Definitions, etiology, Symptoms, Treatment
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| What is interstitial Pulmonary Fibrosis (IPF)? | show 🗑
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| Etiology of IPF. | show 🗑
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| show | Cellular infiltration, acute vasculitis, scar tissue, that can't be reversed.
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| show | A group of occupational diseases causing chronic inflammation of the lungs and interstitial fibrosis due to inhalation of dust or chemical fumes.
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| show | Silicosis(Silica dust),Farmer's lung(moldy hay), Silo-filler disease(Nitrogen dioxide), Coal miners pneumonia(coal dust), Asbestosis(Asbestos), Siderosis(Iron dust), Aluminosis(Aluminum)
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| show | Progressive dyspnea, on exertion in the beginning stages then at rest as the disease progresses (PRIMARY SYMPTOM), nonproductive cough, hemoptysis, hypoxemia,chest pain.
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| Physical examination findings for IPF. | show 🗑
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| show | elevated diaphragm, small lung, large heart, honeycomb appearance from fibrotic changes.
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| Diagnostics used to confirm IPF. | show 🗑
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| show | No known cure. Limit exposure to causative, corticosteroids, O2 therapy, antibiotics, treat symptoms and complications, pulmonary hygiene, bronchodilators.
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| Perimeters for mechanical ventilation in IPF. | show 🗑
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| show | Interstitial pulmonary fibrosis(IPF), Pleural effusion, Pneumothorax, Pulmonary edema(cardiogenic and non-cardiogenic), ARDS, Pneumonia, Pulmonary embolism, Postoperative atelectasis.
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| What is pleural effusion (hemothorax)? | show 🗑
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| Etiology of pleural effusion. | show 🗑
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| show | Chest x-ray.
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| Types of pleural effusions. | show 🗑
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| What is hydrothorax? | show 🗑
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| What is empyema? | show 🗑
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| show | Frank blood or fluid accumulation in the pleural cavity caused by, trauma, malignancy, or ruptured blood vessels.
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| show | Chyle from the thoracic duct into the pleural space, usually caused trauma or tumor.
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| show | Dyspnea, tachypnea, chest pain, cough, hemoptysis, hypoxemia. Breath sounds are decreased or crackles over ther effected area.
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| X-ray findings. | show 🗑
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| show | Thoracentesis, chest tube drainage, O2, need to treat underlying cause, symptoms, and complications.
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| show | Presence of air in the intrapleural space or within other areas of the thorax, can be spontaneous or traumatic. Pressure increases and decompresses lung tissue, resulting in atelectasis and ventilation becomes decreased on the affected side.
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| Two types of pneumothorax. | show 🗑
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| Criteria for an open pneumothorax. | show 🗑
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| Criteria for a tension pneumothorax (spontaneous). | show 🗑
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| show | Pressure does not build up, gas is allowed to move freely in and our of the pleural space
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| Characteristics of a tension pneumothorax. | show 🗑
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| Symptoms of a pneumothorax. | show 🗑
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| X-ray findings for a pneumothorax. | show 🗑
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| show | Place in Fowler's position, O2 therapy w/ nasal cannula (unless contraindicated), chest tube w/ chest drain system, thoracentesis, IPPB to reinflate the lung, and if respiratory failure place on ventilation.
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| What is a chest tube? | show 🗑
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| What are chest tubes used to resolve? | show 🗑
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| show | *Sterile flexible catheter(sizes 7-40 French) *radiopaque stripe
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| Chest tube placement. | show 🗑
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| show | Accumulation of excessive fluid in the alveloi and interstitium.
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| show | *CHF *renal failure *heart disease *myocardial infarction *sepsis *ARDS *pneumonia *near-drowning *embolism *O2 toxicity *smoke inhalation
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| show | *tachypnea *labored shallow breathing *cyanosis *pedal edema *neck vein distension *SOB *HR and BP are increased *respiratory acidosis *profuse diaphoresis *cough w/ pink frothy secretions *hyperventilation *breath sounds: rales.
