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Acute Test #2 > Respiratory Illness > Flashcards

Respiratory Illness Flashcards

1
Q

causes of COPD

A
  • smoking
  • pollution
  • genetics
  • significant respiratory illness (scar tissue)
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2
Q

COPD

A
  • can’t exhale from loss of elastic recoil
  • can’t inhale from mucous hyper-secretion, mucosal edema, and bronchospasm
  • hypoxia and hypercapnia
  • CO2 retainers
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3
Q

COPD pathophysiology (10)

A
  • mucous hyper-secretion
  • cilia dysfuncton
  • airflow limitation
  • hyperinflation of lungs
  • alveolar destruction
  • loss of elastic recoil
  • gas exchange abnormalities
  • pulmonary HTN
  • cor pulmonale
  • systemic effects
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4
Q

pulmonary HTN

A
  • increased pressure from heart to lungs

- leads to cor pulmonale (hypertrophy or RV)

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5
Q

systemic effects of COPD

A
  • skeletal dysfuntion
  • weight loss
  • nutritional abnormalities
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6
Q

treatment for COPD (7)

A
  • smoking cessation
  • medications
  • immunizations (pneumovax)
  • pulmonary rehab
  • hydration
  • nutritional support
  • O2 support
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7
Q

nutritional support for COPD

A
  • high cal + high protein foods

- small/more frequent meals

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8
Q

dangers of O2 for COPD

A
  • CO2 retainers

- O2 can decrease respirations

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9
Q

medications for COPD

A
  • bronchodilators
  • coticosteroids (rinse mouth)
  • anticholinergics (salbutamol, ipotropium)
  • prophylactic antibiotics (doxycycline)
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10
Q

salbutamol

A

increases HR

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11
Q

why to avoid beta blockers for COPD

A
  • puts at risk for bronchospasm (propranolol)

- metoprolol and atenolol are ok because they are cardiac specific

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12
Q

asthma

A
  • hyperresponsivesness of airways

- inflammation, bronchospasm, wheezing

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13
Q

asthma triggers

A
  • allergens
  • exercise
  • cold weather
  • medications (NSAID, acetylsylic acid)
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14
Q

asthmas vs COPD

A
  • onset <40 yrs
  • more trigger related
  • spirometry will normalize
  • stable with some exacerbations
  • not caused by smoking
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15
Q

asthma menifestations (8)

A
  • bronchospasm
  • vascular congestion
  • edema formation
  • mucous secretion
  • impaired microciliary function
  • thickening of airway walls
  • bronchial hyper-responsiveness
  • airway obstruction/remodelling
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16
Q

medications for asthma

A
  • quick relief SABA
  • acute intervention - corticosteroids, anticholinergics
  • daily control - LABA, inhaled corticosteroids, mast cell inhibitors, leukotriene receptor antagonists
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17
Q

ER presentation with acute asthma episode

A
  • Ventolin
  • best through puffer
  • 4-8 puffs q15-20 mins x3
  • if severe 1 puff q30-60 secs max 20 puffs
  • ipotropium used to open airways, lasts longer than salbutamol
  • steroids to decrease inflammation
  • O2 support
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18
Q

puffer vs aerosol

A
  • puffer works faster and more cost effective

- puffer increases HR

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19
Q

prednisone in acute ER presentation of asthma

A
  • to decrease inflammation
  • tastes really bad
  • 1mg/kg for peds
  • methoprednisone IV
20
Q

peak flow expiratory flow meter

A
  • tells strength of exhale
  • deep breath and hard/fast exhale for 1-2 secs
  • highest of 3 tries
  • peak flow may change before symptoms so can catch early
21
Q

peak flow meter numbers

A
  • 80-100% = good control
  • 50-80% = caution asthma is worsening, additional meds
  • <50% = danger, rescue medication, potential for ER
22
Q

types of pneumonia

A
  • community acquired (most common)
  • hospital acquired
  • aspiration pneumonia
  • fungal pneumonia
  • opportunistic pneumonia
23
Q

diagnosis of pneumonia

A
  • Hx and physical
  • CXR
  • sputum for C&S
  • O2 sats
  • blood gases
  • CBC - leukocytes
24
Q

presentation of pneumonia

A
  • SOB
  • cough w or w/out exudate
  • fever
  • congestion in lungs
  • coarse lung sounds (generally one are)
  • dull on percussion
  • consolidation on CXR
25
Q

treatment of pneumonia

A
  • appropriate antibiotics
  • increase fluid intake
  • antipyretics
  • analgesics
  • O2 therapy
26
Q

complications of pneumonia (9)

