Pulmonary

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Anonymous
ID:
13644
Filename:
Pulmonary
Updated:
2010-04-08 22:51:16
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Nursing 306
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Exam 3
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  1. Hyperventilation
    Increase in the amount of air entering the alveoli leading to hypocapria. (PaCO2 < 35 mm Hg)
  2. Hypoventilation
    • Decreased delivery of air to the alveoli
    • Insufficient to provide oxygen and remove caron dioxide (PaCO2 >45 mm Hg).
    • Decreased rate and depth of respiration.

    Causes myasthenia gravis, sleep apnea, chest trauma, morphine
  3. Polmonary Embolism Etiology
    Undissolved embolus that occludes blood vessels of lungs
  4. Pulmonary Embolism Risk Factors
    • Virchow's triad -
    • venous stasis / sluggish blood flow
    • hypercoagulability
    • damage to the venous wall (intimal injury)
  5. Pulmonary Embolism Types and Causes
    • Thrombotic (blood clots develop in venous system, eg. legs)
    • Fat (fat emboli ex. bone / fractures)
    • Amniotic Fluid (seen in pregnancy)
    • Air (from venous access ex. IV)
    • Others
  6. Pulmonary Embolism - Clinical Manifestations
    • Dyspnea
    • Chest Pain (or on inspiration)
    • anxiety
    • Tachycardia
    • Tachpnea
    • Dizziness
    • Hemoptysis (Expectoration of blood)
  7. Pulmonary Embolism Treatment
    • Prevention
    • 1. compression stockings during and after surgery
    • 2. intermittent leg compressions
    • 3. early mobilization
    • Anticoagulants - Heparin, Enoxaparin(Lovenox), Warfarin (Coumadin)
    • Thrombolytics: Streptokinase, tissue plasminogen (TPA), anistreplase (Eminase)
    • Umbrella filter (Mobin Uddin), filter in inferior vena cava
  8. Pulmonary Embolism Complications
    • Shock
    • Respiratory Failure
    • Cardiac and Respiratory Arrest
  9. COPD: Emphysema Pathogenesis
    • Hyperinflation of alveoli
    • Destruction of alveolar walls & capillary walls
    • Loss of Alveolar Walls leads to narrowed airways (Bronchioles)
    • p. 552
  10. Emphysema Etiology
    • Cigarette Smoking, Air Pollution
    • Recurrent Infection
    • Heredity (alpha 1-antitrypsin deficiency)
    • Aging
  11. Emphysema - Clinical Manifestations
    • Dyspnea / Pursed Lip breathing
    • Use of intercostal and accessory muscles
    • Underweight
    • Barrel Chest
    • "Pink Puffer"
    • Cough is minimal
    • Hyposemia (late sign)
  12. Chronic Bronchitis
    Hyperplasia of mucus secreting glands in tracheobronchial tree, increase in goblet cells, decrease in cilia, narrowing of small airways, impaired alveolar macrophages = increase in bronchial infections
  13. Chronic Bronchitis - Clinical Manifestations
    • Productive Cough (winter)
    • Usually heavy set or normal weight
    • "Blue-bloater"
    • Dyspnea
    • Hypercapnia
  14. Asthma
    • Reversible airway obstruction
    • Airway inflammation
    • Increased airway responsiveness
    • Allergic and Non-Allergic (or Extrinsic / Intrinsic)
  15. Asthma Triggers
    • Allergens
    • Tobacco Smoke
    • Exercise (Running, jogging, tennis)
    • Weather changes (cold weather)
    • Respiratory Infections
    • Nose & Sinus Problems
    • Drug and food additives
    • Severe GERD
    • Emotional Stress
  16. Asthma - Clinical Manifestations
    • Dry Cough
    • Wheezing
    • SOB / Dyspnea
    • Complaints of "Chest Tightness"
    • Severe attacks - no audible wheezing
    • "Silent chest" - ominous sign of impending respiratory failure
  17. Asthma Complications
    • Status asthmaticus
    • 1. severe life-threatening attack refractory to usual treatment
    • 2. think respiratory failure
    • Atelectasis
    • Pneumonia
    • Spontaneous Pneumothorax
    • Respiratory failure, Respiratory arrest
  18. Pneumonia - Etiology
    • Upper Respiratory Infection
    • Tracheal intubation
    • Aging
    • Incompetent immune system
  19. Pneumonia Etiology
    • Impaired mucociliary mechanism (smoking, pollution)
    • Decreased cough and epiglottal reflexes (aspiration)
    • Inhalation of microbes (Mycoplasma Pneumoniae)
  20. Pneumonia Classifications
    • Community Acquired (CAP)
    • Hospital Acquired (HAP)
    • Bacterial
    • Viral
    • Atypical
  21. Pneumonia
    inflammatory reaction in the alveoli and insterstitium of lung, usually caused by an infectious agent
  22. Pneumonia - Clinical Manifestations
    Fever, cough, chills, purulent sputum, back pain or pleuritic chest pain, h.a., myalgia, fatigue, sore throat, tachypnea, tachycardia, dyspnea, rales (crackles) over affected lung, abnormal CXR, hypoxemia
  23. Pneumonia - Diagnosis
    • H & P
    • CXR
    • Sputum Culture
    • Elevated WBC
  24. Pneumonia - Treatment
    • Oxygen
    • Antibiotics
    • Analgesics
    • Antipyretics
    • Fluids (IV or oral)
    • Caloric Intake
    • Rest
  25. Tuberculosis
    • Caused by Mycobacterium Tuberculosis
    • Impaired immune systems (HIV, Diabetes, corticosteriod users)
  26. Tuberculosis - Pathogenesis
    • Inhaled bacilli pass down the bronchial system to implant themselves on bronchioles or alveoli
    • Multiply with no initial resistance
    • Can continue to multiply within phagocytes
  27. Tuberculosis - Ghon Tubercle
    • Parenchymal component - necrotic nodule becomes fibrotic and calcified
    • Lymph - found in lymph nodes
  28. Tuberculosis - Clinical Manifestations
    • Low grade fever
    • Cough
    • Night Sweats
    • Fatigue
    • Weight Loss
    • Malaise
    • Anorexia
    • Malnourished, ill-looking

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