restrictive pulmonary disorders (exam 4)

Question 1

what are restrictive pulmonary disorders a result of?

Answer 1

• results from decreased lung expansion
• alterations in lung parenchyma (tissue) pleura, chest wall, or neuromuscular function

Question 2

what are the two classifications of restrictive pulmonary disorders?

Answer 2

1. intra- pulmonary = (diseases of the lung tissue) = pulmonary fibrosis, ARDS, pneumonia
2. Extra-pulmonary = pneumothorax, pleural effusion, chest wall disorders, neuromuscular

Question 3

what are the “lab” characteristics of restrictive pulmonary disorders

Answer 3

• decreased vital capacity, total lung capacity, functional residual capacity, residual volume
• ABG = decreased paO2, normal paCO2, increased pH, at risk for resp alkalosis

Question 4

define atelectasis & how it works

Answer 4

• complete or partial collapse of a lung or lobe of a lung
• alveoli within the lung become deflated
• typical complication after surgery
• general anesthesia changes breathing pattern
• prolonged bed rest w/ few position changes = decreased lung expansion

Question 5

what is an incentive spirometer and how does it work?

Answer 5

• tool of which you inhale to work on lung expansion
• is used after surgeries to prevent atelectasis and to “work out” the lungs

Question 6

what is a pneumothorax?

Answer 6

• accumulation of air in the pleural space, resulting in collapsed lung
• two kinds:
  
  • primary pneumothorax = spontaneous
  • secondary pneumothorax = complication of other disease or problem

Question 7

what is a primary pneumothorax? who does it present in? how does it present?

Answer 7

• spontaneous
• occurs in tall thin men 20 - 40 yrs
• no underlying disease factors
• cig smoking increases risk
• rupture of small subpleural blebs in lung tissue
• air enters plural space, lung collapses & rib cage springs out

Question 8

what is a secondary pneumothorax? what could cause it?

Answer 8

• due to complication of underlying lung problem
• may be due to rupture of cyst or bleb
• may be due to trauma

Question 9

what are the C.M of pneumothorax’s?

Answer 9

• these are emergency situations
• severe tachycardia
• decreased or ABSENT breath sounds on affected side
• hypotension
• tracheal shift to the opposite side
• JVD
• sudden chest pain on effected side
• dyspnea (SOB)
• hyper-resonance (louder and lower pitched)
• Subcutaneous emphysema (air in the skin puffs up, sounds like rice krispies)

Question 10

what is a tension pneumothorax? what is the cause

Answer 10

• traumatic injury penetrating or non penetrating injury
• may be from iatrogenic causes
• medical emergency
• tension - results from buildup of air under pressure in pleural space
• air enters pleural space during inspiration but cant escape during expiration
• Lung on ipsilateral (same) side collapses and
  toward contralateral (opposite) side
• decrease venous concern and cardiac output