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PNCB2 > Respiratory Issues and Disorders > Flashcards

Respiratory Issues and Disorders Flashcards

1
Q

What is obstructive lung disease?

A

decreased air flow
increased lung volumes or normal
trouble exhaling–so results in air trapping

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2
Q

What are examples of obstructive lung disease?

A

asthma, chronic bronchiolitis, cystic fibrosis

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3
Q

What is restrictive lung disease?

A

decreased lung volumes
decreased expiatory flow rates
inhalation problem

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4
Q

What is an example of restrictive lung disease?

A

pneumonia

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5
Q

Explain egophony in relation to respiratory assessment

A

when asking patient to say E sound–it instead comes out like an A sound with auscultating, indicating consolidation

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6
Q

What age group can pulmonary function tests start being used?

A

if greater than 8 years old of age and cooperative

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7
Q

What is bronchiolitis?

A

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)

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8
Q

What are s/sx of bronchiolitis?

A 
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 lungs
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9
Q

What would a chest x-ray show in someone with bronchiolitis?

A

hyper inflated lungs

scattered areas of consolidation

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10
Q

What is the qualifications to receive synagis?

A 
less than 2 years of age with chronic lung disease treated within 6 months of RSV season
premature infant (
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11
Q

How often is synagis given?

A

IM every month during RSV season

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12
Q

What is the pathophysiology of asthma?

A

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

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13
Q

Signs and symptoms of asthma?

A 
respiratory distress
difficulty speaking in sentences
diaphoresis
use of accessory muscles
hyperresonance
cough 
chest tightness
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14
Q

Ominous signs of asthma?

A

absent breath sounds
pulsus paradoxus (>10 mm Hg change in systolic BP amplitude between inspiration and expiration)
inability to ly down
cyanosis

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15
Q

What would a CBC show in someone with asthma?

A

slight white blood cell elevation with eosinophilia

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16
Q

Hospitalization is recommended when peak flow is ____.

A

les than 60 L/min

17
Q

What classifies intermittent asthma?

A 
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
18
Q

What classifies mild persistent asthma?

A 
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
19
Q

What classifies moderate persistent asthma?

A 
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
20
Q

What classifies severe persistent asthma?

A 
symptoms throughout the day 
nighttime awakenings= nightly 
rescue inhaler usage several times per day 
extremely limited normal activity 
lung function FEV1
21
Q

What does FEV1 mean?

A

forced expiratory volume in the 1st second–if too low, then not enough elasticity in alveoli ex) blowing out a candle

22
Q

What is a preferred treatment for someone with persistent asthma?

A

adding daily inhaled corticosteroids

23
Q

Describe the monitoring of someone with asthma

A

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

24
Q

What is the recommended therapy for someone with intermittent asthma?

A

short acting beta agonist to use PRN such as albuterol

25
Q

What is the recommended therapy for someone with mild persistent asthma?

A

short acting beta agonist to use PRN, plus low dose inhaled corticosteroid

26
Q

What is the recommended therapy for someone with moderate or severe persistent asthma?

A

**Refer those ages 0-4 years old

**Look up PDF.

27
Q

What is the pneumonia etiology of a newborn?

A

group b strep, chlamydia, e. coli

28
Q

What is the pneumonia etiology an infant/ young children

A

RSV, H. flu, strep pneumoniae–community acquired pneumonia

29
Q

What is the pneumonia etiology of preschool through young adulthood?

A

strep pneumoniae, myco, chlamydia

30
Q

What are signs and symptoms of pneumonia?

A

fever, shaking chills, purulent sputum, lung consolidation on physical exam, malaise, pulse oximetry will not decrease oxygenation in severe distress

31
Q

What bacterial pneumonias have lobar consolidation?

A

h. influenzae
s. pnumoniae
klebsiella
**affects only 1 lobe usually

32
Q

What bacterial pneumonias have patchy infiltrates?

A

e. coli (plus, pleural effusion)
staphylococcus
pseudomonas
**patchy, so throughout lung fields

33
Q

What are the radiograph characteristics of pneumocystis?

A

diffuse interstitial, alveolar, apical or upper lob infiltrates

34
Q

What is the pharmacologic therapy for s. pneumonias?

A

penicillin

35
Q

What is the pharmacologic therapy for M. catarrhalis?

A

macrolides, such as azithromycin (zithromax)

36
Q

What is the pharmacologic therapy for h. influenzae?

A

amoxicillin or cephalosporin

37
Q

What is cystic fibrosis?

A

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

38
Q

What are signs and symptoms of cystic fibrosis?

A 
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
39
Q

What are laboratory/diagnostic tests for cystic fibrosis?

A

sweat chloride test (pilocarpine iontophoresis test)
pulm function tests
hyponatremia, hypocholremic dehydration (alkalosis)
chest radiograph: cystic lesions, atelectasis

PNCB2 (18 decks)

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