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Stack #239747
| Question | Answer |
|---|---|
| Pulmonary Hypertension (PAH)is a disease characterized by | elevated pulmonary artery pressure, PVR leading to right ventricular failure & death. |
| Pulmonary hypertension 2 causes | Primary cause: familial or idiopathicSecondary: other disease i.e HIV infection, collagen vascular disorders, pulmonary embolus, portal hypertension, congenital hear disease, interstitial lung disease,COPD, & sleep apnea |
| Management of PAH | diuretics (manage volume overload due to right ventricular failure, O2 (hypoxia potent vasoconstrictor, maintain spO2 > 90%digoxin (inotropic agent for HF)Ca channel blockers (used if pt exhibits vasoreactivity during initial treatment) |
| Caring for the PAH patient | increase CO, decrease pulmonary artery pressure, improve quality of life, conserve O2 |
| Common signs & symptoms seen in PAH patients | dyspnea,fatigue,presyncope or syncope,peripheral edema,ascites(worsening symptoms could mean progression of disease and possible increase in medications) |
| 2 most common COPD subtypes | emphysema,chronic bronchitis (contributing factors smoking, environmental pollutants, toxic exposure, predisposing genetic factors i.e. alpha1 antitrypsin deficiency) |
| Symptoms of COPD | increase dyspnea, DOE,sputum production,cough, exhaustion,decrease in expiratory airflow that does not respond to treatment, anxiety,tachycardia,ventricular dysrhthmias |
| Assessing COPD patient | check VS, breath sounds, work of breathing, airway clearance, & LOC |
| Interventions of COPD patient | maintaining oxygenation & ventilation |
| In COPD patients Chest x-ray will show | flatten diaphragm |
| Chronic bronchitis is diagnosed if | chronic cough with sputum production for three months of the year for 2 consecutive years. |
| In chronic bronchitis the mucus glands | are increased in size and the bronchial wall is thickened & presence of cor pulmunale with increase right sided heart failure |
| Pulmonary embolism is when an | emboli dislodge in 1 of the pulmonary vessels, disrupting blood flow to an area of the lung |
| The most common origin of blood clots | deep veins of the legs |
| 3 predisposing factors contributing to pulmonary emboli | Vircho's triad: venous stasis,altered coagulability of the blood,damage to the vessel walls |
| In massive pulmonary embolus | the clot is large enough to obstruct blood flow to 50% or more of the pulmonary vascular bed, patient becomes hypoxemic, increase bronchial constriction can result in to pulmonary hypertension |
| PE is diagnosed via | ABG, ventilation-perfusion scan, spiral CT, pulmonary angiogram, physical assessment |
| PE signs & symptoms | dyspnea,pleurtic type chest pain,dry cough,anxiety with a feeling of impending doom, tachypnea,rales,fever |
| PE treatment | prevent further emboli, heparin, warfarin, IVC filter to prevent further migration of emboli from the lower extremities, oxygenation & ventilation to reverse effects of pulmonary hypertension i.e. intubation & mechanical ventilation |
| Atelactasis | groups of alveoli that have collapsed or are unable to expand |
| Atelactasis contributes to | alveolar hypoventilation and ventilation-perfusion mismatch |
| Atelactasis assessment findings | inspiratory crackles or popping (noise created as ventilatory pressure exceeds the surface tension within the alveoli), changes in VS, slight temperature, mildly increased heart rate & respiratory rate |
| Atelactasis treatment | low-flow oxygen, IS, some mechanism of positive airway pressure |
| Pneumonia (PNA) | inflammation of the lung caused by an infecting agent that usually leads to an area of consolidation within the parenchyma & may result because of decrease in the integrity of the patients immune system or exposure to virulent infecting organism |
| PNA symptoms | fever,chills,cough (productive/non-productive,crackles @ the end of expiratory not cleared by cough or deep breathing)pain @ area of consolidation,limited chest expansion on affected side chest x-ray with pulmonary infiltrates |
| PNA treatment | ID organism through sputum & blood cultures, antibiotic therapy, hypoxemia treated with oxygen, systemic hydration (iv fluids & nutrition), mechanical ventilation if acute respiratory failure |
| Asthma | a chronic disorder of the airways that results in airflow obstruction, bronchial hyper-responsiveness & an underlying inflammation, |
| In asthma the airflow obstruction is triggered by | allergens, viruses or other irritants. airflow is largerly reversible |
| Asthma attack or status asthmaticus or acute asthma is when | the asthma worsens & there is increased SOB, cough, wheezing, & chest tightness as airway continue to narrow |
| Immune response is stimulated by | exposure to an irritant that sets up inflammation in the airways, contributes to bronchospasm, increased mucus production, & mucosal edema, ventilation-perfusion mismatch leads to hypoxemia & tissue hypoxia causing further vasoconstriction |
| Asthma treatment | decrease peak expiratory flow, if PEF < 25% admit to ICU |
Created by:
tauvia2003