Chapter 25, 26 Flashcards by calvin jasfar

What are 5 risk factors for asthma attacks?

Risk
○ Allergies
○ Dust or chemical exposure
○ Family history
○ Cold
○ GERD
§ Can trigger it
□ Stress
□ Cold
□ Exercise

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What 3 things can cause asthma attacks

§ Can trigger it
□ Stress
□ Cold
Exercise

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What are 3 early warning signs of an asthma attack?

○ Early warning signs
§ Cough at night
§ Fatigue with exercise
§ Wheezing with exercise

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What are the 5 late signs of an asthma attack?

○ Late signs
§ Wheezing all the time
§ Fatigue at rest
§ Shortness of breath
§ Constant coughing
§ Retractions (neck muscles)

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What 4 tests are used to diagnose asthma?

Diagnose
○ History and physical
○ Chest X-ray
○ PFT (pulmonary function test)
○ Exercise stress test with ABG’s

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What is albuterol and what disorder is it often used to help treat?

○ Albuterol (selective beta 2 adrenergic)
§ Can cause heart racing
§ Bronchodilators
§ Heart rate rise
§ Hypertension
§ Work on sympathetic nervous system
§ You should pretreat 20 minutes before exercise

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What are the 4 main types of treatments for asthma?

Treatment
○ Albuterol (selective beta 2 adrenergic)
§ Can cause heart racing
§ Bronchodilators
§ Heart rate rise
§ Hypertension
§ Work on sympathetic nervous system
§ You should pretreat 20 minutes before exercise
○ Nebulizer treatments
○ Corticosteroids (Decrease inflammation end in ZONE)
§ Does not help with an active attack
§ Some have both a bronchodilator and a corticosteroid inside
§ Can elevate peoples blood sugars
○ Ipratropium (Atrovent)
§ Anticholinergic

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What are the 3 complications that can occur with asthma?

Complications
○ Low O2
○ Status asthmatics (Attack that will not relieve itself) (THIS IS AN EMERGENCY)
○ More prone to other respiratory infections

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What are some interventions to help asthma?

Interventions
○ Tracheotomy (in extreme cases)
○ Minimize the risk factors
○ Pretreat
○ Know when to seek help
○ Know how to use inhaler
○ Get vaccines
○ Wear masks in the cold

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What are the 6 stages of an asthma attack?

Exposure to trigger
1. Inflammatory response
2. Vasodilation and increased capillary permeability
3. Airway edema
4. Mucus production
  1. Airway thickening and bronchial hyperesponsiveness

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What are the 3 main risk factors to emphysema?

Risk factors
- Smoking
- Overweight
- Air pollution

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What is emphysema and what are its 7 stages?

Pathophysiology emphysema (AIR TRAPPED IN ALVEOLI)
1. Injury to alveoli over time by inhaled pollutants
2. Loss of lung elasticity
3. Hyperinflation of alveoli
4. Small airways collapse prematurely
5. Air trapping
6. Ineffective O2 or CO2 exchange
7. Non-oxygenated blood enters circulation

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What is chronic bronchitis and what are its 4 stages?

Pathophysiology - chronic bronchitis (TOO MUCH MUCUS)
1. Exposure to inhaled pollutants
2. Inflammation of bronchi and bronchioles
3. Bronchiole wall thickness, causing obstruction
4. Increased production of mucus causing obstruction

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What are signs and symptoms of COPD/

S and S
○ Clubbing
○ Chronic hypoxia
○ Low sats
§ Hypoxic drive
□ This can mean that those with COPD may not need high levels of oxygen as it can shut down their breathing drive

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What 3 things are used to diagnose COPD?

Diagnose
○ Chest Xray
○ History
○ PFT measuring

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What 2 drugs are often used to treat COPD?

Treat
○ Ipratropium
○ Steroids (can cause buffalo hump)

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What are 4 complications of COPD?

Complications
○ Pneumonia
○ HAP
○ Respiratory arrest
○ Right sided heart failure

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What is the number one thing that can cause lung cancer?

Smoking?

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What are 5 signs and symptoms of Lung cancer?

Signs and symptoms
○ Coughing
○ Shortness of breath
○ Blood coughs (hemoptysis)
○ Changes in voice
○ Night sweats

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What two treatments exist for lung cancer?

Treatment
○ Surgery
○ Lung lobe removal

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What are the 3 types of surgeries for the lungs?

Types of surgeries for the lungs
- Lobectomy (lobe of the lung)
- Pneumonectomy (removal of entire lung)
- Wedge resection (only a small portion of the lung)

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What happens in a pulmonary embolism?

What’s happening
○ A blockage of a portion of the lung that restricts oxygen flow

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What are the 5 causes of pulmonary embolisms?

Study These Flashcards

Sources
○ 5 causes
§ DVT
§ Air embolism
§ Fat embolism (usually through long bone fractures)
§ Tumor
§ Amniotic embolism

What are risk factors for pulmonary embolisms?

Study These Flashcards

Risk factors
○ Being pregnant
○ High cholesterol
○ Low mobility
○ Obesity
○ Birth control pills
○ Smoking
○ Long bone fracture
○ Atrial fibrillation
○ Tumors

What will patients usually complain of when they are experiencing a pulmonary embolism?

- Complaints of ○ Chest pain ○ Pleuritic chest pain ○ Shortness of breath ○ Signs of early hypoxia ○ Tachypnea ○ Blood pressure down

What diagnostic tests are usually used for those with pulmonary embolisms?

Diagnosis - Imaging studies ○ ECG ○ Chest xray ○ CT scan ○ VQ scan - Laboratory studies ○ Pulmonary Angiogram ○ ABGs ○ D-dimer (Blood test that can show coagulation issues (Clotting))

What is a D-dimer test?

○ D-dimer (Blood test that can show coagulation issues (Clotting))

What are the 2 main types of treatments for those with Pulmonary embolisms?

Treatment - Anticoagulants ○ To stop blood from clotting as much § Is not always a permanent solution § Heparin (works faster) (Protamine sulfate) § Warfarin (vitamin K) ○ Look at § APTT for heparin § PT/INR for warfarin (0.8 to 1) - Surgery ○ Embolectomy ○ Inferior vena cava filter

What are the two medications given to treat PE?

§ Heparin (works faster) (Protamine sulfate) § Warfarin (vitamin K)

What labs are useful in treating PE?

○ Look at § APTT for heparin § PT/INR for warfarin (0.8 to 1)

What are the two surgical procedures that can be used for PE?

- Surgery ○ Embolectomy ○ Inferior vena cava filter

What should you watch for if you think you are having a pulmonary embolism?

- What to watch for ○ Trouble breathing ○ Pain

What can be done for someone beginning to experience a pulmonary embolism?

- Interventions ○ Put oxygen on ○ Sit up head of bed

What are the two types of chest trauma?

- Two types ○ Blunt § Seatbelt § Hit ○ Penetrating § Shot § Stabbed

What is flail chest?

- Flail chest ○ Ribs broken like jello in and out

What are signs and symptoms of chest trauma?

- S and S ○ Unsymmetrical rise and fall ○ Dyspnea ○ Tachycardic ○ Subcutaneous emphysema

What are the 3 tests that can be used to find chest trauma?

- Tests ○ Chest x-ray ○ ABG's ○ CBC

What are 3 complications of chest trauma?

- Complications ○ Stop breathing ○ Infections ○ Tension pneumothorax

What is closed pneumothorax?

- Closed pneumothorax ○ Pleural space is punctured but there is no external opening ○ Air gets trapped in cavity

What is open chest pneumothorax?

- Open pneumothorax ○ Hole or puncture between skin and lung ○ External objects are allowed in

What is tension pneumothorax

- Tension pneumothorax ○ Air can go in but cannot escape

What is hemotorax?

- Hemothorax ○ Blood in the lungs

What is hemopneumothorax?

- Hemopneumothorax ○ Blood and air in the lungs

What is the number one cause of chest trauma?

Motor vehicle accidents are the number one cause of these types of traumas

What should be done in the event that a chest tube escapes the cavity?

We don’t completely cover any holes with dressings so that we don’t end up with tension pneumothorax - We tape 3 sides not 4 - we also dip the end of the tube in normal saline

How many drainage chambers are usually in a chest tube collection device?

- There are usually 3 drainage chambers (5 in total)

What will happen if there is a leak in a chest tube?

- There will be any bubbles if there Is no air leak in the chest

How often are chest Xrays done on chest tube patients?

- Chest x-rays are done every day for these patients

How should the valve on a chest tube be?

- Always keep the valve open

What two things should be documented with a chest tube?

- Document any air leak - Always document the colour of the drainage

What should be done before a chest tube if possible?

- Premedicate before a chest tube if possible

When should a chest tube dressing be changed?

- Do not change dressings unless it falls off or is extremely saturated

What are the 6 DO's of chest tubes?

- Keep lower than body - Tape to the floor - Always keep the valve open - Look for kinked tubing especially without titling - If a tube becomes disconnected put it in sterile water - Inspect the site regularly

What are the 2 DONT's of chest tubes?

Do not take off suction until permission is had from provider Tape on 3 sides not 4

What is a BLEB?

BLEB - A type of spontaneous pneumothorax where a bulge starts in your lung

Chapter 25, 26 Flashcards

(55 cards)