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23 Cards in this Set
- Front
- Back
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what are the indications to intubate
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inability to clear secretions
loss of gag reflex decreasing or deteriorating ABG Acute resp failure |
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hypercapnic resp fail
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inc CO2 c normal or dec O2
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nonhypercapnic resp fail
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O2 dec c normal or dec CO2
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DDx of dyspnea
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asthma
bronchitis emphysema pneumonia pneumothorax Pulmonary emboli CHF |
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Chronic bronchitis etiology
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daily, productive cough for >3 months
smokers Male older |
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chronic bronchitis pathophys
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hypoxemia
hypercapnia polycythemia pulmonary HTN cor pulmonale (enlarged RV) |
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chronic bronchitis Hx and PE
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Hx: dyspnea and smoking, copious sputum
PE: cyanotic, cachectic, wheezes, rales, dec breath sounds |
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emphysema etiology
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smoker
Male older alpha-1 antitrypsin deficiency |
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emphysema pathophys
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permanent enlargement of the air spaces
destruction of alveolar walls |
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emphysema Hx and PE
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Hx: dyspnea and smoking
PE; Barrel chest, wheezes, dec breath sounds |
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pneumonia Hx and PE
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Hx: fever, cough, sputum production, poss hemoptysis
PE: fever, tachypnea, tachycardia, dullness to percussion, fremitus, Egophony (E to A), dec breath sounds, whispered pectoriloquy over consolidation |
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pneumothorax etiology
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typically- COPD, Asthma, malignancy
ocassionally- healthy, esp. thin males |
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pneumothorax Hx and PE
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Hx: sudden onset SOB, pleuritic chest pain, trauma, heavy exertion, prior pneumo
PE: unilateral decreased breath sounds tension pneumo- shock, JVD, tracheal deviation |
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pulmonary emboli etiology
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older
surgery malignancies immobilization pregnancy birth control |
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Pulmonary emboli pathophys
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95% from DVT in legs or pelvis
large emboli= proximal artery, hypotension and shock small emboli= distal arteries, dyspnea, pleuritic pain, hypoxia |
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pulmonary emboli Hx and PE
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Hx: sudden onset dyspnea, pleuritic chest pain, hemoptysis, anxiety, rarely syncope
PE: Tachycardia and tachypnea, cyanosis, pulmonic valve closure, inc temp |
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CHF etiology
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older
Hx of cardiac disease cardiac risk factors ( Myocardial ischemia, tachydysrythmias, inc salt intake, non-compliance w/ diuretics) |
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CHF Pathophys
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LV dysfunction
fluid collection in lung |
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CHF Hx and PE
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Hx: cough, orthopnea, parxysmal nocturnal dyspnea, chest pain
PE: rales, wheezes, JVD, gallop, peripheral edema, diaphoresis |
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Diagnostic testing for COPD
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A-a
CBC X-ray FEV1/PEFR Gram stain |
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what is the A-a equation
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150 - (pO2 + PCO2/.8)
norm is 10 to 20 |
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what do you need to be careful of when giving supp O2 to a COPD pt
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their resp drive is driven by hypoxia now, not CO2
oo rapid of an improvement in hypoxia can compromise breathing and lead to bradypnea Lethargy is a major warning sign of resp fail |
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what is a venturi mask
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oxygen mask that allows an Exact O2 amnt to be administered
typical= 24, 26, or 28% FiO2 nasal canula only approximates O2 levels |
