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47 Cards in this Set

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Inflammation of the bronchi in the lower respiratory tract, usually due to infection?
Bronchitis
What is the cause of bronchitis?
In most cases viral, can be bacterial as well
What is the most common symptom of bronchitis?
Persistent cough, which usually produces clear, mucoid sputum, following an acute upper airway infection
How do you differentiate bronchitis from pneumonia?
Chest X-ray, pneumonia will show consolidation or infiltrates
What is the treatment of acute bronchitis?
Usually symptomatic
Acute inflammation of the the lung parenchyma, caused by a microbial organism?
Pneumonia
What are the factors that predispose a person to pneumonia?
Aging
Air pollution, smoking
Antibiotics
Bed rest
Altered LOC
Intubation
Immunosuppression
Chronic disease
Malnutrition
If the onset of pneumonia is in the community or within the first 2 days of hospitalization it is classified as?
Community-acquired pneumonia
How is community-acquired pneumonia treated?
The sooner the better, start with broad spectrum antibiotics, followed by specific antibiotics once causative pathogen is identified.
Pneumonia occurring 48 hours or longer after hospital admission and not incubating at the time of hospitalization
Hospital-acquired pneumonia
Definition of Ventilator associated pneumonia?
Pneumonia that occurs more than 48-72 hours after endotracheal intubation
Definition of Health care associated pneumonia?
Any patient with new onset pneumonia who: 1) Hospitalized for more than 2 days within 90 days of infection, 2) resided in long-term care, 3) received IV therapy within 30 days, or 4) attended a hospital or hemodialysis clinic
What organisms cause HAP, VAP, and HCAP?
Almost always bacterial
The person with aspiration pneumonia usually has a history of what?
Loss of consciousness
What is the most common AIDS defining opportunistic infection?
Pneumocystis jiroveci pneumonia (PCP), which is fungal
Clinical manifestations of pneumonia?
Fever
Shaking chills
SOB
Cough with purulent sputum
Pleuritic chest pan

***In the elderly or debilitated, only sign may be confusion or stupor****
What would you expect to find upon examination of the patient with pneumonia?
Sign of pulmonary consolidation:
Dullness to percussion
Increased fremitus
Bronchial breath sounds
Crackles
For patients at risk for pneumonia, what is the mainstay for prevention?
Vaccination against influenza
Nursing roles with pneumonia?
Indentify at risk
Proper positioning
Prevent Aspiration
And a bunch of other obvious stuff
What is characterized by permanent, abnormal dilation of one or more large bronchi?
Bronchiectasis
What is the result of bronchiectasis?
Reduced ability to clear mucus from the lungs and decreased expiratory airflow
Hallmark manifestation of bronchiectasis?
Persistent or recurrent cough with large amounts of purulent sputum (may exceed 500ml/day)
Other manifestations of bronchiectasis?
Dyspnea
Wheezing
Pleuritic chest pain
Hemoptysis
Crackles (auscultation)
Collaborative care for bronchiectasis?
Antibiotics
Bronchiodialator therapy to prevent spasms
Chest physiotherapy
Nursing management of bronchiectasis?
Early detection and treatment of lower respiratory tract infection
Promote drainage and removal of mucus
Nutrition and good hydration
ARDS?
Acute respiratory distress syndrome
Patho of ARDS?
Form of acute respiratory failure in which the alveolar capillary membrane becomes damaged and more permeable to intravascular fluid
What is the most common cause of ARDS?
Sepsis
Additional causes of ARDS?
Direct lung injury

Multiple organ dysfunction syndrome (MODS)
What are the phases of ARDS?
1) Injury or exudate phase- alveolar edema and atelectasis

2)Reparative or proliferative phase- lung becomes increasingly dens and fibrous

3)Fibrotic phase- lung is completely dense and uncompliant
Clinical manifestations of ARDS?
Often insidious

Tachycardia, diaphoresis, decreased mentation, cyanosis, ronchi, diffuse crackles
Complications of ARDS?
Hospital-acquired pneumonia (68%)
Barotrauma
Volu-Pressure Trauma
Stress Ulcers
Renal Failure
What positioning do some patients with ARDS benefit from?
Prone (as opposed to supine)
COPD?
Abnormal inflammatory response of lungs to noxious particles or gases

Chronic bronchitis
Emphysema
Chronic bronchitis?
Presence of chronic productive cough for 3 or more months in each of 2 successive months
Emphysema
Abnormal permanent enlargement of the airspace distal to the terminal bronchioles

Destruction of bronchioles without obvious fibrosis
GOLD?
Global initiative for Chronic Obstructive Lung disease

Increase awareness and improve outcomes
COPD risk factors
Recurring infections
Heredity- antitrypsin deficiency
Aiging
Smoking
Pollution
What does COPD do to the chest?
Causes barrel-chest look
(air goes in but remains in the lungs)
Common characteristics of COPD?
Mucus hypersecretion
Dysfunction of cilia
Hyperinflation of lungs
Gas exchange abnormalities
Earliest symptom of COPD?
Intermittent cough
Clinical manifestations
Cough
Dyspnea
Underweight with adequate calories
Chronic fatigue
Wheezes
Diminshed breath sounds
Bluish-red color of skin
COPD can eventually do what to the heart
Cor pulmonale

Hypertrophy of rt side leads to right side heart failure
Other complications of COPD?
Acute Respiratory Failure
Peptic ulcer disease
Depression and anxiety
What is the most common drug therapy for COPD?
Bronchodilators
Sexual activity during COPD?
Plan when breathing is best
Use slow, pursed-lip breathing
Refrain after strenuous activity
Do no assume dominant position or prolong foreplay?

****Seriously? The only reason I included this slide is because it is hilarious ******
"I'm sorry sir, no missionary f'or you, but reverse cowgirl is ok"
Nursing management
All common sense stuff