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NURS 1250 > Respiratory Disorders > Flashcards

Respiratory Disorders Flashcards

1
Q

Legionnaires Disease

A
  • Legionella Pneumophila
  • Gram Negative
  • Has extrapulmonary manifestations
  • Transmission is droplets via mist
  • Incubation 2-10 days
  • Diagnose with PCR, urinary antigen, patchy unilobar infiltrates
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2
Q

Acute Bacterial Pneumonia

A
  • Streptococcus Pneumoniae
  • resides in respiratory tract of 70% of people
  • Transmission via respiratory droplets or aspiration
  • incubation 24-48 hours
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3
Q

Septic Pneumonia Manifestations

A
  • Increase WBC
  • Increase procalcitonin
  • acidosis
  • (+) blood culture
  • abnormal kidney/liver function
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4
Q

Pneumonia Interventions

A
  • Antibiotic, antifungal, antiviral
  • Bronchodilators
  • mucolytics, expectorants
  • IV fluids
  • O2
  • diet high in protein, rest
  • chest physiotherapy
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5
Q

Aspiration Pneumonia

A
  • Caught through aspiration

- predisposing factors: neurological disorder, upper GI disorder, mechanical disruption

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6
Q

Pneumocytosis Jiroveci Pneumoniae

A

-Opportunistic
-airborne transmission
-incubation up to 197 days
-diagnosed with:
diffuse, bilateral, interstitial infiltrates
tinctorial staining
fluorescent antibody
PCR

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7
Q

Viral Pneumonia

A
  • airborne transmission
  • responsible for 10% of cases
  • incubation 2-5 days
  • organisms: RSV, flu, adenovirus, measles, covid
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8
Q

Primary Atypical Pneumonia

A
  • Mycoplasma pneumoniae
  • gram negative
  • manifestation: URI, acute bronchitis, CAP
  • transmission: respiratory droplets
  • incubation 2-3 weeks
  • diagnosis: hemolysis main, patchy opacities, streaks of interstitial infiltrates, areas of atelectasis
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9
Q

Pneumonia Manifestations

A

Neuro: headache, mood swings, confusion
Respiratory: dyspnea, cough, crackles, sputum, hemoptysis, hypoxia
Cardiovascular: pleuritic pain, tachycardia
Integumentary: fever, chills, fatigue, malaise
gastro: loss of appetite, nausea, vomiting

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10
Q

Pneumonia Classifications

A
  • Community Acquired: streptococcus pneumoniae, influenza
  • Healthcare Associated: ventilator associated, pseudomonas aeruginosa, escherichia coli
  • Opportunistic: pneumocystis jiroveci, mycobacterium tuberculosis
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11
Q

Pneumonia Pathophysiology

A

Affects the parenchyma, caused by aspiration of microorganisms thru nasopharynx, they get trapped in cilia and lead to alveolar edema –> dyspnea, hypoxemia

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12
Q

TB Treatment Lengths

A

Latent: 1 to 2 antibiotics for 12-16 weeks
Active: 3 to 4 antibiotics for 18-31 weeks

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13
Q

TB Pharmacological Treatments

A 
Isoniazid
-used for prophylaxis, 1st line treatment
-peripheral neuropathy is the # 1 side effect due to B6 deficiency 
Rifampin
-Combination drug
-red/orange body fluids is a symptom
Ethambutol
-treatment of active TB in combination
-Optic neuritis is as symptom
Pyrazinamide
-hepatoxicity
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14
Q

TB isolation precaustions

A

Airborne isolation precautions

Can be removed if: clinical improvement, on meds minimum of 2 weeks, 3 consecutive negative AFB smears

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15
Q

TB Sputum Tests

A 
Sputum Smear
-read in 24 hours
-(+) acid fast bacteria
-need 3 specimens, 8-24 hours apart
Sputum Culture
-gold standard
-growth of tubercle bacilli
-confirms TB diagnosis
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16
Q

