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Health maintenance > respiratory system > Flashcards

respiratory system Flashcards

1
Q

acute otitus media

A

infection that lasts for up to 6 weeks

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2
Q

chronic otitus media

A

chronic tissue damage that has an irreversible pathology

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3
Q

peak age of otitis media

A

6-18 months

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4
Q

otitis media is the most common disease in children in under the age

A

of 5

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5
Q

OM becomes bilateral how often?

A

50% of the time

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6
Q

OM and effusion

A

OM can occur with or with out effusion

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7
Q

OM can be infectious or it can be

A

non infectious

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8
Q

common in children under 3 years old because

A

they have a wider straighter shorter eustatian tube

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9
Q

OM can cause inflammation where?

A

surrounding lymphoid tissue (AKA adenoid lymphoid hypertrophy)

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10
Q

there is obstruction the pharynx due to

A

enlargement and secretions

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11
Q

risks of OM

A

infection
perforated tympanic membrane
hearing loss
disequilibrium

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12
Q

common surgical interventions for OM

A

tympanoplasty (or reconstruction of the tympanic membrane)

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13
Q

predisposing factors for OM

A 
cleft pallate 
immune defficency 
allergic rhinitis 
sinititus 
down syndrome 
upper respiratory infections
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14
Q

other risk factors for OM

A

passive smoking
poor feeding habits
day care

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15
Q

20-40% of pediatric office visits have to do with what?

A

OM

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16
Q

in acute otitis media a bacterial infection accompanies a

A

viral URI infection

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17
Q

eustachian tube dysfunctions

A

secretions access middle ear via eustacian tube

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18
Q

otorrhea

A

discharge from the ear = perforated tympanic membrane

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19
Q

clinical manifestaions of OM

A 
unilateral, bilateral in children 
otalgia (pain in ear) 
fever (often afebrile)
nasal discharge 
cough
irritable 
pulling at ear 
URI (upper respiratory infection) 
diahhrea, vomiting, anoxeria 
falls 
conductive hearing loss 
strep throat
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20
Q

antibiotic treatments of OM

A 
antibiotics 
amoxicilin
cefaclor
co-trimoxazole 
ciftriaoxone
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21
Q

analgesics and antipyretics used for OM

A

acetaminophen

ibuprofen

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22
Q

other treatments for OM

A

hydration

position on uneffected side

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23
Q

surgical interventions for OM

A

Myringomectomy

incision in the tympanic membrane

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24
Q

what is asthma?

A

chronic inflammation of the airways that causes airway hyper responsiveness mucosal edema and mucus production

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25
Q

inflammation leads to reccurent episodes of

A

cough
chest tightness
wheezing and dyspnea

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26
Q

unlike other COPD

A

asthma is reversible with or with out treatment (spontaneously sometimes)

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27
Q

does asthma lead to long term airway narrowing?

A

yes, due to changes causes by the chronic inflammation

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28
Q

Narrowing airway includes

A

bronchoconstriction, airway edema, airway remodling (causes by chronic inflammation, the airway changes its shape)

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29
Q

hypoxemia can occur

A

in asthma

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30
Q

three common symptoms of asthma

A

dysnpea
cough
wheezing

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31
Q

common triggers (allergins)

A

grass
trees
weeds and pollen

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32
Q

common triggers (pereninnal)

A

mold
dust
roaches
animal dander

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33
Q

common triggers for asthma

A 
air pollutants 
cold 
heat 
weather changes 
strong odors/ perfumes 
smoke 
exercise 
viral infections 
stress
medications
occupational exposure (nuts and shellfish)
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34
Q

treatment of asthma

A

antiinflammatory medications

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35
Q

short acting treatments of asthma

A

relax smooth muscles

relieve acute symptoms onset by stress and exercise

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36
Q

Long acting treatments of asthma

A

corticosteroids
most potent and effective treatment of asthma
use with a spacer and patient should rinse their mouths to prevent thrush

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37
Q

commonly used long acting treatments

A

corticosteroids
theophylline- mild bronchodiolator
Salmeterol and Formoterol

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38
Q

commonly used short acting treatments

A 
beta-andergenic agonists 
Albuterol 
Proventil 
Ventolin 
Levalbuterol 
Pirbuterol
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39
Q

thrush

A

fungal infection on skin or mucus membranes

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40
Q

what is croup?

