Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
59 Cards in this Set
- Front
- Back
Cough
|
Reflex response to stimuli that irritate receptors in the larynx, trachea, or large bronchi
|
|
Cough defends against what...
|
physiological mechanism that defends against respiratory pathogens and helps to clear tracheo-bronchial tree of mucus, foreign particles, and noxious aerosols
|
|
Acute Cough
follows what illness |
commonly follows viral or bacterial URI
|
|
Chronic Cough
Cause |
low-grade chronic bronchitis secondary to exposure to tobacco smoke
|
|
Chronic Cough
Other causes |
Angiotension-converting enzyme (ACE) inhibitors
|
|
Hemoptysis
|
expectoration of blood that originates below the vocal cords
|
|
Evaluation of Hemoptysis should include...
|
-CXR
-CBC (including platelets) |
|
Best way to test Acid-Base status
|
Arterial blood gas (ABG) analysis
|
|
Hypercapnia
|
elevated CO2 levels
|
|
Hypercapnia Symptoms
|
-asterixis (flapping tremor of outstretched hand)
-headache -productive cough -wheezing -increased somnolence -stupor |
|
Normal ABG Values
pH, PaO2 |
pH 7.35 to 7.45
PaO2 80 to 100 mmHg |
|
Normal ABG Values
PaCO2, HCO3, O2 Saturation |
PaCO2 35 to 45 mmHg
HCO3 22 to 26 mEq/L O2 Saturation 97 to 100% |
|
ABG samples kept at room temp....what happens
|
decrease in PaO2 & pH
increase in PaCO2 |
|
Hypoxia
|
lower than normal level of oxygen in inspired gases, aterial blood, or tissue
|
|
Levels of hypoxia
PaO2 = |
60-79 mmHg = mild hypoxia
40-59 mmHg = moderate hypoxia <40 mmHg = severe hypoxia |
|
Pulse ox saturation = ____ PaO2
|
pulse ox 90% = PaO2 59
|
|
Hypoxia
Cardinal symptoms |
disorientation, restlessness, agitation, dyspnea
|
|
Respiratory system's response to hypoxia
|
increase in the rate and depth of breathing
|
|
Cardiovascular system's response to hypoxia
|
increase in cardiac output that causes a paradoxical increase in myocardial hypoxia due to increased workload
|
|
Acidosis
|
pathological process leading to positive balance of fixed acid or CO2
|
|
Mechanisms to maintain pH
|
Respiratory Regulation
Buffer Regulation Urinary Regulation |
|
Compensation
|
occurs when a specific component of acid-base system has shifted outside the normal range as a means of compensating for an abnormality in some other compenent's level
|
|
Compensation by respiratory system....
Fast or slow?? |
Fast -- within minutes
|
|
Compensation by renal system...
Fast or slow?? |
Slow -- hours to days
|
|
Respiratory acidosis
|
characterized by elevation of CO2 > 45 with a decrease in pH
|
|
Respiratory alkalosis
|
occurs when CO2 levels are < 35 and pH is greater than 7.45
|
|
Metabolic acidosis
|
HCO3 <22
pH <7.35 |
|
Metabolic acidosis
Compensation how? |
increase respiratory rate
increase renal runction to excrete H+ |
|
Metabolic alkalosis
|
HCO3 >26
pH >7.45 |
|
Metabolic alkalosis
compensation how? |
decrease renal function to decrease secretion and excretion of H+
|
|
Pleuritis (Pleurisy)
Caused by |
chest pain caused by stimulation of pain fibers in the parietal pleura as a result of acute pleural inflammation
|
|
Pleuritis
Signs & Symptoms |
Pain = localized, sharp or stabbing, & fleeting
Worse with coughing, sneezing, deep breathing, or movement |
|
Pleuritis
Treatment |
**treat underlying disease**
Analgesics & anti-inflammatory drugs |
|
Pleural Effusion
|
abnormal accumulation of significant volume of fluid in the pleural space
|
|
Pleural Effusion
Results from... |
inflammation of the structures adjacent to the pleural space or from lesions within the chest
|
|
Diagnostic thoracentesis
When to do?? |
whenever there is new pleural effusion and no clinically apparent cause
|
|
Pleural Effusion
Signs & Symptoms |
dyspnea, cough, or chest pain worse with inspiration or expiration
|
|
Pleural Effusions
Physical findings |
Small effusions -- no physicial findings
Large effusions -- dullness to percussion and diminished or absent breath sounds over the effusion |
|
Pleural friction rub indicates what....
|
myocardial infarction or pleuritis
|
|
Pleural fluid samples should be measured for what labs??
|
protein
glucose LDH total & differential WBC counts |
|
Pleural effusion
Imaging...chest X-ray shows... |
blunting of costophrenic angle, loss of sharp demarcation of diaphragm and heart, & mediastinal shift to uninvolved side
|
|
Pleurodesis
|
procedure where an irritant is placed into the pleural space following a chest tube drainage and lung re-expansion
|
|
Goal of Pleurodesis
|
form fibrous adhesions between visceral and parietal pleura, resulting in obliteration of pleural space to prevent or reduce reaccumulation of pleural fluid
|
|
Management of a small-volume hemothorax that is stable or improving
|
Close observation
|
|
Treatment of unstable hemothorax
|
immediate insertion of large-bore thoracostomy tube
|
|
Pneumothorax
|
accumulation of air in the pleural space
|
|
Spontaneous Pneumothorax
When it occurs... |
occurs in the absence of an underlying lung disease
|
|
Spontaneous Pneumothorax
Who it usually affects |
tall, thin boys and men btwn 10-30 years old
|
|
Spontaneous Pneumothorax
Other important factors |
family history and cigarette smoking
|
|
Secondary Spontaneous Pneumothorax
|
complication of preexisting pulmonary disease such as COPD, asthma, CF, TB
|
|
Traumatic Pneumothorax
results from... |
results from penetrating or blunt trauma
|
|
Tension Pneumothorax
results from... |
secondary to a sucking chest wound or pulmonary laceration that acts as a check-valve mechanism, allowing air to enter the chest with inspiration but not allowing it to leave on expiration
|
|
Pneumothorax
Signs & Symptoms |
acute onset of chest pain, ranging from minimal to sever on affected side and dyspnea
|
|
Small pneumothorax
S & S |
physical findings are unimpressive excpet for tachycardia
|
|
Large pneumothorax
S & S |
diminished or absent breath sounds, decreased tactile fremitus, hyper-resonant percussion, decreased movement of chest
|
|
When to consider Tension Pneumothorax as dx....
|
presence of marked tachycardia, hypotension, and mediastinal and tracheal shift to the unaffected side
|
|
Pneumothorax
X-Ray findings |
-absence of pulmonary vessels extending to chest wall
-collection of air btwn parietal and visceral pleura -visible pleural line -inc. lucency of one hemithorax -mediastinal shift toward unaffected side |
|
Placement of chest tube
|
over the top of the rib (avoid neurovascular bundle)
|
|
Treatment of Tension Pneumothorax
|
placing large-bore needle in 2nd intercostal space along the mid-clavicular line
|