Definitions, etiology, Symptoms, Treatment
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| show | Excessive formation of connective (scar) tissue in the process of repairing chronic or acute tissue injury.
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| Etiology of IPF. | show 🗑
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| show | Cellular infiltration, acute vasculitis, scar tissue, that can't be reversed.
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| show | A group of occupational diseases causing chronic inflammation of the lungs and interstitial fibrosis due to inhalation of dust or chemical fumes.
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| Types and causes of Pneumoconioses. | show 🗑
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| Symptoms of IPF. | show 🗑
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| Physical examination findings for IPF. | show 🗑
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| Chest x-ray findings for IPF. | show 🗑
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| Diagnostics used to confirm IPF. | show 🗑
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| show | No known cure. Limit exposure to causative, corticosteroids, O2 therapy, antibiotics, treat symptoms and complications, pulmonary hygiene, bronchodilators.
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| show | Vt = 8 to 12ml/kg b/c trying to compensate for diminished lung volume(5-8ml/kg is the norm)
RR = 12-20 b/min
I time = 1.0sec
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| show | Interstitial pulmonary fibrosis(IPF), Pleural effusion, Pneumothorax, Pulmonary edema(cardiogenic and non-cardiogenic), ARDS, Pneumonia, Pulmonary embolism, Postoperative atelectasis.
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| show | Presence of fluid in the pleural space causing compression of the lung on the affected side. If it is large enough the mediastinum will shift. Is is gravity dependent and may shift with changing of positions.
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| show | Inflammation, malignancy, CHF(most common), infection pulmonary infarction, and trauma.
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| Diagnostics used to confirm pleural effusion. | show 🗑
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| show | Hydrothorax, empyema, hemothorax, chylothorax, fibrothorax.
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| show | Noninflammatory accumulation of serous fluid in one or both pleural cavities.
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| What is empyema? | show 🗑
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| What is hemothorax? | show 🗑
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| show | Chyle from the thoracic duct into the pleural space, usually caused trauma or tumor.
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| show | Dyspnea, tachypnea, chest pain, cough, hemoptysis, hypoxemia. Breath sounds are decreased or crackles over ther effected area.
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| X-ray findings. | show 🗑
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| show | Thoracentesis, chest tube drainage, O2, need to treat underlying cause, symptoms, and complications.
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| What is a pneumothorax? | show 🗑
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| Two types of pneumothorax. | show 🗑
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| Criteria for an open pneumothorax. | show 🗑
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| show | Acute medical emergency, air leaks into pleural space but can't escape, not from an injury, should see a shift in mediastinal. Increase in alveolar and intraplural pressure.
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| Characteristics of an open pneumothorax. | show 🗑
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| show | Gas allowed in but not out, significant increases in pressure.
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| Symptoms of a pneumothorax. | show 🗑
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| show | Hyperlucency and absent vascular markings at location, mediastinum shift.
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| show | Place in Fowler's position, O2 therapy w/ nasal cannula (unless contraindicated), chest tube w/ chest drain system, thoracentesis, IPPB to reinflate the lung, and if respiratory failure place on ventilation.
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| What is a chest tube? | show 🗑
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| show | *Pneumothorax(air) *hemothorax(blood) *pleural effusion *empyema(purulent fluid) *cardiac tamponade following open heart surgery.
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| What do chest tubes comprise of? | show 🗑
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| Chest tube placement. | show 🗑
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| What is pulmonary edema? | show 🗑
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| Causes of pulmonary edema. | show 🗑
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| Signs of pulmonary edema. | show 🗑
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| X-ray findings for pulmonary edema. | show 🗑
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| Cardiogenic Pulmonary edema process. | show 🗑
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| Treatment for cardiogenic pulmonary edema. | show 🗑
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| show | Epithelial damage of alveolar allows fluid to enter the alveoli; CNS trauma, drug OD, high altitudes, re-expansion(rapid removal of pleural effusion fluid, >1000ml, may produce edema) Some consider to be early form of ARDS.
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| show | Wet bubbly rales in lung fields, pink frothy secretions.
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| show | Severe pulmonary congestion. Reaction to the respiratory tract to high levels of physiologic stress.
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| show | REFRACTORY HYPOXEMIA(main sign), decreased lung compliance, decreased FRC, atelectasis, shunting, PE, PF, respiratory failure.
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| Chest x-ray findings for ARDS. | show 🗑
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| Symptoms of ARDS. | show 🗑
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| Treatment of ARDS. | show 🗑
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| show | Inflammation, infection, and consolidation of the lungs
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| show | Viral, bacterial(lobar), fungal(Candida), immune-suppressed(pneumocystis Carinii), aspiration, broncho.
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| Signs of pneumonia. | show 🗑
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| show | Reveals location and extent of infection, radiopacity, infiltrated, consolidation.
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| Why take a sputum culture for pneumonia? | show 🗑
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| show | Usually caused by Streptococcus pneumoniae,localized to 1 or more lobes, rusty colored sputum, empyema, O2 problems like shunting, hypoxemia, and increased metabolic rate.
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| Etiology of viral pneumonia. | show 🗑
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| Symptoms of bacterial(lobar) pneumonia. | show 🗑
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| Symptoms of viral pneumonia. | show 🗑
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| show | Legionnaire's disease(gram neg bacteria), pneumocystis carinii pneumonia(PCP)fatal infection in AIDS patients, vent acquired pneumonia(VAP)nosocomial exchange, bronchiolitis obliterans organizing pneumonia(BOOP)seen in COPD.
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| What is ventilator associate pneumonia(VAP)? | show 🗑
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| Treatment of VAP. | show 🗑
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| General treatment for pneumonia. | show 🗑
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| show | Pentamidine(NebuPent), 300mg powder in 6ml sterile water, given 300mg once a week with a nebulization via respigard II nebulizer(has a 1 way valve to keep meds from being exposed to air) Proper PPE.
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| show | Sudden partial or complete blockage of pulmonary artery blood flow.
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| Types of pulmonary embolism (PE). | show 🗑
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| What is a thrombus PE? | show 🗑
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| What is embolus embolism? | show 🗑
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| show | Deep veins of lower extremities, deep veins of pelvis, right side of heart.
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| show | Immobilized b/c of pain, debilitated, paralyzed, prolong bed rest, obesity, surgery, fracture in leg, hip, or pelvis; stroke, MI, cancer
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| Factors facilitating thrombus formation. | show 🗑
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| X-ray findings for PE. | show 🗑
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| show | Increase in dead space ventilation(Vd/Vt ratio)total ventilation is increased in an effort to maintain normal PaCO2(shallow breathing), large emboli
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| show | Chest pain, dyspnea, cough, faintness, anxiety, increased Vd ventilation; if large enough-tachypena & tachycardia,cyanosis, decreased breath sounds, wheezing & rales, pleural friction rub.
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| Diagnosis of PE. | show 🗑
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| show | Leg exercises, compression elastic stockings, increased activity, anticoagulant drugs, clot filter, O2, vent if needed.
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| show | Collapse of lung due to anesthetic drugs or the inability to breath deeply, cough effectively due to pain.
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| Effects and complications from post op atelectasis. | show 🗑
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| Pathophysiology of post-op atelectasis. | show 🗑
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| Effects of post-op atelectasis. | show 🗑
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| Treatment for post-op atelectasis. | show 🗑
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| show | Reduction in lung volume, elevation of hemidiaphragm, mediastinal shifts towards the affected side.
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| show | Decreased VC, dyspnea, tachypnea, increased WOB, late inspiratory crackles, bronchial breath sounds.
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