Term
| Pathophysiology of Atelectasis |
|
Definition
Obstructions
Non Obstructive |
|
|
Term
| Causes of Obstructive Atelectasis |
|
Definition
Secretions from COPD
intubation
anesthetic agents
small clots-uncommon
misplacement of ET tube-uncommon |
|
|
Term
| Causes of non-obstructive atelectasis |
|
Definition
More common cause of atelectasis:
closure of small bronchioles
loss of pulmonary surfactant
decreased functional residual capacity |
|
|
Term
|
Definition
Fever
tachypnea
tachycardia
elevation of diaphragm on cxr
scattered rales
decreased breath sounds
change in MS if hypoxia is significant |
|
|
Term
| Patients are risk for Pulmonary aspiration |
|
Definition
-intubation
-NGT tube
-Increased body habitus such as obesity and pregnancy
-food in stomach
-GERD |
|
|
Term
|
Definition
-Caused by aspiration of stomach contents with low pH <2.5
-acute inflammation of the major airways and lung parenchyma
-local edema and inflammation
-increases the risk of secondary infection |
|
|
Term
| Clinical sequelae of chemical pneumonitis |
|
Definition
-hypoxemia
-tachypnea
-crackles-
-wheezing
-hypotension and shock
-fever
-leukocytosis
-pulmonary infiltrates
-early cxr changes reflect inflammation |
|
|
Term
| Clinical manifestations of post-op pneumonia |
|
Definition
-fever
-tachypnea
-increase secretions
-physical changes suggestive of consolidation: diminished breath sounds, +egophony, bronchial breath sounds, decreased excertion |
|
|
Term
ABX for post-op pneumonia
NOT MDR |
|
Definition
ceftriaxone
OR
flouroquinolone: levaquin
OR
ampicillin/sulbactam |
|
|
Term
ABX for post-op pneumonia
if MDR |
|
Definition
antipseudomonal cephalasporin OR antipseudomonal carbepenem OR beta-lactam/beta-lactamase
PLUS
antipseudomonial flouroquinolone (levaquin or cipro)
PLUS
linezoid or vanco (for MRSA) |
|
|
Term
|
Definition
| In the absence of heart failure or abd. surgery, if it occurs later in the post-op process, consider sub-diaphragmatic process, such as abscess or acute pancreatitis |
|
|
Term
|
Definition
-neurologic dysfuction
-respiratory insufficiency
-petichiae of the axilla, chest and arm
-usually within 12-72 post-op |
|
|
Term
|
Definition
-normal cxr with hypoxia: PE until ruled out
-+Hamptoms Hump
-+Westermark sign |
|
|
Term
| Acute EKG changes seen in Cor Pulmonale |
|
Definition
S1Q3T3
S1-S wave in lead 1
Q3-Q wave in lead 3 T3-slightly elevated ST segment and decreased T wave |
|
|
