Respiratory Disorders Flashcards
What is Pneumonia?
A Bacterial or Viral Lung Infection
What’s the cause for Pneumonia?
Typical Organisms or Atypical Organisms
What groups are at risk for Pneumonia?
Elderly + Chronic Lung Disease + The Immunocompromised
How are the pathogens for Pneumonia transmitted?
Via Droplet or Aerosol
What does Consolidation mean?
It’s when the air in the lungs is replaced with a Solid, Fluid, or Other Substance (Pus/Blood/Cells)
What is it called whenever Consolidation involves the entire lobe of a lung?
Lobar Pneumonia
What is it called when inflammation in the lungs is settled around the Bronchi and isn’t localized to any one lobe of the lung?
Bronchopneumonia
What’s the most common bacterial cause of Pneumonia? What is this also called?
S. pnuemoniae (Typical Pneumonia)
What does Aspiration Pneumonia result from?
Inhalation of Gastric or Oropharyngeal Fluid in the Lower Airways (Which may contain bacteria)
What is Chemical Pneumonitis a result of?
Aspiration of Gastric Fluid that causes an Inflammatory Reaction in the Lower Airways
What Respiratory Viruses may cause Pneumonia?
Influenza A and B + SARS-CoV-2 + Rhinoviruses + Parainfluenza Viruses + Adenoviruses + RSV
What Chronic Lung Diseases may cause Pneumonia?
COPD + Cystic Fibrosis
Heart Disease and Lung Cancer both increase the risk for -
Pneumonia
It’s estimated that what percentage of pt’s with Community Acquired Pneumonia (CAP) will experience a new episode of CAP within the same year and require hospitalization?
9%
What’s the mortality rate for CAP during hospitalization?
6.5%
Does Pneumonia get caused by an Exacerbation of other Comorbitities?
Yes
What tissues are important for resisting any infection?
The tissues of Extrapulmonary Organs (Like the Liver or Bone Marrow)
Is the diagnosis and management of Pneumonia the same in the elderly as it is in normal pt’s?
Yes
What are the manifestations of Pneumonia?
Cough + Dyspnea + Pleuritic Chest Pain + Adventitious Lung Sounds (Rales + Crackles + Ronchi)
Fever + Chills + Malaise + Headache + Loss of Appetite + Myalgia
Cough (Productive or Non-Productive) + Tachypnea + Labored Breathing
Tactile Fremitus + Dull-Sounding Percussion of the Lungs
What is the gold standard for diagnosis Pneumonia?
Chest X-Ray
When should a CT Scan of the chest be used to diagnose Pneumonia?
When the results of the Chest-X Ray look normal, but other indications of Pneumonia still remain
What is Malaise?
A general feeling of unwellness
What is Myalgia?
Muscle Pain / Discomfort (Can affect Muscles, Ligaments, Tendons, and Fascia)
What is Tactile Fremitus?
A Vibration felt in the chest wall when a pt speaks or sings
What is Pleuritic Chest Pain?
Chest pain that worsens when Inhaling or Exhaling
What’s important to keep in mind about a pt with Pnuemonia?
They may present with Anxiety
What are some Environmental Irritants of Pneumonia?
Smoke or Gases
What things especially need to be assessed for a pt with Pneumonia?
Assess for Airflow Obstruction + Manifestations History + Exposure to Risk Factors
What should treatment of Pneumonia be targeted towards?
Focus on effective management of Pneumonia with Encouragement to Mobilize + Adhere to treatment therapies
Immobilization puts a pt at more risk for Pneumonia.
True or false?
True
What things can Pneumonia develop into?
Hypoxia + Sepsis
What’s Sepsis?
Bacteria in the Bloodstream
When caring for a pt with Pneumonia, what interventions are needed?
Change positions frequently + Administer Oxygen to minimize Dry Secretions + Encourage Fluid Intake + Elevate HOB
Why should a pt be encouraged to increase their fluid intake if they have Pneumonia?
To offset fluid loss due to increased workload from Breathing + Fever
Should an Incentive Spirometer be used for a pt with Pneumonia?
Nah
For how long should you monitor a pt’s manifestations after starting Antibiotic Use?
24-48 Hrs
Can Blood Cultures or I&O be used to determine if a pt with Pneumonia is improving?
Yes
What lab tests can be used to diagnose Pneumonia?
C-reactive Protein (CRP) + Erythrocyte Sedimentation Rate (ESR) + Procalcitionin.
(The above labs should all be high if they have Pneumonia, they all indicate Inflammation).
Blood Culture + Routine Blood Counts + Sputum Culture + Lymphocyte Count.
A Chemistry Panel (To assess Hydration Status).
Prior to the administration of Antibiotics, what labs need to be obtained?
Blood Cultures
You have a pt who you suspect to have Pneumonia, they also have HIV. On top of the labs of what you’d normally obtain for a pt with Pneumonia, what other labs do you need to obtain because of their HIV?
CD4 Levels
What is Pulmonary Edema?
A life-threatening buildup of fluid in the lungs
What are the causes of Pulmonary Edema?
Systolic or Diastolic Dysfunction + Renovascular Hypertension.
Congestive Heart Failure / Left Ventricular Failure.
