Ecco Bccc Ormc Pulmonary

Front 1

Hallmark signs of COPD

Back 1

Chronic cough chronic expectoration, varying levels of dyspnea on exertion, decreasing expiratory airflow that does not respond to pharmacologic interventions.

Front 2

Factors that contribute to the development of chronic bronchitis or emphysema include----

Back 2

Cigarette smoking, environmental pollutants, toxic exposure, and some predisposing genetic factors such as alpha-1 anti-trypsin deficiency.

Front 3

How is chronic bronchitis diagnosed?

Back 3

Patient will have a chronic cough and sputum production for three months of the year for two consecutive years.

Front 4

What would you assess for right-sided failure or cor pulmonale associated with chronic bronchitis?

Back 4

Peripheral edema, distended neck veins, dusky skin color, increased hematocrit or polycythemia on CBC. (occurs as compensatory response to chronic hypoxemia)

Front 5

What is core pulmonary?

Back 5

Failure of right-sided heart brought on by long-term high blood pressure in the pulmonary arteries and right ventricle of heart

Front 6

Exacerbations of COPD are usually attributed to –

Back 6

Viruses, bacteria, or environmental pollutants.

Front 7

Physical assessment and presentation of patients with COPD include:

Back 7

Present to ICU with dyspnea and ^sputum production, exhaustion, and anxiety. Likely to have tachycardia and perhaps ventricular dysrhythmias. Normal for ABG to show level of hypoxemia with compensated respiratory acidosis. As they worsen PaCO2 will continue to increase pH to uncompensated respiratory acidosis.

Front 8

What are the breast sounds associated with COPD?

Back 8

Chronic bronchitis – crackles and wheezes, large volume thick secretions.
Emphysema – distant breath sounds..

Front 9

What is the position of comfort for someone with emphysema?

Back 9

Sitting upright in leaning forward with arms supported on over bed table.

Front 10

What does pursed lipped breathing accomplish?

Back 10

Helps to decrease air-trapping.

Front 11

What type of oxygen delivery device should be used for COPD patients?

Back 11

If in ARF noninvasive mechanical ventilation. Somnelence and inability to cooperate with treatments are strong indications for intubation.

Front 12

How should oxygen be administered to the COPD patient and is a low flow or high flow device better?

Back 12

It should be administered in lower concentrations with the control delivery device such as Venturi mask, BiPap or CPAP.

Front 13

Should COPD patients be corrected to normal PaCO2 levels?

Back 13

No, they should be corrected to their normal rather than trying to achieve a normal value. Not good to decrease PaCO2 rapidly.

Front 14

Why is hydration important in the COPD patient

Back 14

To loosen secretions keep hydrated keep Volume

Front 15

What are the causes of pulmonary emboli?

Back 15

Blood clot, dislodged fat tumor, amniotic fluid and air.

Front 16

Patients at risk for PE include:

Back 16

Bedbound patients, patient status post trauma, recent birth, and insertion/removal of large core central catheters.

Front 17

What is Virchows triad?

Back 17

1. Venus stasis.
2. Altered Coaguability of the blood. 3. Damage to vessel walls.

Front 18

Massive PE includes ---percent occlusion of the pulmonary art

Back 18

50

Front 19

What are the hemodynamic consequences of massive PE?

Back 19

The development of pulmonary hypertension in response to the large blockade of blood flow and the release of mediators that contribute to bronco constriction that will cause further vasoconstriction and increased pulmonary vascular constriction.

Front 20

What are the patient signs of PE?

Back 20

Complain of dyspnea, pleuritic type of chest pain, dry cough, feeling of impending doom; increasing hypoxemia and hypercalcemia leading to change in loc; they also developed hemoptysis, diaphoresis and audible wheezing. Also tachypnea, crackles, tachycardia, ^T. Poss

Front 21

What are the test typically used to diagnose PE?

Back 21

Physical findings. Spiral CT angiography. ABG results. Pulmonary angiogram. Ventilation perfusion lung scans.

Front 22

What are treatment modalities for PE?

Back 22

Heparin infusion. Thrombolytic if hemodynamically unstable. Maintain oxygenation and ventilation. Hemodynamic support.

Front 23

What should be ordered for DVT prevention for patients that are not moving?

Back 23

Low-dose heparin or anticoagulants. Compression hose or SCDs.

Front 24

Describe normal breath sounds.

Back 24

Bronchial heard over trachea down to Corina.
Bronchial vesicular- over areas where there is a transition between large and small airways.
vesicular-heard over small airways and terminal respiratory units.
Decreased-indicate absence of air movement from pneumonia, atelectasis or pleural effusion. Displaced.
Adventitious -extra sounds like wheezing crackles rails friction rubs.