A
  • pleurisy
  • pleural effusion
  • atelectasis (collapse)
  • lung abscess (in lung)
  • empyema
  • pericarditis
  • bacteremia (in blood)
  • endocarditis
  • meningitis
27
Q

pleurisy

A
  • inflammation of lining of lung
28
Q

pleural effusion

A
  • fluid in pleural space
29
Q

empyema

A
  • pockets of pus in pleural space
  • big consolidation
  • treated with chest tube with TPA to break up pus and drain
30
Q

pediatric differences in upper airway

A
  • <3 months are nose breathers
  • large tongue
  • trachea narrower
  • airway resistance greater
31
Q

paediatric differences in lower airway

A
  • alveoli fewer in # at birth

- weaker intercostal muscles

32
Q

retraction

A

in peds when you can see skin pulling in at ribs

33
Q

paediatric vs adult airway diameter

A
  • adult = 20mm; 1mm swelling = 18mm

- peds = 4mm; 1mm swelling = 2mm

34
Q

peds respiratory assessment

A
  • HR, resp rate, O2 sats
  • position of comfort
  • behaviour (best indicator)
  • skin/mucous membrane colour
  • Work of breathing (retraction, abd muscles, shoulders rising, head bobbing, grunting)
  • chest auscultation
  • signs of dehydration
  • family/caregiver coping
35
Q

locations of retraction

A
  • suprasternal
  • supraclavicular
  • intercostal
  • substernal
  • subcostal
  • tracheal tug
36
Q

normal respiratory rate per age group

A
  • newborn = 30-55
  • 1yr = 25-40
  • 3yrs = 20-30
  • 6-10 = 16-22
  • 17+ = 12-20
37
Q

normal HR per age group

A
  • newborn = 100-170
  • infant-2yrs = 80-130
  • 2-6yrs = 70-120
  • 6+ = 60-110
38
Q

bronchiolitis

A
  • inflammation of bronchioles
  • <2yrs
  • starts upper then moves lower
  • wheezing, fever, cough, resp distress, retraction
  • preceded by 1-3 days runny nose (causes most problems)
  • can decomponsate quickly
39
Q

treatment for bronchiolitis

A
  • hydration
  • ins/out (wet diapers, time breastfeeding)
  • saline drops/suction of nose
  • sometimes salbutamol or sale aerosol
40
Q

respiratory syncytial virus (RSV)

A
  • most common cause of bronchiolitis
  • breakdown of cell wall in airway causing clumps = blockage
  • contagious
  • nasopharyngeal aspirate to diagnose
  • can get second time
41
Q

treatment of RSV

A
  • same as bronchiolitis

- hydration, O2, respiratory

42
Q

Croup

A
  • inflammation of vocal cords
  • symptoms, not a virus
  • Barky cough
  • cold air/humidity can help decrease inflammation
  • dexamethasone, aerosolized epinepherine
  • not admitted
  • up to date croup scores
43
Q

signs of respiratory failure in children - initial respiratory failure

A
  • restlessness, tachycardia, dyspnea, tachypnea

- monitor frequently, sats

44
Q

signs of respiratory failure in children - early de compensation

A
  • nasal flaring, retraction, grunting

- respiratory & doc, 100% O2 mask available

45
Q

signs of respiratory failure in children - severe hypoxia/airway arrest

A
  • cyanotic, SOB, HR slows, cant breath deep enough for audible wheezes, stupor, diaphoretic
  • prepare for intubation

Acute Test #2 (4 decks)

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