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RTH 112
test #3
| Question | Answer |
|---|---|
| over time COPD what happens to the alveoli | they lose their elasticity and can't expand and contract normal |
| why do alveoli distend in COPD | they trap air, can get in but not out |
| COPD history | 1.medical conditions 2.smoking 3.chronic cough/SOB |
| physical exam for COPD patients | 1.auscultation 2.BP 3.peripheral perfusion 4.chest (barrel) 5.clubbing 6.peripheral edema |
| COPD spiromety test FVC indicates | restrictive, normal/decreased in emphysema |
| COPD spirometry test FEV1 indicates | obstructive, decresed |
| what happens to the FEF 25-75% in COPD | is down with and obstructive disease |
| COPD pt's TLC will be | higher cause of air trapping |
| COPD ABG | 1.not ventilating=high CO2 2.hypoxemia 3.chronic |
| what is chronic bronchitis | chronic excessive production of mucus in bronchi, source unknown |
| who usually gets chronic bronchitis | e.mphysema pt's |
| chronic bronchitis major contributing factors | 1.smoke 2.air pollution 3.lung disease 4.age |
| chronic bronchitis is different from acute bronchitis because | the cough/disease doesn't go away and can cause damage to the lining of the bronchi |
| treatment for chronic bronchitis | 1.BHT-chest pt 2.bronchodilators 3.antibiotice-inifection 4.O2 5.rehab |
| test results to confirm chronic bronchitis | 1.ABG-hypoxemia/hypercapnia 2.CXR-normal 3.PFT-decreased flow/increased FRC |
| what is emphysema | permentant enlargement of alveoli= rupture walls= destroyed pulmonary capillaries |
| what causes emphysema | 1.somking 2.alpha 1 |
| in emphysema increased intrathorasic pressure causes the alveoli to | collapse/ close because of damaged alveoli |
| emphysema resistance | increases |
| emphysema complianace | increaase |
| tests for emphysema | 1.ABG 2.CXR |
| ABG for emphysema | compensated resp. acidosis with moderate hypoxemia |
| CXR for emphysema | 1.hyperlucency 2.decreased vascular markings 3.flattened diaphragm 4.blebe/bullous lesions |
| blebs | weakened pouches in lungs that can rupture= pneumothorax |
| bullae | blebs on pleura |
| emphysema RV | increased |
| emphysema FRC | increased |
| emphysemaTLC | increased |
| emphysemaVC | decreased |
| emphysema FEV1/FEF25-75% | decreased |
| treatment for emphysema | 1.stop smoking 2.BHT 3.bronchodilators/steroids 4.antibiotics 5.pulmonary rehab 6.O2 7.ventilator 8.resections |
| what immunizations should COPD patients get | 1.pneumonia 2.influenza |
| what can exercise help COPD | 1.ease symptoms 2.develop higher tolerence 3.improves tolerance |
| what can nutrition do to help COPD | 1.overweight= harder to breath 2.max body's fuel source 3.fights infection |
| what is cor pulmonale | right heart failure because of long time high blood pressure in pulmonary artery and right ventricle |
| what causes cor pulmonale | high blood pressure in the arteries/veins in the lungs (pulmonary hypertension) |
| other name for swan ganz catheter | 1.pulmonary artery catherization 2.flow directed, balloon tipped catheter |
| what does a swan ganz catheter do | measures heart pressure |
| treatment for cor pulmonale | 1.treat underlying disease 2.O2 3.less salt 4.diuretics 5.meds for pulmonary hypertension 6.lung/heart transplant |
| what is cystic fibrosis | genetic disorder effects exocrine glands=sweat/pancreas/lungs= mucus stagnates= obstruction/atelectasis/bacteria |
| characteristics of cystic fibrosis | 1.family history 2.small for age 3.malnorished look 4.dyspnea on exertion 5.cough up thick secretions |
| what test are done for cystic fibrosis | 1.newborn screening 2.sweat test 3.CXR 4.PFT |
| cystic fibrosis sweat test | >60mEq/L |
| cystic fibrosis CXR | 1.hyperinflation 2.flattened dyphram 3.increased AP diameter |
| cystic fibrosis PFT | 1.decreaased flows (FEV1) 2.increased FRC |
| cystic fibrosis treatment | 1.nutrition 2.BHT 3.O2 4.Antibiotics 5.Pulmozyme 6.lung transplant |
| what is asthma | 1.stimulated bronchospasm 2.increased mucus production 3.mucosal swelling |
| asthma is different from other obstructive diseases because | it is reversable |
| what happens during an asthma attack | 1.narrow airways 2.constricted muscles 3.inflammation 4.damaged airway walls |
| 4 symptoms of asthma attack | 1.cough 2.wheeze 3.hypoxemia/hyperventilation 4.increase HR |
| types of asthma | 1.occupational 2.exercise induced |
