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27 Cards in this Set
- Front
- Back
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List the S&S of Asthma
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Dyspnea (SOA)
Nasal Flaring Pursed Lip Breathing Expiratory Wheeze (Significant w/ asthma pts) Expiratory progresses w/ Inspiratory Wheeze |
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Treatment of Asthma
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* Mgmt based on severity
* Meds - Corticosteroids (Asmacort & Flovent) - Mast Cell Stabilizers (Cromolyn) - Bronchodilators (Advair & Theophylline) - Leukotriene Modifiers (Singulair) * Low Dose O2 * Hydration * Conserve Energy * No triggers in room (flowers, perfume, smoke) * Severe attack = emergency - Maintain Airway - Maintain Gas Exchange (2 L of O2) - If bronchodilators ineffective, nebulize Atropine Sulfate, Theophylline (hard on elder), IV or IV steroids |
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List the S&S of Acute Bronchitis
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* Mucopurulent Sputum
* Noisy Inspirations * Sternal Soreness from Coughing * Fever * General Malaise |
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Treatment of Acute Bronchitis
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* Symptomatic Treatment
* Sore Throat * Secretions * Tylenol/Ibuprofen for Aches & Pains * Cool Steam Inhalation * Increased Fluid Intake - 2 to 3 L/24 h * Bedrest * Antibiotics after sputum culture obtained * Bronchial Hygiene |
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List the S&S of Chronic Bronchitis
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* Productive Cough (3 months/year for 2 years)
* Hx of frequent Resp Infections * Usually Hx of Smoking or Pollution Exposure * Barrel Chest * Club Fingers |
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Treatment of Chronic Bronchitis
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Bronchodilators
Postural Drainage & Secretions Increase Fluid Intake - 2 to 3 L/24 h If no improvement, Corticosteroids (Asmacort/Flovent) |
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List the S&S of Emphysema
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* Progressive DOE (cluster care)
* Thin pt * Tachypnea w/ prolonged expiration * Leaning forward position w/ arms on knees * Barrel Chest * Accessory Muscle Use |
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Treatment of Emphysema
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* Bronchodilators & Steroids
* O2 (1-3L NC to raise PO2 to 60-80, w/ bubbler or hum) * Exercise (mild) * Pursed Lip Breathing * Keep Mucous Membranes Moist |
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List the S&S of TB
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* + TB Test
* Hx of exposure * Cough * Fatigue * Anorexia & Wt Loss * Low Grade Fever * Chest Pain * Crackles * SPUTUM ***DEFINITIVE DIAGNOSTIC TOOL |
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Treatment for TB
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* Most pts newly diagnosed are not hospitalized
* 3+ Meds - Isoniazid (can be used for tx or prophylaxis (2 wks) - Rifampin - Streptomycin - Pyrazinamide * Meds taken 4-12 mos. even though feels better 2-3 wks |
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List the S&S of Lung Abscess
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* Usually pts w/ impaired cough reflex susceptible
- CVA, Sz, Drug/ETOH, Esopagheal prob., NG tube pts) * Fever * Chills * Pleuritic Pain * Cough * Copious Sputum - foul & bloody * Decreased breath sounds, dull percussion, friction rub * Crackles as abscess drains (Crackles are improvement) |
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Treatment for Lung Abscess
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* Antibiotics (broad spectrum til C&S culture)
* Bronchoscopy (for suctioning) * Postural drainage * Frequent mouth care - pt may have diff. swallowing * High Calorie/High Protein diet - may be malnourished * Educate - sit up when eating, swallowing precautions |
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What are the S&S of Pleural Effusion?
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* Depends on amount of fluid present & degree of lung commpression
* Dry Non-Productive Cough * Dull Percussion * May or may not have pleurisy (pain) |
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Treatment for Pleural Effusion.
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* Primary Pleural Effusion
- Thoracentesis to remove fluid * Recurrent Pleural Effusion - may recur despite repeated thoracentesis - Tx accomplished through obliteration of pleural space - chest tube left in to drain current PE |
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What are the likely dx r/t rales & crackles?
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* Heart Failure
* COPD * Pneumonia * Bronchitis * TB |
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What are the likely dx r/t Rhonchi?
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* Secretions
* Tumor |
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What are the likely dx r/t Wheezing?
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* Asthma
* Chronic Bronchitis |
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What are the likely dx r/t Friction Rub?
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* Trauma
* Pneumonia * Chest Tubes * Cancer |
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What are the likely dx r/t Stridor?
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* Status Asthmaticus
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What is asthma?
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A chronic inflammatory process that constricts air passages characterized by bronchospasms.
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What is asthma asthmaticus?
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An asthma attack lasting over 24 h. Severe & life threatening. Acute episode that intensifies & w/ severe bronchospasms. This increased work load of breathing increased 5-10x is called COR PULMONALE. Also includes paradoxical pulse (pulse decreases during inhalation)
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What is Acute Bronchitis?
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Inflammation of the bronchial tree that often follows an upper respiratory infection.
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What is Chronic Bronchitis?
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A COPD Disorder. A productive cough lasting minimum of 3 months a year for 2 or more years.
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What is emphysema?
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A destruction of alveolar walls that leads to permanent distention of air space. WOB if ^ due ti decreased functional lung tissue to exchange O2 & CO2. Lung are hardened making it harder to breath.
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What is TB?
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An infection that causes necrotic degeneration of lung tissue. Produces cavities/cheese like mass, dead WBC's, necrotic lung tissue. This area liquifies & drains & is coughed up. Heals over months & calcifies. Calcified lesions can be reactivated after years & cause secondary infection. Primary TB causes allergic reaction that can be detected in 2-6 wks post infection.
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What is a Lung Abscess?
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Collection of pus in lung tissue (empyema). Early stages resembles pneumonia. If undx or untreated = lung necrosis can occur. May need VATS to scrape out necrosis. Usually affects posterior upper lobe of R lung.
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What is Pleural Effusion?
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Accumulation of fluid of pleural space. Commonly affects MVA, HA, Renal Pts, Cancer Pts.
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