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SOPN lower respirato
SOPN lower respiratory
Question | Answer |
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Inflammation of the bronchi. Very Common occurance. Results in very little lung damage. Pneumonia may be a complication | Acute Bronchitis |
Manifestations: Low grade fever, not above 101 degrees. Cough dry to start then progressing to productive mucopurulent, and attacks of coughing occurs especially at night. | Acute Bronchitis |
Treatment: Bedrest, antitussives, NO ANTIBIOTICS (unless of course you received a positive C&S of the sputum) | Acute Bronchitis |
Acute infection and or inflammation of the respiratory bronchioles and aveoli | Pneumonia |
Bacterial, Viral, and due to the aspiration of stomach contents | 3 Types of Pneumonia |
What causes viral pneumonia | Type A Virus |
the most common viral pneumonia in the immunosuppressed | Cytomegalovirus |
Most common bacterial pneumonia caused by GROUP AB - HEMOLYTIC STREPTOCOCCI | streptococcus pneumonia (bacterial pneumonia) |
Gram negative bacilli bacteria common in patients with COPD, VIRAL INFLUENZA, and MEASLES | HEMOPHILUS INFLUENZA (bacterial pneumonia) |
What is considered normal flora of the upper respiratory tract | MORAXELLA CATARRHALES (bacterial pneumonia) |
ATYPICAL pneumonia is the frequent cause of community acquired pneumonia in young people. Has characteristics of bacterial and viral pneumonias. *RUSTY SPUTUM* | MYCOPLASIA PNEUMONIA (atypical pneumonia) |
Non bacterial - *CAUSES MULTI-SYMPTOM FAILURE* | Legionella Pneumophilia (atypical pneumonia) |
Hospital acquired pneumonia - high mortality rate - GRAM NEG most common - | Nosocomial pneumonia |
What meds used for the management of Strep | 1st or 2nd generation cephalosporin, PCN, or Erythromycin |
Prevention of Pneumonia | pneumovax vaccine (only given once and is good against 2 pneumonia strains AND only good for 10 years) |
Prevention of Influenza | Vaccine once yearly |
Aspiration of stomach contents, toxic materials, or a forgein body into the lower respiratory tract, triggers injury within 48-72 hours. Temp will elevate 2 hours after insult of aspiration. | Aspiration Pneumonia Syndrome |
Prevention of Aspiration pneumonia will be achieved by what methods? | Side lying position, frequent mouth care, Tube feeds w' HOB elevated 30 degrees, and WITH HOLD FEEDS OF RESIDUALS ARE GREATER THAN 100mls, and call MD please! |
Localized collection of PUS within the lungs | LUNG ABSCESS |
Infections ESPECIALLY with staph, TB, some fungal infections, aspiration, pulmonary infarct, and lung cancer. Any of which could cause what condition? | Lung abscess |
Manifestations: fever, cough, sputum production, possible DULL CHEST PAIN, dyspnea, weakness, anorexia, and weight loss. CONFIRMED BY CHEST X-RAY. | Lung abscess |
high doses of antibiotics that usually last 6-12 *WEEKS* if the source is bacterial Surgical removal in rare cases via lobectomy or drainage | Lung abscess |
What are the 3 major groups of viruses responsible for Influenza Virus Infections | A, B, and C |
Which type of influenza mutates the most and is responsible for most deaths; especially in the very young and very old. TRANSMITTED MOSTLY BY AIR. complication is bacterial and viral pneumonia | TYPE A influenza |
encephalitis, sinusitis, exacerbation of preexisting respiratory diseases. Incubation is 1-3 days, then fever sweating, H/A, muscle aches, pain, non-productive cough, conjunctival irritation, rhinitis, general malaise, sore throat, and laryngitis | Guilliam Barre Syndrome |
What is the prevention for Guilliam Barre Syndrome | flu vaccine or Amanatadine Hcl may be given of caught early enough |
an infection disease of the lung primarily spread thru airborne route, can also occur in other sites | Tuberculosis |
Most common cause of tuberculosis | mycobacterium |
What disease requires close and frequent PROLONGED contact with the infected | TB |
Occurs when inhaled into the lungs via droplet nuclei after an infected individual coughs, sneezes, laughs, or talks. The bacteria lodges in the alveoli with resultatnt GHONS lesion, the spreads to the lymph nodes and blood stream. Leads to necrosis | TB |
Manifestations: starts low grade fever, night sweats, chills, anorexia, wt. loss, malaise, then pulmonary inflammatory symptoms ie cough especially in the AM. Cough increases, sputum production, can be purulent or blood tinged, later dyspnea & chest pain | TB |
Diagnosis: Mantoux test, PPD test, Sputum smears positive for acid-fast bacillus (AFB), Chest X-Ray | TB |
How would you obtain a definitive diagnosis of TB | C&S of microbacteria will take 3-6 weeksBiopsy |
0.1ml of purified protein derivative injected intradermally into the forearm determines a diagnosis of | TB |
Treatment: Negative pressure room, HEPA FILTERS, | TB |
How many acid fast bacillus smears does a negative diagnosis of TB make? | 3 no more no less (2 would be to little and 4 RIGHT OUT!) |
Drug therapy for TB must be adhered to for how long? | 6 months to 2 years |
what is used to help prevent TB in high risk infants and children | BCG Bacille Calemte Guerin Vaccine |
Medications must be taken STRICTLY otherwise patient could develop what? | resistance |
Collection of pus fluid in the pleural space. A pleural effusion with pus ESPECIALL FROM STAPH | EMPYEMA |
