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Pulm Disease 5

spc

QuestionAnswer
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