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Pulm Disease Exam 5
SPC Pulmonary Disease Exam 5 Ch. 20 Pulmonary Edema
Question | Answer |
---|---|
2 categories of Pulmonary Edema? | Cardiogenic & Non-Cardiogenic |
Most common cause of Cardiogenic Pulmonary Edema? | CHF (Left Heart Failure) |
Oncotic pressure is produced by what? | Albumin & Globulin in the blood |
The stability of fluid within the pulmonary capillaries is determined by a balance of what? | Hydrostatic & Oncotic Pressure |
T/F Hydrostatic pressure of 10-15mmHg is offset by Colloid Osmotic Force (Oncotic Pressure) of 23-30mmHg? | True |
How is the balance tested between Hydrostatic & Oncotic Pressures? | Pulmonary Capillary Wedge Pressure |
The result in pulmonary edema in a patient is caused by what? | 1. Hydrostatic >25-30 mmHg 2. Oncotic Pressure loses holding force 3. Fluid spills into interstitial space & alveoli |
Movement of fluid in and out is expressed as? | Starlings Equation |
Most common Non-Cardiogenic Pulmonary Edema include? | 1. Increased Capillary Permeability 2. Lymphatic Insufficiency 3. Decreased/Intrapleural Pressure 4. Decreased Oncotic Pressure |
What is a flash pulmonary edema? | Fast re-expansion of lung from pneumothorax secondary to other pulmonary diseases |
What is Lymphangitic Carcinomatosis? | Lymphatic vessels obstructed by a tumor |
Decreased oncotic pressure may be caused by what? | 1. Overtransfusion/Rapid Transfusion of Intravenous fluids 2. Uremia 3. Hypoproteinemia 4. Sever Trauma decreases Oncotic Pressure |
Causes of Increased Capillary Permeability? | 1. ARDS #1 2. Alveolar Hypoxia 3. Inhalation of Toxic Agents 4. Pulmonary Infection (Pneumonia) 5. Therapeutic Radiation of the lung 6. Acute Head injury |
Clinical data associated with Pulmonary Edema? | 1. ^ Tachypnea 2. ^HR & ^ BP 3. Cheyne-Stokes Respiration 4. Paroxysmal Nocturnal Dyspnea 5. Orthopnea |
Sputum with Pulmonary Edema? | Frothy & Pink |
Oxygenation indices with Pulmonary Edema? | Increase O2Er & Increase Os/Ot shunt |
Hemodynamic Indices with CARDIOGENIC Pulmonary Edema? | 1. ^CVP 2. ^PCWP |
Is pulmonary edema restrictive or obstructive? | Restrictive |
How are the lung volumes in relation to Pulmonary Edema? | All Decrease |
How is FEV related to Pulmonary Edema? | FEV1/FVC is the only one that increased |
Radiologic findings of Cardiogenic pulmonary Edema? | 1. Left Vent Hypertrophy (Cardiomegaly) 2. Engorgement of Pulmonary Arteries 3. Kerley A & B Lines 4. Pleural Effusion |
Radiologic findings of Non-Cardiogenic pulmonary Edema? | 1. Fully densities 2. unilateral or bilateral infiltrates |
What are inotropic agents and what does it treat? | Produce vasodilation & increase cardiac output. Treats hypotension |
Inotropic agents used with Pulmonary edema? | 1. Dobutamine** 2. Dopamine 3. Norepinephrine |
Respiratory care treatment protocals with lung expansion therapy? | CPAP is used to: 1. Improved decreased lung compliance 2. Reduce WOB 3. Enhances gas exchange 4. Decrease vascular congestion |
When is mechanical ventilation protocol used? | When CPAP fails |
Cardiogenic Pulmonary Edema occurs when? | The left ventricle is unable to pump out sufficient amount of blood during each ventricular contraction. |