Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 322 > Respiratory Disorders > Flashcards

Respiratory Disorders Flashcards

1
Q

What is rhinosinusitis? What are some causes?

A

– rhinosinusitis (AKA sinusitis): inflammation of the mucous membranes of one or more of the sinuses

– causes

  • after rhinitis
  • Strep
  • bacteria
  • predisposing factors
    • deviated septum
    • nasal polyp
    • nasal tumor
    • facial trauma
    • dental infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some signs and symptoms of rhinosinusitis? What are some interventions?

A

– s/s

  • similar to cold
  • facial pressure
  • tenderness to touch

– interventions

  • antibiotics
  • antipyretics
  • decongestants
  • steam humidification
  • hot/wet packs
  • nasal saline irrigations
  • functional endoscopic sinus surgery (FESS) – removes infected areas of mucosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is pharyngitis? What are some causes? How is pharyngitis diagnosed? What are some signs and symptoms?

A

– pharyngitis: sore throat; inflammation of pharyngeal mucous membranes

– causes

  • bacteria
  • viruses
  • irritants
  • group A beta Strep –> acute glomerulonephritis

– diagnosed by rapid antigen test (RAT)

  • screens group A beta hemolytic streptococcal antigen

– s/s

  • odynophagia – pain during swallowing
  • dysphagia
  • fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is pneumonia? What are the 5 types of pneumonia? Which population is especially at risk?

A

– pneumonia: inflammation of the air sacs of the lungs caused by

  • excess fluid in lungs
  • infectious agents
  • inhaled irritants

– 5 types:

  • community-acquired – easier to treat
  • healthcare-associated – more difficult to treat (antibiotic resistance)
  • bacterial – caused by Strep or Staph
  • viral – most common
  • atypical – caused by Chlamydophila

– elderly population is at higher risk – likely to experience confusion due to hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is bronchiolitis? How is it different than bronchitis?

A

– bronchiolitis: inflammation of terminal airways – common in younger kids

– bronchitis: inflammation of main airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some diagnostics tests for respiratory infections?

A
  • sputum sample
  • CBC
  • blood labs
    • BUN
  • CXR
  • pulse ox
  • bronchoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some of the main interventions for respiratory infections?

A
  • manage hypoxemia
  • prevent airway obstruction
    • CDB Q2H
    • IV
    • inhaled steroids
  • manage sepsis by eradicating pathogens
  • incentive spirometry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is severe acute respiratory syndrome (SARS)? What are interventions for SARS?

A

– SARS: virus infection of respiratory tract cells, triggering inflammatory response

– interventions:

  • no known effective treatment
  • prevent spread
    • airborne iso
    • handwashing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Discuss TB?

A
  • high communicable
  • Mycobacterium TB pathogen
  • airborne
  • miliary/hematogenous TB: spread of TB throughout the body
  • secondary TB: pt has TB but never presented, and then presents later
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some signs and symptoms of TB?

A
  • persistent cough
  • night sweats
  • hemoptysis – coughing blood
  • weight loss
  • anorexia
  • SOB
  • fever, chills
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some diagnostic tests for TB?

A
  • nucleic acid amplification test (NAAT) – detects nucleic acids for TB
  • purified protein derivative (PPD) – 2 step
    • induration of 10+ mm = positive
  • tuberculin test (Mantoux) – intradermal PPD
  • Quantiferon = gold standard
  • sputum culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some interventions for TB?

A
  • combined drug therapy
    • isoniazid (INH) and rifampin used throughout
    • pyrazinamide
    • ethambutol
    • 6 month therapy with strict adherence
  • airborne precautions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is pulmonary empyema? What are some causes?

A

– pulmonary empyema: collection of pus in pleural space causing lung collapse

– causes:

  • pulmonary infection
  • pneumonia
  • lung abscess
  • chest surgery
  • chest trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some signs and symptoms of pulmonary empyema? Interventions?

A

– s/s:

  • recent febrile illness
  • chest pain
  • cough
  • dyspnea
  • diminished breath sounds
  • fever, chills, night sweats
  • collapsed lung
  • medial stinal deviation

– interventions:

  • chest tube in pleural space
  • thoracentesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is thoracentesis? What is a potental complication?

