Term
|
Definition
| decrease in arterial oxygen |
|
|
Term
|
Definition
Saturation of oxygen on hemoglobin
--Normal = 95% to 100%
--Below 90% pt needs supplemental H20 |
|
|
Term
|
Definition
Partial pressure of oxygen in arterial blood.
--Mild Hypoxemia PA02 < 80mmHg |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| early Signs and Symptoms of Hypoxemia |
|
Definition
| Restless, Tachycardia, increased BP, anxiety, change in respiratory pattern. |
|
|
Term
| Lates signs & symptoms for Hypoxemia |
|
Definition
| Decrease in BP, cyanosis, lethargy, confusion, dyspnea, dysrhythmias, cool extremities, coma |
|
|
Term
| Chronic or Long-standing hypoxemia |
|
Definition
| Lethargy, inattention, apathy, delayed reaction time. |
|
|
Term
| Normal PaCAO2 (Partial pressure of carbon dioxiode) |
|
Definition
|
|
Term
| Hypercapnia (hypercarbia) |
|
Definition
|
|
Term
|
Definition
Dilates blood vessels in the brain - felling of fullness in the brain.
-- inc. HR, inc RR, inc BP, headache, confusion, drowsiness, mental cloudiness, ventricular fibrillation, weaknes, dull headache. |
|
|
Term
|
Definition
| Hyperventilation PaCO2 < 35 mmHg |
|
|
Term
| S/Sx of Hypocapnia/ Hyperventilation |
|
Definition
-- Light headedness d/t vasoconstriction of cerebral blood vessels.
-- Inability to concentrate, numbenss and tingling in the extremities, tinnitus, and at times loss of consciousness |
|
|
Term
|
Definition
--caused by desaturation of the hemoglobin
--very late indicator of hypoxia
-- 5 or more grams per deciliter of desaturated hemoglobin. |
|
|
Term
|
Definition
Visualization of the tracheobronchial tree via a scope sent through the mouth/nose into the bronchi.
-- Therapeutic or diagnostic purposes.
-- remove foreign bodies, secretions, determine location of pathologic process, diagnose bleeding site, obtain tissue samples, excise or destroy lesions. |
|
|
Term
|
Definition
Provide info about chest that other assessment means cannot offer.
- as part of routine screening procedure
-when pulmonary diesease is suspected
-for confirmation of ET or trach tube placement.
-To monitor status of repiratory disorder and abnormalities |
|
|
Term
|
Definition
MRI CT SCAN Pulomonary Angiography
Floursocpy
- use of x-rays to observe deep structures in motion.
Ultrasonogrpahy
- Especially useful for detecting 50ml or less of pleural fluid. |
|
|
Term
|
Definition
-Spirometer is used to measure amounts of gas exchanged between the patient and the atmosphere.
-Used to detect abnormalities in the respiration and the extent of those abnormalities.
- Measures lung volumes, lung mechanics, and the diffusion capabilities of the lungs. |
|
|
Term
|
Definition
Perfusion, Ventilation, Inhalation Gallium.
-- used to detect normal lung functioning, pulmonary vascular supply and gas exchange |
|
|
Term
|
Definition
-Aspiration of pleural fluid for therapeutic of diagnostic purposes.
- The fluid collected is sent to the laboratory and assessed for:
- specific gravity, glucose, protein, ph, culture, and sensitivity, and cytology |
|
|
Term
|
Definition
| -Exploration of the pleural cavity by an endoscope |
|
|
Term
|
Definition
Goblet cells produce 100ml of mucus daily. Infection can inc. production.
