Respiratory 5

Question 1

what can you develop if you have COPD

Answer 1

right sided HF

Question 2

what are the causes of COPD

Answer 2

Smoking, chronic URI, air pollution, allergies

Question 3

describe emphysema

Answer 3

cannot recoil

Question 4

describe bronchitis

Answer 4

swollen bronchiole tubes

Question 5

findings in COPD pt

Answer 5

• Tachycardia, tachypnea, barrel chest, cachectic, cough with sputum
• Prolonged expiratory phase, crackles, rhonchi
• ABG’s have < pO2, >paCO2
• Hgb elevated
• Acidodic

Question 6

When would you call for help with a COPD patient?

Answer 6

Call for help when pO2 gets <60s (will be intubated)

Question 7

treatment for COPD

Answer 7

-Oxygen supplements,
-May need ETT and ventilation if pO2 less than 60
-Inhaled bronchodilators, like albuterol or ephinephrine
I-V corticosteroids, like solu-medrol to decrease inflammation
-Diuretics to decrease edema
-Antibiotics if infection
-Chest tube if pneumohorax

Question 8

what to rememeber about oxygen supplementation for COPD pt

Answer 8

remember the patient responds to higher than normal paCO2 levels to breathe

Question 9

next to HF, _____ is the most common hospital admission

Answer 9

-COPD is the most common admission
(go back in the hospital often for pneumonia)
-cannot get fluid to exchange

Question 10

pneumonia pt presents with

Answer 10

• Fatigue (very tired), painful cough, rapid RR, pleuritic pain and fever
• Sputum may be yellow, green or rust colored
• Lungs may have crackles, wheeze and dullness over the infected lung

Question 11

describe the process from pneumonia to atelectasis

Answer 11

Bacterial infection triggers alveolar inflammation and edema, capillaries engorge with blood, causing stasis, edema and blood atelectasis

Question 12

what needs to be done once pneumonia is dx

Answer 12

Need sputum culture to determine what they are carrying

And blood culture to see if bacteria is in blood stream

Question 13

who is most at risk for pneumonia

Answer 13

Older patients are at greater risk because of weak chest musculature, can not clear secretions

Question 14

what are the community acquired pneumonias

Answer 14

strep, mycoplasma, Hemophilus influenza, viral, Legionnaires

Question 15

what are the hospital acquired pneumonias

Answer 15

*Pseudomonas, Staphylococcal, Klebsiella

Question 16

bacterial vs viral infections development (pneumonia)

Answer 16

Bacterial infections only take a few weeks to develop

Viral infections can take months to develop

Question 17

describe strep pneumonia

Answer 17

Dark reddish/dry sputum: strep (d/t URI that is not treated)

Fever, URI, rust sputum, consolidation on Xray

Question 18

describe mycoplama pneumonia

Answer 18

• Sore throat, ear pain, headache, pain, rash, myalgia

- can be chronic and stay in system

Question 19

describe Hemophilus influenza pneumonia

Answer 19

• URI, settles in lungs and stays there(develops over a long period), transmitted through droplet
• URI 2-6 wks earlier, chills, dyspnea, cough

Question 20

describe viral pneumonia

Answer 20

typically type A (can be deadly)

Question 21

describe Legionnaires pneumonia

Answer 21

spread through dirty water vapor (can be found in airplanes)

Flulike symptoms, malaise, headache within 24 hours,

Question 22

number 1 hospital acquired infection

Answer 22

Pseudomonas pneumonia

Question 23

describe pseudomonas pneumonia

Answer 23

• (bright green sputum)
• brought on by water vapor, anaerobic bacteria
• chills and fever, forms at base of lungs, large consolidation (not ventilated well)

Question 24

describe stap pneumonia

Answer 24

Cough, chills, high fever, pain, bloody sputum, hypoxemia. Lung abscess

Question 25

describe Klebsiella pneumonia

Answer 25

Fever, chills, rust, bloody sputum, cyanosis of lips and nails, shallow grunting respirations, pleuritic pain, consolidation

Question 26

symptoms of aspiration pneumonia

Answer 26

Fever, crackles, dyspnea, hypotension, tachycardia, cyanosis

Question 27

pneumonia treatment

Answer 27

``` Oxygen supplement, put HOB up, pulse ox Ventilation if needed Antibiotics Bronchodilator therapy Antitussive for cough High calorie diet and fluid Bed rest Analgesics for chest pain Cardiac monitoring ```

Question 28

pneumonia pts need to _____

Answer 28

cough! get junk out of lungs | can only cough things out if hydrated (Fluids, High protein, antitussive)

Question 29

describe pneumothorax

Answer 29

- Accumulation of air in the pleural cavity and leads to lung collapse - Spontaneous or traumatic

Question 30

describe tension penumothorax

Answer 30

is when venous return to the heart is impeded