q

History for Chronic Bronchitis

A
  • Frequent respiratory infections
  • Productive cough
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21
Q

Inspection findings for Chronic Bronchitis

A
  • Often Overweight
  • Pursed-Lip Breathing
  • JVD
  • Ankle Edema
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22
Q

Lung sound for Chronic Bronchitis

A

Rhonchi

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23
Q

Management of Chronic Bronchitis

A
  • Relieve hypoxia (seated semi-fowlers, O2 prn to maintain SpO2> 90%, IV NS TKVO)
  • Reverse bronchoconstriction (bronchodilator nebulized)
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24
Q

Destruction of the alveolar walls distal to the terminal bronchioles that causes abnormal enlargement of gas exchange airways and loss of elastic recoil. Decrease in diffusion.

A

Emphysema

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25
Q

Pink Puffers

A

Emphysema

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26
Q

History for Emphysema

A
  • Recent weight loss
  • Dyspnea with exertion
  • Cigarette and tobacco usage common
  • Lack of cough except in the AM
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27
Q

Inspection finding for emphysema

A
  • Thin
  • Barrel chest
  • Pink skin due to extra red cell production (Polycythemia)
  • Hypertrophy of accessory muscles
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28
Q

Percussion finding with Emphysema

A

Hyperresonance

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29
Q

Lung sounds for emphysema

A
  • Wheezes and rhonchi
  • Prolonged expiration
30
Q

Emphysema management

A
  • STOP SMOKING
  • Relive hypoxia (semi-fowlers, O2 prn to maintain SpO2 >90%, IV NS TKVO)
  • Reverse Bronchocontriction (Anticholinergic inhaled/nebulized, B2-adrenic agonist inhaled/nebulized)
31
Q

Form of pulmonary edema that is caused by fluid accumulation in the interstitial space within the lungs

A

ARDS

32
Q

Precipitating factors of ARDS

A
  • Sepsis
  • Aspiration
  • Pneumonia
  • Pulmonary injury
  • Burns/inhalation injury
  • Oxygen toxicity
  • Drugs
  • High altitude
  • Hypothermia
  • Near-drowning syndrome
  • Head injury
  • Pulmonary Emboli
  • Tumor Destruction
  • Pancreatitis
  • Invasive procedures
  • Bypass, hemodialysis
  • Hypoxia, hypotension, or cardiac arrest
33
Q

Pathophysiology of ARDS

A
  • Disruption of the alveolar-capillary membrane
  • Affects interstitial fluid
34
Q

Treatment of ARDS

A
  • Manage underlying condition
  • High-concentration O2 (CPAP, PEEP)
  • IV access
  • Pulse oximetry, ECG
  • RApid transport
  • Use of pharmacological agents
35
Q

Passage of fluid and solid particles into lungs

A

Aspiration

36
Q

Signs and Symptoms of Aspiration

A
  • Decreased LOC or CNS causing cough reflex
  • abnormal swallowing mechanism
37
Q

Predisposing Factors for Aspiration

A
  • Substance abuse
  • Sedation
  • Anesthesia
  • Seizure disorder
  • CVA
  • Myasthenia gravis (neuro disorder)
  • Guillain-Barr’s syndrome (inflammation of nerves)
38
Q

History taking for Aspiration

A
  • Sudden onset of choking
  • May be fever, dyspnea, wheezing
39
Q

Aspiration Management

A
  • Prevention
  • Standard dyspnea treatment pre-hospitally
  • ??PEEP
  • ??Antibiotic
40
Q

Ventilation that exceeds metabolic demands

A

Hyperventilation Syndrome

41
Q

Common Causes of Hyperventilation Syndrome

A
  • Anxiety
  • Hypoxia
  • Pulmonary disease
  • Cardiovascular disorders
  • Drugs
  • Fever
  • Infection
  • Pain
  • Pregnancy
42
Q

Signs and Symptoms of Hyperventilation Syndrome

A
  • Dyspnea with rapid breathing and high minute volume
  • Chest pain
  • Circumoral tingling
  • Carpopedal spasm
  • Other assessment findings will vary, based on the cause of the syndrome
43
Q

Infection of the lower respiratory tract

A

Pneumonia

44
Q

Types of Pneumonia

A
  • Bacterial
  • Viral
  • Aspiration
45
Q
  • Hospital acquired vs community acquired
  • Inhalation of microorganisms
  • Infection can spread throughout lungs
  • Alveoli may collapse, resulting in ventilation disorder
A

