Respiratory Disorders

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Author:
wiscflor
ID:
13054
Filename:
Respiratory Disorders
Updated:
2010-04-04 14:51:54
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MS1 Quiz 4
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RD
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  1. Decreased FEV-1 is indicative of what diseases?
    • Asthma
    • COPD

    (air trapping)
  2. Decreased vital capacity indicates what?
    • Pulmonary Fibrosis
    • Neuromuscular disorders

    (restrictive lung disease)
  3. What are common etiologies of epistaxis?
    • Trauma
    • Nasal sprays
    • Street drugs
    • Coagulopathy
  4. What is the most effective medication for allergic rhinitis?
    Nasal corticosteroid
  5. What other medications help with allergic rhinitis?
    • 1st generation antihistamine: Benadryl
    • (highly sedating)

    2nd generation non-sedating: Claritin

    Leukotriene inhibitors: Singulair
  6. Obstructive Sleep Apnea
    Risk factors:
    S/S:
    • Obesity
    • Age > 65y/o

    • Snoring
    • AM Headache
    • Somnolence
    • HTN
  7. Obstructive Sleep Apnea
    Diagnostic:
    Managment:
    Polysomnography (Sleep Study)

    • Weight loss
    • Avoid sedatives
    • CPAP or BiPAP
  8. Oxygen Delivery Methods
    Nasal Canula:
    Simple Mask:
    Venturi Mask:
    Non-Rebreather:
    • NC
    • Up to 6L
    • Drying
    • Fall risk, skin breakdown

    • SM
    • 6-10L
    • Uncomfortable

    • VM
    • Delivers 24-55%

    • NR
    • Up to 100%
    • Intake valves
  9. What are the two artificial airways?
    • Endotracheal Intubation
    • (short-term mechanical vent)

    • Tracheostomy
    • (long-term mechanical vent)
    • (for upper airway obstruction)
  10. Tracheostomy Management
    What equipment should be at the bedside?
    • Ambu Bag
    • Suction
    • Oxygen
    • Obturator
    • Trach Tube
  11. Tracheostomy Management
    Important things to consider when suctioning:
    • Limit attempts
    • 10 seconds per attempt
    • Pre-oxygenate
    • Assess vitals pre/post
  12. Pneumonia
    Risk Factors:
    • Chronic lung disease
    • Immunocompromised
    • Immobility
    • Altered LOC
    • Intubation
    • Tube Feeding
  13. Community-Acquired Pneumonia
    Typical vs. Atypical Organisms:
    • Typical
    • Strep Pneumoniae
    • Haemophilus Influenzae

    • Atypical
    • Mycoplasma
    • Chlamydia
    • Legionella
  14. Hospital-Acquired Pneumonia
    Prevalence?
    Associated with?
    Second most common nosocomial infection

    • Ventilator
    • (prevention: Elevate HOB, Closed circuit, suction)
  15. Antibiotics should be administered within ____ hours
    4 hours
  16. Why are blood cultures done for pneumonia?
    To look for sepsis
  17. Tuberculosis
    S/S:
    • Coughing hemoptosis
    • Fever
    • Chills
    • Weight loss
  18. Tuberculosis
    Diagnostics:
    • PPD skin test
    • CXR
    • Sputum
  19. Tuberculosis
    Latent vs. Active:
    Latent - patient has it but immune system has it under control...can be active later

    Active - currently has it
  20. What precautions must be taken with an active TB patient?

    How long is the treatment?
    • Respiratory isolation in a negative pressure room
    • (air that won't be circulated out into the halls)

    • 6 months - 2 years
    • (compliance can be an issue)
  21. TB Drugs and their risks:
    • Isoniazid (INH)
    • Hepatotoxicity
    • Neuropathy

    • Rifampin
    • Hepatotoxicity
    • Orange urine

    • Pyrazinamide
    • Hepatotoxicity
    • Dermatitis

    • Ethambutol
    • Optic neuritis
  22. What is the leading cause of cancer death?
    Lung Cancer
  23. Lung Cancer
    Risk Factors:
    S/S:
    Diagnostics:
    • Smoking
    • Radon
    • Inhaled carcinogens

    Chronic cough

    • CXR
    • CT, MRI, PET
  24. Lung Cancer
    Types:
    Non-small cell

    • Small cell
    • (Influences SIADH = hyponatremic)
    • (more aggressive with poor prognosis)
  25. Lung Cancer
    Treatment:
    Nursing Care:
    • Surgery
    • Radiation
    • Chemotherapy

    • Oxygenation
    • Symptoms management
    • Nutrition
    • Psychosocial
  26. Chest Tube - 3 Chamber System
    Water seal vs. Suction
    WS - Let's air come out but not back in. Look for bubbles, if you see it check lines to find air leak

    S - Draws off air and fluid
  27. Restrictive Lung Disease
    Etiologies:
    S/S:
    • Idiopathic
    • Inhalation or dust
    • Also amioderone

    • Dry cough
    • Crackles
    • Hypoxia
  28. Asthma
    S/S:
    • Wheezing
    • Cough
    • Dyspnea
    • Prolonged Expiration
    • Decreased breath sounds
    • Exercise-Induced
  29. Asthma Medications: B-2 Agonists
    Types:
    Adverse Effects:
    • Albuterol - short-acting
    • Salmeterol - long-acting

    • Tachycardia
    • Angina
    • Tremors
    • Palpitations
    • Anxiety
  30. Asthma Medications: Corticosteroids
    • For long-term use
    • Less adverse effects
    • Most effective
    • NOT a rescue inhaler
    • Rinse mouth after use
  31. Asthma Medications: Anticholinergic
    Types:
    Atrovent
  32. Asthma Medications: Leukotriene Inhibitors
    Types:
    Also used for:
    Singulair

    Allergies
  33. Asthma Medications: Theophylline
    Toxicities:
    Therapeutic Range:
    Cardio, Neuro, GI

    5-15 mg/L

    (Many drug interaction)
  34. Asthma Medications: Combo Inhalers
    • Advair (Flucticasone + Salmeterol)
    • BID dosing
    • NOT rescue
    • Don't increase inhalations

    • Combvient (Albuterol and Ipratropium)
    • Can be QID prn dose
  35. Status Asthmaticus
    Silent chest?
    Initial ABGs?
    Late ABGs?
    • Hear wheezing then nothing = BAD!
    • (lung are not moving)

    • PO2 decrease
    • PCO2 decrease
    • pH increase
    • (resp. alkalosis = hyperventilating)

    • PO2 decrease
    • PCO2 increase
    • pH decrease
    • (resp. acidosis = not breathing)
  36. How to manage asthma?
    • Avoid triggers
    • Reduce allergens
    • Understand medication usage
    • Peak flow meter
  37. COPD
    Reversible?
    Risk Factors?
    Not fully reversible

    • Tobacco smoke - #1
    • Occupational
  38. COPD
    Chronic Bronchitis vs. Emphysema
    • CB
    • Productive cough for 3 months in 2 consecutive years

    • E
    • Destruction of terminal bronchioles with air trapping
    • Decreased surface area for gas exchange
  39. What is the purpose of pursed lip breathing?
    Prevents the airway from collapsing
  40. COPD Treatments: Anticholinergic Inhalers
    Types:
    • Atrovent - short-acting
    • Spiriva - long-acting

    (bronchodilators)
  41. Cystic Fibrosis
    Genetics:
    Diagnostic:
    Autosomal recessive

    Sweat chloride test
  42. Cystic Fibrosis
    Median survival age:
    Treatment:
    35

    Lung transplant

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