Term
| CAP-onset in the community or during the 1st 2 days of hospitalization, "door to dose" |
|
Definition
| this classification of pneumonia can be bacterial or viral |
|
|
Term
| HAP (hospital acquired pneumonia) |
|
Definition
| this classificaiton of pneumonia occurs 48 hours after intubation |
|
|
Term
| VAP (ventilation acquired pneumonia) |
|
Definition
| this classification of pneumonia occurs within 48-72 hours after intubation |
|
|
Term
|
Definition
| this classificaiton of pneumonia occurs 2 or more days within 90 days of infection, LTC, IV therapy or wound therapy within 90 days |
|
|
Term
| this is pneumonia in immunocompromised patients |
|
Definition
| pneumocystis jiroveci (PCP) |
|
|
Term
|
Definition
what is the best way to tell if someone has pneumonia?
|
|
|
Term
atypical: hypoxemia, cough/dyspnea/fever/chills
typical: tachypnea, crackles, anxious, CXR, older adult-confusion, WBC > 15,000 U/L |
|
Definition
| what are some clinical manifestations of pneumonia? |
|
|
Term
| CXR, WBC, Pulse oximetry, ABGs (PaO2 < 80 mmHg=hypoxemia, PaCO2>45 mmHg) |
|
Definition
| what are the diagnostic criteria for pneumonia? |
|
|
Term
| older, immuno suppressed, COPD, homeless, chronically ill, |
|
Definition
| who are the high risk individuals for pneumonia? |
|
|
Term
| this is what you want to ask in the nursing hx about pneumonia: onset, location, duration, characteristics, aggravating factors, relieving factors, treatment |
|
Definition
| what does OLDCART stand for? |
|
|
Term
| TCDB, health promotion, observe response to ATB, follow up |
|
Definition
| what are some ways to manage pneumonia as a nurse? |
|
|
Term
| capillary leak spreads infetion to other areas of the lung, organisms move into the bloodstream, sepsis results |
|
Definition
| how can pneumonia become septic? |
|
|
Term
| fibrin and edema, both compl. and cap. are reduced |
|
Definition
| what stiffens the lungs in peumonia? what happens to compliance and capacity? |
|
|
Term
| oral care, hand hygiene, head of bed elevation |
|
Definition
| what are the three care actions, known as the ventilator bundle that reduce incidence of VAP? |
|
|
Term
| flushed cheeks, anxiety, chest or pleuritic pain, discomfort, myalgia, headache , sputum production, crackles are heard |
|
Definition
| what are some clinical manifestations of pneumonia? |
|
|
Term
| over ares of density or consolidation |
|
Definition
| where are bronchial breath sounds heard in a pt with pneumonia? |
|
|
Term
| positioning, teaching, TCDB, hydration |
|
Definition
| what are some independent nursing interventions for a pneumonia pt? |
|
|
Term
| O2 therapy/ humidification, incentive spirometry, medications |
|
Definition
| what are some collaborative actions for a pt with pneumonia? |
|
|
Term
| bronchial hygiene used in pneumonia, improves inspiratory muscle performance, prevent or reverses atelectasis |
|
Definition
| what is incentive spirometry used for? |
|
|
Term
| prolongs exhalation and increases airway pressure, increases arterial O2, decreases RR |
|
Definition
| what does purse lipped breathing do? |
|
|
Term
| relax smooth muscle-bronchodilation |
|
Definition
| what will beta-agonsists do? |
|
|
Term
|
Definition
| this is asthma that is less than 2x/wk |
|
|
Term
|
Definition
|
|
Term
|
Definition
| daily symptoms of asthma with exacerbations of 2 x /wk |
|
|
Term
|
Definition
| continuous asthma symptoms, exacerbations impact the quality of life |
|
|
Term
| reversible airflow obstruction and wheezing |
|
Definition
| unlike COPD, asthma is an intermittent disease with... |
|
|
Term
|
Definition
| does bronchial asthma affect alveoli? |
|
|
Term
| inflammation (affects lumen) and airway hyperresponsiveness (constricts bronchial smooth muscle, narrows airways) |
|
Definition
| what two ways can air obstruction occur in asthma? |
|
|
Term
| allergens, exercise, air pullutants, occupational factors, respiratory infections, nose and sinus problems, drugs and food additives |
|
Definition
| what are some triggers of asthma attacks? |
|
|
Term
| SOB< brochoconstriction, chest tightness, audible wheeze (louder on exhalation), increased secretions, mucosal edema, cough |
