UNIT 8 - ALTERATIONS IN RESPIRATORY FUNCTION Flashcards
ETIOLOGY OF WHICH RESTRICTIVE RESPIRATORY DISORDER?
o BEGINS WITH INHALATION OF PATHOGENS. PATHOGENS THEN ESTABLISH THEMSELVES INSIDE THE LUNGS
o ASPIRATION – VOMITING AND INHALING GASTRIC CONTENTS. BURNS THE BRONCHI AND RESPIRATORY PASSAGES
o ENDOGENOUS – INFECTION THAT OCCURS SOMEWHERE ELSE IN THE BODY. TRAVELS TO THE LUNGS AND ESTABLISHES INFECTION THERE
PNEUMONIA
ETIOLOGIC ORGANISMS OF WHICH RESTRICTIVE RESPIRATORY DISORDER?
STREPTOCOCCUS PNEUMONIAE
LEGIONELLA PNEUMOPHILA
PNEUMONIA
CLASSIFICATION OF WHICH RESTRICTIVE RESPIRATORY DISORDER?
o NOSOCOMIAL VS COMMUNITY ACQUIRED o ETIOLOGIC ORGANISM STREPTOCOCCUS PNEUMONIAE LEGIONELLA PNEUMOPHILA o ANATOMIC DISTRIBUTION
PNEUMONIA
PATHOGENESIS OF PNEUMONIA:
INVADING ORGANISM SETS OF _____________ REACTION. ALVEOLI FILL WITH EXUDATE RESULTING IN ____________.
INFLAMMATORY
CONSOLIDATION
CLINICAL MANIFESTATIONS OF PNEUMONIA CAN VARY WITH AGE, CAUSE, & __________
SEVERITY
CLINICAL MANIFESTATIONS OF WHICH RESTRICTIVE RESPIRATORY DISORDER?
o FEVER, CHILLS
o COUGH (MAY OR MAY NOT BE PRODUCTIVE)
o DYSPNEA, CRACKLES OVER AFFECTED LOBE
PNEUMONIA
EVALUATION OF PNEUMONIA
__________ DONE TO CHECK FOR CONSOLIDATION
_________ CULTURE
XRAYS
SPUTUM
TREATMENT OF PNEUMONIA IS \_\_\_\_\_\_\_\_\_\_\_: OXYGEN PRN ANTI-INFECTIVES FLUIDS ANTIPYRETICS EXPECTORANTS VENTILATORY SUPPORT
SUPPORTIVE
DEFINITION - COLLAPSE OF LUNG TISSUE
ATELECTASIS
TYPES OF __________
o OBSTRUCTION
o COMPRESSION BY EXTERNAL MASS
ATELECTASIS
PATHOGENESIS OF ATELECTASIS
o AIRLESS ALVEOLI ________ DUE TO ELASTICITY – BECAUSE THEY ARE NOT RECEIVING AIR
o INTERFERES WITH BLOOD FLOW THROUGH LUNGS (DECREASED ____ _________ & ____________)
SHRIVEL
GAS EXCHANGE & OXYGENATION
DURING ATELECTASIS, CLIENT BECOMES _____________ VERY QUICKLY
HYPOXEMIC
RISK FACTORS FOR ATELECTASIS
o ____________ – SECRETIONS POOL IN LUNGS AND CLOG SMALL BRONCHIOLES. ALVEOLI THAT ARE PASSED THE AREA OF OBSTRUCTION DO NOT RECEIVE AIR AND SHRIVEL. INHIBITS BLOOD VESSELS. IF OXYGEN ISN’T RESTORED THE TISSUE BECOMES NECROTIC AND DIES.
o SURGERY
IMMOBILITY
CLINICAL MANIFESTATIONS OF WHICH RESTRICTIVE RESPIRATORY DISORDER?
o DYSPNEA o COUGH o FEVER o LEUKOCYTOSIS o TACHYPNEA o FOCAL DECREASED BREATH SOUNDS o INCREASED CRACKLES AT LUNG BASES o HYPOXEMIA o DECREASED DEPTH OF RESPIRATORY EXCURSIONS
ATELECTASIS
TREATMENT OF ATELECTASIS
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ IS KEY!! DEEP BREATHING AND COUGHING REPOSITIONING AMBULATION IF NOT CONTRAINDICATED INCENTIVE SPIROMETRY
PREVENTION
CHEST WALL STRUCTURAL ABNORMALITIES
DEFINITION - HUNCHED BACK. ELDERLY WITH OSTEOPOROSIS. INHIBITS CHEST EXPANSION.