A

– thoracentesis: removal of fluid by suction using a large needle into intrapleural space

– potential complication = rebound pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 3 diseases that are classified as chronic air flow limitation diseases?

A
  1. asthma
  2. chronic bronchitis
  3. pulmonary emphysema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is COPD? What are some characteristic signs of COPD?

A

– chronic obstructive pulmonary disease: progressive disease that limits airflow due to abnormal inflammatory response to noxious particles

  • includes
    • emphysema – damaged alveoli – loss of tissue elasticity from hyperinflation of alveoli –> CO2 retention –> chronic acidic state
    • bronchitis – inflammation of cronchi –> stimulates production of mucous
  • tissue damage in COPD is irreversible and gradually increases in severity –> respiratory failure

– characterized by

  • bronchospasms
  • dyspnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are characteristic signs and symptoms of bronchitis vs. emphysema?

A

– bronchitis:

  • “blue bloaters” = cyanotic
  • overweight
  • elevated hemoglobin
  • peripheral edema
  • rhonchi
  • wheezing

– emphysema:

  • “pink puffers” = CO2 retention
  • thin
  • severe dyspnea
  • quiet chest
  • CXR shows hyperinflation with flattened diaphragm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is asthma? Which population experiences asthma most frequently?

A

– asthma: an intermittent, reversible airflow obstruction affecting only the bronchial airways – NOT the alveoli

– populations:

  • adults – more common in women
  • children – more common in boys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do the airways become obstructed in asthma?

A
  1. exposure to an irritant
  2. inflammation obstructs the lumen of the airway, causing swelling and mucous production
  3. airway hyperresponsiveness – constriction of the bronchial smooth muscle obstructs the airways
21
Q

Which antibody is involved in the inflammation associated with asthma? What chemicals become triggered by this antibody, causing inflammatory response?

A

– IgE

– chemicals triggered:

  • histamine – immediate inflammatory response
    • treat with Benadryl
  • leukotriene and eotaxin – slower, prolonged inflammatory response
    • treat with Singulair, Accolate, Zyflo
22
Q

What are some signs and symptoms of asthma?

A
  • audible wheeze
  • increased respiratory rate
  • increased cough
  • use of accessory muscles
  • barrel chest
  • long breathing cycle –> clipped speech
  • cyanosis
  • hypoexmia
23
Q

What are some diagnostic tests for asthma?

A
  • ABG
    • decreased O2 during asthma attack
  • CO2
    • decreased early in attack
    • increased later
  • eosinophil and IgE
    • increased in allergic asthma
  • sputum
    • may contain eosinophils and shed epithelial cells
  • pulmonary function test
    • 15 - 20% decrease from predicted may indicate asthma
    • 12% increase after bronchodilators indicates asthma
24
Q

What are the 3 measured components of pulmonary function tests?

A
  1. forced vital capacity (FVC): volume of air exhaled from full inhale to full exhale
  2. forced expiratory volume in first second (FEV1): volume of air blown out as hard and fast as possible during first second of most forceful inhale and exhale
  3. peak expiratory flow rate (PEFR): fastest airflow rate reached at any time during exhalation
25
Q

What are the 3 zones for peak flow meters?

A
  1. green zone: asthma is under good control; 80% of personal best
  2. yellow zone: caution; airway narrowing present; administer rescue medication
  3. red zone: medical alert; take rescue medication; seek medical attention
26
Q

What are some interventions for asthma?

A
  • peak flow meter used 2x/day
  • drugs
    • preventative – change airway responsiveness to prevent asthma attacks; used every day
    • rescue – stop an attack once started
  • exercise and activity – promotes ventilation and perfusion
  • oxygen therapy
    • heliox – mix of helium and oxygen
27
Q

What are the drugs used for asthma?