|
Definition
| what are some clinical manifestations fo asthma? |
|
|
Term
| 30-60 minutes after exposure, inflammatory process, thick mucus, airway hyperresponsiveness |
|
Definition
| this is the early phase of asthma |
|
|
Term
| clinical manifestations occur 4-10 hours after initial attack, may last for 24 hours |
|
Definition
| what happens in the late phase of asthma? |
|
|
Term
| decreased PaCO2 early in attack, later in attack will be increased (indicates co2 retention and poor gas exchange) |
|
Definition
| what will the ABG indicate early in attack |
|
|
Term
| respiratory failure(monitor o2 levels and acid-base, possible ventilation), status asthmaticus (life threatening airway obstruction) |
|
Definition
| what are some complications with asthma? |
|
|
Term
| labored breathing, wheezing, use of accessory muscles, distended neck veins, bronchodilators, prepare for intubation |
|
Definition
| what are some signs of status asthmaticus? |
|
|
Term
| anticholinergics, increase bronchodilation |
|
Definition
| these are given to an asthma pt, which will improve airflow |
|
|
Term
| short acting beta agonists |
|
Definition
| these are short term drugs to relieve asthmatic symptoms |
|
|
Term
| long acting beta agonists, inhaled corticosteroids |
|
Definition
| these prevent episodes of asthmatic attack |
|
|
Term
|
Definition
| can the pt use LABA to rescue them during an attack? |
|
|
Term
| IV fluids, bronchodilators, steroids, epinephrine, and O2, prepare for emergency intubation |
|
Definition
| if a person comes in with status asthmaticus, what do you do? |
|
|
Term
| PaCO2 (35-45 mmHg), PaO2 (80-100 mmHg), H2CO3 (22-26), SaO2 (greater than 95%) |
|
Definition
| what are the normal ABGs? |
|
|
Term
|
Definition
| older people are less senstive to these asthmatic tx. |
|
|
Term
| short acting beta agonists (albuterol) |
|
Definition
| if a person has mild intermittent asthma, what will they be given to tx it? |
|
|
Term
| daily anti-inflammatory inhaled corticosteroids (fluticasone) |
|
Definition
| if a person has mild persistent asthma, what will they be given? |
|
|
Term
| long-acting beta agonist to ICS, salmeterol |
|
Definition
| is a person has moderate persistent asthma, what will they be given? |
|
|
Term
| medium dose ICS and long acting beta agonist |
|
Definition
| if a person has severe persistent asthma, what will they be given? |
|
|
Term
| loss of elasticity, hyperinflation of the lung |
|
Definition
| what are the two major changes that occur with pulmonary emphysema? |
|
|
Term
|
Definition
| this is not reversible and include chronic bronchitis and emphysema |
|
|
Term
|
Definition
| what is inflamed in chronic bronchitis? |
|
|
Term
| hyperinflation of the lung flattens the diaphragm |
|
Definition
| why does weakening of the diaphgram occur in emphysema? |
|
|
Term
|
Definition
| what is inflamed in chronic bronchitis? |
|
|
Term
| loss of recoil in the alveolar walls and collapse of the small airways |
|
Definition
| what changes in emphysema increase the work of breathing? |
|
|
Term
| chronic cough for 3 or more months for 2 consecutive years |
|
Definition
| what will be a sign of chronic bronchitis? |
|
|
Term
| smoking, occupational hazards, air pollution, infection, heredity, aging |
|
Definition
| what etiologies lead to COPD? |
|
|
Term
|
Definition
| in which COPD are the alveoli NOT affected? |
|
|
Term
| small airways thicken first |
|
Definition
| which airways are affected in chronic bronchitis? |
|
|
Term
| large amount so mucous are produced in the inflamed airways, this creates plugs that clog narrow airways |
|
Definition
| why is gas exchange affected in chronic bronchitis? |
|
|
Term
| decrease in arterial O1, increase in arterial CO2 |
|
Definition
| what ABGs would be affected with bronchitis? |
|
|
Term
| organ anoxia, tissue death (due to decrease in oxygenation and tissue perfusion), cardiac failure (cor pulmonale due to increased lung tissue pressure), |
|
Definition
| what are some complications of chronic bronchitis? |
|
|
Term
|
Definition
| heart dysrhythmias with chronic bronchitis are a result of... |
|
|
Term
|
Definition