A

an acute infection of the upper and lower respiratory tract that occurs in children 3mo-3yrs after an URI

41
Q

croup is characterized by

A

hoarseness
irriability
fever
brassy cough, dysnpea, and tachynpea, resulting from the obstruction of the larynx
cyanosis and pallor occurs in severe cases

42
Q

interventions for croup

A

bed rest
fluid intake
allevation of airway obstruction to ensure adequate respiratory exchange
provide humidity and monitor for signs of distress

43
Q

what is tonsillitis?

A

inflammation of the tonsils usually due to an URI

44
Q

Acute tonsillitis can be confused with

A

pharyngitis

45
Q

chronic tonsillitis can be mistake for other disorders such as

A

allergy
asthma
rhinosinitus

46
Q

tonsillitis can occur where?

A

adenoid or pharyngeal tonsils

47
Q

why does tonsillitis occur after a Uri

A

because the bacteria is inhaled and can get into the tonsils

48
Q

symptoms of acute tonsilitis

A

sore throat
fever
snoring
difficulty swallowing

49
Q

enlarged adenoids causes

A 
mouth breathing 
ear ache 
draining in ear 
frequent head colds 
bronchitis 
foul smelling breath
voice impairment 
noisy respiration
50
Q

why does tonsilitus present this way?

A

enlargement of the tonsils causes filling behind the nares, making it difficult for air to travel from the nose to the throat resulting in nasal obstruction. the infection can also travel through the eustain tubes causing acute otitis media which can lead to tympanic rupture

51
Q

medical treatment of tonsilitis

A 
increase fluid intake 
salt water gargles 
rest 
anaglesics 
bacterial infections are treated with penicillin (or cephalosporins)
52
Q

post op position for tonsilectomy

A

prone to allow draniage from the phayrnx and mouth (with head turned to the side)

53
Q

pt may not return to a normal position and oral airway must not be removed until

A

gag reflex has returned

54
Q

risk of hemorrhage mean that

A

there is risk for damage to the patients airway

55
Q

bleeding is common however

A

excess bleeding needs to be reported

56
Q

teach patient that

A

bleeding may occur up till 8 days after surgery
sore throat
stiff neck
minor ear pain
vomiting
all may occur in the first 24hrs after surgery

57
Q

encourage what? after tonsillectomy

A

ice chips, soft foods and liquids

58
Q

apply what? after tonsillectomy

A

ice collar

59
Q

pulmonary perfusion

A

blood flow through the respiratory system

60
Q

goal of oxygen therapy

A

provide adequate transportation of oxygen in the blood while decreasing the work of breathing and reducing the stress on the myocarduim

61
Q

oxygen transport is dependent on

A

cardiac output
hemoglobin
arterial oxygen content
metabolic requirements

62
Q

hypoxemia

A

decrease in the arterial oxygen saturation (low o2 in blood)

63
Q

manifestation of hypoxemia

A

changes in mental status
impaired judgement
agitation, confusion, disorientation, confusion, lethargy, increased BP, changes in HR, dysrythmias, central cyanosis, disphoresis, cool extremities

64
Q

hypoxemia leads to

A

hypoxia

65
Q

what is hypoxia?

A

decrease in oxygen saturation of tissues severe hypoxia is life threatening

66
Q

rapidly occuring hypoxia leads to changes in what?