| what are asthma prophylactic treatment goals | prevent/control 1.avoid triggers 2.meds 3.monitor 4.maintain activity 5.prevent exaspirations |
| asthma reliever inhaler | 1.quick acting to relieve symptoms 2.short lasting |
| asthma controller inhalor | 1.daily prevent symptoms 2.7-14 days for effect 3.not immediate relief |
| asthma long acting bronchodilator | reliever that lasts for 12 hours |
| goals during asthma attack | treat agessively 1.bronchodilators 2.O2 3.IV fluids 4.IV theophylline 5.IV steroids 6.heliox 7.magnesium 8.NIV 9.ventilator |
| what is status asthmaticus | sever asthma attack that doesn't respond to bronchodilators |
| symptoms of status asthmaticus | 1.history 2.retractions/pulsus paroxus 3.ABG=resp. acidosis/failure |
| what is bronchiectasis | chronic dilation of bronchi from inflammation and destroy bronchial wall=mucus forms=infection |
| 3 forms of bronchiectasis | 1.varicose 2.cylindrical 3.saccular |
| what is varicose bronchiectasis | bronchi dilate and contract irregularly causing distorted bulbous shape |
| what is cylindrical bronchiectasis | bronchi are dilated and look like a tube=don't taper the squared off ends |
| what is saccular bronchiectasis | bronchi dilate till large cyst like sacs |
| what is the best test for bronchiectasis | air bronchogram |
| what will and air bronchogram show for bronchiectasis | tree in winter pattern |
| bronchiectasis ABG | hypoxemia/hypercapnia |
| bronchiectasis CXR | 1.lung markings from fibrosis 2.flattened diaphragm 3.segmented atelectasis |
| bronchiectasis PFT | 1.mild=no change 2.advanced=high FRC/low FEV1 |
| initial assesment bronchiectasis give away | 3 layered sputum |
| bronchiectasis treatment | 1.BHT 2.antibiotics 3.humididty 4.immunizations 5.O2 6.surgical ressection |
| what is Alpha-1 deficiency | inherited disease that can cause emphysema/ liver disease |
| what causes Alpha-1 deficiency | gene that makes ATT is defective |
| what does ATT neutralize | neutrophil elastase |
| where does ATT accumulate | in liver |
| what is the test to confirm Alpha-1 deficiency | Alpha-1 deficiency coded test, blood test from dr, free, sent to lab |
| treatment for Alpha-1 deficiency | 1.Alpha-1 replacement with IV 2.BHT 3.immunizations 4.pulmonary rehab 5.lung volume reduction surgery 6.lung transplant |
| what is pulmonary edema | accumulation of fluid in lung tissue/alveoli because of increased pulmonary vascular pressure |
| cardiogenic pulmonary edema | from left heart failure fluid from capilaries forced into lung |
| noncardiogenic pulmonary edema | 1.increased pulmonary capilary permeability from infection/inflammation 2.increased negative pressure in intrathoracic cavity from rapid re-expansion after pneumothorax/effusion |
| what causes pulmonary edema | 1.left heart failure-cardiogenic 2.noncardiogenic pulmonary permeability increase |
| affect of fluid on lungs | 1.wet/stiff 2.lose A/C surface area 3.pink/frothy secretions fill airway |
| why can pulmonary edema cause resp. failure | where theres fluis there cant be air=failure |
| what tests can be done to determine pulmonary edema | 1.swan ganz catheter to check cardiogenic 2.ABG 3.CXR |
| pulmonary edema CXR | 1.fluffy 2.left vent hypertrophy 3.pulmonary congestion 4.increase vascular markings 5.pleural effusion |
| pulmonary edema ABG | hypoxemia/hypercapnia |
| treatment for pulmonary edema | 1.O2 via positive pressure/NRB/ventilator 2.diuretics 3.meds to reduce hypertension/increase heart contraction |
| for pulmonary edema what IPPB therapy was done | 5-15ml 30-50% ethanol |
| what is pulmonary embolism | occlusion of pulmonary artery=dead space disease=ventilation without perfusion |
| most common cause of pulmonary embolism | blood clot |
| what other things can cause pulmonary embolism other than blood clot | 1.fat piece 2.air tissue piece 3.foreign body |
| predisposing factors for pulmonary embolism | 1.prolonged bed rest 2.condition=stagnate blood 3.pregnancy 4.trauma 5.coagultion disorder 6.DVT- |
| pulmonary embolism ABG | 1.low PO2 2.normal PCO2 even though pt is hyperventilating |
| single most important test for pulmonary embolism | V/Q lung scan-vent normal/ perfusion missing |
| another test for pulmonary embolism | pulmonary angiogram- when V/Q inconclusive |
| dead space ventilation | Vt not involved in perfusion |
| nonvented pt range dor deadspace ventilagtion | 20-40% |
| vented pt range of dead space ventilation | 40-60% |
| life threatenting dead space range | >60% |