| right ventricular hypertrophy, peripheral edema, distended neck veins, what condition is this? |
|
|
Term
| diuretics, low Na diet, bronchodilators, low flow O2 |
|
Definition
| what is the collaborative care for a cor pulmonale? |
|
|
Term
| inc metabolic needs as a result of the increased work of breathing |
|
Definition
| why does weight loss occur with COPD? |
|
|
Term
| low arterial O2, inc. arterial CO2, dec pH (acidotic), increased bicarbonate levels are found in late stages of COPD |
|
Definition
| what would the ABG typical findings be with someone who has COPD |
|
|
Term
| genetic error in chloride transport in the cell membranes |
|
Definition
| what is the etiological cause of cystic fibrosis? |
|
|
Term
|
Definition
| a chest xray shows hyperinflation and flattened diaphragm, what does this pt have? |
|
|
Term
| emphysema, because the alveoli are infected, wherein bronchitis, the the airways are affected |
|
Definition
| is hypercarbia a problem moreso in advanced emphysema or bronchitis? |
|
|
Term
| because the patient adjusts the respiratory rate |
|
Definition
| why is it that in emphysema, ABGs do not show gas exchage problems until the patient has advanced disease? |
|
|
Term
| rapid, shallow, may use accessory muscles |
|
Definition
| what are the respiratory changes in COPD? |
|
|
Term
| in CF there is a thick sticky mucus that causes organ dysfunction, airways become narrowed as a result which interferes with oxygenation and tissue perfusion |
|
Definition
| what happens in CF and why are the lungs affected? |
|
|
Term
| incr chloride in sweat, steatorrhea, malnourshed, Vit. ADEK deficiency, abdominal distension, diabetes due to pancreatic malfunction, pulmonary manifestations |
|
Definition
| what are some clinical manifestations in CF? |
|
|
Term
| chest physiotherapy (Pos. expir. pressure), airway clearance 2x/day), increased oxygenation, antibiotics, heliox, lung, pancreatic transplant |
|
Definition
|
|
Term
|
Definition
| T/F the cause of primary pulmonary hypertension is unknown. |
|
|
Term
|
Definition
| what does the MPAP have to be to be considered hypertensive? |
|
|
Term
|
Definition
|
|
Term
|
Definition
| what are the diagnostics used to assess pulmonary hypertension? |
|
|
Term
| fatigue, dizziness, exertional syncope, chest pain |
|
Definition
| what are the clinical manifestations for pulmonary hypertension? |
|
|
Term
| CCBs, Warfarin, Lanoxin, O2, Reduce PAP |
|
Definition
| what is the tx of pulmonary hypertension? |
|
|
Term
| granulomas, autoimmune response, fibrosis |
|
Definition
| what does sarcoidosis cause? |
|
|
Term
| how do you diagnose sarcoidosis |
|
Definition
|
|
Term
|
Definition
| how do you treat sarcoidosis? |
|
|
Term
|
Definition
| what kind of cancers are lung cancers mostly? |
|
|
Term
| reduce tobacco smoking, early detection |
|
Definition
| what is a primary prevention of lung cancer? secondary prevention? |
|
|
Term
| smoking, chronic exposure to pollutants |
|
Definition
| what are some risk factors for lung cancer? |
|
|
Term
| hoarseness, areas of tenderness, chest pain, cough, sputum production, hemoptysis, shortness of breath, change in endurance, increased fremitus |
|
Definition
| what are some lung cancer manifestations |
|
|
Term
| cytology, CXR, CT scan, fiberoptic bronchoscopy, MRI, needle biopsy |
|
Definition
| what are some diagnostic assessments used for lung cancer? |
|
|
Term
|
Definition
| what is the treatment of choice for lung cancer? |
|
|
Term
|
Definition
| these are used to examine and identify lesions more clearly |
|
|
Term
|
Definition
| these are used to determine location of metastatic tumors in lung cancer |
|
|
Term
|
Definition
| this can be an effective treatment for locally advanced lung cancers confined to the chest |
|
|
Term
| N/V, alopecia, mucositis, anemia, immunosuppresion, thrombocytopenia |
|
Definition
| what are some common side effects of chemotherapy? |
|
|
Term
| skin irritation, peeling, fatigue, nausea, taste changes |
|
Definition
| what are some common effects of skin radiation? |
|
|
Term
|
Definition
| this is the main treatement for a stage I and II Non small cell primary lung cancer |
