Upper/Lower Infectious/Non-Infectious Diseases Flashcards
Chronic airflow limitations (CAL)
asthma and COPD (chronic bronchitis and emphysema)
Causes of Asthma
inflammation and hyper responsiveness of airways to common stimuli
inflammation in the mucous membranes and hyper responsiveness constricts the bronchial smooth muscle
intermittent if well controlled
triggers of asthma
allergens
cold air/poor air quality
exercise
respiratory illness/ URI
general irritants
microorganisms
GERD
diagnostics on asthma
ABG (hypoxemia or acidosis)
PFTs
treatment and nursing care for asthma
goal: control and prevent episodes, improve airflow, relieve symptoms
medications: inhaled or systemic; preventative and rescue; bronchodilators and anti-inflammatory agents
avoidance of triggers, inhalers and nebulizers, oxygen therapy if extreme
status asthmaticus
severe and life threatening
treatment: oxygen, IV fluids, potent systemic bronchodilation, IV steroids, epinephrine
emergency intubation
can develop pneumothorax and cardiac respiratory arrest
absence of wheezing can indicate complete airway obstructions
COPD causes
chronic exposure to irritants, commonly smoking.
causes inflammation, congestion, mucosal edema and bronchospasm.
only effects airways, not alveoli
production of large amounts of thick mucus
EMPHYSEMA
emphysema
chronic exposure to irritants cause damage to the alveoli and small airways.
air trapping occurs in alveoli as it loses elasticity and are destroyed and small airways collapse
decrease surface area for gas exchange
hyperinflation of lung
abnormal excretion of proteases, an enzyme that breaks down the elastin in the alveoli
Symptoms of COPD
dyspnea
orthopnea
cough with sputum production
use of accessory muscles
hypoxemia
chronic acidosis
weight loss
fatigue
barrel chest
cyanosis
clubbing of fingers
anxiety
diagnostics for COPD
ABG
sputum sample
CBC
chest xray
chest CT
PFTs
nursing care for COPD
attain or maintain gas exchange within the patient’s baseline and control symptoms
O2 therapy: O2 sat between 88-90
Hypoxic vasoconstriction with emphysema (blood shunting from unhealthy part of lung to healthy part… artificial O2 will mess up this process)
Positioning; elevate the HOB, tripoding
Cessation of smoking
energy conservation
breathing exercise
nutritional counseling
medications (bronchodilators, anti-inflammatories, mucolytic agents)
COPD complications
hypoxemia
acidosis
respiratory infection
cardiac failure
cardiac dysrhythmias
Nursing implications of the older adult with chronic respiratory condition
rest periods between activities/ADLs
Upright position while eating meals to prevent aspiration
Encourage nutritional fluid intake after the meals
Schedule drugs around routine activities to promote adherance
Encourage patient notification for infection symptoms
cause of cor pulmonale
right sided heart failure caused by pulmonary disease
increased vascular resistance in the lung causes the right side of the heart to work harder against the increased pressure
right side of the heart enlarges and can cause a back flow of blood into the venous system
cor pulmonale symptoms
hypoxemia
dyspnea
cyanosis
JVD
systemic edema
acidosis
fatigue
enlarged liver
chest pain
cor pulmonale diagnostics
ABG
BNP
Echocardiogram
Rt heart cauterization
Ventilation Perfusion scan
cor pulmonae treatment and nursing care
medications
oxygen therapy
heart/lung transplant
Lung cancer
leading cause of cancer deaths word-wide. poor long-term survival due to late stage diagnosis. staged to assess size and extent of disease (metastasis)
types of lung cancer
small cell lung cancer- worse prognosis, chemo
non small cell lung cancer- better prognosis, surgery
causes of lung cancer
exposure to inhaled irritants over time
cancer cells arise from the bronchial epithelium secondary to irritation/inflammation
genetic predisposition
lung cancer symptoms
dyspnea
persistent cough or change in cough
hemoptysis/ rust colored sputum
hoarseness
late signs of lung cancer
weight loss
fatigue
dysphagia
anorexia
lung cancer diagnostic
Chest xray
chest CT
bronchoscopy with biopsy
CT guided biopsy
Open lung biopsy
PET scan
Thoracentesis
treatment and nursing care for lung cancer
surgical intervention; best option of NSCLC
chemotherapy: best option for SCLC
Radiation therapy: used in conjunction with other treatments
palliative treatment with lung cancer
goal: comfort and symptom relief
Oxygen
medications
radiation (decrease tumor size/pain relief)
thoracentesis (dyspnea management)
purpose of lung cancer chest tubes
collects air, fluid, or blood from the pleural space
allows the lung to re-expand
prevents air from re-entering the pleural space
wet drainage system
nursing care for lung cancer chest tubes
ensure dressing is tight and intact around tubing
assess SOB and breath sounds
check alignment of trachea
Palpate for puffiness or crackling
observe for signs of infection
check to see if tube ‘eyelets’ (holes indicating dislodgment) are visible
Keep drainage system lower than the level of the patient’s chest
asses for tidaling
watch for tension pneumothorax and SQ emphysema
lung cancer chest tube emergencies
tracheal deviation
sudden onset or increased intensity of dyspnea
O2 sat less than 90
Drainage greater than 70mL/hr
eyelets on the chest tube
chest tube falls out of patient’s chest
What are some most common types of
pneumonia? (Select all that apply)
A. community acquired
B. hospital acquired
C. ventilator associated
D. healthcare associated
E. dormant pneumonia
ABCD
Which clinical manifestations would the
nurse most likely see in a client
diagnosed with pneumonia? (Select all
that apply)
A. Chest discomfort
B. Dyspnea
C. Fever
D. Cough
E. Myalgia
F. Increased respiratory rate
ABCDEF