TB Blood Tests

A 
IGRA
-for people who had BCG 
-Can't be followed up
QuantiFERON TB gold
T-spot TB test
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17
Q

TB Skin Test

A

TST, PPD Test, Mantoux test

  • intradermal
  • read within 2-3 days
  • negative TB test means TB is unlikely
  • must have a 2nd test if positive
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18
Q

TB Manifestations

A
  • chest pain
  • weight loss
  • chills
  • long-term cough
  • fever
  • fatigue
  • night sweats
  • no appetite
  • cough up blood
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19
Q

TB Pathophysiology

A

TB inhaled thru airborne droplets, they multiply in the alveoli, macrophages and T-Lymphocytes form granulomas, some TB is released when macrophages die and spread in blood

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20
Q

CPAP vs BiPAP

A

CPAP
-continuous pressure on inhale
BiPAP
-Pressure during inhale and exhale

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21
Q

OSA risk factor reduction

A
  • Weight loss
  • Smoking Cessation
  • Avoid supine position when sleeping
  • Limit alcohol
  • CPAP and BiPAP
22
Q

OSA Diagnostic Criteria

A

STOP & BANG test more than 5 checked recommend for a sleep study

Polysomnography

23
Q

OSA Manifestations

A
  • Snoring
  • AM headache
  • Excessive daytime sleepiness
  • mood change
  • difficulty concentrating
  • waking with chest pain/dry mouth
24
Q

OSA pathopysiology

A

While awake small airway and neuromuscular compensation, at sleep onset you loose neuromuscular compensation and decreased pharyngeal muscle activity and the airway collapses. Apnea occurs leading to hypoxia and hypercapnia and increased ventilary effort. This leads to arousal, and airway is restored, and hyperventilation occurs

25
Q

Metabolic Alkalosis Causes

A
  • Over use of antacids
  • Diuretic therapy
  • Loss of acid via GI tract
26
Q

Metabolic Acidosis Causes

A
  • Diabetic ketoacidosis
  • hyperchloremic acidosis
  • kidney disease
  • lactic acidosis
  • salicylate (aspirin) poisoning
  • dehydration
  • starvation
27
Q

Respiratory alkalosis causes

A
  • hyperventilation

- stimulation of respiratory center through sepsis, brain injury, or aspirin overdose

28
Q

Respiratory Acidosis Causes

A
  • airway obstruction
  • depression of respiratory center
  • chronic respiratory problems
29
Q

metabolic alkalosis nursing interventions

A
  • -monitor vitals
  • assess neurological level
  • monitor ABGs
  • administer IV and electrolytes (NaCl)
30
Q

Metabolic Alkalosis Symptoms

A 
Respiratory: slow, shallow breathing
Neurological: irritability, disorientation, belligerence
Cardiovascular: dysrhythmia
Neurological: tingling, cramps, tetany
Gastro: anorexia, nausea, vomiting
31
Q

metabolic acidosis nursing interventions

A
  • monitor vitals
  • monitor neurological status
  • position pt. to facilitate breathing
  • admin O2 to correct lactic acidosis
  • monitor ABGs
  • monitor HCO3 and K+
  • administer IV (lactated ringers)
  • admin NaHCO3 caustiously
  • high carb, low fat diet
  • cardiac monitoring
32
Q

metabolic acidosis symptoms

A

respiratory: kassmaul breathing, fruity breath
neurological: headache, lethargy, confusion, coma
cardiovascular: arrythmia, hypotension
neurological: tingling and numbness
gastro: abdominal pain, anorexia, nausea, vomiting

increased blood K+

33
Q

Respiratory Alkalosis Nursing Interventions

A
  • have pt. breathe slow and less deeply
  • monitory vitals
  • monitor ABGs
  • monitor serum potassium
  • administer sedatives caustiously
  • reinforce pt. teachings like antianxiety

decreased K+ outside cell

34
Q

Respiratory Alkalosis Symptoms

A

respiratory: periods of apnea and hyperventilation
neurological: light headedness, confusion, lethargy
cardiovascular: tachycardia, arrythmia
neurological: tingling, hyperreflexia, tetany, seizure
gastro: epigastric pain, nausea, vomiting

