Shared Flashcard Set

Details

Lower Respiratory Problems
Chernecky Week 2
27
Nursing
Graduate
01/26/2014

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Cards

Term
Patho, Unique Sign, and Tx for Pulmonary Contusion
Definition
Patho: interstitial pulmonary bleeding and edema
Sx: frothy, bloody sputum
Tx: O2, fluid restriction, and pain mgmt
Term
Definition & Causes of Pneumothorax
Definition
Pneumothorax: air in the interstitial space of the thorax
Causes of a closed pneumothorax: blunt trauma, bleb
causes of an open pneumothorax: penetration (DO NOT REMOVE OBJECT), and vascular access device (VAD; central line) insertion
Term
Signs of pneumothorax
Definition
DYSPNEA and HYPOXEMIA as well as deviated trachea, decreased chest wall movement, and decreased air intake
Term
Mediastinal shift: definition, indication, and signs
Definition
the entire mediastinum (heart and surrounding tissues) has deviated to one side
as a result of a Tension Pneumothorax
signs include deviated trachea, dyspnea, decreased CO, etc.
Term
Pneumothorax vs. Hemothorax
Definition
air vs. blood; otherwise causes, signs, and interventions are very similar
chest tube: air high, fluid (blood) low
If > 1500 mL of blood is lost, may need more serious surgery
Term
Flail Chest
Definition
unstable chest wall due to rib fractures around a larger portion of the ribs
Term
If 2+ ribs are broken in 2+ places...
Definition
...may allow for free-floating sternum (risk for further organ damage)
Term
SubQ Emphysema: patho, assessment findings, common cause
Definition
air invades the subcutaneous space in the upper chest
auscultate crackles, PALPATE CREPITUS
common within a day of tracheotomy
Term
Cardiac Tamponade: patho, signs, and causes
Definition
P: blood in the pericardium (30-50 mL--> diastolic collapse)
Sx: Beck's Triad: hypotension (narrowing pulse pressure, pulsus paradoxus <10 mmHg), muffled heart sounds, and neck vein distention
C: Cancer, HIV
Term
Major Signs of Venous Congestion (Cardiac Tamponade)
Definition
visceromegaly
bilateral JVD/++hepatojugular reflex
increased Central Venous Pressure
Term
2 important Cardiac Tamponade interventions
Definition
Dobutrex (cardiac stimulant)
Teach to avoid excessive yawning, need to keep O2 Sat high
Term
Signs of Blunt Cardiac Injury
Definition
ECG which mimics MI
Elevated cardiac enzymes, especially TROPONIN I (>1)
Term
Pleural Effusion: Patho and Tx
Definition
P: fluid in the plueral space: transudate (low protein content) or exudate (high protein content; worse, leads to malnutrition)
Tx: thoracentesis, needle and syringe to draw out fluid (don't show the needle to the patient, it's scary)
Term
Pleurisy: Patho, Causes, and Assessment findings
Definition
P: inflammation of the pleura due to
C: infection, trauma, or cancer
AF: pleural friction rub possible, low pitch, grating sound upon respiration
Term
Atelectasis: Patho and Tx
Definition
P: collapsed, empty alveoli
Tx: incentive spirometry, positioning and oxygen
Term
Pulmonary Edema: patho, causes, and tx
Definition
P: fluid in alveoli
C: left-sided heart failure (most common), fluid overload, and capillary/alveolar membrane alteration
Tx: cause, oxygen, diuresis (Lasix)
Term
Lesser known risk factors for pulmonary emboli (PE)
Definition
A-Fib
Virchow's Triad: decreased blood flow, clotting abnormality, vascular injury
Term
PE Prevention Strategies
Definition
Heparin/Pradaxa therapies
PCDs/Stockings
Prudent nursing practice regarding vascular devices
Term
5 signs of PE
Definition
DYSPNEA/cough
TACHYPNEA
TACHYCARDIA/fever
Term
Large PE definition and secondary conditions
Definition
>50% pulmonary vascular occlusion--> right sided heart failure & pulmonary hypertension (300/200)
Term
Wells Score
Definition
assesses risk for PE: >4 = high risk
Term
Diagnostic Tests to Rule Out PE
Definition
V/Q Radiography
D-dimer lab test
Term
Drugs involved in anticoagulation therapy r/t PE, and dx values to monitor
Definition
Heparin: aPTT (1.5-2.0x normal: 60-80)
Coumadin: INR (stop heparin at 2-3)
Term
Five most common symptoms of PE
Definition
Anxiety
Dyspnea
Tachypnea
Tachycardia
Malaise: "I just don't feel well"
Term
Primary Pulmonary Hypertension (PPH): main signs, and Tx
Definition
DOE and poor CO
Tx: Coumadin & Pulmonary vasodilation (to prevent PE), O2, and diuretics
Term
common suffix for calcium channel blockers (pulmonary vasodilators)
Definition
-dipine
i.e. amlodipine, clevidipine, felodipine, etc.
Term
effects of Secondary pulmonary HTN
Definition
COPD, pulmonary fibrosis, and PE
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