|
|
Term
| pneumonectormy, lobectomy, segmentectomy |
|
Definition
| removal of entire lung, removal of a lobe, segmetnal resection of a lung including bronchus, pulmonary artery and vein |
|
|
Term
| to drain fluid, or air, reestablish negative pressure |
|
Definition
| why are chest tubes put in? |
|
|
Term
1st-drainage collection
2nd-water seal to prevent air from moving back into the chest
3rd-suction regulator |
|
Definition
| what are the 3 chambers for on a Pleur-Evac? |
|
|
Term
| every hour for first 24 hours |
|
Definition
| when do you measure fluid from chest tubes? |
|
|
Term
|
Definition
| is it okay for fluid in the chambers of the Pleur-Evac to come into contact? |
|
|
Term
| upright and below chest tube insertion at all times |
|
Definition
| where must the chambers of a Pleur-Evac be kept? |
|
|
Term
| this is where the water in the second chamber rises and falls slightly with the pt's respiratory cycle |
|
Definition
| this is a normal process in a Pleur-Evac and is called tidaling |
|
|
Term
| if it is continuous- no, if is stops this could mean that there is a block or kink in the chest tube |
|
Definition
| if there is bubbling occuring from chest tubes into the water seal chamber is this normal? |
|
|
Term
| when intrathoracic pressure is greater than atmospheric pressure, such as when patient exhales, coughs or sneezes |
|
Definition
| when is bubbling seen on a chest tube? |
|
|
Term
|
Definition
| in which container is continous bubbling seen on a Pleur-Evac? |
|
|
Term
| 2 hemostats. sterile water, and occlusive dressing at bedside at all times |
|
Definition
| when dealing with a Pleur evac, what do you keep at the bedside at all times? |
|
|
Term
|
Definition
| if a pt with chest tubes O2 saturation is less than 90%, do you notify physician and call RRT? |
|
|
Term
| cover area with sterile gauze, then notify physician and or call RRT |
|
Definition
| if a chest tube falls out of a patient what is the first thing you do? |
|
|
Term
| patient exhales as much as possible, cleanse tips and reconnect |
|
Definition
| what do you do is a chest tube seperates? |
|
|
Term
|
Definition
| what happens is a chest tube is clamped or kinked for too long? |
|
|
Term
|
Definition
| this is a fracture of 2 or more ribs in 2 or more locations |
|
|
Term
| affected protion of lung sinks in upon inspiration, bulges outward with expiration (opposite of what lung is supposed to do) |
|
Definition
| what happens upon inspiration and expiration with a flail chest? |
|
|
Term
| pain, rapid shallow breathing, tachycardia |
|
Definition
| what are the clinical manifestations fo a flail chest? |
|
|
Term
|
Definition
| what are the diagnostics used on a flail chest? |
|
|
Term
|
Definition
| this is a collection of fluid in pleural space |
|
|
Term
| pulmonary infection, malignancy, GI, pancreatitis |
|
Definition
| what are the causes of exudative accumulation of fluid in a plueral effusion? |
|
|
Term
|
Definition
| how is a pleural effusion diagnosed? |
|
|
Term
| dyspnea, pleuritic pain, decreased movement in affected side |
|
Definition
| what are the clinical manifestations of a pleural effusion |
|
|
Term
| transudative pleural effusion |
|
Definition
| this is a plerual effusion that is not caused from an inflammatory process but from liver/renal disease of CHF |
|
|
Term
Peak expiratory flow
green readings (greater than 80% personal best)
yellow-50-80% personal best
red reading- less than 50% of personal best. |
|
Definition
| for asthmatic patients, what do you need to check for breathing exercises? |
|
|
Term
green-have them do it 2x a day for 2 wk
yellow- use rescue drug, check PEF after rescue drug, if the readings are consistently in the yellow, change the med
red reading-use rescue drug, seek emergency care |
|
Definition
| for asthmatic patients, what is the proper procedure for each PEF reading? |
|
|
Term
|
Definition
| REMOVAL OF THE PERIPHERAL PORTION OF A SMALL LOCALIZED AREA OF DISEASE of lung cancer |
|
|
Term
| MAY MEAN Chest Tube IS BLOCKED OR eXPANDED LUNG HAS BLOCKED EYELETS OF Chest Tube |
|
Definition
| IF TIDALING HAS STOPPED what does this mean? |
|
|