Possible Exacerbation of Chronic Heart Failure.
Can occur after an MI.
What is Renovascular Hypertension?
HTN that occurs because the Kidney’s aren’t getting enough Blood Flow
If a pt has Pulmonary Edema, where specifically are they going to have fluid buildup in their lungs?
In the Interstitial Spaces + Alveoli
What does an increase in fluid in the Pulmonary Interstitial and Alveolar Spaces cause to occur? Why?
Cardiogenic Pulmonary Edema
Because of a rapid and acute increase in Left Atrial Filling Pressure (Caused by an elevated Left Ventricular Filling Pressure)
What does Noncardiogenic Pulmonary Edema occur due to?
An increase in the Permeability of Pulmonary Endothelium
What is Noncardiogenic Pulmonary Edema associated with?
Diffuse filling of the Alveolar Spaces in the absence of elevated Pulmonary Capillary Wedge Pressure
What Disorders can leave a pt more at risk for Pulmonary Edema?
Chronic Disorders (like Myocardial Ischemia) + Acute Disorders (like Acute Hypertensive Crisis)
Renovascular Disease
How can Renovascular Diseases cause Pulmonary Edema?
Renal Artery Stenosis (Narrowing of one or more arteries to the Kidneys, causing a lack of blood flow to the kidneys, which causes Renovascular HTN)
What is the survival rate for Pulmonary Edema?
It has a 1 Year survival rate of 50% (The mortality rate of pt’s with Pulmonary Edema and Congestive Heart Failure is much higher)
Between Males and Females, which is typically more affected by Pulmonary Edema?
Males
Are the Elderly more at risk of Pulmonary Edema?
Yes
What comorbidities often occur with Cardiogenic Pulmonary Edema and Noncardiogenic Pulmonary Edema?
Cardiogenic Pulmonary Edema:
Preexisting Heart Disease + Acute MI
Noncardiogenic Pulmonary Edema:
Complications of preexisting conditions that can be Systemic or Pulmonary (like Pneumonia, Trauma, and Sepsis).
Most pt’s with Noncardiogenic Pulmonary Edema will display symptoms of Acute Respiratory Distress Syndrome (ARDS).
What electrolyte should be avoided if you have heart disease?
Sodium
Aging is associated with a higher sensitivity to-
Adverse reactions to meds
What are the manifestations of Pulmonary Edema?
SOB + Anxiety + Confusion + Agitation + Hypotension + HTN + JVD
Hypoxia + Tachypnea + Respiratory Distress + Diaphoresis
Cyanosis of Lips + Cold Extremities
Pedal Edema
Cough with Blood Tinged Frothy Sputum (Pink Sputum)
What symptoms of Pulmonary Edema are indicative of Severe Left Ventricular Systolic Dysfunction or Cardiogenic Shock?
Hypotension
What symptom of Pulmonary Edema is usually present with pt’s who have chronic heart failure?
Pedal Edema
In order to diagnose Pulmonary Edema, what needs to be ruled out first?
Anemia, Sepsis, Electrolyte Imbalance
What things need assessed to diagnose Pulmonary Edema?
Chest X-Ray, Pulse Oximetry, ABG’s
A pt with Pulmonary Edema may be experiencing-
Multiorgan Involvement (Depending on Comorbidities)
Are cardiac conditions one of the main reasons for Pulmonary Edema?
Yes
Pt’s with Pulmonary Edema should have discharge teaching involving Blood Pressure and Glycemic Control.
True or false?
True
Is Rhinitis a Viral or Allergic disease?
Both
What is Rhinitis?
A Runny Nose
What is Nasal Drainage called?
Rhinorrhea
What is a common viral cause of Rhinitis?
Common Cold
What are the manifestations of Rhinitis that only appear if Viral?
Low Grade Fever & Cough
What are the manifestations of Rhinitis that can appear if non-viral?
Itchy Nose, Ears, etc. + Watery Eyes
How should Rhinitis be treated?
Saline Nasal Spray (Antihistamine Nasal Sprays), Warm Shower, Home Humidifier, Increased Fluid Intake
Tyelenol / Motrin are good if Viral
Is Saline Nasal Spray an OTC med?
Yes
What is Sinusitis?
A Sinus Infection
How is Sinusitis diagnosed?
A CT Scan
Is Facial Pain symptom of Sinusitis?
Yes
What can be caused by Sinusitis?
Cyst Formation
How should Sinusitis be treated?
Blow nose when possible + Use a Humidifier + Avoid Swimming.
May need Broad Spectrum Antibiotics, NSAID’s, etc.
What is the other name for Influenza?
Swine Flu
How is Influenza diagnosed?
Flu Test
What precautions should a pt with Influenza be put on?
Droplet Precautions
Do Antivirals (Such as Antiflu) treat or cure the flu?
Antivirals only treat the flu, they don’t cure it
Is the Flu Shot always a gamble in terms of if it will actually work or not?
Yes
What allergies make a patient contraindicated for the Flu Vaccine?
Allergic to Eggs
What is important to keep in mind about Antihistamine Nasal Sprays?
They may cause Rebound Congestion or Addiction
What precautions should a pt be put on if they have Pneumonia?
Droplet and Contact