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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
Metabolic Alkalosis Causes
- Over use of antacids - Diuretic therapy - Loss of acid via GI tract
26
Metabolic Acidosis Causes
- Diabetic ketoacidosis - hyperchloremic acidosis - kidney disease - lactic acidosis - salicylate (aspirin) poisoning - dehydration - starvation
27
Respiratory alkalosis causes
- hyperventilation | - stimulation of respiratory center through sepsis, brain injury, or aspirin overdose
28
Respiratory Acidosis Causes
- airway obstruction - depression of respiratory center - chronic respiratory problems
29
metabolic alkalosis nursing interventions
- -monitor vitals - assess neurological level - monitor ABGs - administer IV and electrolytes (NaCl)
30
Metabolic Alkalosis Symptoms
``` Respiratory: slow, shallow breathing Neurological: irritability, disorientation, belligerence Cardiovascular: dysrhythmia Neurological: tingling, cramps, tetany Gastro: anorexia, nausea, vomiting ```
31
metabolic acidosis nursing interventions
- 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
metabolic acidosis symptoms
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
Respiratory Alkalosis Nursing Interventions
- 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
Respiratory Alkalosis Symptoms
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
Respiratory Acidosis Nursing Interventions
- maintain patent airway - admin O2 cautiously - monitor vitals - monitor serum potassium - administer sedatives cautiously - reinforce pt. teachings
36
Respiratory Acidosis Symptoms
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
Uncompensated vs. partially compensated vs. fully compensated
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
Lungs role in maintaining acid/base
-alternate rate and depth of breathing to eliminate CO2 during acidosis and retain CO2 during alkalosis
39
Kidney's role in maintaining acid/base
excrete H+ in acidosis absorb HCO3 in acidosis conserve H+ in alkalosis eliminate HCO3 in alkalosis
40
Thoracentesis
removes fluid/air from around lungs | tests for infection/cancer
41
Thoracotomy Incisions
``` Posterolateral -gold standard for thorax access Anterolateral -can be used for cardiac Axillary -quicker recovery -less muscles damage, less pain ```
42
Thoracotomy
surgical opening to gain access into pleural space, most painful manage pain with PCEA or PCA
43
Pleural Disorder Symptoms
- chest pain - diminished/absent breath sounds - asymmetrical chest wall movement - cough - fever - SOB - cyanosis
44
COPD non-pharmacological therapy
- pursed lip breathing - increase fluid intake - small frequent meals - percussion/postural drainage - smoking cessation
45
COPD Pharmacotherapy
- short an long acting beta 2 agonist - corticosteriods - anticholinergics - mucolytic/expectorant - broad spectrum antibiotic - O2 therapy
46
COPD diagnostic findings
- 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
COPD risk factors
- smoking - lung irritants - family history with AATD gene - history of childhood respiratory infections
48
Bronchitis Symptoms
- productive cough - cough that lasts longer than 3 months - fatigue - dyspnea - cyanosis - rhonci
49
Bronchitis pathopysiology
loss of cilia leads to hypertrophy/hyper secretion in goblet cells/mucous glands. Chronic inflammation occurs and obstructs airflow
50
Emphysema Symptoms
- Wheezing - Cough - use of accessory muscles - increased respiratory rate with prolonged expiratory phase - anorexia/weight loss - wheezing
51
Emphysema pathophysiology
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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