KYPHOSIS
CHEST WALL STRUCTURAL ABNORMALITIES
DEFINITION - (CHEST EXCAVATION) STERNUM IS DISPLACED BACKWARDS.
PECTUS EXCAVATUM
CHEST WALL STRUCTURAL ABNORMALITIES
DEFINITION - STERNUM IS PROTRUDING FORWARD. BIRD CHEST.
PECTUS CARINATUM
CHEST WALL STRUCTURAL ABNORMALITIES
DEFINITION - SPINE IS ‘S’ SHAPED. INTERFERES WITH MOVEMENT OF RIBS AND INHIBITS MOVEMENT OF CHEST WALL.
SCOLIOSIS
CHEST WALL STRUCTURAL ABNORMALITIES SUCH AS KYPHOSIS, PECTUS EXCAVATUM & CARINATUM, & SCOLIOSIS CAN ALL LEAD TO RECURRENT _________ INFECTIONS
CHEST
WHICH CHEST WALL INJURY?
o VARIES IN SEVERITY FROM AN ISOLATED RIB FRACTURE TO SEVERE CRUSH INJURY TO CHEST
o RULE OUT UNDERLYING INJURY
o IMPORTANT TO OBTAIN AN ACUTE HISTORY OF THE MECHANISM OF INJURY.
o PAINFUL – INTERFERES WITH LUNG EXPANSIONS. LEADING TO PNEUMONIA OR ATELECTASIS
RIB FRACTURES
TREATMENT OF RIB FRACTURE DEPENDS ON __________ OF INJURY
SEVERITY
TREATMENT OF RIB FRACTURE
INCENTIVE SPIROMETRY, DEEP BREATHING AND COUGHING; SUPPORT RIBS WITH PILLOWS DURING COUGHING
NSAIDS
________ SMOKING, OR USE OF BINDERS OR RIB BELTS
AVOID
WHICH CHEST WALL INJURY?
o USUALLY 2 FRACTURES PER RIB IN CONSECUTIVE RIBS OR FRACTURE OF STERNUM PLUS CONSECUTIVE RIBS.
o RESULTS IN PARADOXICAL BREATHING (REVERSE OF NORMAL BREATHING INHALATION - CHEST GOES IN, EXHALATION, CHEST GOES OUT)
FLAIL CHEST
TREATMENT OF WHICH CHEST WALL INJURY?
PAIN CONTROL AND MANAGEMENT OF UNDERLYING PULMONARY AND/OR CARDIAC INJURY
CHEST TUBES, MECHANICAL VENTILATION
FLAIL CHEST
FLAIL CHEST CAN CAUSE ______________
PNEUMOTHORAX
DEFINITION - AN ACCUMULATION OF AIR IN THE PLEURAL SPACE
CAUSES ATELECTASIS (GREATER AMOUNT OF AIR = MORE SEVERE ATELECTASIS)
PNEUMOTHORAX
PNEUMOTHORAX CAN RESULT FROM ____________ DISEASE (SUCH AS COPD) OR FROM CHEST __________ (RIB FRACTURES)
UNDERLYING
TRAUMA
TYPES OF \_\_\_\_\_\_\_\_\_\_\_\_\_ o SPONTANEOUS PRIMARY SECONDARY o OPEN o TENSION
PNEUMOTHORAX
WHICH TYPE OF PNEUMOTHORAX?
o SPONTANEOUS RUPTURE OF BLEBS (AIR BLISTER) ON VISCERAL PLEURA. MAY OCCUR DURING REST, EXERCISE, OR SLEEP.
o USUALLY OCCURS IN MEN BETWEEN 20 – 40 YRS
SPONTANEOUS: PRIMARY
WHICH TYPE OF PNEUMOTHORAX?
o RESULTING FROM TRAUMA OR SPONTANEOUS RUPTURE OF BLEB ON VISCERAL PLEURA SECONDARY TO PRE-EXISTING PULMONARY DISEASE
SPONTANEOUS: SECONDARY
WHICH TYPE OF PNEUMOTHORAX?
