Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

nurse 251 > week 4 (resp disorders) > Flashcards

week 4 (resp disorders) Flashcards

You may prefer our related Brainscape-certified flashcards:
NCLEX-PN® flashcards NCLEX-RN® flashcards
1
Q

what is pneumonia

A

is an acute inflammation of the lungs parenchyma caused by a microbial agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what protective defense mechanisms keep the airway distal to the larynx sterile?

A

includes filtering of air, humidification of inspired air, epiglottis closure over the trachea, and cough reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is contracting pneumonia? what are the three methods that pneumonia can reach the lungs?

A

1) aspiration from the nasopharynx or oropharynx
2) inhalation of microbe present in the air
3) hematogones spread from a primary infection elsewhere in the body ie.staphlococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is community-acquired pneumonia

A

is defined as a lower respiratory tract infection of the lungs parenchyma with onset in the community
-most frequently occur in winter months or if there is a history of smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what prevention methods can be used for community-acquired pneumonia

A

prevention includes modifiable risk factors such as presence of COPD, recent use of antibiotics and conditions including the risk of aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the second most common hospital-associated infection as has high mortality and morbidity rates?

A

hospital-acquired pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when does hospital-acquired pneumonia occur?

A

occurs 48 hours or longer after hospital admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what may be some predisposing factors for hospital-acquired pneumonia?

A

immunosuppressive therapy, general debility and endotracheal intubation
pts with altered immune response are highly susceptible to respiratory infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what individuals are at risk for opportunistic pneumonia?

A
  • severe protein-calorie malnutrition
  • those with immune deficiencies
  • those who have received transplants and been treated with immunosuppressive drugs
  • pts undergoing tx of radiation, chemo, and corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some signs and symptoms of pneumonia?

A
  • loss of appetite, fatigue, changes in mental health
  • nausea, vomiting, or diarrhea
  • lower body temp and shaking chills
  • pain in chest while coughing or breathing
  • coughing may produce phlegm
  • shortness of breath and restlessness
  • fever and sweating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are some clinical manifestations of Pnu.

A

usually a bunch of symptoms including sudden onset of fever, chills, productive cough with purulent sputum and chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

atypical (unusual) presentations of pnu include what?

A

headache, myalgias, fatigue, sore throat, and nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some manifestations of viral pnu are?

A

highly variable but may be characterized by chills, fevers, dry nonproductive cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some complications of pnu?

A
  • generally, there are no complications
  • complications more frequently develop in those with underlying chronic disease and include pleurisy, pleural effusion, atelectasis, empyema, pericarditis, and bacteremia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is pleurisy?

A

inflammation of the pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is pleural effusion?

A

abnormal collection of pleural fluid that usually reabsorbs within 1-2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is atelectasis?

A

collapse, airless alveoli; usually clear with effective coughing and deep breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is pericarditis?

A

the spread of infection organism from an infection pleura to the pericardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is bacteremia?

A

can occur with pneumococcal pneumonia, more so with other adult patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are some signs of pulmonary consolidation?

A

dullness to percussion, increased fremitus, bronchial breath sounds and crackles may be heard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is needed for the diagnosis of pnu?

A
  • chest x ray
  • sputum cultures are recommended if the presence of a drug -resistant pathogen or an oranism is suspected that is not covered by the usual empirical therapy
  • gram stain of the sputum provides info on the predominant causative organism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how many blood cultures may be done for a critically ill pt?

A

two blood cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is ABG? what is it used to assess?

A

arterial blood gas - used to assess for hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is a CBC and what is it used for

A

Complete blood count- is a blood test used to evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is found in the majorty of pts with bacterial pneumonia?

A

leukocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

should all cultures be collected before initiating antibiotic therapy?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

in uncomplicated cases, the pt responsd to drug therapy usually between within what hours?

A

48 - 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what supportive measures can be used besides antibiotic therapy for pnu?

A

O2 therapy - to tx hypoemia
alalgesics to releive the chest pain
antipyretics to tx fever

29
Q

what is recommended annually for individuals at high risk of developing pnu?

A

influenza vaccine

30
Q

who is at high risk for pnu?

A 
older adults 
nursing home residents 
pts with COPD
diabeties 
health care workers
31
Q

who is indicated for the pnumococcal vaccine?

A

chronic heart and lung disease pts
diebetic pts
pts recovering from severe illnesses
65 year and older in long term facility care

32
Q

what is the tx of choice for otherwise healthy individuals with community acquired pnu?

A

macrolide (erythromycin, azithromycin, or clarithromycin)

33
Q

what ppl are at risk of gram-negitive infections?

A

1) a COPD pts who has taken an oral steroid or antibiotics within the past 3 months
2) nursing home residents

34
Q

what is required to treat gram negitive infections?

A

fluroquinolones (levofloacin, moxifloaxcin)

or amoxicillin and clavulanate

35
Q

what are pts who are hosptialized on medical wards with bacteremic pneumococcal pneumonia treated with?

A

fluoroquinolone

36
Q

fluid intake of at least ___ /day is important in the supportive tx of pnu

A

3/liters a day

37
Q

intake of at least ____ calories per day should be maintained to provide energy for the increased metabolic processes in the pt

A

1500 calories

38
Q

what are small, frequent meals better tolerated by?

A

people with dyspnea

39
Q

how often should a nurse reposition a pt and why?

A

every 2 hours facilitates adequate lung expansion and to discourage pooling of secretions

40
Q

what is theraputic positioning?

A

better oxygenation is achieved when the good lung is placed down to achieve maxium lung expansion

41
Q

what is turberculosis?