| pulmonary embolism treatment | 1.prevent 2.anticoagulant-heprin 3.compression socks 4.screens to filter clots(IVC/Greenfield) 5.positioning/movement 6.O2 7.hypotensive=fluids/vasorpressors 8.urokinase/streptokinase |
| pulmonary embolism CXR | 1.fluffy 2.dilated vasculature 3.peripherial wedge shaped infiltrates |
| what is ARDS | inflammation of alveoli=fill with fluid=colapse |
| ARDS causes | 1.thoracic trauma 2.pulm contusion 3.pullm aspiration 4.inhale toxic fumes 5.pulm infections 6.near drowning 7.sepsis 8.shock |
| ARDS phase 1 | 1.dyspnea 2.tachypnea 3.normal CXR 4.O2 normal |
| ARDS phase 2 | 1.12-48hr after illness 2.CXR=infiltrates 3.alveolar damage=epithelial breaks=flooding=no diffusion |
| ARDS phase 3 | 1.AC membrane leak 2.surficant decrease 3.atelectasis 4.stiff wet noncompliant lungs 5.resp failure start 6.CXR-fluffy/ground glass/honeycomb |
| ARDS phase 4 | 1.resp failure 2.fibrosis 3.infection 4.CXR -white out |
| ARDS ABG | refrectory hypoxemia |
| ARDS PFT | worsening compliance |
| treatments for ARDS | 1.O2 2.CPAP/PEEP 3.titrate PEEP/O2 4.ventilator 5.monitor with swan ganz 6.BHT 7.fix underlying problem 8.support give time to heal |
| why use pressure control ventilation for ARDS | 1.reduce baurotrauma 2.pushes air in |
| why use high frequency ventilation for ARDS | 1.small Vt/high frequency 2.adequate ventilation at low pressures oscillator |
| general treatment for pneumoconiosis | 1.limit exposure 2.O2 3.pulm rehab 4.minimize infections 5.stop smoking |
| what causes asbestosis | asbestos=fibrous sillicates from insulation/roofing/break lines |
| what is asbestosis | inhales asbestos fibers inflame/scar till lungs can't function |
| what cancer can asbestos cause | mesothelioma-in plaural/abdominal wall |
| asbestosis CXR | 1.shaggy heart 2.pleural plaques 3.diaphragm calcification |
| what is silicosis caused by | silca=crystalline quartz in 95% of rocks being inhaled |
| what is silicosis | small silica particles eaten by macrphages=damage=release enzymes=inflames=nodules |
| silicosis CXR | eggshell calcification/calcified hilar nodes |
| what causes black lung | from chronic/long exposure to coal dust |
| what is black lung | coal colllects in alveoli=lungs cant get it out=black lesions form=black sputum |
| what is idiopathic pulmonary fibrosis | chronic diffuse lung disease=orgin unknown liance |
| idiopathic pulmonary fibrosis disease process | 1.chronic inflammation 2.avleoli walls thicken 3.wall become fibris 4.scar tissue develops 5.lungs become stiff 6.restrict function/comp |
| idiopathic pulmonary fibrosis CXR | 1.reticular/nodular densities 2.hazy ground glass appearance 3.honeycomb |
| idiopathic pulmonary fibrosis treatment | unknown 1.symptom 2.prevent infection 3.avoid irritants 4.O2 |
| what is sarcoidosis | granulomatous disease=granulomas of epithelial cells=in bronchial/subpleural tissue/bronchial mucosa |
| sarcoidosis typically effects | 20-40 yr old african american women |
| what organs does sarcoidosis effect | 1.lymph nodes 2.lung 3.liver 4.spleen 5.skin 6.eyes |
| sarcoidosis symptoms | 1.fever 2.rash 3.joint pain 4.efects eyes 5.coough 6.fatigue 7.dyspnea |
| routine sarcoidosis test | PFT |
| sarcoidosis PFT | 1.restrictive 2.some obstructive 3.decreased compliance 4.low diffusing capacity |
| sarcoidosis CXR | 1.large lymph 2.infiltrates 3.lung leasions 4.uneven fibrosis |
| sarcoidosis treatments | 1.may improve 2.steroids |
| CXR hyperinflation noted with wheezing= | asthma adult onset=LABA/ SABA/ ICS |
| CXR fibrosis/flatten disphrgm/segmented atelectasis with crackles | bronchiectasis=BHT/O2/resection |
| CXR decreased vascular markings/hyperlucency/flattened diaphragm with diminished BS | COPD exaspiration=antibiotics/small O2/meds/stop smoking/BHT |
| CXR wall thickening with wheeze/ronchi/ bad cough | chronic bronchitis=BHT/Pulm rehab/O2 |
| CXR kid Peribronchial thickening and hyperinflation with wheeze | asthma=allergy to animals/exercise induced=meds/peakflow |
| CXR Decreased vascular markings, flattened diaphragm, hyperlucent painter | Emphysema/A1 defiency=A1 replacement/meds/O2/transplant |
| CXR Fluffy opacities, left ventricular hypertrophy, pulmonary venous congestion, pleural effusions, increase vascular markings, Batwing or Butterfly pattern with pink frothy secretions | Pulm. edema-NIPPV/lasic/NRB/heart meds |
Created by:
Kataleshire
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