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Critical Care Nursing Exam 4 > Upper and Lower Respiratory Disorders > Flashcards

Upper and Lower Respiratory Disorders Flashcards

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1
Q

What parts of the body qualify as the upper respiratory tract? (6)

A

Nose

Paranasal Sinuses

Pharynx

Larynx

Trachea

Bronchi

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2
Q

Fill in the blank:

Most upper airway disorders are _____.

A

minor

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3
Q

what can upper airway disorders cause?

A

discomfort

inconvenience

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4
Q

how are upper airway disorders treated?

A

self treated

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5
Q

What is the most common the of upper airway disorder?

A

the common cold

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6
Q

True or False?

URI’s are the most common reason for seeking health care?

A

True

It is also the most common cause of children missing school, and adults missing work

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7
Q

What type of pathogen most often causes URI’s?

A

Viruses

90% caused by viral infection

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8
Q

What are the four causes of upper airway obstruction and trauma?

A
  1. OSA
  2. Nasal obstruction
  3. Fractures of the nose
  4. Epistaxis
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9
Q

what is OSA?

A

Obstructive sleep apnea

causes recurrent apnea during sleep

loud snoring with periods of apnea

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10
Q

what is nasal obstruction? and what are 3 examples of a nasal obstruction?

A

blockage in the nose

may be caused by deviated septum, hypertrophy of turbinate and nasal polyps.

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11
Q

Why might a fracture in the nose cause obstruction?

A

location of the nose makes it susceptible to injury

may result in hematoma, infection, abscess, avascular or septic necrosis

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12
Q

what type of population is OSA most common in?

A

overweight men with large, thick necks

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13
Q

what is epistaxis?

A

nose bleed

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14
Q

what is the tx for OSA?

A

CPAP during sleep

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15
Q

what is a deviated septum characterized by?

A

sideways deviated septum, causing congestion, and noisy breathing

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16
Q

what might the treatment be for deviated septum?

A

nasal steroids; may resolve over time

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17
Q

what is a primary concern for nose fractures?

A

blood flow to the nose

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18
Q

treatment for nose fractures?

A

surgery if the bone is displaced.

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19
Q

when do we recommend people see an ENT for epistaxis?

A

if they have frequent nosebleeds

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20
Q

what can cause nose bleeds?

A

Hypertension

nose fractures

deviated septum

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21
Q

what is a laryngeal obstruction?

A

blockage of the upper airway, when the passage become narrow or blocked

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22
Q

what parts are effected?

A

trachea
larynx
pharynx

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23
Q

what is exercise induced laryngeal obstruction?

A

transient, reversable narrowing of the larynx, caused by intense exercise

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24
Q

what happens in exercise induced laryngeal obstruction?

A

airflow becomes impeded causing SOB, stridor, and some discomfort

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25
Q

who is exercise induced laryngeal obstruction most often seen in?

A

athletes

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26
Q

what may exercise induced laryngeal obstruction be misdiagnosed as?

A

exercise induced bronchoconstriction

Asthma

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27
Q

what is the larynx?

A

a stiff box that has a mucosal lining

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28
Q

what is most important to remember when treating disorders of the larynx?

A

it is stiff, and can be obstructed quickly

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29
Q

what is sinusitis?

A

inflammation of the paranasal sinuses

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30
Q

what does paranasal mean?

A

adjacent/surrounding to the nasal cavities

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31
Q

What pathogens could cause the sinusitis? (3)

A

bacteria

virus

fungus

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32
Q

what can sinusitis also be the result of? (2)

A

allergic reaction

autoimmune reaction

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33
Q

what is an autoimmune reaction?

A

when the immune system attacks the good parts of the body

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34
Q

what is sinusitis also known as?

A

rhinosinusitis

this is because inflammation of the nose almost always occurs with inflammation of the sinuses

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35
Q

true or false:

Sinusitis cannot be referred to as the cavity it affects

A

FALSE

sinusitis is referred to as the cavity it is affecting

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36
Q

what are the 4 different sinuses?

A
  • maxillary
  • frontal
  • ethmoid
  • sphenoid
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37
Q

what might maxillary sinusitis present with?

A

-pt feels pain/pressure in the cheek area

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38
Q

what might maxillary sinusitis be misdiagnosed as?

A

toothache/headache

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39
Q

what might frontal sinusitis present with?

A

pt feels pain behind or above the eyes

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40
Q

what may frontal sinusitis be misdiagnosed as?

A

headache

will enjoy cool/warm compresses

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41
Q

what may ethmoid sinusitis present with?

A

pain and pressure behind or between the eyes

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42
Q

what may ethmoid sinusitis be misdiagnosed as?

A

Headache

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43
Q

what may sphenoid sinusitis present with?

A

pain and pressure in the top part of the head

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44
Q

what is sinusitis linked to?

A

asthma

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45
Q

non-pharm tx for sinusitis?

A

salt water flushes

steam inhalation

fluids

46
Q

pharm tx for sinusitis?

A

antibiotics

nasal corticosteriods

47
Q

when may sinusitis need surgery?

A

if a patient has it chronically

48
Q

what is acute tracheobronchitis?

A

acute inflammation of mucuous membranes of trachea and bronchial tree

49
Q

what is tracheobronchitis often preceded by?

A

URI

50
Q

what organisms can cause tracheobronchithis?

A

strep pneumonia

H.Flu

mycoplasma pneumonia

aspergillus

bordatella

pertussis

coronavirus

51
Q

what non organism is a cause of tracheobronchitis?

A

inhalation of irritants

52
Q

s/s of acute tracheobronchitis?

A

dry/convulsive cough on inspiration, mucoid sputum, SOA, stridor, wheeze, purulent sputum

53
Q

what percent of cases of acute tracheobronchitis are viral?

A

more than 80%

54
Q

tx of acute tracheobronchitis?

A

antibiotics

antiinflammatories

sputum culture

fluids to thin secretions

rest

55
Q

what is pneumonia?

A

inflammation of the lung parenchyma

56
Q

what is parenchyma?

A

any form of lung tissue including bronchioles, bronchi, blood vessels, interstitum, and alveoli

57
Q

what can cause pneumonia?

A

bacteria
mycobacteria
fungi
viruses

58
Q

who is most susceptible for pneumonia?

A

those with history of pneumonia

59
Q

what is the most common cause of pneumonia in a child?

A

virus

60
Q

what is the most common cause of pneumonia in an adult?

A

bacterial

61
Q

T/F

Pneumonia is the leading infectious killer of children under 12

A

FALSE

it is the leading infectious killer of children under the age of 5

62
Q

What is a non pathogenic cause of pneumonia?

A

aspiration pneumonia

63
Q

what may cause a patient to obtain hospital acquired pneumonia?

A

a ventilator with improper oral care and suctioning

64
Q

who is at highest risk for aspiration pneumonia?

A

Patients with an OG, Ventilated, poor gag reflex, or stroke pts

65
Q

what is 3 ways to prevent pneumonia?

A

immunization

adequate nutrition

environmental factors

66
Q

what does pneumonia create a mismatch in?

A

ventilation and perfusion

67
Q

what does the ventilation and perfusion mismatch cause?

A

arterial hypoxia

68
Q

how can pneumonia cause death?

A

it effects ventilation and perfusion; oxygen has trouble reaching the blood; causing the body to not work properly

the risk of infection increases and can easily spread throughout the body

69
Q

what does the secretions and mucosal edema occlude?

A

ventilation

70
Q

what can cause the block of diffusion of oxygen and C02?

A

exudate in the alveoli

71
Q

what is indicative of arterial hypoxia?

A

An ABG, showing a Pa02 of <80mmHg

72
Q

clinical manifestations of pneumonia?

A

-HA, fever, pleuritic pain, myalgia, pharyngitis, purulent sputum, orthopnea, confusion and lethargy

73
Q

how to dx pneumonia?

A

chest Xray, history, exam, cultures

74
Q

tx of pneumonia?

A

antibiotics

hydration

rest

NSAIDS

75
Q

what is the most common antibiotic used for pneumonia?

A

zithromax

76
Q

T/F

It is very important to take a cough suppressant when you have pneumonia

A

FALSE

if you suppress the cough, there is no way for all of the sputum to escape the lungs

77
Q

what are the 3 keys to management of pneumonia?

A
  • blood cultures
  • antibiotics do not work for viral pneumonia
  • monitor for shock and respiratory failure
78
Q

What is pulmonary tuberculosis caused by?

A

acid fast aerobic rod

79
Q

what does pulmonary tb affect?

A

lung parenchyma, meninges, kidneys, bones, and lymph nodes

80
Q

how is TB spread?

A

airborne

81
Q

how does TB settle in the lungs?

A

inhaled mycobacteria settle in the alveoli and can enter blood stream and spread to different areas

82
Q

what test is used to dx TB?

A

PPD or Mantoux skin test

83
Q

What is the difference between latent and active TB?

A

latent causes the germs to be dormant; they cannot spread TB to others
active TB causes germs to be reproducing and spreading through out the body

84
Q

how is latent TB treated?

A

one medication for nine months

85
Q

what are the s/s of active TB?

A

cough lasting more than 3 weeks

weight loss, night sweats and fever

86
Q

what is the tx for active TB?

A

3-4 meds for at least 6 months

87
Q

how to ID tb?

A

PPD test, CXR, sputum, interferon Gamma Release assay

88
Q

what is COPD?

A

a group of lung conditions that make it hard to breathe well

89
Q

What are the 2 most common COPD lung diseases?

A

chronic bronchitis

emphysema

90
Q

why are chronic bronchitis and emphysema both classified together as COPD?

A

because those with COPD generally have symptoms of both disorders

91
Q

What type of disease is COPD?

A

chronic and progressive; meaning it never goes away, and it never gets better, it slowly gets worse and worse over time

92
Q

what are the primary causes of COPD?

A

breathing in irritants and toxins, pollution, exposure to dust and chemicals, cigarette smoke, secondhand smoke

93
Q

what is the number one cause of COPD?

A

smoking cigarettes

94
Q

how do pts with COPD present?

A

coughing, wheezing, barrel shaped chest, accessory breathing, tripod positioning

95
Q

tx of COPD?

A

bronchodilators; they work to decrease hyperinflation, improve the emptying of the lungs and improve exercise performance

96
Q

what are the goals for tx of COPD?

A
  • slow the decline in lung fx
  • relieve s/s
  • improve daily function
  • decrease exacerbations
  • improve quality of life
97
Q

what is a pulmonary embolism?

A

obstruction of the pulmonary artery or branch by thrombus/emboli

98
Q

what is ventilation and perfusion mismatch?

A

ventilation is the air that reaches the alveoli and perfusion is the blood that reaches the alveoli

99
Q

how is ventilation and perfusion measured?

A

with a V/Q scan

100
Q

what does the V represent in a V/Q scan?

A

amount of air that reaches the alveoli

101
Q

what does the Q represent in a V/Q scan?

A

amount of blood that reaches the alveoli

102
Q

what does the V/Q scan determine?

A

o2 and C02 concentration

103
Q

what does the PVR look like during a PE?

A

increased

104
Q

What does the PAP look like during a PE?

A

increased

105
Q

why might there be increased ventricular work during a PE?

A

to maintain pulmonary blood flow

106
Q

what may increased ventricular work cause?

A

right ventricular failure which leads to decreased CO followed by decreased systemic BP and shock

107
Q

s/s of PE?

A

dyspnea, tachypnea, pleuritic chest pain, anxiety, fear, tachycardia, hemoptysis, syncope

108
Q

when can death occur with a PE?

A

within 1 hour of onset of symptoms

109
Q

how to dx a PE?

A 
CXR, EKG, usually sinus tach, PR interval depression and nonspecific T wave changes
ABG
VQ scan or CT
D-dimer
pulmonary angiogram
110
Q

what is the most definitive method of dx a PE?

A

pulmonary angiogram

Critical Care Nursing Exam 4 (4 decks)

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