Disease

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Author:
darrell2662
ID:
216006
Filename:
Disease
Updated:
2013-04-27 16:33:32
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Test three
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Test three
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  1. Anatomic Alterations of the Lungs with pneumothorax!
    • Lung collapse
    • Atelectasis
    • Chest wall expansion
    • Compression of the great veins and decreased cardiac venous return
  2. Traumatic pneumothorax!
    Penetrating wounds to the chest wall
  3. Open pneumothorax or sucking chest wound!
    The pleural space is in direct contact with the atmosphere and gas can move into and out of the pleural cavity
  4. Closed or tension pneumothorax!
    • A one way valve like action of the ruptured parietal pleura
    • Gas enters the pleural space during inspiration but cannot leave
  5. Spontaneous pneumothorax!
    When a pneumothorax occurs suddenly and without any obvious underlying cause
  6. Iatrogenic Pneumothorax!
    occurs during specific diagnostic or therapeutic procedures
  7. Cardiopulmonary Clinical Manifestations Associated with Pneumothorax!
    Atelectasis
  8. Vital signs with pneumothorax!
    • Increased respiratory rate
    • Increased Heart rate (pulse)
    • Increased Blood pressure
  9. Chest Assessment Findings with pneumothorax!
    • Hyperresonant percussion note over the pneumothorax
    • Diminished breath sounds over the pneumothorax
    • Tracheal shift
    • Displaced heart soundsIncreased thoracic volume on the affected side
  10. Chest radiograph with pneumothorax!
    • Increased translucency on the side of pneumothorax
    • Mediastinal shift to unaffected side in tension pneumothorax
    • Depressed diaphragm
    • Atelectasis
  11. Management of pneumothorax!
    • The management of pneumothorax depends on the degree of lung collapse...
    • When suction is used, the negative pressure need not exceed -12 cm H2O; -5 cm H2O is generally all that is needed.
    • After the lung has reexpanded and bubbling from the chest tube has ceased, the tube is left in place without suction for another 24 to 48 hours
  12. Respiratory Care Treatment Protocols for pneumothorax!
    • Oxygen Therapy Protocol (100 % increases rate of absorption of gas)
    • Lung Expansion Therapy Protocol
    • Mechanical Ventilation Protocol
  13. Anatomic Alterations of the Lungs with pneumonia!
    • Inflammation of the alveoli
    • Alveolar consolidation
    • Atelectasis
  14. Gram positive causes of Pneumonia!
    • Streptococcus
    • Staphylococcus
  15. Gram negative causes of Pneumonia!
    • Haemophilus influenzae
    • Pseudomonas aeruginosa
  16. Cardiopulmonary Clinical Manifestations Associated with Pneumonia!
    • Alveolar Consolidation 
    • Increased Alveolar-Capillary Membrane Thickness 
    • Atelectasis
    • Excessive Bronchial Secretions
  17. Vital signs associated with pneumonia!
    • Increased Respiratory rate (Tachypnea)
    • Increased Heart rate (pulse)
    • Increased Blood pressure
  18. The Physical Examination with pneumonia!
    • Chest pain/decreased chest expansion
    • Cyanosis
    • Cough, sputum production, and hemoptysis
  19. Chest Assessment Findings with pneumonia!
    • Increased tactile and vocal fremitus
    • Dull percussion note
    • Bronchial breath sounds
    • Crackles and rhonchi
    • Pleural friction rub
    • Whispered pectoriloquy
  20. Chest Radiograph with pneumonia!
    • Increased density
    • Air bronchograms
    • Pleural effusions
  21. CT Scan with pneumonia!
    • Alveolar consolidation
    • Air bronchograms
  22. The treatment of pneumonia is based on...
    • The specific etiology of the pneumonia, and
    • The severity of symptoms demonstrated by the patient.