- analysis of sputum for bacteria or tumor cells
- Culture and Sensitivity
-- Determine bacteria drug sensitivity
-- Start antibiotics only after the C&S is obtained
-Cytology: Examine Cells for malignancy |
|
|
Term
|
Definition
| indicates exposure and antibody development to cmycobacterium tuberculosis; screening tool only, does not mean active disease is present. |
|
|
Term
|
Definition
| precise measurment of acid-base balance and of the lungs ability to oxygenate the blood and remove excess CO2. |
|
|
Term
|
Definition
PA02 80-100 mmHG. 02 delievered by the lungs to the blood
pH 7.35-7.45 Measures acidity or alkalinity of blood
PC02 35-45 mmHg. Amount of carbon dioxide in blood
HC03 22-26 mEq/L. Ion solution - regulated by the kidney. The metabolic parameter. |
|
|
Term
|
Definition
Acidic <7.35
Neutral 7.35-7.45
Alkaline >7.45 |
|
|
Term
| Acid/Base Parameters PaCO2 |
|
Definition
Acidic >45
Neutral 35-45
Alkaline <35 |
|
|
Term
| Acid/Base parameters HCO3 |
|
Definition
acidic <22
Neutral 22-26
Alkaline >26 |
|
|
Term
|
Definition
1st - assess the PaO2 first - hypoxic?
2nd - pH. acid or alkaline?
3rd - PCO2. acid or alkaline?
4th - HCO3. acid or alkaline? |
|
|
Term
| ABG's - Totally compensated |
|
Definition
| the pH will be within normal parameters |
|
|
Term
| ABG - Partially Compensated |
|
Definition
| the other system will be altered |
|
|
Term
|
Definition
| other system will be normal. (not trying to help.) |
|
|
Term
| What systems are responsible for ABG's and how do they respond? |
|
Definition
Respiratory sytem is able to compensate quickly - minutes to an hour
The renal system is SLOW - Hours to days. |
|
|
Term
|
Definition
-Collapse or closure of alveoli
-Can be acute or chronic and have a broad range of pathophysiologic changes.
--Occurs most frequently postop. or with patients who have a shallow monotonous breathing pattern |
|
|
Term
|
Definition
| -Absorptive atelectasis -Reduced alveolar ventilation or any type of blockage that impedes passage of air to and from alveoli |
|
|
Term
|
Definition
Decreased surfactant production or loss of surfactant integrity
- Surfactant decreased surface tension, which allows the alvioli to stay open.
-Has short half-life and must be constantly replenished with normal ventilation. |
|
|
Term
|
Definition
| Cough, sputum production, and low grade fever. - Decreased breath sounds, crackles over affected area - CXR-"patchy or consolidated areas" - SaO2 - may be <90%, PaO2 may be low. - large area of lung tissue is involved may have marked respiratory distress - May also have dyspnea, tachycardia, tachypnea, pleural pain, and central cyanosis, anxiety |
|
|
Term
|
Definition
Acute viral respiratory infection
-Three types of virus -A,B, and C |
|
|
Term
|
Definition
| responsible for the epidemics of repiratory illness that occur almost every winter and are associated with increase rates of hospitalization and death |
|
|
Term
|
Definition
| Frequently causes milder disease outbreaks |
|
|
Term
|
Definition
| infection usually causes either very mild respiratory illness or no symptoms at all. |
|
|
Term
| Influenza Pathophysiology |
|
Definition
-aerosolized mucus droplets are shed from infected persons by caughing, talking or sneezing.
- Droplets penetrate the surface of the upper respiratory tract mucosal cells (eyes, nose, and mouth) and destroy cilliated epithelium and cause cell lysis |
|
|
Term
|
Definition
| Severe Acute Respiratory Syndrome |
|
|
Term
|
Definition
Spread by person to person contact through the air and possibly other ways which are not known yet.
- incubation period: 2-8 days |
|
|
Term
|
Definition
Elevated temp. >100.4
-Chills, headache, malaise, body pain, mild respiratory symptoms including caugh, SOB, dyspnea
3-7 days may develop: dry non-productive cough, dyspnea which may progress to hypoxemia.