A
  • an infectious disease caused by M.tuberculosis
  • usually involves the lungs, also occurs in the larynx, kidneys and bones
  • kills more ppl worldwide than any other infectious disease
42
Q

what is M.tuberculosis?

A

gram positive

  • acid-fast bacillus
  • usually spread from person to person via airborne droplets, which are produced when a infected individual with pulmonary or laryngeal tb coughs, sneezes, speaks, or sings
43
Q

what happens when a TB lesion regresses and heals?

A

the infection enters a latent period in which it may persist without producing clinical symptoms of illness

44
Q

in early stages of TB, are symptoms present?

A

no

45
Q

what are some systemic manifestations of tb?

A

fatigue, malaise, wieght loss, low grade fevers, and night sweats

46
Q

what are some pulmonary manifestations of tb?

A

cough that becomes frequent and produces muciod or mucopurulent sputum

47
Q

what is used to diagnose tb?

A

the Tuberculin skin test

  • a positive reaction indicates presence of tb infection, but it doesnt shoe whether it is latent or active
  • induration greater than 5mm are considered positive
48
Q

what are some other ways to diagnos TB?

A

chest X-ray (CXR): shows multinodular lymph node involvment with cavitation in the upper lobes of the lungs

  • three sputum samples collected on different days are obtained and sent for smear and culture
  • Quantiferon: tube blood test that recognizes antigens in TB positive pts
49
Q

what is the main tx of TB?

A

drug therapy

  • active tb should be managed agressively
  • usually consists of a combo of at least 4 drugs
50
Q

why is combination therapy need for tb pts?

A

it is needed to decrease the development of resistant strains of M.tuberculosis

51
Q

how long should they receive tx for?

A

-infected pts should receive tx for at least 6 months beyond the conversion of sputum cultures to a negitive status

52
Q

what are the four drugs used to tx TB?

A

rifampicin
isoniazid
pyrazinamide
Ethambutol

53
Q

what is direct observation therapy?

A

because of nonadherance being a mjaor factor in the emergence of multidrug reistance and tx failures, DOT is expensive but essential to public health issues
-DOT involves observing the injection of every dose of mediation for the TB pts entire course of tx

54
Q

where should a pts with TB be placed in a hosptial?

A

a pt with TB should be placed in isolation until the pt is considered noninfectious (three negitive AFB smears)

55
Q

what should a pt with TB be taught?

A

to cover nose and mouth with paper tissue everytime he or she coughs, sneezes, or produces sputum
-also taught careful handwashing techniques

56
Q

what is Pulmonary Embolism?

A

PE is the blockage or pulmonary arteries by a thrombus, fat, or air embolus
-the embolus travels with the blood flow through the small vessles until it lodges and obstructs perfusion of teh alveoli

57
Q

where do most PE’s arise from?

A

deep vein thromboses

58
Q

where do lethal PE most commonly originate from?

A

the femoral or iliac veins

59
Q

what are some clinical manifestations of PE?

A
  • classic triad: dyspnea, chest pain, and hemoptysis

- symptoms may begin slowly or suddenly

60
Q

what could a masssive emboli produce?

A

abrupt hypotension, pallor, severe dyspnea and hypoxemia

other symptoms: cough, fever, pleurtic chest pain, tachycardia

61
Q

what are the causes of PE?

A

1) venous statis
2) trauma
3) hypercoagulability

62
Q

what are some diagnostic tools for PE?

A

CT scan = most frequently used
-contrast media is required to veiw blood vessles
-Ventilation/ perfusion scan is done if pt cannot tolerate contract media
-D-Dimer = controversial - is a lab test that measures the amount of cross-linked fibrin fragments
disadvantage= neither specific or sensitive

63
Q

how to prevent PE?

A

prevent VTE first (Venous thromboembolism (VTE) is a condition in which a blood clot forms and lodge in vessles) - to avoid this, includes use to compression devices, early ambulation, and use to anticoagulant meds

64
Q

what drug therapy is available for PE?

A

Fibrinolytic drugs: Tissue plasminogen activator is a protein involved in the breakdown of blood clots.

  • unfractionated heparin IV
  • Enoxaparin is becoming more common
  • Warfain should be initated within the first 24 hrs and is typically administered for 3 to 6 months
65
Q

what is pneumothorax?

A
  • presense of air in the pleural space
  • should be suspected after any blunt trauma to chest wall (deep chest wound)
  • causes lung to collapes
66
Q

what is open pneumothorax?

A

occurs when air enters the pleural space through an opening in the chest wall

  • Ex: gunshot wounds and surgical thoracotomies
  • often referred to as sucking chest wound
  • should be covered with a vented dressing
  • a vented dresssing is one secrued on the three sides and the forth side is left untapped (allows air to escape from vent and decrease likelihood of a tension pnueothorax developing
67
Q

what is closed pneumothorax?

A
  • has no associated external wound
  • most common form is a spontanous pneumothorax
  • caused by rupture of small blebs
  • occurs most commonly in underweight male cig smokers between age 20 and 40
68
Q

what is tension pnuemothorax?

A
  • a medical emergency
  • rapid accumulation of air in the pleural space causing severely high intrapleural pressures with resultant tension on the heart and great vessles
  • can occur if the chest tubes are clammed or blocked in a pt with pneumothorax
  • nurse and paramedics are now trained to insert large-bore neddles to release trapped air
69
Q

what are some clinical manifestations of pneumothroax?

A
  • if it is small, mild tachycardia and dyspnea may be the only manifestations
  • if pneumothorax is large, resp distress may be present, including swallow, rapid respirations, dyspnea, air hunger and decreased o2 saturation
  • on auscultation, no breath sounds are over affected area
  • most definitive and common form of treatment is to insert a chest tube and connect it to a water-seal drainage

nurse 251 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions