210 Ch. 23 Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
Atelectasis? How it develops? | At: closure or collapse of alveoli Dev: acute in postop/immobile/decr ventilation/blockage/xtra pressure on lung |
Diff b/n pleural effusion? pneumothorax? hemothorax? | eff: fluid in pleural space(bn parietal and visceral pleurae) pneu: air in space hemo: blood in space |
s/s of atelectasis? | dyspnea, cough, sputnum acute: resp distress showing tachyc/tachyp/pleural pain/central cyanosis(late sign of hypoxia) |
Nsg preventions for atelectasis | turn, mobilization, deep breathing(q2h), incentive spir. Mgmt secretions: cough/suction/nebulizer/CPT |
Other nsg mgmt when first line measures fail | PEEP(+ end-expiratory pressure)- mask that provides exp resistance CPPB(continuous pos press breathing) |
Tx for pleural effusion? | thoracentesis - needle aspiration of fluid, or chest tube |
what is acute tracheobronchitis? | inflammation of mucous membranes of trachea/bronchial tree. |
Manifestations of tracheobronchitis? TX? | scanty sputum at first, fever, chills, insp stridor, exp wheeze, purulent sputum tx: fluids to thin secretions, moisture |
Two classifications of pneumonia | CAP-community-acquired: w/in 1st 48h after hospitalization. HAP- hospital-acquired/nosocomial: More than 48h after admission |
CAP types Steptococcal pneumonia 14% mortality rate | winter/Af Am/elderly/COPD, heart failure, alcoholism, asplenia, DM s/s: pain, quick onset tx: penicillin |
Haemophilus influenza 30% mortality rate | alcoholics/elderly/DM/COPD/child<5y s/s: assoc with URI tx: amoxicillin |
Legionnaires' Disease 15-50% mortality rate | summer/fall, older men/smokers/excavation sites s/s: flu like tx: fluoroquinolone,azithromycin |
Mycoplasma pneumonia Viral Chlamydial | tx: macrolie, tetracycline oseltamivir/zanamivir fluoroquinolone |
HAP Pseudomonas Pn 40-60% mortality | cancer/burns/lung disease s/s: productive cough, fever, chill tx: betalactam + cipro, levofloxin, aminoglycoside |
Staphylococcal pn 25-60% mortality | drug users/hiv/MRSA s/s: hypoxemia, cyanosis, necrotizing inf tx: vancomycin, linezolid |
Klebsiella pn 40-50% mortality | alcoholic/COPD/elderly s/s: tissue necrosis, cough, fever tx: levofloxacin, piperacillin/tazobactam + amikacin |
Pneumonia in Immunocompromised PCP, fungal, mycobacterium(TB) | from corticosteroids, chemo, AIDS |
Aspiration Pn | aspirate GI contents, gases, chemical contents |
Who should get pnue vaccine? | >65, immunocompetent, asplenia(w/o spleen) |
Complications of pneumonia | hypotension, shock, resp failure, heart failure, dysrhythmias, pericarditis, pleural effusion |
what is silent aspiration | non-fx nasogastric tube allows gastric contents to accumulate in stomach Placement is key to prevention |
When is residual volume checked in tube feedings? | q4h and if >200-250ml residual volume, then pt shows intolerance to feedings |
what is SARS | viral resp illness caused by coronavirus. s/s: fever >100.4, coughing, trouble breathing tx: droplet/contact/airborne |
TB preventions | negative pressure private room, fitted respirators, standard precautions |
What is the Mantuox test for TB | Dx of TB How: deposit purified protein PPD subq w/ bevel of needle facing up to create bleb/wheal. Results in 48/72h Reaction pos: induration(hardening) and erythema |
Induratino measurements for pos TB | 0-4mm- not signuficant >5mm- sig for at risk(HIV+, contact, + chest xray) >10mm- sig with impaired immunity Pos not mean active TB, immunocompromised may be + and not show = anergy |
What may be diff for elderly wtih TB tests | s/s of confusion, fever, anorexia, wt. loss. TB test can show no reaction or delay up to wk(recall phenomenon), need 2nd test |
TB tx? | antifubercolosis agents 6-12mos with 3-4 or more meds INH, Rifampin, pyrazinamidem, ethambutol Nsg Intv: compliance |
contraindications for IHH and rifampin | INH avoid tyramine(tuna, aged cheese) (Vit B given with INH) Rifampin: alter metabolism and make less effecitve of BB, warfarin, dig, corticosteroids, oral contraceptives |
Lung abscess s/s? tx? | necrosis of pulmonary parenchyma by inf s/s: pleural friction rub, crackles tx: clindamycin(Cleocin) |
Peurisy s/s? tx? nsg mgmt? | inflamm both layers of pleurae s/s: knifelike pain, maybe one side s/s effusion: sob, pain, decr chest wall excursion tx: indomethacin(anti-inflamm) nsg: splinting, thoracentesis |
Empyema s/s? tx? nsg? | thick, purulent fluid in space w/ walled off area s/s: like pneumonia dx: chest CT tx: drainage, abx nsg: breathing excercises |
Pulmonary Edema s/s? tx? | fluid in alveolar space/lung tissue from heart prob(LV), pneumonectomy, pneumothorax dx: crackles, frothy secretion tx: fix problem |
Acute Resp Failure vs chronic | acute: ventilation/perfusion impaired..PaO2<50, PaCO2>50, pH<7.35 chronic: long period, by COPD, neuromuscular diseases |
ARDS Acute Resp Distress Syndrome | from acute lung injury 4-48h leading to hypoxemia tx: PEEP, nutritional support 35-45kcal/kg/day nsg: turning(prone), decr anxiety, sedate(ativan/versed/propofol/precedex), paralytics(pavulon/norcuron/tracrium/zemuron |
pulmonary arterial hypertension two types? | MAP>25, wedge press <15mmHg 1.idiopathic,primary from known cause: women, 20-40y, death in 5y 2.From known cause |
Pulmonary arterial htn s/s? tx? | s/s: dyspnea(exertion/rest), chest pain, weakness, fatigue, syncope, Rside heart failure tx: viagra/tracleer/thelin/letairis |
Pulmonary Heart Disease-Cor Pulmmonale | RV enlarges of heart from diseases(COPD, pulmonary htn) tx: treat cause |
Pulmonary Embolism | obstruction of pulmonary art or branch by thrombus from venous sys or Rside of heart. |
risk factors for PE | venous stasis, injury, tumor, polycythemia, splenectomy, vascular dis, DM, COPD, HF, obesity, preg, elderly, oral contraceptives |
Emergency mgmt for PE | O2, ABGs, CT, ECG, catheter if suffered embolism, stockings |
anticoagulation therapy for PE | heparin continued til INR is 2.0-2.5 then need to take same kind of warfarin PO |
Thrombolytic therapy for PE | urokinase, streptokinase, alteplase |
Sarcoidosis | mostly of lung w/ s/s dyspnea, cough, hemoptysis, congestion |
Lung Cancer Staging and types | 1.sm cell cancer 2. non-sm cell cancer sqaumous cell, lg cell, adenocarcinoma Stage 1 to IV(metastatic) Cough that changes can mean cancer |
Rib fractures 1-3 means? 5-9? lower? | 1-3: high mortality bc subcl aa/vv 5-9: most common lower: spleen/liver injury tx: control pain |
Flail chest? | 3 or more adjacent ribs fractured at 2 or more sites..free floating rib segments tx: airway/secretions/pain |
what is a contrecoup contusion | contused lung occurs on other side of pt of body impact |
Gunshot wounds classified by 3 types of velocity? Factors to determine? | low, med, high factor: distance from which gun was fired, caliber of gun, size of bullet |
Nsg intv to mgmt gunshot wound to chest | maintain cardiopulmonary fx, assess further injuries, type blood for transfusion, peripheral pulses, lg bore IV line, catheter, NG tube, chest tube |
What causes a pneumothorax? | pleural space exposed to pos atmospheric pressure. Normal is neg or subatmospheric simple/traumatic |
tension pneumothorax? | air pulled into pleural space from lacerated lung or chest wall wound and gets trapped, not expelled. Lung collapse, heart/trachea shift to unaffected side(mediastinal shift). Incr press so decr circulation. tx: chest tube in 2nd intercostal space |
When is a thoracotomy needed in open pneumothorax? | If >1500ml blood aspirated by thoracentesis or >200ml/h from chest tube |
Created by:
palmerag
Popular Nursing sets