Manifestations: untreated? sepsis may ensue, fever, chills, pleuritic chest pain, dyspnea, anorexia, PLEURAL FRICTION RUB | EMPYEMA |
Treatment: draining the pleural space (may need chest tube), antibiotics, maybe O2 therapy, and occassionally surgical evacuation is needed | EMPYEMA |
Inflammation of the pleura almost always secondary effect of an underlying disease. Pleura becomes red and swollen and covered in exudate. Pain will occur when the pleura rubs against the parietal pleura during respirations | PLEURITIS |
Causes of condition: TB, pnuemonia, lung abcess, pulmonary embolism, bronchiectasis, lung CA, trauma, thoracotoy, rheumatic fever, lupus uremia, and sepsis | Pleuritis |
Manifestations: chest pain related to respiratory movements (SHARP and aggravated by deep breathing, coughing, sneezing, body movements ie turning and stooping. Friction rub may be heard on auscultation | Pleuritis |
Chronic inflammatory disorder of the airways. Ranges from mild to severe. Hereditary. Produces episodes of variable but revisable air flow obstruction and a bronchial hypersensitivity to various stimuli | Asthma |
Many patients remain in a mild state at all times with exacerabations with triggers such as URI and or exposure to allergens | ASTHMA |
airway is HYPER-RESPONSIVE to certain triggers usually an allergen, irritant, or viral infection leads to wheezing | asthma |
Characterized by a bronchospasm resulting from mast cells release of HISTAMINE triggering contraction of the smooth muscle of the bronchi with edema of the bronchial mucosa and secretion of mucus into the bronchi | EARLY RESPONSE (ASTHMA) |
3-4 hours later up to 12 hours lungs immune defenses are activated with eosinophils moving in producing prostoglandins, leukitrienes, nad other substances which produce inflammation sustained inflammation of the bronchial mucosa | LATE RESPONSE (ASTHMA) |
lungs are hyperinflated with hyper resonance. Dyspnea, wheezing, paroxysmal attacks of coughing, tightness, mucous may be produced, diaphoresis, cyanosis if severe, wheezes. Bad stuff | Asthma |
what type of asthma attack lasts for hours to days and does not respond to the usual treatment. can progress to respiratory failure with CO2 retention, respiratory acidosis, hypoxemia, severe bronchospasm, bronchial inflammation, and edema | asthma |
Treatment: asthma quick relief | beta 2 adrenergic agonists usually albuteral, terbutaline, or maybe an anticholinergic |
Treatment: asthma quick relief | beta 2 agonist ipratropium bromide (atrovent) bronchodilator with decreased cardiac side effects |
asthma long term control | inhaled or PO steroids OR long term Beta 2 agonists to decrease leukotrines (bronchoconstrictors from WBC's) may use accolate. Inhalers may come with spacers to dispense medication uniformly and deeper airways. Peak flow meters, and O2 therapy |
What do you NEVER administer to asthmatic patients, a beta 2 blocker causes bronchoconstriction | Inderol |
Chronic Obstructive pulmonary Disease or an impairment in expiratory air flow, | COPD |
excess production of mucus, accompanied by a chronic cough lasting 3 months of the year for 2 CONSECUTIVE YEARS. Caused by prolonged exposure to bronchial irritants ie smoking, air pollutants, toxic fumes, or dust | Chronic Bronchitis |
results from inflammation of the bronchi with enlargement and hypersecretion of the mucous glands caused by repeated infections with persistant obstruction which can lead to scarring and damage to the lining of the airway, necrosis of some bronchioles | Airway Obstruction |
a progressive disease characterized with enlarged air spaces and destruction of the aveoli walls and supporting structures. DUE TO A DECREASE IN ALPHA ANTITRYPSIN an enzyme inhibitor | EMPHYSEMA |
lung tissue loses its elasticity, elastic tissue around alveoli dissolves causing stiffening of the lung with the loss of elasticity. In a patient with this condition the primary drive to breathe is a *LOW O2 LEVEL IN THE BLOOD* | Emphysema |
Form of emphysema which is more the central portion of the lung lobe more common especially in men. Respiratory bronchioles enlarge, the walls are destroyed, and the bronchioles become more confluent | Centrilobular |
form of emphysema where destruction of the actual alveoli and bronchioles equally affects men and women | Panlobular |
Manifestations of emphysema | accessory muscles used in respirations, pursed lip breathing, expirations prolonged, chest hyper-resonant to percussion, appetite decreased leading to weightloss, CO2 retention, CO2 necrosis, bounding pulse, tremors, confusion, & death. BARRELL CHEST |
permenant dilation and distortion of the bronchi and the bronchioles. Can be isolated segments or widespread. Can be congential or acquired | Bronchiectasis |
a loss of volume in a segment of lobe of the lung due to collapse of aveoli which were previously expanded. Obstruction of bronchi and or lower air passages which block movement of air such as from a mucus plug or forgein body, plural effusions, bedrest | atelectasis |
occlusion of the pulmonary artery (or one of its branches) by matter carried in the blood stream from a vein of right side of the heart to the lungs. Most common in deep vein thrombosis | disorders of pulmonary circulation |
Virchow's Triad - 3 factors that predispose a person to thrombus formation | 1) damaged venous epithelium 2) venous stasis 3) hypercoaguability of blood such as from increased platelets, post surgery, trauma, or dehydration |