10-20% pts require intubation and mechanical ventilation |
|
|
Term
|
Definition
Approximately 13%
13% for patients <60 years old
43% for patients >60 years old
DX - CDC developing serum antibody tests
- Right now, diagnosis based on symptoms and exposures |
|
|
Term
|
Definition
Maintain oxygenation and hydration
Prevent secondary infections
Meds:
-Corticosteroids and antibiotics |
|
|
Term
|
Definition
| Inflammation of the lung parenchyma that is caused by a microbial agent... Bacteria, mycobacteria, chlamydiae, mycoplasm, fungi, parasites and viruses |
|
|
Term
| Pneumonia Pathophysiology |
|
Definition
| infectious particles reach the normally sterile lower respiratory tract -Affects both ventilation and diffusion. -Inflammatory reaction may occur in the alveoli and produces exudate that interferes with oxygen/carbon dioxide diffusion. - Neutrophils migrate to area and fill air containing spaces - Inadequate ventilation due to bronchial edema and secretion buildup. |
|
|
Term
|
Definition
| one or more lobes involved |
|
|
Term
|
Definition
| one or more lobes involved |
|
|
Term
|
Definition
| distributed in a patch fashion |
|
|
Term
|
Definition
| typically caused by a virus. Diffuse, bilateral involving the alveoli and interstitial spaces |
|
|
Term
|
Definition
| disease caused by mycobacterium tuberculosis. can affect any part of the body but usually attacks the lungs. |
|
|
Term
|
Definition
once inhaled the organisms implant themselves in the lung and begin dividing slowly.
-This causes inflammation, and development of primary tubercle, and eventual caseation and fibrosis
-Pulmonary macrophages and white cells migrate to infected areas, surrounding and isolating the bacilli and producing a lesion called a Ghon tubercle
-Scar tissue grows around the tubercle preventing further multiplicaiton, the bacilli become inactive forming a substance called caseation necrosis.
- isolated bacilli can remain dormant for life.
-if the pts immune system becomes impaired, live bacilli will escape into the bronchial tree and cause the patient to become contagious. this is called active TB disease. |
|
|
Term
|
Definition
| PPD skin test = determines antibody response to TB |
|
|
Term
|
Definition
| Inflammation of the visceral and parietal membranes which rub together during respiration and cause pain. |
|
|
Term
|
Definition
| Chest trauma, TB, Pneumonia, Chest surgery |
|
|
Term
|
Definition
Knife like pain on inspiration.
Localized and radiates to shoulder or abdomen. |
|
|
Term
|
Definition
Treat cause and underlying condition.
Analgesics
Hot and cold application
anti inflammatory meds.
Splint chest wall when coughing
Intercostal nerve block for sever pain. |
|
|
Term
|
Definition
Colleciton of fluid in the pleural space, resulting in decreased lung volume on the affected side.
-Pleural space normally has 15ml of fluid to keep surfaces lubricated an moving without friction. |
|
|
Term
|
Definition
| pleuritic pain that is sharp and increases on inspiration. Dyspnea. Tachycardia. Cough - productive or non-productive. Decreased breath sounds. impaired chest wall excursion. Chest xray can confirm but needs 200-300mls to be visualized. |
|
|
Term
|
Definition
Thoracentesis (might be with) pleurodesis -- medicated shot. change position q 15 min to achieve uniform distribution
-May need chest tube. High fowlers position to promote ventilation. ABG, pulse oximetry. |
|
|
Term
|
Definition
| Obstruction of the pulmonary artery or one of its branches by an emolus |
|
|
Term
|
Definition
When a thrombus occludes or partially occludes a pulmonary artery, the alveolar dead space is increased.
-Substances released from the clot cause blood vessels and bronchioles in the area to constrict. Can lead to right Ventricular failure due to increased workload. |
|
|
Term
|
Definition
| Dyspnea, Chest pain, Fever, Tachycardic, apprehension, Cough, Diaphoresis, sycope |
|
|
Term
|
Definition
Ventilation/Perfusion scan
Pulmonary angiography
Spiral/electron-beam cantrast CT or MRI
Peripheral Vascular studies
ABG's D-dimer lab assay |
|
|
Term
|
Definition
| Anticoagulation therapy, Surgery-embolectomy. maintenance of blood pressure, 02, ABG's, oximetry, maybe ventrilator. IV meds -- DIG, antiarrythmics, diauretics, morphine, elevate HOB |
|
|
Term
Chronic Obstructive Pulmonary Disease
COPD |
|
Definition
air flow is obstructed by emphysema, chronic bronchitis or both.
- Progressive and irreversible and may associate with airway hyperactivity.
