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SOPN Upper Rest Test
SOPN Upper Resp Test 7 (2 of 2)
| Question | Answer |
|---|---|
| Permanent dilation and distortion of bronchi and or bronchioles | Bronchiectasis |
| Seen in Cystic Fibrosis, asthma and bronchities if severe | Bronchiectasis |
| Cough with large sputnum, hemoptyis, malise, fatigue, DOE signs of what | Bronchiectasis |
| DX: *CT scan of th ebronchi showing the dilated airways* | Bronchiectasis |
| Collapse of aveolie which were previously expanded, commonly associated with different pulmonary diseases | Atelectasis |
| NI: TCDB, ambulation, incentive spirometer, Chest PT if ordered, | Atelectasis |
| Greatest Risk for Pulmonary Embolism | Immobilized patients with heart failure, long bone fractures, abdominal surgery, others: Preg, varicose, Ca, obestity, sickel cell anemia. |
| Most common risk for Pulmonary Embolism | Detached Deep Vein Thrombi |
| Virchow's Triad: 3 factors predispose person for a thrombus formation: | Damanged venous epithelium, Venus Statis, Hypercoagubility of blood (from surgery, increarsed pltelet, trauma, dyhydration). |
| Occlusion of Pulmonary Artery: | Pulmonary Embolism carried in blood stream for a veinor right side of the heart to the lungs. |
| VQ Scan: | Diminished or absent radioacivity suggest lack of perfusion or air flow greater than 1. |
| Signs of Pulmonary Embolism | Increase RR, HR, and DECREASE BP. *GENERLIZED CHEST DISCOMFOR AND PLUEURITIC TYPE CHEST PAIN CRUSHING SUSTERNAL CHEST PAIN AND TACKYCARDIA* |
| DX of Embolism: | Difficult mimics other disorders VQ scan, ABG's *PULMONARY ATERIOGRAPHY IS DEFINITIVE DIAGNOSIS* |
| Treatment Embolism | Ambulation, elevation, leg exercise, elastic stockings, hydration, low dose heparing sc, asprin and coumadin |
| What to give with decrased BP with Embolsim: | Dobutamine or Dopamine IV |
| Drugs Embolism: | Streptokinase, Urokinase TPA, Throbolytics are quicker than heparin but higher risk for bleeding *Monitor PT* |
| Greenfield Filer for what | Embolism, inserted in Vena Cava allows blood to flow but prevents passage of thrombi |
| NI Embolism: | Check Homans sign, RR, Chest Pain, JVD. |
| What is Normal Systolic Pulmonary Pressure? | Less than 12 mm Hg |
| What is Normal Dystolic Pulmonary artery pressure? | 20-30 mm Hg |
| PA pressure greater than 30/16 is what | Pulmonary Hypertension |
| Increase resistance to blood flow in the pulmonary vessels resulting increased pulmonary artery pressure: | Pulmonary Hypertension |
| Cause of Pulmonary Hypertension | Emphysema, hypoxemia, chronic bronchitis |
| DX of Pulmonary Hypertension | Heart catheterization, lung scans, pulmonary angiography |
| NI Pulmonary Hypertension | Adequate oxygenation, monitor RR |
| Severe hypoxemia and decreased lung compliance due to pulmonary edema, Not heart failure | Adult Respiratory Distress Syndrome, ARDS is life threatening. |
| Cause of ARDS | injury to lung, cuases increased pulmonary vascular permeability. |
| At risk for ARDS | CABG, sepis, transfussions, CVA, brain tumor, ICP, Smoke inhalation |
| Latent Stage of ARDS | 1st stage: damage at the level of cell membranes |
| Interstitial Edema Stage of ARDS | 2nd stage: aveoli elasticity reduced, dyspnea, increase RR, restlessness |
| Acute Intra Aveolar Edema stage of ARDS | 3rd stage: fluid accumulation around the aveoli and aveoli becomes flooded, decrease mental status |
| Fibrotic Stage of ARDS | 4th stage: scarring occurs and pt remains hypoxemic, despite aggressive 02 and mechanical ventilation |
| DX ARDS | ABG, CXR, DECREASING PA02, INCREASING PaCO2 |
| Lesion in mostly lower lobes lead to brochogenic carcinoma or pulmonarry fibrosis | Abestosis |
| Silicosis | Coal miners disease, silca nodules in lungs especially upper lobes |
| Black Lung | Prolonged exposure to coal dust. |
| Complications of Black Lung | Pulmonary Hypertension and severe destructive lung disease |
| NI Coal Workers Pneumoconiosis | Fowlers postion, ventilators, space activities, rest periods |
| Fractured Ribs: | Perforates lung causing hemothorax, pneumothorax, and laceration of liver, lung and spleen DX: XRAY |
| What to avoid with factured Ribs | Narcotics, decrease respirations, heal 3-6 weeks Do not wrap chest |
| Flail Chest | when 3 or more ribs are fractured in 2 or more places, causing free floating rib segments |
| NI Flail Chest | Watch for pneumothorax, hydration, 02 |
| Pneumothorax | Air enter the pleural space from the lung, increased intrapleural pressure can be from Emphysema |
| Tension Pneumothorax | Air leaks into the pleural space during inspiration but prevented from escaping during exhalation therfore air pressure increases = MEDIASTINAL SHIFT, impairing venous return. |
| When would you hear a sucking sound audible on inspiration with varying degress of respiratory distress on severity | Tension Pneumothorax |
| Accumulation of blood in the pleural space, from internal bledding | Hemothorax |
| SS: Mediastinal shift, signs of shock, Increased HR, Increased RR, decrased BR, Pallor | Hemothorax |
| Chest tube tor restablish intra pleural pressure as well as drainage in a hemothorax | Hemothorax Chest Tube, or Thoractomy |
| NI: Hemothorax & Pneumothorax | RR, 02 sats, assess respiratory, observe for dyspnea, assess for deviation of the trachea |
| Crushing and brusing of the lung | Pulmonary Contusion |
| DX of Pulmonary Contusion | Hx of trauma, CXR reveal area of atelectasis |
| Neoplasms | Lung Cancer |
| Management Neoplasms | Decreased fluid if damaged vessels, antibiotics to prevent septicemia, high fowlers |
| Air which has escaped lung enters subcutaneous tissue. Popping sounds under skin | Subcutaneous Emphysema |
| Squamous Cell Neoplasms | From large bronchi, obstruction of airways, spread to bowel and thorax, poor prognosis. |
| Adenocarcinoma Neoplasms | Most Common. Arise in lungs, spread to brain |
| Large Cell Carcinomas | Arise in Peripheral Bronchi, mass tumor, spread to CNS |
| Small Cell Carcinomas | Most malignant of lung cancers, they metastasize early via blood stream and lymph system, secrete ADH 9 antidiuretic hormone leads to hyponatremia. |
| SS Neoplasms | Blood tinged sputnum, wheeze, chest pain, hoarse, anorexia, wt lose, anemia. |
| DX Neoplasms | CXR CT MRI, Confirmed sputnum cytology or biopsy or broncoscopy |
| Treatment Subcutaneous Emphysema |
Created by:
keldog09
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