Vascular Disorders

Question 1

In pulmonary edema, fluid accumulates in 2 places:

Answer 1

1. Alveoli

2. Interstitial area

Question 2

What sound is heard when one listens to the chest of a patient with pulmonary edema?

Answer 2

Rails

Question 3

What happens to the gas exchange capabilities of a patient with pulmonary edema?

Answer 3

Gas exchange is impaired, the amount of oxygen diffusing into the blood is decreased.

Question 4

What does pulmonary edema interfere with?

Answer 4

Lung expansion

Question 5

What heart problem could cause pulmonary edema?

Answer 5

Left sided heart failure

Question 6

In pulmonary edema patients, what does inflammation in the lungs cause an increase of?

Answer 6

The permeability of capillaries

Question 7

A cause of pulmonary edema is hypoproteinemia.

1. What is that?
2. What does it cause?
3. What does it result from?

Answer 7

1. Low protein levels
2. It causes a decrease in osmotic pressure
3. It could result from kidney or liver disease

Question 8

Where does albumin come from?
What does it do with increased or normal levels?
What does it do with decreased levels?

Answer 8

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

Question 9

How could a tumor cause pulmonary edema?

Answer 9

By causing obstruction of the lymph vessels

Question 10

What are the 3 clinical manifestations of mild pulmonary edema?

Answer 10

1. Cough
2. Orthopnea
3. Rales (the finer type)

Question 11

Define orthopnea

Answer 11

Shortness of breath when laying flat

Question 12

What happens to the cough from pulmonary edema when there is an increased amount of fluid congestion?

Answer 12

Hemoptysis occurs

Question 13

When pulmonary edema has increased fluid congestion, there is sputum involved. Describe it.

Answer 13

Frothy, blood tinged sputum

Question 14

When pulmonary edema has increased fluid congestion breathing becomes ___ ___ as lungs become ___ ___ ___ ___.

Answer 14

When pulmonary edema has increased fluid congestion breathing becomes MORE LABORED as lungs become MORE DIFFICULT TO EXPAND.

Question 15

Patients describe the discomfort of pulmonary edema with increased fluid as “feeling like they are drowning.”
What is that called?

Answer 15

Orthopnea

Question 16

How do you treat pulmonary edema?

Answer 16

1. Treat the causative factor (left sided heart failure, inflammation, etc.)
2. Supportive care
3. Possibly a positive-pressure mechanical ventilation

Question 17

What is a thrombus?

Answer 17

A stationary mass

Question 18

What is an embolus?

Answer 18

A moving mass

Question 19

What is a Pulmonary embolus?

Answer 19

A blood clot or mass that obstructs pulmonary artery or any of its branches

Question 20

What does the effect of the embolus depend on? (3)

Answer 20

1. Material
2. Size
3. Location

Question 21

Usually when people have a small pulmonary embolus, they are usually silent. When might a small pulmonary embolus not be silent?

Answer 21

When they are in a large area of the lung.

Question 22

A large embolus may cause ___ ___.

Answer 22

A large embolus may cause SUDDEN DEATH.

Question 23

90% of pulmonary emboli originate from ___ ___ ___ in ___.

Are they preventable?

Answer 23

90% of pulmonary emboli originate from DEEP VEIN THROMBOSES in LEGS.
Yes they are preventable

Question 24

What are the 3 clinical manifestations of a small pulmonary embolus?

Answer 24

1. Transient chest pain
2. Cough
3. Dyspnea

Question 25

Are larger emboli insidious or acute.

Answer 25

Acute

Question 26

What are the 4 clinical manifestations of a large pulmonary embolus?

Answer 26

1. Increased chest pain with coughing or deep breathing
2. Tachypnea
3. Dyspnea
4. Later: hemoptysis and fever

Question 27

A large pulmonary embolus (PE) could cause hypoxia. This stimulates the __ __ causing 4 signs/symptoms.

Answer 27

This stimulates the sympathetic response.

This causes anxiety, restlessness, pallor, and tachycardia

Question 28

What are the symptoms of having a massive embolus? (4)

Answer 28

1. Severe, crushing chest pain
2. Low blood pressure
3. Rapid, weak pulse
4. Loss of consciousness

Question 29

What are the 4 prevention techniques for PE?

Answer 29

1. Health teaching prior to surgery
2. Anti-embolic stockings
3. Exercise to prevent thrombosis
4. Use of anticoagulant drugs

Question 30

What 4 diagnostic tests are preformed for PE?

Answer 30

1. Radiography
2. Lung scan
3. MRI
4. Pulmonary angiography

Question 31

What assessment is performed on patients with a PE during treatment?

Answer 31

Assessment of risk factors

Question 32

A patient with a PE is told to have prolonged ___ ___ and wear ___ ___.

Answer 32

A patient with PE is told to have prolonged BED REST and wear COMPRESSION STOCKINGS.

Question 33

What surgical procedures are used for patients with a PE?

Answer 33

Surgically inserting a filter into the vena cava or an embolectomy

Question 34

What medications are prescribed for a patient who has had or has a PE.

Answer 34

1. Heparin

2. Streptokinase

Question 35

A patient with a PE is placed on mechanical __ to help them breath.

Answer 35

A patient with a PE is placed on mechanical VENTILATION to help them breath.