Front 25

Atelectasis is common in the – patient.

Back 25

Post operative

Front 26

Large area of Atelectasis can cause – and –

Back 26

Hypoxemia and ARF

Front 27

Cough and deep breathing may – atelectasis and – Airways.

Back 27

Diminish

Open

Front 28

What breath sounds would you hear with atelectasis?

Back 28

Inspiratory crackles

Front 29

– – Oxygen may be used for mild atelectasis; – maybe necessary for severe atelectasis.

Back 29

Low flow

Positive airway pressurezza

Front 30

What would your physical assessment find with pneumonia?

Back 30

Bacterial pneumonia – fevers, chills, dyspnea and cough (productive or nonproductive) and purulent sputum if productive.
Crackles at end of inspiration that do not clear with coughing or deep breathing.
Complain of pain in the area of consolidation.
Limited chest expansion on affected side.

Front 31

Patients with pneumonia may also exhibit – in the area of consolidation.

Back 31

Limited chest expansion

Front 32

Diagnosis of pneumonia is usually based on – on –.

Back 32

Pulmonary infiltrate

Chest x-ray

Front 33

Treatment modalities for pneumonia include –, –, possible –, or – if respiratory failure develops.

Back 33

Antibiotics
Broad-spectrum antibiotics
02 therapy
Mechanical ventilation

Front 34

What breath sounds would you hear in the patient with asthma?

Back 34

Wheezing

Front 35

The immune response in asthma causes –, –, and –.

Back 35

Bronchospasm.
Increased mucus production
Mucosal edema.

Front 36

Unlike COPD, asthma is a – condition.

Back 36

Reversible

Front 37

The initial ABG in status asthmatic us would be –, and change to – as the patient tires.

Back 37

Respiratory alkalosis or low PaCO2

Respiratory acidosis due to hypoxemia and hypercapnea

Front 38

If you auscultate wheezing in the patient in status asthmaticus that changes to decreased breath sounds, this is a sign of –, especially if the patient is tired or has altered mental status

Back 38

Exhaustion and a precursor of ARF

Front 39

– Is the diagnostic tool to determine the severity of asthma

Back 39

Peek expiratory flow. PEF less than 25% of expected results requires hospitalization

Front 40

Which bronchodilators and corticosteroid are used to treat asthma

Back 40

B2 agonist

Inhaled

Front 41

The defects of ARFare:

Back 41

failure of gas exchange including oxygenation failure, ventilation failure, or oxygenation and ventilation failure.

Front 42

ABG in ARF is:

Back 42

PaO2 less than 50. (hypoxemic failure)
PaCO2 greater than 50. (hypercapnic failure).
A combination of both. PH will be asked acidotic and buffers that are the bicarbonate and base excess will be normal or show mild increases

Front 43

Assessment findings and ARF include:

Back 43

Recent onset of dyspnea or increased work of breathing.
Increased pulmonary secretions.
Change in LOC confusion restlessness.
change in ABG, tachypnea or tachycardia.
History of precipitating factors example smoking heart disease

Front 44

Priority intervention for ARF is application of –.

Back 44

02

Front 45

Monitoring during ARFshould include –, –, –, and –.

Back 45

Continuous O2 saturation.
ET CO2.
Cardiac monitoring.
Arterial catheter for continuous blood pressure or serial ABGs

Front 46

It's anxiolytic drugs are used in patients that are not intubated, care must be taken to prevent –.

Back 46

Over sedation and decreased ventilatory effort

Front 47

Nutritional consideration would be to avoid feeding –.

Back 47

Carbohydrates.
(byproduct of carbohydrate metabolism is CO2)

Front 48

Standard of care for ARF include

Back 48

1".Administer O2 to maintain O2 sat greater than 90%.
2.Administered diuretics.
3. Provide emotional support to patient and family.
4. Continuous oxygen saturation.
5. Cardiac monitoring.
6.Nutritional support.

Front 49

PAH is an abnormal condition of the pulmonary vasculature causing:

Back 49

1. Abnormal pulmonary arteries.
2. Media Thickens and hypertrophied.
3. increased muscle fibers.
4. chronic vasoconstriction.
5. fibrosis.
6. Plexiform lesions.

Front 50

Common symptoms of PAH include:

Back 50

Dyspnea, angina, syncope, and edema.

Front 51

IV medication for pulmonary hypertension is a – infusion, but if allowed to run out, could be –.

Back 51

Continuous

Fatal.