Vascular Disorders Flashcards
In pulmonary edema, fluid accumulates in 2 places:
- Alveoli
2. Interstitial area
What sound is heard when one listens to the chest of a patient with pulmonary edema?
Rails
What happens to the gas exchange capabilities of a patient with pulmonary edema?
Gas exchange is impaired, the amount of oxygen diffusing into the blood is decreased.
What does pulmonary edema interfere with?
Lung expansion
What heart problem could cause pulmonary edema?
Left sided heart failure
In pulmonary edema patients, what does inflammation in the lungs cause an increase of?
The permeability of capillaries
A cause of pulmonary edema is hypoproteinemia.
- What is that?
- What does it cause?
- What does it result from?
- Low protein levels
- It causes a decrease in osmotic pressure
- It could result from kidney or liver disease
Where does albumin come from?
What does it do with increased or normal levels?
What does it do with decreased levels?
Albumin is from the kidneys
At higher levels albumin attracts water, keeping water in the blood stream
At low levels, it allows water to pool in tissue
How could a tumor cause pulmonary edema?
By causing obstruction of the lymph vessels
What are the 3 clinical manifestations of mild pulmonary edema?
- Cough
- Orthopnea
- Rales (the finer type)
Define orthopnea
Shortness of breath when laying flat
What happens to the cough from pulmonary edema when there is an increased amount of fluid congestion?
Hemoptysis occurs
When pulmonary edema has increased fluid congestion, there is sputum involved. Describe it.
Frothy, blood tinged sputum
When pulmonary edema has increased fluid congestion breathing becomes ___ ___ as lungs become ___ ___ ___ ___.
When pulmonary edema has increased fluid congestion breathing becomes MORE LABORED as lungs become MORE DIFFICULT TO EXPAND.
Patients describe the discomfort of pulmonary edema with increased fluid as “feeling like they are drowning.”
What is that called?
Orthopnea
How do you treat pulmonary edema?
- Treat the causative factor (left sided heart failure, inflammation, etc.)
- Supportive care
- Possibly a positive-pressure mechanical ventilation
What is a thrombus?
A stationary mass
What is an embolus?
A moving mass
What is a Pulmonary embolus?
A blood clot or mass that obstructs pulmonary artery or any of its branches
What does the effect of the embolus depend on? (3)
- Material
- Size
- Location
Usually when people have a small pulmonary embolus, they are usually silent. When might a small pulmonary embolus not be silent?
When they are in a large area of the lung.
A large embolus may cause ___ ___.
A large embolus may cause SUDDEN DEATH.
90% of pulmonary emboli originate from ___ ___ ___ in ___.
Are they preventable?
90% of pulmonary emboli originate from DEEP VEIN THROMBOSES in LEGS.
Yes they are preventable
What are the 3 clinical manifestations of a small pulmonary embolus?
- Transient chest pain
- Cough
- Dyspnea
Are larger emboli insidious or acute.
Acute
What are the 4 clinical manifestations of a large pulmonary embolus?
- Increased chest pain with coughing or deep breathing
- Tachypnea
- Dyspnea
- Later: hemoptysis and fever
A large pulmonary embolus (PE) could cause hypoxia. This stimulates the __ __ causing 4 signs/symptoms.
This stimulates the sympathetic response.
This causes anxiety, restlessness, pallor, and tachycardia
What are the symptoms of having a massive embolus? (4)
- Severe, crushing chest pain
- Low blood pressure
- Rapid, weak pulse
- Loss of consciousness
What are the 4 prevention techniques for PE?
- Health teaching prior to surgery
- Anti-embolic stockings
- Exercise to prevent thrombosis
- Use of anticoagulant drugs
What 4 diagnostic tests are preformed for PE?
- Radiography
- Lung scan
- MRI
- Pulmonary angiography
What assessment is performed on patients with a PE during treatment?
Assessment of risk factors
A patient with a PE is told to have prolonged ___ ___ and wear ___ ___.
A patient with PE is told to have prolonged BED REST and wear COMPRESSION STOCKINGS.
What surgical procedures are used for patients with a PE?
Surgically inserting a filter into the vena cava or an embolectomy
What medications are prescribed for a patient who has had or has a PE.
- Heparin
2. Streptokinase
A patient with a PE is placed on mechanical __ to help them breath.
A patient with a PE is placed on mechanical VENTILATION to help them breath.
