Respiratory Issues and Disorders Flashcards
What is obstructive lung disease?
decreased air flow
increased lung volumes or normal
trouble exhaling–so results in air trapping
What are examples of obstructive lung disease?
asthma, chronic bronchiolitis, cystic fibrosis
What is restrictive lung disease?
decreased lung volumes
decreased expiatory flow rates
inhalation problem
What is an example of restrictive lung disease?
pneumonia
Explain egophony in relation to respiratory assessment
when asking patient to say E sound–it instead comes out like an A sound with auscultating, indicating consolidation
What age group can pulmonary function tests start being used?
if greater than 8 years old of age and cooperative
What is bronchiolitis?
a disease of the lower respiratory tract that causes inflammation leading to obstruction in the small airways
typically seen in children less than 3–this is a viral illness with RSV typically being responsible (50% of cases)
What are s/sx of bronchiolitis?
URI symptoms
moderate fever (102)
gradual dev of resp distress:
tachypnea
non-productive cough
paroxysmal wheezing (sudden)
progressive stridor
restlessness, changes in mental status
cyanosis
palpable liver and spleen--pushed down due to hyper inflated lungsWhat would a chest x-ray show in someone with bronchiolitis?
hyper inflated lungs
scattered areas of consolidation
What is the qualifications to receive synagis?
less than 2 years of age with chronic lung disease treated within 6 months of RSV season premature infant (
How often is synagis given?
IM every month during RSV season
What is the pathophysiology of asthma?
hypertrophy of smooth muscle
mucosal edema and hyperemia
hypertrophy of mucus glands
acute inflammation and plugging of airways by thick, viscid mucus
**thickening of epithelial basement membrane–remodeling
Signs and symptoms of asthma?
respiratory distress difficulty speaking in sentences diaphoresis use of accessory muscles hyperresonance cough chest tightness
Ominous signs of asthma?
absent breath sounds
pulsus paradoxus (>10 mm Hg change in systolic BP amplitude between inspiration and expiration)
inability to ly down
cyanosis
What would a CBC show in someone with asthma?
slight white blood cell elevation with eosinophilia
Hospitalization is recommended when peak flow is ____.
les than 60 L/min
What classifies intermittent asthma?
symptoms = 2 days/week nighttime awakenings =2 times/month rescue inhaler usage = to 2 days/week does not interfere with normal activity lung function FEV1 >80% predicted and normal between exacerbations
What classifies mild persistent asthma?
symptoms >2 days/week nighttime awakenings 3-4 times/month rescue inhaler usage > 2 days/week, but not daily minor interference with normal activity lung function FEV1 >80% predicted
What classifies moderate persistent asthma?
symptoms DAILY nighttime awakenings more than 1/week, but not daily rescue inhaler usage daily some limitation with normal activity lung function FEV1 60-80% predicted
What classifies severe persistent asthma?
symptoms throughout the day nighttime awakenings= nightly rescue inhaler usage several times per day extremely limited normal activity lung function FEV1
What does FEV1 mean?
forced expiratory volume in the 1st second–if too low, then not enough elasticity in alveoli ex) blowing out a candle
What is a preferred treatment for someone with persistent asthma?
adding daily inhaled corticosteroids
Describe the monitoring of someone with asthma
Do more frequent monitoring with someone who does not have their asthma controlled:
initially every 2-4 weeks until control is achieved
if uncontrolled, escalate treatment steps and follow up at
least every 2 weeks
If continued control for 3 months, then do step down
therapy
What is the recommended therapy for someone with intermittent asthma?
short acting beta agonist to use PRN such as albuterol
What is the recommended therapy for someone with mild persistent asthma?
short acting beta agonist to use PRN, plus low dose inhaled corticosteroid
What is the recommended therapy for someone with moderate or severe persistent asthma?
**Refer those ages 0-4 years old
**Look up PDF.
What is the pneumonia etiology of a newborn?
group b strep, chlamydia, e. coli
What is the pneumonia etiology an infant/ young children
RSV, H. flu, strep pneumoniae–community acquired pneumonia
What is the pneumonia etiology of preschool through young adulthood?
strep pneumoniae, myco, chlamydia
What are signs and symptoms of pneumonia?
fever, shaking chills, purulent sputum, lung consolidation on physical exam, malaise, pulse oximetry will not decrease oxygenation in severe distress
What bacterial pneumonias have lobar consolidation?
h. influenzae
s. pnumoniae
klebsiella
**affects only 1 lobe usually
What bacterial pneumonias have patchy infiltrates?
e. coli (plus, pleural effusion)
staphylococcus
pseudomonas
**patchy, so throughout lung fields
What are the radiograph characteristics of pneumocystis?
diffuse interstitial, alveolar, apical or upper lob infiltrates
What is the pharmacologic therapy for s. pneumonias?
penicillin
What is the pharmacologic therapy for M. catarrhalis?
macrolides, such as azithromycin (zithromax)
What is the pharmacologic therapy for h. influenzae?
amoxicillin or cephalosporin
What is cystic fibrosis?
autosomal recessive disorder which produces a defect in epithelial chloride transport resulting in dehydrated, thick secretions. It affects respiratory, GI, hepatobiliary, and reproductive tracts (so it affects all the wet stuff), It is characterized by recurrent bronchial infections, obstructive pulmonary disease, and pancreatic insufficiency with intestinal malabsorption
What are signs and symptoms of cystic fibrosis?
viscid meconium in newborn recurrent respiratory infection large, liquid, bulky, voul stool salty skin chronic cough, rhinorrhea hepatosplenomegaly fat-soluble vitamin deficiencies failure to thrive delayed puberty infertility
What are laboratory/diagnostic tests for cystic fibrosis?
sweat chloride test (pilocarpine iontophoresis test)
pulm function tests
hyponatremia, hypocholremic dehydration (alkalosis)
chest radiograph: cystic lesions, atelectasis