  23. Respiratory Care Treatment Protocols for pneumonia!
    • Oxygen Therapy Protocol
    • Bronchopulmonary Hygiene Therapy Protocol
    • Lung Expansion Therapy Protocol
  24. Anatomic Alterations of the Lungs with ARDS!
    • Interstitial and intra-alveolar edema and hemorrhage
    • Alveolar consolidation
    • Intra-alveolar hyaline membrane
    • Pulmonary surfactant deficiency or abnormality
    • Atelectasis
  25. Cardiopulmonary Clinical Manifestations Associated with ARDS!
    • Atelectasis 
    • Alveolar Consolidation
    • Increased Alveolar-Capillary Membrane Thickness
  26. Vital signs with ARDS!
    • Increased Respiratory rate
    • Increased Heart rate
    • Increased Blood pressure
  27. Chest Assessment Findings with ARDS!
    • Dull percussion note
    • Bronchial breath sounds
    • Crackles
  28. Chest Radiograph with ARDS!
    Increased opacity
  29. Respiratory Care Treatment Protocols with ARDS!
    • Oxygen Therapy Protocol
    • Lung Expansion Therapy Protocol 
    • Mechanical Ventilation Protocol
  30. Common ARDS mechanical ventilation
    strategy!
    • Low-tidal volumes and high respiratory rates
    • Ø5 to 7 mL/kg
    • ØVentilatory rates between 20 and 25 bpm
    • Ventilatory rates as high as 35 bpm may be needed.
    • PEEP and/or CPAP
    • Permissive hypercapnia is often allowed
  31. The therapeutic goals of low-tidal volume
    ventilation with ARDS!
    • Decrease high transpulmonary pressure Reduce overdistention of the lungs
    • Decrease barotrauma
  32. Anatomic Alterations of the Lungs associated with Myasthenia Gravis!
    • Mucous accumulation
    • Airway obstruction
    • Alveolar consolidation
    • Atelectasis
  33. Screening and Diagnosis for Myasthenia Gravis!
    • The clinical history
    • Neurologic examination
    • Electromyography
    • Blood analysis
    • Edrophonium test
    • Ice pack test
    • Sleep test
    • Computed tomography or magnetic resonance imaging
  34. Cardiopulmonary Clinical Manifestations Associated with Myasthenia Gravis!
    • Atelectasis
    • Alveolar Consolidation
    • Excessive Bronchial Secretions
  35. Vital signs with Myasthenia Gravis!
    • Respiratory rate
    • ØVaries with the degree of respiratory muscle paralysis
    • Ø Apnea (in severe cases)
  36. Chest Assessment Findings with Myasthenia Gravis!
    • Diminished breath sounds
    • Crackles and rhonchi
  37. Chest Radiograph with Myasthenia Gravis!
    • Normal in early stage
    • Increased opacity (when atelectasis is present)
  38. General Management of Myasthenia Gravis!
    • Frequent measurements of the patient’s:
    • VC 
    • NIF
    • Blood pressure
    • Pulse oxygenation saturation
    • ABG's
  39. Respiratory Care Treatment Protocols for Myasthenia Gravis!
    • Oxygen Therapy Protocol
    • Bronchopulmonary Hygiene Therapy Protocol
    • Lung Expansion Therapy Protocol
    • Mechanical Ventilation Protocol
  40. Anatomic alterations of the lungs with flail chest!
    • Double fracture of numerous adjacent ribs
    • Rib instability
    • Lung volume restriction
    • Atelectasis
    • Lung collapse
    • Lung contusion
    • Secondary pneumonia
  41. Flail chest!
    The result of double fractures of at least three or more adjacent ribs, which causes the thoracic cage to become unstable
  42. Vitals signs with flail chest!
    • Increased respiratory rate
    • Increased heart rate
    • Increased Blood pressure
    • Paradoxical movement of the chest wall
  43. Chest assessment findinf with flail chest!
    Diminished breath sounds, on both the affected and the unaffected sides
  44. Chest radiograph with flail chest!
    • Increased opacity
    • Rib fractures
  45. Respiratory care treatment protocol!
    • Oxygen therapy protocol
    • Lung expansion therapy protocol
    • Mechanical ventilation protocol
  46. Factors that increase risk of hospital acquried infections!
    • Long hospital stay
    • Indwelling catheters, central lines, and ventilators
    • Complications following surgery
    • Failure of healthcare workers to wash hands
    • Overuse of antibiotics.
  47. Role of the RT in Preventing hospital acquried infections in ventilated Patients!
    • Humidification and Filtration
    • Avoiding manipulation of the ETT
    • Ventilator circuit changes
    • Maintenance of ETT Cuff Pressures
    • Endotracheal Tube Modifications
    • Hand Hygiene and Glove / Gown Adherence
    • Head of Bed elevated 30 degrees or greater Oral Hygiene
    • Use of Non-invasive Ventilation
    • Assessment for Daily SBTs
    • Infection Control- Disinfecting equipment
    • Use of Ventilator Bundles

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