35
Q

Respiratory Acidosis Nursing Interventions

A
  • maintain patent airway
  • admin O2 cautiously
  • monitor vitals
  • monitor serum potassium
  • administer sedatives cautiously
  • reinforce pt. teachings
36
Q

Respiratory Acidosis Symptoms

A

Respiratory: rapid and shallow breathing that leads to shallow and depressed
Neurological: dizziness, disoriented, headache, coma, muscle twitches, seizures
Cardiovascular: arrythmia, hypotension

increased K+ in blood

37
Q

Uncompensated vs. partially compensated vs. fully compensated

A

Uncompensated: pH abnormal, either HCO3 or CO2 normal, either HCO3 or CO2 abnormal

Partially Compensated: pH abnormal, both CO2 and HCO3 abnormal

Full Compensation: pH normal, both CO2 and HCO3 abnormal

38
Q

Lungs role in maintaining acid/base

A

-alternate rate and depth of breathing to eliminate CO2 during acidosis and retain CO2 during alkalosis

39
Q

Kidney’s role in maintaining acid/base

A

excrete H+ in acidosis
absorb HCO3 in acidosis
conserve H+ in alkalosis
eliminate HCO3 in alkalosis

40
Q

Thoracentesis

A

removes fluid/air from around lungs

tests for infection/cancer

41
Q

Thoracotomy Incisions

A 
Posterolateral
-gold standard for thorax access
Anterolateral
-can be used for cardiac
Axillary
-quicker recovery
-less muscles damage, less pain
42
Q

Thoracotomy

A

surgical opening to gain access into pleural space, most painful manage pain with PCEA or PCA

43
Q

Pleural Disorder Symptoms

A
  • chest pain
  • diminished/absent breath sounds
  • asymmetrical chest wall movement
  • cough
  • fever
  • SOB
  • cyanosis
44
Q

COPD non-pharmacological therapy

A
  • pursed lip breathing
  • increase fluid intake
  • small frequent meals
  • percussion/postural drainage
  • smoking cessation
45
Q

COPD Pharmacotherapy

A
  • short an long acting beta 2 agonist
  • corticosteriods
  • anticholinergics
  • mucolytic/expectorant
  • broad spectrum antibiotic
  • O2 therapy
46
Q

COPD diagnostic findings

A
  • ABG - respiratory acidosis
  • CBC - Increased RBC
  • decreased FEV1
  • decreased FVC
  • increased RV
  • increased airway resistance

diagnosed as FEV1/FVC ratio of less than 70% in addition to manifestations

47
Q

COPD risk factors

A
  • smoking
  • lung irritants
  • family history with AATD gene
  • history of childhood respiratory infections
48
Q

Bronchitis Symptoms

A
  • productive cough
  • cough that lasts longer than 3 months
  • fatigue
  • dyspnea
  • cyanosis
  • rhonci
49
Q

Bronchitis pathopysiology

A

loss of cilia leads to hypertrophy/hyper secretion in goblet cells/mucous glands. Chronic inflammation occurs and obstructs airflow

50
Q

Emphysema Symptoms

A
  • Wheezing
  • Cough
  • use of accessory muscles
  • increased respiratory rate with prolonged expiratory phase
  • anorexia/weight loss
  • wheezing
51
Q

Emphysema pathophysiology

A

hyperinflation of lungs, respiratory acidosis

breakdown of elastin in lung tissue leads to increased size of airspace. Increase of alveolar space causes loss of elastic recoil, air trapping, and imbalance of lung proteases. Diffuse airway narrowing.

NURS 1250 (6 decks)

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