• CAUSED BY OPENING IN CHEST WALL SECONDARY TO TRAUMA SUCH AS STAB WOUNDS, BULLET WOUNDS. (CHEST INJURY)
• AIR IS DRAWN THROUGH THE WOUND INTO THE PLEURAL SPACE DURING INSPIRATION AND FORCED BACK OUT DURING EXPIRATION. WOUND IN THE CHEST WALL APPEARS TO BE “SUCKING AIR” AND IS VISIBLY BUBBLING; THEREFORE REFERRED TO AS “SUCKING WOUND”
o LEADS TO ATELECTASIS
OPEN
PRESSURE IN PLEURAL SPACE EQUALS ___________ PRESSURE
ATMOSPHERIC
WHICH TYPE OF PNEUMOTHORAX?
- SITE OF PLEURAL RUPTURE ACTS AS A ONE-WAY VALVE PREVENTING AIR FROM ESCAPE DURING EXPIRATION
- AIR ENTERS THE PLEURAL SPACE DURING INSPIRATION; ON EXPIRATION, OPENING IS SEALED AND AIR BECOMES TRAPPED, INCREASING THE PRESSURE WITHIN THE THORACIC CAVITY
- MEDIASTINUM BECOMES DISPLACED CONTRALATERALLY, COMPRESSING THE HEART AND GREAT VESSELS, INHIBITING VENOUS RETURN
TENSION
A ____________ PNEUMOTHORAX IS THE MOST SEVERE.
TENSION
CLINICAL MANIFESTATIONS VARY WITH THE ___________ OF THE PNEUMOTHORAX
EXTENT
CLINICAL MANIFESTATIONS OF PNEUMOTHORAX
o _____________: CHEST PAIN, DYSPNEA, TACHYCARDIA, DECREASED BREATH SOUNDS ON AFFECTED SIDE
INITIALLY
CLINICAL MANIFESTATIONS OF PNEUMOTHORAX
o AS PNEUMOTHORAX ____________: ABSENT BREATH SOUNDS ON AFFECTED SIDE, HYPOXEMIA, LABOURED BREATHING, JUGULAR VENOUS DISTENSION, HYPOTENSION, CONTRALATERAL TRACHEAL SHIFT.
PROGRESSES
DIAGNOSIS OF PNEUMOTHORAX IS DONE VIA __________ ________
CHEST XRAY
TREATMENT OF PNEUMOTHORAX DEPENDS ON ______ & ________.
o ASPIRATION, O2 THERAPY
o CHEST TUBE INSERTION TO GET RID OF AIR THAT IS COLLECTING IN PLEURAL SPACE.
TYPE & SIZE
PLEURAL EFFUSION IS SAME PRINCIPLE AS PNEUMOTHORAX BUT INSTEAD OF AIR IT IS ________ IN THE PLEURAL SPACE
FLUID
FLUID IS HEAVY AND SITS AT THE ______________ OF PLEURAL SPACE
BOTTOM
TYPES OF \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_: o HEMOTHORAX o TRANSUDATE o EXUDATE o EMPYEMA o CHYLOUS PLEURAL EFFUSION
PLEURAL EFFUSIONS
WHICH TYPE OF PLEURAL EFFUSION?
BLOOD IN PLEURAL SPACE USUALLY ASSOCIATED WITH TRAUMA
HEMOTHORAX
WHICH TYPE OF PLEURAL EFFUSION?
WATERY DRAINAGE IN PLEURAL SPACE, LOW PROTEIN COUNT (SEEN IN PNEUMONIA)
TRANSUDATE