Bacterial and Viral Pneumonia

46
Q

History Assessment for Pneumonia

A
  • Generally, appear ill with generalized weakness and malaise
  • Recent Hx of fever and chills
  • Deep, productive cough (yellow to brownish sputum)
47
Q

Inspection finding for Pneumonia

A

Pleuritic chest pain (sharp, tearing pain)

48
Q

Auscultation finding for Pneumonia

A
  • Inspiratory crackles with decreased air movement in involved segment
  • Egophony
49
Q

Management of Pneumonia

A
  • Adequate ventilation and oxygenation (semi-fowlers, O2 prn to maintain SpO2 > 90%, IV NS TKVO)
  • Reverse Bronchospasm prn (symptomatic relief) (B2-adrenergic agonist inhaled/nebulized)
  • In-hosptal:
  • X-ray/lab confirmation
  • Antibiotic therapy (bacterial)
50
Q

Inflammation of the pleura

A

Pleurisy

51
Q

Pleurisy Pathology

A

Frequently preceded by upper respiratory infection

52
Q

History finding for Pleurisy

A
  • Chills
  • Fever
53
Q

Inspection finding for Pleurisy

A
  • Pleuritic chest pain (sharp, tearing) on inspiration
  • Pain may also be referred to shoulder
54
Q

Auscultation findings for Pleurisy

A

Pleural friction rub may be heard over affected area

55
Q

Pleurisy Management

A
  • Adequate ventilation and oxygenation (semi-fowlers, O2 prn to maintain SpO2 > 90%)
  • ECG
  • IV NS TKVO
  • If unsure of cause of chest pain, treat according to chest pain protocol
56
Q

Presence of fluid in the pleural space

A

Pleural Effusion

57
Q

Sources of fluid in Pleural Effusion

A
  • Blood vessels
  • Lymph nodes
  • Abscess
  • Inflammation of tissue
  • CHF
58
Q

History Findings for Pleural Effusion

A
  • Chills
  • Fever
59
Q

Inspection finding for Pleural Effusion

A
  • Pleuritic chest pain (sharp, tearing pain) on inspiration
  • Pain may also be referred to shoulder
60
Q

Auscultation findings for Pleural Effusion

A

Pleural friction rub may be heard over affected area

61
Q

Management of Pleural Effusion

A
  • Adequate ventilation and oxygenation (semi-fowlers, O2 prn to maintain SpO2 > 90%)
  • ECG
  • IV NS TKVO
  • if unsure of cause of chest pain, treat for chest pain protocol
62
Q

A condition characterized by an abnormal collection of fluid in the lungs

A

Pulmonary Edema

63
Q

Assessment for Pulmonary Edema

A

Diaphoresis, pallor and pitting edema are commonly found

64
Q

Lungs Sounds for Pulmonary Edema

A
  • Mild to moderate presents with crackles in bases of lungs upon inspiration
  • Moderate to Severe produce coarse crackles heard throughout all lungs lobes during both inspiration and expiration
  • Tactile fremitus may also be present, palpating abnormal chest wall vibrations as a patient speak
65
Q

Management of Pulmonary Edema

A
  • High flow O2
  • If SpO2 < 85% despite basic O2 therapy, advanced airway management with PEEP may be indicated
  • Rapid transport
66
Q

Occlusion of a portion of the pulmonary vascular bed by an embolus

A

Pulmonary Embolism

67
Q

What can cause a Pulmonary Embolism

A
  • Thrombus
  • Tissue fragment
  • Lipids
  • Air embolus
68
Q

History findings for Pulmonary Embolism

A
  • Sudden onset of dyspnea
  • Pleuritic chest pain
  • Unproductive cough (rare hemoptysis)
  • Recent Hx immobilization (trauma, inactivity)
69
Q

Inspection findings of Pulmonary Embolism

A
  • Laboured breathing
  • Tachypnea, tachycardia
  • S&S of right sided failure (JVD, hypotension)
70
Q

Auscultation of Pulmonary Embolism

A
  • Usually unremarkable
  • Occasionally crackles, wheezes may be noted
71
Q

Assessment findings for Pulmonary Embolism

A
  • Check extremities for S&S of deep vein thrombosis (DVT) (warm, swollen extremity, thick cord palpated along medial thigh, pain on palp or calf extension)
  • Extreme S&S include: confusion, cyanosis, hypotension, cardiac arrest, petachiae)
72
Q

Pulmonary Embolism Management

A
  • Maintain airway
  • Support breathing
  • IV NS TKVO
  • Monitor vitals
  • Transport in position of comfort
  • Definitive care requires hospitalization and thrombolytic or heparin therapy
  • Prepare for cardiac arrest

Respiratory Emergencies (7 decks)

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