A
  • bronchodilators – increase bronchial muscle relaxation
    • short-acting beta 2 agonists – rapid, short-term relief
    • long-acting beta 2 agonists – taken over a period of time; long-term relief
  • anticholinergics – blocks PSNS to increase bronchodilation
  • methylxanthines – last resort
    • cardiac and CNS side effects
  • anti-inflammatories
    • corticosteroids
    • NSAIDs
    • leukotriene antagonists
28
Q

What is status asthmaticus?

A

severe, life-threatening, acute episode of airway obstruction; intensifies once it begins; does not often respond to common therapies

if not reversed, pneumothorax and cardiac or respiratory arrest could result

29
Q

What are some interventions for status asthmaticus?

A
  • IV fluids
  • systemic bronchodilator
  • steroids
  • epinephrine
  • oxygen
  • magnesium – helps relax skeletal muscles
30
Q

What are some risk factors of COPD?

A
  • cigarette smoking – biggest risk factor
  • alpha 1-antitrypsin (AAT) deficiency – enzyme made by the liver that is present in the lungs and regulate the breakdown of inhaled pollutants
  • air pollution
31
Q

What are some complications of COPD?

A
  • hypoexmia
  • acidosis
  • respiratory infection
  • cardiac failure – cor pulmonale (R side heart failure with enlargement of R ventricle)
  • cardiac dysrhythmias
32
Q

How do you determine smoking pack years?

A
  1. determine number of years smoked
  2. determine packs per day
  3. multiply values
33
Q

What are some diagnostic tests for COPD?

A
  • ABG
    • hypoxia
    • hypercarbia
  • sputum
  • CBC
  • H&H
  • electrolyte levels
  • AAT levels
  • CXR
  • pulmonary function tests
34
Q

What are some interventions for COPD?

A
  • airway management
    • breathing techniques
    • positioning
  • monitor respiratory changes Q2H
  • effective coughing
  • oxygen therapy
    • pts with chronic hypercarbia require lower levels = 1 - 2 L/min
  • drugs
    • inhaled corticosteroids
    • systemic
    • mucolytics
  • pulmonary rehab
    • exercise to improve respiratory strength and endurance
  • energy conservation
    • avoid activites that arms raised
    • pace activities
    • gradually increase activity
  • hydration – at least 2 - 3 L/day
    • beverages
    • humidifiers
  • nutrition
    • monitor prealbumin
    • prevent protein-calorie malnutrition
    • many small meals per day
  • manage anxiety
    • can worsen symptoms
  • manage risk for respiratory infection
    • avoid large crowds
    • flu and pneumonia vaccinations
  • surgery
    • lung transplant for end-stage pts
35
Q

What is cystic fibrosis? Which populations most commonly experience cystic fibrosis? How is it diagnosed?

A

– cystic fibrosis: error of chloride transport which produces a thick mucous with low water content; genetic disease that affects multiple organs and lethally impairs pulmonary function

  • mucous plugs up glands, causing atrophy and organ dysfunction
  • present from birth
  • damages lungs, pancreas, liver
  • caused usually by respiratory failure

– mostly whites are affected

– diagnosed by

  • sweat chloride analysis
    • normal = 35 mEq/L
    • CF = 60 - 200 mEq/L
  • genetic testing
  • pulmonary function test
  • may also see pancreatic problems, malnutrition, stunted growth, and cirrhosis
36
Q

What are some signs and symptoms of cystic fibrosis?

A
  • malnutrition
    • smaller
    • thinner
    • vitamin deficiency
  • abdominal distention
  • GERD
  • rectal prolapse
  • foul-smelling stools
  • steatorrhea
  • DM – due to pancreatic failure
  • respiratory infection – common
  • chest congestion
  • exercise intolerance
  • cough and sputum production
  • use of accessory muscles
37
Q

What are some diagnostic tests for cystic fibrosis?

A
  • pulmonary function tests
  • CXR
  • increased anteroposterior diameter
38
Q

What are some interventions for cystic fibrosis?

