Respiratory In Class Flashcards
what is atelectasis and what are the causes, how do we prevent it?
collapse of the alveoli
caused by obstructions in the small airways like with secretions
-common post-op (especially abdominal or thoracic pts b/c of the pain of deep breathing)
*** splint cough, incentive spirometer, pain meds
what is pneumonia
acute inflammation of the alveoli/lungs, through the inflammatory response fluid leaks from the capillaries into the alveoli
-most commonly caused by infection, but not always
Risk Factors: depressed cough reflex, intubation, viral URI, air pollution
COPD exacerbation often leads to pneumonia
prevention of pneumonia
-get the flu and pneumococcal vaccines
especially those with chronic illness, in a long term care facility, 65 years of older
-avoid cigarette smoke
-encourage ambulation
-careful about aspirating
S/S of penumonia
productive cough
yellow green or bloody tinged sputum
SOB
snap crackle pops sounds over the alveoli
restlessness and confusion from the hypoxemia
high RR, and high HR
how are we going to take care of the patient with penumonia
broncho dilator inhaler or nebulizer, antibiotic therapy , expectorant, antipyretics, analgesics , oxygen as needed
what diagnostic tests
sputum culture, CBC, chest xray, c-reactive protein , BNP, electrolytes,
how is TB spread?
through airborne droplets
in a healthy immune system, your immune system will surround it into a granuloma, this is called latent TB
what is a primary tuberculosis infection
the bacilli are not contained, they multiply and spread
Primary progressive TB infection symptoms
weight loss, fatigue, night sweats
progresses to crackles, dyspnea, orthopnea (SOB when laying down), productive cough with rusty colored sputum
taking care of someone with active TB
PIER
pyrazinamide
isoniazid
ethambutol
rifampin
*drugs are highly hepatotoxic
for which patients do we do airborne precautions?
TB, measles, influenza, SARS
clinical manifestations of lung cancer
-often silent
-latent manifestations are fatigue weight loss, nausea and vomiting
-then frequently presents as pneumonia but does not respond to treatment (and xray would look different)
paraneoplastic syndrome
often associated with small cell
the cancer cells are secreting hormones, cytokines, and enzymes,
manifestations can include hypercalcemia, SIADH, adrenal hypersecretion, polycythemia
knowing that someone will have contrast media, what are some nursing actions that need to happen?
check kidney function (asses BUN and creatinine)
-stop metformin 48 hours (this is a concern b/c of lactic acidosis)
- contrast media is really hard on the kidneys
-check allergies to shellfish or iodine
nursing management of pulmonary hypertension
-happens when the pulmonary artery pressure is elevated due to an increase in resistance to blood flow (can be from COPD or left sided heart failure)
-give meds that vasodilate the pulmonary blood vessels
*vasodilators like Epoprostrenol
*PDE5 Inhibitors like Sildenafil,
*Calcium Channel blockers like Nifedipine,
* Loop Diuretics like Furosemide
what is a pulmonary angiography
we are looking at the vessels in the pulmonary vasculature with contrast media
how do we diagnose pulmonary artery hypertension
with a right-sided cardiac catheterization (this will measure cardiac output, pressure, pulmonary vascular resistance )
nursing management of asthma
2 drugs to treat: broncho-constriction and inflammation
*Beta 2 adrenergic agonists like methylxanthines and anticholinergics
*anti inflammatory agents like glucocorticoids, leukotriene modifier, mast cell stabilizers (cromolyn)
what is a complication of asthma
Status Asthmaticus
-resistant to the usual treatment
-pt will speak in words not sentences & be extremely anxious
-may result in pneumothorax, respiratory arrest
TREATMENT: IV aminophyllin, IV corticosteroids like Methylpredinosolone, subcutaneous epinephrine
risk factor for developing COPD that is not their fault
-heredity (A1-Antitrypsin Deficiency)
-leads to destruction of the alveoli
COPD acid base inbalance
respiratory acidosis
drug therapy for COPD
bronchodilators (SABA and LABA) , inhaled corticosteroid therapy , antibiotics as needed
weight loss and emphysema
pressure on diaphragm from full stomach causes dyspena
encourage small, frequent meals
drive to breath for emphysema people
hypoxemia
COPD complications
pulmonary hypertension, cor pulmonale, acute respiratory failure, depression/anxiety
T/F:
emphysema is a progressive disorder
weight loss and malnutrition are common with emphysema
pts with emphysema need high levels of supplementary oxygen 24/7
respiratory alkalosis is the expected acid-base imbalance
-purse-lipped breathing should be encouraged
T, T, F, F, T
what is a cbc result you might see for the pt with emphysema
RBC high, HGB high, HCT high
this is normal because they are overproducing in order to compensate for the lower perfusion
nursing care for someone with emphysema entering the ED
high fowlers, give her oxygen, she needs an IV for in case she crashes on us
lab tests: CBC, ABG, BNP, chest xray (to help check for pneumonia) , ECG
medications: albuterol beta 2 agonist , IV Methylprednisolone
