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TERM 4 N2261 KNLG 3 > THORACIC > Flashcards

THORACIC Flashcards

1
Q

What are two kinds of pleuritis?

A
  1. Fibrinous (dry)
  2. Serofibrinous (wet)
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2
Q

What is the underlying mechanism behind pleural effusion?

A

Alteration in hydrostatic or oncotic pressure

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3
Q

What is the term for collapsed airless alveoli?

A

Atelectasis

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4
Q

What patient population are all at risk for hospital acquired pneumonia?

A

Postop patient who have received general anesthesia

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5
Q

What is the difference between community acquired and hospital acquired pneumonia?

A

CAP: onset in community or within 2 days of hospitalization

HAP: onset after 2 days of hospitalization

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6
Q

What are 6 risk factors for hospital acquired pneumonia?

A
  1. Aspiration
  2. Immunosuppression
  3. Immobility
  4. Intubation
  5. Poor glycemic control
  6. Failure to use aseptic technique
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7
Q

What is the definition of a lung abscess?

A

Pus containing lesion of lung that results in tissue necrosis

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8
Q

What are 2 possible causes of a lung abscess?

A
  1. Infection
  2. Infarction
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9
Q

What are 4 complications of a lung abscess?

A
  1. Chronic abscess
  2. Bronchiectasis
  3. Systemic spread
  4. Fistula
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10
Q

What are 2 treatments for lung abscess?

A
  1. Bronchoscopy
  2. 2-4 months of antibiotics
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11
Q

Why is percutaneous drainage of a lung abscess not recommended?

A

High risk of pleural space contamination

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12
Q

What are 2 kinds of lung cancer, which is most common, and how do they differ clinically?

A
  1. Non-small cell lung cancer (most common)
  2. Small cell lung cancer (grows faster but easier to treat)
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13
Q

What is the term for a complication of lung cancer involving systemic manifestations including hormonal, dermatological, neuromuscular, vascular, hematological, and connective tissues?

A

Paraneoplastic syndrome

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14
Q

What causes hypercalcemia associated with paraneoplastic syndrome?

A

Increased bone resorption

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15
Q

What causes hyponatremia associated with paraneoplastic syndrome?

A

Tumor cells produce excess ADH, leading to SIADH and water retention

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16
Q

What are 4 common surgeries performed for patients with lung cancer?

A
  1. VATS
  2. Wedge resection
  3. Lobectomy/pneumonectomy
  4. Sleeve resection
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17
Q

What is the difference between open and closed pneumothorax?

A

Open: A puncture wound allows air to enter the chest

Closed: Air collects in the pleural space originating from the respiratory system

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18
Q

What is the term for rapid accumulation of air in the pleural space, increasing intrapleural pressure and causing tension on the heart?

A

Tension pneumothorax

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19
Q

What are 3 ways pneumothorax resolves?

A
  1. Spontaneous
  2. Large bore needle aspiration
  3. Chest tube
20
Q

What is the primary goal of treatment in cases of rib fracture?

A

Promote chest/lung expansion

21
Q

What are 4 diagnostics or treatments that can be done with bronchoscopy?

A
  1. Bronchial washing
  2. Endobronchial ultrasound
  3. Transbronchial needle aspiration
  4. Unblock airway via laser/stent
22
Q

What must be monitored when a patient returns from bronchoscopy?

A

Return of gag reflex

23
Q

What are 2 indications for thoracentesis?

A
  1. Pleural effusion
  2. Empyema
24
Q

Where is thoracentesis usually performed?

A

Interventional radiology

25
Q

What 3 complications should be monitored for after thoracentesis?

A
  1. Pneumothorax
  2. Respiratory distress
  3. Worsening pleural effusion
26
Q

What position should patients with a chest tube be kept in?

A

Semi-fowlers to make breathing easier

27
Q

What are 2 kinds of chest tube drainage systems?

A

Wet and dry suction

28
Q

What should be assessed for at the site of chest tube insertion?

A

Subcutaneous emphysema (aka crepitus)

29
Q

Why should dependent loops be avoided in chest tubes drainage tubing?

A

Can dramatically increase intrathoracic pressure, decreasing drainage

30
Q

What are 2 things never to do with a chest tube drainage system?

A
  1. Strip/milk tubing (can increase pressure)
  2. Clamp tubing (except right before removal)
31
Q

What does the level of water in the water seal chamber of the chest tube drainage system indicate?

A

Intrathoracic pressure

32
Q

If the water seal chamber stops tidaling, what are 2 things this could indicate?

A
  1. Tube blockage
  2. The patient’s lung has re-expanded
33
Q

What should NOT be seen in the water seal chamber, and what would this indicate?

A

Continuous bubbling; this may indicate leakage

34
Q

Over time, we would expect the level of the water seal chamber to __________, signaling healing

A

Rise

35
Q

How is the chest tube collection chamber monitored?

A
  1. q8h
  2. Mark the level of drainage on the outside of the chamber with date, time, initials
36
Q

What kind of drainage should be reported to the HCP?

A
  1. Bright red blood >100 ml/h
  2. Excess pleural fluid >1-1.5 L
  3. Cloudy
37
Q

What do we expect to see in the suction chamber of the chest tube drainage system?

A

Gentle continuous bubbling

38
Q

Is chest tube indicated for lobectomy, and why?

A

Yes, as the remaining lung will expand to fill the space of the lobe removed

39
Q

Is chest tube indicated for pneumonectomy, and why?

A

No, as serosanguineous fluid must fill the empty space of the lung removed

40
Q

What is the term for removal of a small, localized lesion that occupies only a small segment of lung?

A

Wedge resection

41
Q

What is the indication for thoracotomy?

A

Assess internal injury

Perform surgery

42
Q

What are 2 kinds of thoracotomy?

A
  1. Median sternotomy
  2. Lateral thoracotomy
43
Q

What is the term for a procedure involving insertion of scope into the pleural space through an intercostal incision, and insertion of instruments through additional intercostal incisions?

A

Video assisted thorascopic surgery (VATS)

44
Q

Why is the ability to self monitor a requirement for lung transplant?

A

High risk of infection (esp by CMV)

45
Q

What is the most common cardiac complication after thoracic surgery?

A

Arrhythmia (esp a-fib)

46
Q

What does I-COUGH stand for?

A

Incentive spirometry
Cough and deep breathe
Oral care
Up (Head of bed up)
Get out of bed
Have a conversation

TERM 4 N2261 KNLG 3 (9 decks)

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