A

central nervous system
lack of coordination or impaired judgement
fatigue, drowsiness, apathy, inattentiveness, delayed reaction

67
Q

hypoxia can occur in patients with

A

COPD, CHF

68
Q

hypoxia is assessed by

A

ABGS, pulse ox, clinical evaluation

69
Q

hypoxia is the leading cause of

A

post op mortality and morbidity

70
Q

indicators of poor respiratory status

A 
confusion 
restlessness 
diaphoresis 
pallor 
tachycardia 
tachypnea
hypertension
71
Q

preoperative risk factors

A 
preexisiting 
medications 
life style 
weight 
age
72
Q

intraoperative risk factors

A

location of incision
horizontal vs vertical
anesthia
duration of anesthia

73
Q

when pt coughs

A

have them hold a pillow over their chest

74
Q

post op risk factors

A

having an NG tube in longer that 24hrs
immobilization
pain

75
Q

hypoventalion causes

A

decreased o2 transfer
mild hypoxemia
moderate hypoxemia
respiratory acidosis

76
Q

causes of post op hypoventilation

A 
residual paralysis 
airway resistance 
increased tissue resistance 
lung and chest compliance 
obesity 
abdominal distension 
dressings and casts
77
Q

what is atelectasis?

A

incomplete expansion of the lung or part of the lung

78
Q

Microatelectasis

A

involves the collapse of aveoli

79
Q

macroatelectasis

A

collapse of a lobe or lung, normally not bilateral

80
Q

atelectisis can is caused by

A

intrinsic obstruction
extrinsic airway obstruction
lung tissue may be compressed
aveoli may be incompletely and eventually collapse

81
Q

acute atelectisis

A

closure or collapse or airless condition of the aveoli caused by hypoventilation or obstruction of the airway

82
Q

chronic atelectisis

A

with out enough surfactant lungs may collapse

83
Q

acute atelectasis is usually a

A

post operative complication

84
Q

clinical manifestations of atelectasis

A 
insidious 
cough 
sputum 
acute marked distress 
chronic, similar to acute 
pt may be anxious
85
Q

universal sign of atelectasis

A

low grade fever

86
Q

nursing diagnosis for atelectasis

A 
ineffective airway 
ineffective gas exchange
infection 
activity intolerance 
altered mobilization
87
Q

nursing interventions for atelectasis

A 
education 
auscultation 
pulse ox 
t and p 
cough/deep breathe
incentive spirometry
suctioning 
ambulation 
chest physiology 
thoracentesis 
mechanical ventilation 
bronchodialators
88
Q

thoracentesis

A

procedure that removes the fluid from the pleural space

89
Q

what is pneumonia?

A

lower respiratory infection
most common cause of death from infectious disease, at all ages
8th leading cause of death
treated inpatient and outpatient
caused by bacteria, myobacteria, fungi, parasites, viruses

90
Q

community acquired pneumonia

A 
common cause strep pneunomia 
all ages in children- URI
acute symptoms
Gold standard CXR 
treatment 10-14 days of antibiotics 
fluids and rest 
occurs in community or 48hrs after hospitalization
91
Q

hospital acquired pneumonia

A 
nosocomial 
common causes- staph, strep, psuedomonas, MRSA
CBC, CXR, blood culture, sputum culture 
colonized by multiple organisms 
occurs 48 hours after admission
92
Q

immunocompromised pneumonia

A

caused when a pt is immunocompromised and cannot fight of the infection

93
Q

aspiration pneumonia

A

inhalation of gastric content
regurgitation is silent
chemical irritation and pneumonia
signs and symptoms depends on severity
prevention and reduction of complications
can cause tachycardia, dysnpea, cyanoisis, hyper or hypotension, death

94
Q

clinical manifestations of pneumonia

A 
depends on extent and location 
depends on cause 
depends on patients condition 
predominant symptoms 
low grade fever, cough, myaglia plueratic pain, mucoid sputum
95
Q

inoculum

A

introduction of microorganisms or pathogens into the body

96
Q

gold standard cxr

A

review of cxr by 3 radiologists

97
Q

ventilation associated pneumonia

A

type of pneumonia that occurs >48hrs after ventilation

98
Q

causes of aspiration pneumonia

A

brain injury, decreased LOC, drug or alchohol, intoxication, seiziure activity, flat body positioning, stroke, swallowing disorders,v

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