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| X-ray findings for pulmonary edema. | show 🗑
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| Cardiogenic Pulmonary edema process. | show 🗑
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| show | Lasix -to decrease fluid, Morphine -vasodilation to decrease vascular resistance, Digitalis -increase contractility of heart and increase CO, O2 therapy, CPAP/BiPAP, ventilation w/PEEP
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| show | Epithelial damage of alveolar allows fluid to enter the alveoli; CNS trauma, drug OD, high altitudes, re-expansion(rapid removal of pleural effusion fluid, >1000ml, may produce edema) Some consider to be early form of ARDS.
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| show | Wet bubbly rales in lung fields, pink frothy secretions.
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| What is ARDS? | show 🗑
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| show | REFRACTORY HYPOXEMIA(main sign), decreased lung compliance, decreased FRC, atelectasis, shunting, PE, PF, respiratory failure.
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| Chest x-ray findings for ARDS. | show 🗑
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| Symptoms of ARDS. | show 🗑
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| Treatment of ARDS. | show 🗑
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| show | Inflammation, infection, and consolidation of the lungs
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| show | Viral, bacterial(lobar), fungal(Candida), immune-suppressed(pneumocystis Carinii), aspiration, broncho.
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| show | Cough w/sputum, dyspnea, chest pain, chills, fever, hypoxemia. Breath sounds:rhonchi, crackles, wheezes. At first it mimics a cold or flu.
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| X-ray findings for pneumonia. | show 🗑
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| show | It can reveal type of pulmonary infection.
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| Etiology of lobar pneumonia. | show 🗑
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| Etiology of viral pneumonia. | show 🗑
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| Symptoms of bacterial(lobar) pneumonia. | show 🗑
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| show | Onset is gradual, low fever, thin mucoid sputum, uncommon to have chills, tachycardia,hypoxemia, or pleuritic pain, x-rays look normal, <10,000/cu mm,
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| Other types of pneumonia. | show 🗑
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| What is ventilator associate pneumonia(VAP)? | show 🗑
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| show | remove ETT as soon as possible, check feeding tube placement, clear secretions orally and endotracheal before messing with ETT, elevate HOB 30-40%
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| General treatment for pneumonia. | show 🗑
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| Treatment of PCP. | show 🗑
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| show | Sudden partial or complete blockage of pulmonary artery blood flow.
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| Types of pulmonary embolism (PE). | show 🗑
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| What is a thrombus PE? | show 🗑
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| What is embolus embolism? | show 🗑
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| Most common sites of thrombus formation. | show 🗑
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| Most common causes for thrombus. | show 🗑
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| show | Abnormal vessel walls, blood stagnation, coagulability increase.
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| X-ray findings for PE. | show 🗑
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| show | Increase in dead space ventilation(Vd/Vt ratio)total ventilation is increased in an effort to maintain normal PaCO2(shallow breathing), large emboli
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| Clinical presentation of PE. | show 🗑
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| show | V/Q lung scan and pulmonary angiography
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| Treatment for PE. | show 🗑
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| show | Collapse of lung due to anesthetic drugs or the inability to breath deeply, cough effectively due to pain.
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| Effects and complications from post op atelectasis. | show 🗑
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| show | surfactant depletion b/c of inability of alveoli to maintain stability and prevent collapse.
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| show | Decreased FRC, V/Q mismatch, intrapulmonary shunting, decrease lung compliance, increase WOB, possible respiratory failure.
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| show | IS, IPPB, CPAP, PEP, secretion removal, deep breathing and cough, CPT, IPV, mechanical ventilation if needed.
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| X-ray results for post-op atelectasis. | show 🗑
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| show | Decreased VC, dyspnea, tachypnea, increased WOB, late inspiratory crackles, bronchial breath sounds.
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