A

– mainly symptom management and weight management

  • nutrition
    • weight management – space out meals
    • vitamin supplement
    • DM management
    • pancreatic enzyme replacement
  • chest physiotherapy
  • exercise
  • avoid mechanical ventilation – difficult to wean pts off of this
  • supplemental oxygen
    • heliox
  • airway clearance techniques
  • drugs
    • antibiotics for chronic infections
  • avoid crowds to avoid infection
  • organ transplant – will not cure, but extends life 10 - 20 years
    • lung
    • pancreas
39
Q

What is pulmonary arterial hypertension (PAH)?

A

– pulmonary arterial hypertention (PAH): blood vessel constriction with increasing vascular resistance in lung; cor pulmonale

  • unknown cause – may be autoimmune
  • death could result in 2 years without treatment
40
Q

What are some interventions for PAH?

A
  • drugs
    • warfarin – prevents clot formation due to stagnant blood
      • aiming for INR = 1.5 - 2.0
    • calcium channel blockers – dilate pulmonary vessels to prevent clots
      • diltiazem (Cardizem)
      • nifedipine (Procardia)
    • endothelin receptor antagonists – promote BV relaxation, decrease pulmonary artery pressure
      • bosentan (Tracleer)
    • digoxin – antiarrhythmic
    • diuretics
  • oxygen therapy
41
Q

What is interstitial pulmonary disease?

A

– interstitial pulmonary disease: AKA fibrotic lung disease; restrictive disease where lung tissue thickens, reducing gas exchange because lungs cannot expand (stiff lungs)

  • affects
    • alveoli
    • BVs
    • surrounding lung tissue
  • slow onset
  • dyspnea is most common symptom
42
Q

What is sarcoidosis? Which population most commonly experiences sarcoidosis? What are some signs and symptoms? What is the main intervention?

A

– sarcoidosis: granulomatous disorder (growth of granulomas – lymphocytes, macrophages, epithelial cells, etc.) that most commonly affect the lungs

  • autoimmune
  • T lymphocytes damage lung tissue

– affects younger population most commonly

– s/s

  • cough
  • SOB
  • abnormal CXR

– main intervention = corticosteroids

43
Q

What is idiopathic pulmonary fibrosis? Which population most commonly experiences? What are some interventions?

A

– idiopathic pulmonary fibrosis: common restrictive lung disease with unknown etiology

  • extensive fibrosis and scarring as a result of excessive inflammation
  • poor prognosis – 5 years even with proper interventions and treatment

– population = older pts with hx of smoking or exposure to lung irritants

– interventions seek to reduce inflammation:

  • corticosteroids
  • immunosuppressants
44
Q

What is occupational pulmonary disease? How can it be prevented?

A

– occupational pulmonary disease: disease caused by exposure to occupational or environmental hazards

  • ranges from reversible effects to chronic lung disease
  • dependent on amount of exposure
  • worsened by cigarette smoke

– prevented via special respirators and adequate ventilation

45
Q

What is the main type of lung cancer?

A

bronchogenic carcinomas in bronchial epithelium

46
Q

What are some interventions for lung cancer?

A
  • chemotherapy
  • targeted therapy
    • targets specific phase of cancer cell division
  • radiation therapy
    • reduces size of tumor
  • photodynamic therapy
    • injected with an agent that sensitizes cancer cells to light
    • medications administered – leave normal cells more rapidly
    • laser treatment causes irreversible damage to cancer cells
  • lobectomy
  • pneumonectomy
    • removal of entire lung and severing bronchus
  • segmentectomy
    • removal of bronchus, pulmonary artery and vein, and tissues of involved segment of lung
  • wedge resection
    • removal of peripheral portion of lung
47
Q

What is a chest tube?

A

drain placed in the pleural space to restore intrapleural pressure, allowing the lung to expand again

48
Q

What are the 3 chambers of chest tubes?

A
  1. chamber 1 = collects fluid draining from pt
  2. chamber 2 = water seal that prevents air from entering pt’s pleural space
    • one-way valve allowing gas to escape but not to enter
  3. chamber 3 = suction control
    • gentle bubbling is normal
49
Q

What are some postop care interventions for thoracotomy?

A

– thoracotomy: incision into pleural space of chest cavity

– postop care:

  • pain management
    • PCAs
  • respiratory management
    • assess Q2H

NURS 322 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions