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

Upper and Lower Respiratory Disorders Flashcards

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
who is exercise induced laryngeal obstruction most often seen in?
athletes
26
what may exercise induced laryngeal obstruction be misdiagnosed as?
exercise induced bronchoconstriction Asthma
27
what is the larynx?
a stiff box that has a mucosal lining
28
what is most important to remember when treating disorders of the larynx?
it is stiff, and can be obstructed quickly
29
what is sinusitis?
inflammation of the paranasal sinuses
30
what does paranasal mean?
adjacent/surrounding to the nasal cavities
31
What pathogens could cause the sinusitis? (3)
bacteria virus fungus
32
what can sinusitis also be the result of? (2)
allergic reaction autoimmune reaction
33
what is an autoimmune reaction?
when the immune system attacks the good parts of the body
34
what is sinusitis also known as?
rhinosinusitis this is because inflammation of the nose almost always occurs with inflammation of the sinuses
35
true or false: Sinusitis cannot be referred to as the cavity it affects
FALSE sinusitis is referred to as the cavity it is affecting
36
what are the 4 different sinuses?
- maxillary - frontal - ethmoid - sphenoid
37
what might maxillary sinusitis present with?
-pt feels pain/pressure in the cheek area
38
what might maxillary sinusitis be misdiagnosed as?
toothache/headache
39
what might frontal sinusitis present with?
pt feels pain behind or above the eyes
40
what may frontal sinusitis be misdiagnosed as?
headache | will enjoy cool/warm compresses
41
what may ethmoid sinusitis present with?
pain and pressure behind or between the eyes
42
what may ethmoid sinusitis be misdiagnosed as?
Headache
43
what may sphenoid sinusitis present with?
pain and pressure in the top part of the head
44
what is sinusitis linked to?
asthma
45
non-pharm tx for sinusitis?
salt water flushes steam inhalation fluids
46
pharm tx for sinusitis?
antibiotics nasal corticosteriods
47
when may sinusitis need surgery?
if a patient has it chronically
48
what is acute tracheobronchitis?
acute inflammation of mucuous membranes of trachea and bronchial tree
49
what is tracheobronchitis often preceded by?
URI
50
what organisms can cause tracheobronchithis?
strep pneumonia H.Flu mycoplasma pneumonia aspergillus bordatella pertussis coronavirus
51
what non organism is a cause of tracheobronchitis?
inhalation of irritants
52
s/s of acute tracheobronchitis?
dry/convulsive cough on inspiration, mucoid sputum, SOA, stridor, wheeze, purulent sputum
53
what percent of cases of acute tracheobronchitis are viral?
more than 80%
54
tx of acute tracheobronchitis?
antibiotics antiinflammatories sputum culture fluids to thin secretions rest
55
what is pneumonia?
inflammation of the lung parenchyma
56
what is parenchyma?
any form of lung tissue including bronchioles, bronchi, blood vessels, interstitum, and alveoli
57
what can cause pneumonia?
bacteria mycobacteria fungi viruses
58
who is most susceptible for pneumonia?
those with history of pneumonia
59
what is the most common cause of pneumonia in a child?
virus
60
what is the most common cause of pneumonia in an adult?
bacterial
61
T/F | Pneumonia is the leading infectious killer of children under 12
FALSE | it is the leading infectious killer of children under the age of 5
62
What is a non pathogenic cause of pneumonia?
aspiration pneumonia
63
what may cause a patient to obtain hospital acquired pneumonia?
a ventilator with improper oral care and suctioning
64
who is at highest risk for aspiration pneumonia?
Patients with an OG, Ventilated, poor gag reflex, or stroke pts
65
what is 3 ways to prevent pneumonia?
immunization adequate nutrition environmental factors
66
what does pneumonia create a mismatch in?
ventilation and perfusion
67
what does the ventilation and perfusion mismatch cause?
arterial hypoxia
68
how can pneumonia cause death?
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
what does the secretions and mucosal edema occlude?
ventilation
70
what can cause the block of diffusion of oxygen and C02?
exudate in the alveoli
71
what is indicative of arterial hypoxia?
An ABG, showing a Pa02 of <80mmHg
72
clinical manifestations of pneumonia?
-HA, fever, pleuritic pain, myalgia, pharyngitis, purulent sputum, orthopnea, confusion and lethargy
73
how to dx pneumonia?
chest Xray, history, exam, cultures
74
tx of pneumonia?
antibiotics hydration rest NSAIDS
75
what is the most common antibiotic used for pneumonia?
zithromax
76
T/F | It is very important to take a cough suppressant when you have pneumonia
FALSE | if you suppress the cough, there is no way for all of the sputum to escape the lungs
77
what are the 3 keys to management of pneumonia?
- blood cultures - antibiotics do not work for viral pneumonia - monitor for shock and respiratory failure
78
What is pulmonary tuberculosis caused by?
acid fast aerobic rod
79
what does pulmonary tb affect?
lung parenchyma, meninges, kidneys, bones, and lymph nodes
80
how is TB spread?
airborne
81
how does TB settle in the lungs?
inhaled mycobacteria settle in the alveoli and can enter blood stream and spread to different areas
82
what test is used to dx TB?
PPD or Mantoux skin test
83
What is the difference between latent and active TB?
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
how is latent TB treated?
one medication for nine months
85
what are the s/s of active TB?
cough lasting more than 3 weeks | weight loss, night sweats and fever
86
what is the tx for active TB?
3-4 meds for at least 6 months
87
how to ID tb?
PPD test, CXR, sputum, interferon Gamma Release assay
88
what is COPD?
a group of lung conditions that make it hard to breathe well
89
What are the 2 most common COPD lung diseases?
chronic bronchitis | emphysema
90
why are chronic bronchitis and emphysema both classified together as COPD?
because those with COPD generally have symptoms of both disorders
91
What type of disease is COPD?
chronic and progressive; meaning it never goes away, and it never gets better, it slowly gets worse and worse over time
92
what are the primary causes of COPD?
breathing in irritants and toxins, pollution, exposure to dust and chemicals, cigarette smoke, secondhand smoke
93
what is the number one cause of COPD?
smoking cigarettes
94
how do pts with COPD present?
coughing, wheezing, barrel shaped chest, accessory breathing, tripod positioning
95
tx of COPD?
bronchodilators; they work to decrease hyperinflation, improve the emptying of the lungs and improve exercise performance
96
what are the goals for tx of COPD?
- slow the decline in lung fx - relieve s/s - improve daily function - decrease exacerbations - improve quality of life
97
what is a pulmonary embolism?
obstruction of the pulmonary artery or branch by thrombus/emboli
98
what is ventilation and perfusion mismatch?
ventilation is the air that reaches the alveoli and perfusion is the blood that reaches the alveoli
99
how is ventilation and perfusion measured?
with a V/Q scan
100
what does the V represent in a V/Q scan?
amount of air that reaches the alveoli
101
what does the Q represent in a V/Q scan?
amount of blood that reaches the alveoli
102
what does the V/Q scan determine?
o2 and C02 concentration
103
what does the PVR look like during a PE?
increased
104
What does the PAP look like during a PE?
increased
105
why might there be increased ventricular work during a PE?
to maintain pulmonary blood flow
106
what may increased ventricular work cause?
right ventricular failure which leads to decreased CO followed by decreased systemic BP and shock
107
s/s of PE?
dyspnea, tachypnea, pleuritic chest pain, anxiety, fear, tachycardia, hemoptysis, syncope
108
when can death occur with a PE?
within 1 hour of onset of symptoms
109
how to dx a PE?
``` CXR, EKG, usually sinus tach, PR interval depression and nonspecific T wave changes ABG VQ scan or CT D-dimer pulmonary angiogram ```
110
what is the most definitive method of dx a PE?
pulmonary angiogram

Critical Care Nursing Exam 4 (4 decks)

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