Week 5: Respiratory Flashcards
Typical pneumonia
infection by bacteria, multiply extracellularly in the alveoli & cause inflammation and exudation of fluid into the alveoli
Atypical pneumonias
viral and mycoplasma infections,
Community acquired pneumonia
infections from organisms found in the community, S.pneumoniae
Hospital acquired pneumonia
lower respiratory tract infection
Aspiration pneumonia
substances/secretions enter lower airway from the mouth and trachea
Acute bacterial pneumonia
caused by normal flora of the nasopharynx
Lobar pneumonia
consolidation of part or all of a lung lobe
Bronchopneumonia
patchy consolidation involving more than one lobe
Complications of pneumonia
blood poisoning, abscess, septic shock
Explain the development of COPD
inflammation and fibrosis of bronchial walls > hypertrophy of sub mucousal glands > hypersecretion of mucus > loss of alveolar tissue & elastic lung fibers > results in obstruction of airflow, v surface area for gas exchange
Explain the development of tuberculosis (TB)
airborne infection > pathogenesis > exposure > cell medicated immune response > resistance > hypersensitivity to TB antigens
Discuss the development of hypoxia as a result of respiratory compromise
the body or region is deprived of adequate oxygen supply resulting in hypoxia
Small cell lung cancer (SCLC)
highly malignant, association with smoking, secondary’s are common
Non small cell lung cancer (NSCLC)
originates in central bronchi. Adrenocarcinomas: most common in women and non smokers, located peripherally. Large cell carcinmoas: occur peripherally, highly anaplastic
Relationship between respiratory failure and hypoxemia
recused oxygenation of arterial blood caused by respiratory alterations in one or more of the following: oxygen delivery to the alveoli, ventilation of the alveoli, diffusion of oxygen, perfusion of pulmonary capillaries
Corticosteroids role
used in asthma to reduce airway obstruction due to inflammation (used after bronchodilator) v mucus production
Use of antihistamines
block the action of histamines, v capillarity permeability and oedema, ADR’s: sedation, muscle weakness, dizziness, insomnia, hypertension
Use of surfacants
reduce surface tension of the alveoli thus allowing expansion for gas exchange, ADR’s: bradycardia, pneumothorax, oxygen desaturation, pulmonary haemorrhage
Process of respiratory assessment
history (reason, symptoms, medications, cultural consideration), ausculatation (breath sounds), palpation (temp & moisture of skin, chest size, tender spots, symmetry of chest call, trachea midline), percussion (flat over sternum & lung fields, resonance over lung fields, dullness over heart), diagnostics (chest xray, sputum sample, ECG)
Define fine crackles
short duration, high pitched just before inspiration
Define course crackles
long and low pitched
Define rhonchi
continuous loud low pitched rumbling course sounds on inspiration and expiration
Define wheeze
high pitched continuous musical sounds in all lung fields, squeak heard continuously during inspiration and expiration
Common investigations for a person undergoing respiratory assessment >
physical exam, chest x-ray, pulmonary function test, BMI, ABG’s, ECG, sputum sample, echocardiogram
Define tracheostomy
a surgical incision into the trachea
5 indications for a tracheostomy
long term ventilation > 10 days, bypass upper airways, to remove excess secretions where airway clearance is ineffective, facilitate weaning from mechanical ventilation, protect airway from aspiration > lack of gag reflex
4 physical effects of a tracheostomy
communication, fear, difficulty breathing, scar
Why do we humidify the oxygen inhaled by a patient
warms and moistens air, decrease viscosity of secretions, prevent sputum plugging, reduce risk of trauma to airway
5 complications of a tracheostomy
infection, bleeding and scarring at stoma site, formation of granulation, obstruction of the tube, displacement of the tube, development of a medical emergency
Define the acronym TRACHE
tube secure, resus, airway clear, care of site, humidification, emergency equipment
Nursing interventions priority for a trachea patient
humidified o2 , communication, positioning (Fowlers), physiotherapy, oral hygiene
Specific emergency equipment for trachea pt
tracheostomy tray, oxygen and suction
What’s in a trachea tray
dilator/retractors, gauze, replacement tube
Specific respiratory assessments for a trachea pt
o2 stats, vitals, auscultation of lungs, inspection of chest