- Asthma may be part of COPD or its own disorder |
|
|
Term
|
Definition
Genetics- Lack of alpha 1 antitrypsin
Occupational exposure - Coal, cotton, grain
-Cigarette smoking -- PRIMARY CAUSE 80-90% of cases. |
|
|
Term
|
Definition
| The lack of CFTR (a protein) causes improper regulation of the chloride channel and chloride is prevented from leaving the cells. Affects a wide reange of organs in the body |
|
|
Term
| Cystic Fibrosis effects on the body |
|
Definition
NaCl concentration 5x normal
-Reproductive organs - 98% of men are infertile due to improper transport of sperm to semen.
GI- clogging of pancreatic ducts leads to enzyme deficiency in intestines
-Liver -- Billary obstruction, malnutrition, portal hypertension
Pancreas - Becomes fibrotic with decreased production of enzymes. |
|
|
Term
|
Definition
failure to regain 10% of weight loss at birth
-failure to thrive
-protruding abdomen with atrophy of extremeties.
- Cardiac enlargement
-Presence of cough or wheezing during first 6 months of age
-decreased ability to absorb fat soluble vitamins
-clotting problems
-Retarded bone growth
-clubbing of fingers |
|
|
Term
| Cystic Fibrosis TX for pulmonary |
|
Definition
Prevent infections
chest phiotherapy, CP, PD, humidification
Bronchodillators
Antibiotics
Expectorants |
|
|
Term
| GI problems: Cystic Fibrosis |
|
Definition
Pancreatic enzymes
balanced nutrition, increased salt, increased calcium, double dose vitamins. |
|
|
Term
|
Definition
| Inflammation of the Larynx, trachea, and bronchi; usually preceeded by a 1-3 day cold. |
|
|
Term
|
Definition
| narrowing of air passages produced by edema. Usually viral |
|
|
Term
|
Definition
restlessness
"barking" cough
respiratory distress
hoarseness
inspiratory stridor (take a breath high pitched weezing)
High fever
nasal flaring
worse at night. |
|
|
Term
|
Definition
-can be treated at home
careful observation for symptoms of res. obstruction
-cool, humidified environment
-encourage fluid intake
-temperature reduction
-bedrest |
|
|
Term
|
Definition
as previously listed
-oxygen
-iv fluids
-epinephrine for temp. relief
have endotracheal intubation equipment available |
|
|
Term
|
Definition
-usually 3-7 days
antibiotic for bacterial origin
Complications
-pneumonia
-Laryngospasm |
|
|
Term
|
Definition
| inflammation of the epiglottis and aryepiglottic folds usually resulting from Hemophilus influenza B |
|
|
Term
|
Definition
Abrupt onset
elevated temp.
Toxic appearance
Tachycardia, tachypnea
Thick muffled voice
sore throte
retractions
posture --> sitting up, leaning forward, open mouth and drooling
-red inflamed throat with distinctive cherry-red, edematous epiglottis.
2-5 yrs |
|
|
Term
|
Definition
Therapeutic management
- Throat examine with extreme care.
- Antibiotics
- Respiratory isolation for 24hrs
- oxygen
- Vaccination. if child is > 24months disease should cause natural immunity |
|
|
Term
| Epiglottitis complications |
|
Definition
OM, adenitis, meningitis, pericarditis, pneumonia
--Mortality 5-10%-- |
|
|
Term
|
Definition
| often caused by RSV (respiratory syncytial virus) |
|
|
Term
|
Definition
first symptoms are like a cold
-Cough, tachypnea, and wheezing
-retractions
-fever
-dehydration |
|
|
Term
Bronchiolitis
Therapeutic management |
|
Definition
Cool mist
clear liquids
nasal saline drops and bubl syringe
Elevate HOB
Tylenol for fever
avoid Smoke
Careful observation of breathing |
|
|
Term
Bronchiolitis
Hospital Management |
|
Definition
IV, Antipyretics, Respiratory isolation, Epinephrine for sever stridor, Ribaviroan via aerosol (antiviral medication) to high risk groups
-intubation equipment on hand
-RSV immunoglobulin |
|
|
