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resp disorders
Common respiratory disorders
| Question | Answer |
|---|---|
| An inflammatory response to uncontrolled multiplication of microorganisms invading the lower respiratory tract | pneumonia |
| Community acquired pneumonia (CAP) | strep, hemophilus, influenza, staph |
| Hospital acquired pneumonia (HAP) | (nosocomial) ecoli, MRSA Centilator acquired pneumonia with in 48 hours of intubation |
| aspiration pneumonia | caused by gastric contents or oropharyngeal bacteria |
| S&S of pneumonia | dyspnea, fever chills, cough, purulent sputum, crackles, confusion and tachypnea, CBC, blood clutures, ABG's |
| people at risk for pneumonia | age 65 or older, under 65 and have a chronic disease, psplenia or splenic dysfunction |
| Acute hypoxic injury | ARDS |
| direct injury | aspiration, pulmonary infection, near drowning, thoracic trauma or toxic inhalation |
| indirect injury | shock, sepsis, hypothermia, DIC, multiple transfusion eclampsia, pancreatitis, burns |
| presentation of pneumonia | bilater infiltrates on CRX, non cardiogenic pulmonary edema, hypoxemia despite increaseing FiO2, increasing peak ariway pressure and reduced lung compliance |
| early phase of pneumonia | edematous-mediators released, damaging alveolar capillary membrane |
| late phase pneumonia | fibrotic and brittle lungs |
| hypoxia | tachypnea, restlessness and apprehension, moderate increased work of breating, all worsening until resp failure develops |
| improves perfusion to areas of the lung with better ventilation, length of time depends on how the patient is improving, require team effort | prone position |
| leasing cause of hospital admission for children | asthma |
| asthma | a chronic inflammatory disease of the airways, hyperresponsiveness, variable ariway obstruction, resolves spontaneously or after using a bronchodilator |
| testing for asthma | spirometry, pulmonary function testing |
| common triggers of asthma | upper resp tract infection, allergens, exercise, medication (b-blockers), food (sulfites), emotions |
| severe attack failing to respond to rigorous conventional therapy with bronchodilators | status asthmaticus |
| sub-glottic edema, 3month to 3 years, gradual onset, hoarseness barking cough stridor, treat with mist, hydration, steroids, corse of 3-4 days | croup |
| inflammation of the epiglottis, 2-6years, acute onset, drooling air hunger, treat with antibbiotics and fix airway, corse 36-48 hours after antibiotics begin | epiglottitis |
| clot lodges i nthe pulmonary arterial system disrupting blood flow to a region of the lungs | pulmonary embolism |
| predisposing factors to DVT | venous stasis, hypercoagulability, vein wall damage |
| where do most pulmonary embolisms arise from | deep leg veins |
| polycythemia, injury to vascular endothelium, venous stasis(decreased CO, A-fib, immobility), previous PE, cancer, trauma | DVT/PE risk factors |
| massive PE, occlusion of more than 40% of the vascular bed | Saddle PE |
| causes increased dead space, bronchoconstriction, resp failure, decrease in LV preload, decreased CO, decreased BP, shock | what happens with PE |
| S&S of PE | dyspnea, sudden onset of pleuritic chest pain (worsens with breathing), cough, tachypnea, rales, tachycardia, sinus tachycardia |
| What is used to diagnosis PE | spiral CT |
| Prevention of PE | compression stockings, SCD's, ambulation, hydration, anticoagulation, inferior vena cava filter |
| What is PTT used to test for | heparin |
| What is PT used to test for | comadin warfarin |
| disruption of the nurmal negative pressure in the pleural space | pleural space disease |
| pheumothorax | air in the pleural space |
| hemothorax | blood in the pleural space |
| pleural efusion | accumulation of pleural fluid secondary to increased fluid formation |
| empyema | pus infection |
| what is usualy needed when there is a pleural space disease | chest tube to drain fluid or air |
| causes pressure on great vessels, heart and other lung, This compromises cardiac output, and resp function | tension pneumothorax |
| tension pneumothorax | air enters the lung on inspiration but cannont get out on expiration so air builds up |
| what are chest tubes used for | removeal of air or fluid from the pleural space, re-expand the collapsed lung, restore negative pressure to the pleural space |
| on a chest tube drain what do you want to set the water pressure to | 20cm |
| what does the water seal chamber do | creates a seal between the thoraic cavity and the open environment |
| if there are bubbles in the water chamber what does that mean | there is air comming out of the lung or there is a leak in the connections |
Created by:
dnoyes
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