Definitions, etiology, Symptoms, Treatment
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| What is interstitial Pulmonary Fibrosis (IPF)? | show 🗑
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| show | An immune reaction to inhaled substances like, Chlorine, Ammonia, PVC, smoke inhalation, Radiation. May also result from complications of other pulmonary diseases such as TB, unresolved pneumonia,fungal infections,& diseases of unknown etiology.
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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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| show | Silicosis(Silica dust),Farmer's lung(moldy hay), Silo-filler disease(Nitrogen dioxide), Coal miners pneumonia(coal dust), Asbestosis(Asbestos), Siderosis(Iron dust), Aluminosis(Aluminum)
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| Symptoms of IPF. | show 🗑
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| show | Increased WOB, tachypnea w/ shallow VT, accessory muscle use, breath sounds(diffused, dry, crackling rales) cyanosis, restricted chest wall movement, later stages show clubbing and cor pulmonale.
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| show | elevated diaphragm, small lung, large heart, honeycomb appearance from fibrotic changes.
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| show | Bronchoscopy, biopsy, PFT, history.
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| Treatment of IPF. | show 🗑
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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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| What types of lung diseases are restrictive? | show 🗑
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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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| Etiology of pleural effusion. | show 🗑
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| show | Chest x-ray.
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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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| What is chylothorax? | show 🗑
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| Symptoms of pleural effusion. | show 🗑
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| X-ray findings. | show 🗑
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| Treatment for pleural effusion. | show 🗑
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| What is a pneumothorax? | show 🗑
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| show | Open and tension.
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| Criteria for an open pneumothorax. | show 🗑
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| Criteria for a tension pneumothorax (spontaneous). | show 🗑
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| show | Pressure does not build up, gas is allowed to move freely in and our of the pleural space
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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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| X-ray findings for a pneumothorax. | show 🗑
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| Treatment for pneumothorax. | show 🗑
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| What is a chest tube? | show 🗑
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| What are chest tubes used to resolve? | show 🗑
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| What do chest tubes comprise of? | show 🗑
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| show | Fowler's/semi-Fowler's position, 2in. into pleura cavity. Pneumothorax, placed @ apex of lung(2nd/3rd intercostal space) hemothorax, placed @ base of lung slightly lateral(6th/8th intercostal space)w/both place 2 tubes & connect w/ a "Y" connector.
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| What is pulmonary edema? | show 🗑
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| Causes of pulmonary edema. | show 🗑
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| show | *tachypnea *labored shallow breathing *cyanosis *pedal edema *neck vein distension *SOB *HR and BP are increased *respiratory acidosis *profuse diaphoresis *cough w/ pink frothy secretions *hyperventilation *breath sounds: rales.
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| show | Prominent vascular markings, diffuse fluffy infiltrates w/ butterfly pattern and possible cardiomegaly.
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| show | Alveolar edema; surfactant flushing which increases surface tension (alveolar collapse) a V/Q occurs (intrapulmonary shunting)and hypoxemia happens.
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| show | Lasix -to decrease fluid, Morphine -vasodilation to decrease vascular resistance, Digitalis -increase contractility of heart and increase CO, O2 therapy, CPAP/BiPAP, ventilation w/PEEP
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| Non-cardiogenic pulmonary edema. | show 🗑
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| Diagnosis of Pulmonary edema. | show 🗑
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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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| What is pneumonia? | show 🗑
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| Types of pneumonia. | show 🗑
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| show | Cough w/sputum, dyspnea, chest pain, chills, fever, hypoxemia. Breath sounds:rhonchi, crackles, wheezes. At first it mimics a cold or flu.
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| X-ray findings for pneumonia. | show 🗑
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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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| show | Common with ICU, 70% of patients on vent >2 days will get & 50% will die. Can be caused by caregiver error, aspiration, weak immune system.
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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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| show | Thrombus and Embolus.
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| show | A blood clot attached to its site of origin, usually deep in the leg veins.
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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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| show | Prominent vascular markings, diffuse fluffy infiltrated w/ butterfly pattern, possible cardiomegaly.
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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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| Clinical presentation of PE. | show 🗑
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| Diagnosis of PE. | show 🗑
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| Treatment for PE. | show 🗑
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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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| show | Can lead to pneumonia, respiratory failure, and longer hospital stay.
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| Pathophysiology of post-op atelectasis. | show 🗑
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| show | Decreased FRC, V/Q mismatch, intrapulmonary shunting, decrease lung compliance, increase WOB, possible respiratory failure.
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| show | IS, IPPB, CPAP, PEP, secretion removal, deep breathing and cough, CPT, IPV, mechanical ventilation if needed.
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| show | Reduction in lung volume, elevation of hemidiaphragm, mediastinal shifts towards the affected side.
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| Clinical signs of post-op atelectasis. | show 🗑
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