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Pulm Disease 5
spc
| Question | Answer |
|---|---|
| Pulmonary edema results from? | excessive movement of fluid from the pulm vascular system to the extravascular system and air spaces of the lungs |
| As a consequence of this fluid movement? | the alveolar walls and interstitial spaces swell |
| What is the common cause of cardiac pulm edema? | left heart failure, commonly called congestive heart failure |
| Cardiac pulm edema occurs when? | the left ventricle is unable to pump out enough blood during each contraction |
| The ability of the left ventricle to pump out blood can be determined by? | an LVEF test, done with echocardiogram |
| An LFEF less than 40%? | may confirm heart failure, anything lower is life threatening |
| A patient with left ventricular failure often has? | activity intolerance, weight gain, anxiety, delirium, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough, fatigue, cardiac arrhythmias, and adventitious breath sounds |
| Pulm edema may also result from? | increased capillary permeability, lymphatic insufficiency, decreased intrapleural pressure, decreased oncotic pressure (rare) |
| Inotropic agents like dobutamine are given too? | augment left ventricular function, produce vasodilation, increase CO |
| Pulm edema would result in ? | restrictive PFT results |
| Physical exam signs of pulm edema? | tachypnea, decreased compliance, hypoxemia, anxiety |
| What type of respirations may be seen in pt's with left sided heart failure and pulm edema? | cheyne stokes |
| Patients with pulm edema often awaken with severe dyspnea after several hours of sleep, this is called? | paroxysmal nocturnal dyspnea |
| What will happen to your 02ER with pulm edema? | decreased |
| What hemodynamic changes will you see with cardiogenic pulm edema? | increased CVP, Increased PA pressure, Increased PCWP, Decreased CO and SV |
| What x-ray findings will you see with cardiogenic pulm edema? | fluffy opacities, kerly A and B lines, bats wings or butterfly pattern, pleural effusion( cardiogenic) |
| Kerly A lines represent deep interstitial edema, Kerly B lines? | short, thin horizontal lines of interstitial edema |
| With non cardiogenic pulm edema you will not have pleural effusion, you will see? | fluffy densities, unilateral or bilateral infiltrates |
| Lung expansion therapy is often used for cardiogenic pulm edema too? | offset fluid accumulation and atelectasis |
| Mask CPAP for pulm edema? | improves compliance, reduces WOB, enhances gas exchange, decreased vascular congestion |
| What other treatment protocols are used for pulm edema? | 02 therapy, Broncho pulmonary hygiene, mechanical ventilation, aerosolized medication |
| A blood clot that becomes dislodged and travels to another part of the body is called? | an embolus |
| DVT and Pulm embolus are often clinically insidious disorders, if the pulm embolus is small? | signs and symptoms are vague and non specific |
| Often sudden death is the first symptom in? | 25% of large pulm embolus cases, one of the most common causes of sudden death in all age groups |
| A blood clot in the lungs is often not considered until? | autopsy in 70-80% of all cases |
| There are many possible sources of a pulm emboli, such as? | fat, air, amniotic fluid, bone marrow, tumor fragments |
| The most common cause of a pulm emboli is? | blood clots that break away from sites of DVT in the lower parts of the body |
| What are the three primary factors associated with the formation of DVT's? | known as Virchows triad, venous stasis, hypercoagulability, injury to the endothelial cells that line the vessels |
| Risk factors associated with pulm embolus? | Venous stasis (inactivity), surgical procedures, trauma, oral contraceptives |
| Angiography is an outdated form of pulm ebolus diagnosis, we use? | high resolution CT angiogram (CTPA) |
| Pulm embolus is treated with? | anticoagulant (heparin), long term post treatment with Coumadin, umbrella placement |
| Physical exam findings in pulm embolus pt? | Tachypnea, hypoxemia, tachycardia, sinus tachycardia EKG rhythm, crackles, wheezing |
| Abnormal heart sounds will be heard with pulm embolus pt's? | increased second hart sounds (S2), increased splitting of the second heart sounds |
| What are preventative measures for pulm embolism? | walking, exercise while seated, drink fluids, graduated compression stockings |
| Pulm embolism cuts off blood vessels, resulting in? | lung infarction, atelectasis, pulm htn |
| hemodynamic values with pulm edema? | Increased CVP, Increased PA pressure, Same of increased PCWP, decreased CO |
| What are the sleep disorder categories? | sleep related breathing disorders, insomnia, hypersomnia's, parasomnias, movement disorders |
| What is cheyne stokes breathing? | three consecutive central apneas followed by crescendo-decrescendo breathing |
| What are signs of obstructive sleep apnea? | loud snoring, abrupt awakenings and sob, insomnia, morning headache, excessive daytime sleepiness(hypersomnia) moodiness |
| What is mixed sleep apnea? | combo of OSA and CSA |
| OSA is often seen in pt's with? | large neck. neck circumference >17 inches |
| Treatment of sleep apnea? | CPAP, 02 therapy, oral dental appliances |
| CSA is often seen in pt's with? | hypothyroidism |
| CPAP titration is done to? | determine best pressure, OSA pt's need continuous positive airway pressure to keep airways open |
| OSA pt's have a higher incidence of? | HTN |
Created by:
juialynn92
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