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2012-07-08 16:19:15

Chapter 19
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  1. Tuberculosis
    • Cause: mycobacterium tuberculosis
    • Contracted by the inhalation of infectious bacteria
    • Incidence: 10 million world wide
    • TB is a disease of poverty, crowding, refugees, HIV carriers
    • Signs and Symptoms:
    • Anorexia, malaise, fatigue, and weight loss, hemoptysis
    • Dx: positive TB skin test (mantoux test), chest x-ray, sputum culture (C&S test) x3, CT scan
    • Treatment: multidrug treatment: isoniazid (INH), rifampin, ethambutol, pyrazinamide, streptomycin
    • Treatment for 3-12 months
  2. Pneumonia Dx and Trx
    • Dx: chest x-ray, sputum smears, and blood culture
    • Treatments:
    • Antivirals and supportive care for viral
    • Antibiotics for bacterial
    • Postural drainage
    • Bedrest
  3. COPD
    Chronic Obstructive Pulmonary Disease 
  4. COPD Def.
    • on-going condition that is incurable, structural problems within the lungs that impair respirations and inadequate ventilation
    • Includes Chronic Bronchitis
  5. Atelectasis
    • Collapsed Lung
    • Manifestations: Dyspnea, increased heart and respiratory rates, and chest pain
    • Dx: CXR, bronchoscopy, CT
    • Trx: Chest percussion & drainage, cough and deep breathing, and bronchoscopy
  6. Emphysema
    • Dx: PFT,ABG, CXR
    • TRX: Bronchodilators, anti-inflammatories, low flow oxygen, pulmonary rehab
    • S&S: dyspnea, barrel chest, pink puffers(over ventilation)
    • Pink Puffers:
    • Smoking history- usual
    • Age of onset 40-50 years of age
    • Clinical features- often dramatic
    • SOB-may be absent early in disease
    • Sputum- may develop late in the course
    • Prognosis-slowly debilitating disease
  7. Bronchospasms
    Spasms in the Bronchial tubes
  8. Bronchiectasis
    • Causes:
    • airway obstruction, congenital, lung infection, Cystic Fibrosis
    • Pathology:
    • Chronic dilation of large bronchi, infection, destruction of bronchi walls, overlaps another disease, i.e. bronchitis, CF
    • S&S:
    • fever, recurrent infection, coughing, copious amounts of foul smelling purulent sputum, hemoptysis
  9. Asthma
    periodic episodes of severe reversible (usually) bronchial obstruction manifested as bronchoconstriction, inflammation with edema and thick mucus; usually begins as acute: extrinsic found in kids to allergy, will be rates as mild, intermittent, severe or persistent
  10. Lung Cancer
    • Causes: cigarettes, asbestos, coal dust, arsenic, and other industrial air pollutants
    • Types: Non-small cell carcinoma, Squamous cell carcinoma, Adenocarcinoma, Large cell carcinoma, Small
    • cell carcinoma
    • S&S: Hemoptysis, coughing, dyspnea, hoarseness, weight loss, and fatigue
    • Dx: H&P, CXR (will show a tumor up to 2 years before s&s), CT scan, bronchoscopy, sputum for cytology, needle bx., thoracentesis
    • Trx: surgery (stage 1, 2, and some 3) lobectomy, pneumonectomy
    • Radiation Therapy (all stages)
    • Chemotherapy used in combination protocols (generally does not effect long term survival in most cases)

  11. Barrel Chest
    Overexpanded Chest Muscles
  12. Flail Chest
    • Trauma to the chest
    • Double fracture= more than 1 rib
    • Inability to maintain normal movement of the thoracic wall in affected area
    • Mediastinal shift= shifts and squishes the heart
    • Tx:Ventilator assistance, Chest tubes, Pain medication
  13. CBABE
    • Chronic
    • Bronchitis
    • Asthma
    • Bronchiectasis
    • Emphysema