Term
|
Definition
caused by decreased respiration causing acid-base disturbance
Increased PaCO2 from alveolar hypoventilation
Increased H+ as H2CO3 |
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Term
| Respiratory Acidosis Conditions |
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Definition
Acute= Paco2 <45 mmHg and acidotic pH < 7.35
- respiratory depression from TBI, drug induced, airway obstruction, and Guillan- Barre
chronic=Paco2 <45 mmHg and pH is normal
- from obesity hypoventilation, COPD, chest wall deformity |
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Term
| signs and symptoms of acidosis |
|
Definition
headache, restlessness, apprehension
progresses to lethargy, tremors, convulsions, coma
Diagnosed by ABF for pH and PaCO2
Treat by correcting respiratory issue, may require ventilator |
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Term
|
Definition
Alveolar hyperventilation, reduction of CO2
pH < 7.35 and PaCO2 < 38 mmHg
Alkalsosis starts within minutes of hyperventilation |
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Term
| Respiratory Alkalosis-Causes |
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Definition
pulmonary disease, CHF, hyper metabolic states, sepsis
Chronic alkalosis produces renal compensation for pH level |
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Term
|
Definition
Conditions from pulmonary Disease
-excessive fluid in lungs
-Commonly from heart disease
- see SOB, dyspnea on exertion, coughing, and wheezing
-pt is typically volume overloaded and will need diuresis
-May need supplemental o2 |
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Term
|
Definition
fluid and/or solid particles enter the lung
usually caused by impaired swallow mechanism
RL is more likely to have aspiration- angle of main bronchus
lower lobes- gravity dependent
Large food particles can obstruct airway, lead to inflammation and infection |
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Term
|
Definition
gastric fluid with low pH can cause pneumonitis bronchial damage
aspiration of oral secretion can cause pneumonia, especially oral cavity has bacteria colonized |
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Term
| signs and symptoms of aspiration |
|
Definition
coughing, choking while eating/drinking
may have silent aspiration with no signs
recurrent infections in lungs treated with antibiotics
preventative measures are helpful
swallow study from SLP
positioning
food, texture restrictions, thickened liquid |
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Term
|
Definition
recurrent infections in lungs treated with antibiotics
preventative measures are helpful
swallow study from SLP
positioning
food, texture restrictions, thickened liquid |
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Term
|
Definition
collapse of lung tissue ( not entire lung)
can be from compression: tumor, air, blood
absorption of air from hypo-ventilated alveoli |
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Term
|
Definition
Fibrosis, scarring of lung tissue (TB)
surfactant issue: infants, post op |
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Term
|
Definition
increased fluid in between pleura
can be caused by heart failure, PE, open heart surgery, cancer, TB |
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Term
| plural effusion- symptoms |
|
Definition
no symptoms or can have chest pain, dry cough, dyspnea, orthopnea
diagnosed via x-ray, CT, thoracentesis |
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Term
| plural effusion- treatment |
|
Definition
diuretics
chemotherapy, if malignant
talc pleurodesis
VATS- video assisted thoracoscopic surgery |
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Term
|
Definition
-medical procedure that causes the outside of the lung to adhere to the chest wall
-prevents lung from collapsing
-if pt has chest tube in can use that to put talc slurry into the pleural space, causes the visceral and parietal pleura to scar together |
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Term
|
Definition
surgical drainage of fluid from the thoracic cavity
-local anesthesia
-needle drainage, can leave catheter in to continue drainage |
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Term
|
Definition
-infected pleural effusion, pus in pleural space
-usually caused by pneumona caused by S. aureus
-thought to occur if the pulmonary lymphatics are blocked, and infected lymph fluid enters the pleural space |
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Term
| empyema- signs 7 treatment |
|
Definition
pt has fever, tachycardia, pleural pain
tx- antibiotics, thoracentesis |
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Term
|
Definition
-infection causes destruction of lung parenchyma, tissue consolidates, and inflammatory process fills area with fluid, pus, microorganisms
-results in nectrotic tissue
-if abscess communicates with bronchus, will empty into bronchus |
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Term
|
Definition
-abscess empties and leaves a cavity
-infection caused by pneumonia, aspiration
-associated with alcoholism, swallowing, disorders, seizure disorders, that lead to aspiration |
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Term
|
Definition
-pts have fever, cough, chills, foul smelling sputum
-treat with chest PT and antibiotics, bronchoscopy to drain |
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Term
|
Definition
-change in lungs from inhalation of inorganic particles
-ususally have years of exposure to dust
-silica, asbestos, coal, talc, fiberglass, cement
-permanent dust deposits
-diagnose by history radiograph |
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Term
|
Definition
-caused by inhalation of silicon dioxide and compounds and contains silica
-exposure to miners, sand blasting, iron steel foundry workers
-silica particles injected by macrophages, get fibrogenic response as macrophages break down
-10-20 years of exposure to cause disease
-see as cough and dyspnea
-predispose for other respiratory tract infections |
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Term
| Coal workers pneumonconiosis |
|
Definition
black lung disease
coal dust in lungs, also includes silica and quartz dust
caused by inhalation of carbon
marcrophages envelope, cause fibrotic response
small to large nodules form in lung
produce chronic bronchitis, right heart failure |
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Term
| Coal workers pneumonconiosis symptoms |
|
Definition
marcrophages envelope, cause fibrotic response
small to large nodules form in lung
produce chronic bronchitis, right heart failure |
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Term
|
Definition
abnormal and persistant dilation of the airways
- usually seen with other respiratory disease, can be from obstruction of airway
-mucous plug, aspiration, TB
-also, systemic disease like IBD, AIDS |
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Term
|
Definition
inflammatory obstruction of small airways
usually caused by chronic bronchitis in adults
acutely caused by viral infection or inhalation injury
diffuse disease, causes a decrease in the ventilation-perfusion ratio
-treated with antibiotics, steroids, chest PT |
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Term
|
Definition
-late stage scars lungs, occludes airways
-most common in lung transplant
-diagnosed with bronchoscopy and biopsy
-treat with steroids and immunosuppresents |
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Term
|
Definition
caused by DVT- deep vein thrombosis usually occurs in LE
-part of the clot break off and migrate to lungs |
|
|
Term
| pulmonary embolism- prevention |
|
Definition
Prevention = mobility
use of anticoagulant in high-risk patient |
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Term
|
Definition
| Risk for DVT- fx, surgery, bedrest, immobility, increased estrogen |
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Term
|
Definition
| pain, swelling, redness, but may have no signs at all |
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Term
|
Definition
| SOB, chest pain with increased deep breathing, anxiety, tachycardia, hemoptysis |
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Term
|
Definition
3000,000-6 estimated per year in the US
-use doppler ultrasound to see BF in vessel |
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Term
|
Definition
x-ray of chest is abnormal, but non-specific
-D-dimer is blood marker released when a clot dissolves, high levels indicate clot
-spiral CT uses contrast to image the blood vessels |
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Term
|
Definition
the clot in the lung artery can damage the lung from ischemia
cause: hypoxia, death |
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Term
|
Definition
| large clot that sits in the bifurcation of the pulmonary arteries |
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Term
|
Definition
if have DVT will be treated with herapin to anticoagulant, then coumadin
-greenfield filter may be placed to IVC to catch clots
-compression stockings |
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Term
|
Definition
-anticoagulation
-tPA for fibrinolytic therapy
-surgical embolectomy may be done via catheter |
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Term
|
Definition
- pneumothorax
-hemothorax
-barotrauma
-chemical inhalation |
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Term
|
Definition
-air leak into the pleural space ( bwtwn lungs and chest wall)
- can be spontaneous, from blunt trauma, or penetrating chest trauma ( knife, GSW, MVA)
-causes pain, SOB
TX= chest tube |
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Term
|
Definition
blood in pleural cavity
most often caused by trauma
-or by cardiothoracic surgery, cancer, TB
-pt has chest pain, SOB, tachycardia, hypotension
TX- chest tube or surgery |
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Term
|
Definition
extra-alveolar air from over- distention of the alveoli ( if alveoli has increased pressure can rupture
-most commonly from mechanical ventilation
-can cause respiratory distress, subcutaneous, emphysema, pneumomediastinum, tension, pneumothorax
-prevent by using low tidal volume on ventilator |
|
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Term
|
Definition
-also caused by scuba diving, free diving,
-holding breath during ascent causes compression gas to expand
-no good pharmacology tx
-rarely require surgery to correct ( would need to treat a pneumothorax) |
|
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Term
|
Definition
-toxic chemicals ( chlorine, hydrogen chloride, ammonia)
- smoke-injury from soot and chemical compounds in smoke
- mustard gas
- cause mucous membrane injury, tracheitis, bronchitis, PE
-treat with supportive therapy, analgestics, O2, ventilator support |
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Term
| Most common cause of short-term disability in USq |
|
Definition
| Respiratory tract infection ( cold, sore throat, laryngitis) |
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Term
| infectious pulmonary disease |
|
Definition
RTI, lungs are sterile,
LRTI- usually occur in those with impaired immune systems
-very young, old, co-morbidities |
|
|
Term
| Examples of Infectious pulmonary diseases |
|
Definition
| pneumonia, TB, whooping cough |
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Term
|
Definition
|
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Term
|
Definition
-can be caused by bacteria, virus, or fungal agents
-Streptococcus pneumonia is most common bacteria
-influenza is most common viral cause
-aspiration
-hospital acquired |
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|
Term
| Signs/symptoms of pneumonia |
|
Definition
| fever, cough, nausea, vomiting, SOB, chills, chest pain |
|
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Term
|
Definition
1.1 million in US were hospitalized with pneumonia
50,000 died |
|
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Term
|
Definition
adults over 65
children under 5
adults with underlying medical conditions, smoking
*vaccine can reduce risk |
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Term
| Ventilator associated Pneumonia |
|
Definition
| infection from pathogens entering via aspiration of secretions, use of contaminated equiptment, colonization of aerodigestive tract |
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|
Term
| Ventilator associated Pneumonia risk factors |
|
Definition
| prolonged intubation, enteral feedings, paralytic agents |
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|
Term
| Ventilator associated Pneumonia treatment |
|
Definition
antibiotics, antivirals, antipyretics
mobility and positioning |
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Term
|
Definition
bacterial disease caused by mycobacterium tuberculosis
-airborne transmission
-latent TB- no symptoms, not infectious
-TB disease- bacteria are active if the immune system can't destroy them |
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Term
| Tuberculosis risk factors |
|
Definition
immunodeficiency
recent infection with TB bacteria |
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Term
|
Definition
| chest pain, weakness, chills, fever, night sweats, hemoptysis |
|
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Term
|
Definition
skin test or blood test- Id's that the person is infected, but not if they have latent or TB disease
-if someone has had TB vaccine skin test will be +
+ test, now identify if they have signs, chest x-ray, physical |
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Term
|
Definition
may involve lung, kidney, liver, brain
-may see parenchymal consolidation, then as heals shrinks into nodule
-airways may be compressed, have mucosal infection
-pleura may be involved |
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Term
|
Definition
latent TB treated with 1 of 3 drugs
-isoniazid, rifampin, rifapentine |
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|
Term
|
Definition
antibiotic therapy for 6-9 months
-isoniazid, rifampin, ethambutol, pyrazinamide |
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Term
|
Definition
Pertussis caused by bacteria Bordetella
-Bacteria attach to cilia in URT and release toxins damaging the cilia and causing inflammation |
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Term
|
Definition
initially have cold symptoms, cough, fever, runny nose
After 2 weeks, severe coughing begins and the pt can have paroxysms (coughing fits) for weeks causing vomitting and exhaustion
2nd stage lasts 2 weeks or more |
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|
Term
| Whooping cough complications |
|
Definition
infants and children- pneumonia, convulsions, apnea, ecenphalopathy, death
adults, wt loss, syncope, rib fx
diagnosed by history of signs, examination and secretion sample from nasopharyngeal swab |
|
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Term
|
Definition
| early tx with azithromycin, early in tx shortens the periods of the pts contagious stage |
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|
Term
| Obstructive Pulmonary Disease--emphysema, bronchitis, asthma |
|
Definition
-airway obstruction in exhalation
-more force, more time, or both is needed to exhale a given amount of air
-increased work of breathing
-dyspnea
-emphysema, bronchitis, asthma |
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|
Term
COPD- chronic obstructive pulmonary disease
Prevalence and risk factors |
|
Definition
15 mil Americans
Smoking is leading risk factor
air pollution
includes emphysema, and chronic bronchitis |
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|
Term
|
Definition
alveoli lose elasticity
increased mucous production
destruction of alveolar walls |
|
|
Term
| Signs and symptoms of COPD |
|
Definition
| chronic cough, SOB, excess sputum, wheezing, dyspnea on exertion, Decreased FEV1, FVC |
|
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Term
|
Definition
hyper-secretion of mucus
irritants in airway cause inflammation of the epithelium
chronic productive cough for at least 3 months for at least 2 consecutive yrs
thicker mucus, allows bacteria to embed in airway secretions |
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