Respiratory Pathology Flashcards
ARDS fatality
Fatal in 25-40% of people who develop it
Survivors of ARDS may not regain full lung function for how long?
A year or greater
Mechanical cause of ARDS
Fluid leaks from the smallest blood vessels in the lungs into the alveoli
*normally a protective membrane keeps fluid in the vessels, but INFLAMMATION undermines the membrane’s integrity
Conditions that can damage the lungs and lead to inflammation and ARDS
- severe pneumonia
- sepsis
- heart failure
- multiple/massive blood transfusions
- serious head/chest injury
- fat embolism (long bone fx)
- prolonged use of large volumes of supplemental O2
- accidental inhalation of vomit or chemicals
- smoke inhalation
- near drowning
- adverse rxn to cancer drugs or other meds
- drug OD (commonly heroin)
- shock from any cause
s/s of ARDS
- severe SOB
- labored and unusually rapid breathing
- hypotension
- confusion
- extreme fatigue
- cough
- fever
Asthma etiology
- respiratory infections
- allergens
- cold air exposure (or sudden temp change)
- cigarette smoke
Severe asthma attack sx
- dyspnea
- nostril flaring
- diminished wheezing
- anxiety
- cyanosis
- inability to speak
Can result in respiratory failure
Two classes of meds used to treat asthma
- anti-inflammatory agents
- bronchodilators
Asthma: anti-inflammatory agents
- interrupt bronchial inflammation
- PREVENTATIVE
Asthma: bronchodilators
dilate the airways by relaxing bronchial smooth muscle
Etiology of atelectasis
Conditions and factors that prevent deep breathing and coughing
Think post op pain, pleural effusion, asthma, COPD, CF
Atelectasis: large area affected
S/s
- cyanosis
- SOB
- increased breathing rate
- increased HR
What devices may be used to treat atelectasis?
- positive end-expiratory pressure device (PEEP)
- continuous positive airway pressure device
PT treatments for atelectasis
- deep breathing
- position changes
- airway clearance techniques
What causes bronchiectasis?
Bronchial walls weaken over time due to infection and allow for permanent dilation of bronchi and bronchioles
Bronchiectasis s/s
- consistent productive cough
- hemoptysis
- weight loss
- anemia
- crackles
- wheezes
- loud breath sounds
Meds for bronchiectasis
Antibiotics
Bronchodilators
Expectorants
Mucolytics
Primary cause of chronic bronchitis
Cigarette smoke
People with bronchitis compensate by
Use of accessory muscles while breathing
Progression of COPD includes
alveolar destruction and subsequent air trapping
COPD: characteristics of total lung capacity and residual volume
- Increased total lung capacity
- SIGNIFICANT INCREASE in residual volume
S/s of COPD
- excessive mucus production
- chronic productive cough
- wheezing
- SOB
- fatigue
- reduced exercise capacity
CF is an (genetic type) of disease
Autosomal recessive
CF: mutation of the gene causes
Body produces unusually thick, sticky mucus that leads to life-threatening lung infections, obstructs the pancreas, and inhibits normal digestion and food absorption
Characteristic s/s of CF
- salty tasting skin
- persistent/productive cough
- frequent lung infections
- wheezing/SOB
- poor growth/weight gain in spite of good appetite
- frequent greasy, bulky stools
Emphysema: deflation of alveoli
Alveoli are permanently deflated and dead space increases in the lungs
Emphysema s/s
- SOB
- wheezing
- chronic coughing
- orthopnea
- BARREL CHEST
- increased use of accessory muscles
- fatigue
Etc.
Pleural effusion: excess fluid can cause
Can push the pleura agains the lung, making it hard to breath and can cause atelectasis in some cases
Pleuritis is caused by
Viral infection
Pneumonia
PE
Autoimmune diseases
Pleuritis s/s
- SOB
- dry cough, fever, chills (if fluid becomes infected)
Large pleural effusion may need this for treatment
Chest tube to drain fluid
Cause of pneumonia
Bacterial, viral, fungal, or parasitic infection
Important consideration about acute pulmonary edema
Medical emergency
Usual cause of pulmonary edema
Left sided heart failure: LV is unable to pump blood adequately
As a result, pressure increases in the L atrium and then in the pulmonary veins and capillaries
Causes fluid to be pushed through the capillary walls into the alveoli
Pulmonary edema s/s
- extreme SOB
- difficulty breathing
- feeling of SUFFOCATING or DROWNING
- anxiety/restlessness
- blood-tinged sputum
- rapid, irregular pulse
- cyanosis
- severe drop in BP
PE s/s
- Sudden onset SOB
- chest pain that gets worse with deep breathing, coughing, eating, or bending
- coughing up bloody sputum
Treatments for PE
- anticoagulants
- thrombolytic agents
*may require surgery to remove the clot or insert a filter into the inferior vena cava
Prevention methods for PE
Compression stockings
Pneumatic compression
Physical activity
Drinking fluids
Treatment for pulmonary fibrosis
No treatment is effective at stopping the progression , but some may improve sx
- corticosteroids
- immunosuppressive drugs
- pulmonary rehab
*may need lung transplant
RLD s/s
- dyspnea on exertion
- persistent NON-PRODUCTIVE cough
- increased RR
- HYPOXEMIA and decreased vital capacity
- abnormal breath sounds
- reduced exercise tolerance
