29 terms

Pulmonary Diseases 2

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Bronchiectasis- pathophysiology
permanent dilation & distortion of bronchi 2' destruction of elastic & mm bronchial wall. Dilated regions breed infections
Bronchiectasis- etiology
A bacterial infection that alters cilia motility, allows secretions to stagnate & destroy tissue. May be R/T asthma, CF, chronic bronchitis, or aspiration
Bronchiectasis- clinical features
constant cough w/ copious amounts of purulent secretions, crackles, recurrent pulmonary infections w/ hemoptysis
Bronchiectasis- late stages
Cyanosis, digital clubbing
Bronchiectasis- ABGs
hypoxemia w/ high CO2 levels
Pneumonia- pathophysiology
Inflammation of lung parenchyma 2' infection of the lower respiratory tract, alveoli fill w/ exudates (WBC) & edema
Bacterial pneumonia- onset, infiltrates, temp, cough, pain, WBC
abrupt onset, lobar consolidation, high fever w/ chills, productive cough, pleuritic pain, leukocytosis
Viral pneumonia- onset, infiltrates, temp, cough, pain, WBC
insidious onset, diffuse infiltrates, mod fever, nonproductive cough, myalgia, nml WBC
Pneumonia- ABGs, presentation
hypoxemia, bronchial bs, bronchophony, egophony, whispered petriloquy, dullness to percussion
Pneumocystic carinii pneumonia, nosocomial, lobar, bronchopneumonia
opportunistic infection in immunocompromised pts, hospital-aquired, lung involved at lobar level, at the level of broncioles & alveoli
ARDS- general def
Acute lung injury from, aspiration, barotrauma, inhaled toxins, trauma, etc
ARDS- pathophysiology
Increased permeability of alveolar membrane, alveoli fill with fluid causing increased pulmonary vascular resistance. Leads to decreased gas exchange, surfactant production
ARDS- late stages
Alveolar fibrosis, atelectasis, chronic restrictive dysfunction
PE- presentation
Hypoxemia, hyperventilation, pleuritic chest pain, respiratory acidosis, V/Q mismatch
Normal mean pulmonary arterial pressure, PH values at rest, w/ exercise
Norm: <15 mm Hg, PH: (rest) >25 mm Hg, (exercise) >30 mm Hg
Pulmonary HTN- etiology
secondary- congenital heart defect, lung PATH causing chronic hypoxia & vasoconstriction, scleroderma
Pulmonary HTN- presentation
heart sounds- S4, split S2 w/ progression to S3, peripheral edema
Plumonary edema- pathophysiology
accumulation of vascular fluid in the interstitial spaces & alveoli
Pulmonary edema- etiology
Cardiogenic- LHF, Noncardiogenic- ARDS, acute lung trauma, PE, Post-op fluid overload
Pulmonary edema- presentation
Difficulty breathing when laying flat, pink frothy sputum
Pulmonary effusion- pathophysiology
Excessive fluid in the pleural space due to fluid overload, inflammatory process, increased permeability of pleura
Pulmonary effusion- presentation
atelectasis, decreased chest expansion, pleuritic pain, tracheal shift
Pneumothorax- pathophysiology
Air or gas in the pleural cavity that disrupts the parietal or visceral pleura
Pneumothorax- spontaneous, traumatic, iatrogenic
Spontaneous- no MOI, maybe 2' lung path (COPD), Traumatic- Entry of air through chest wall due to rib fracture or wound, Iatrogenic- complication of a treatment or procedure
Tension pneumothorax
Entered air can't escape, causing atelectasis w/ compromise of CO & venous return. Can lead to shock.
Pneumothorax- presentation
absent or diminished BS, hyperresonant to percussion, mediastinal shift, respiratory distress
Resiratory failure- general definition
Pulmonary gas exchange is impaired such that severe hypoxemia results
Respiratory failure- etiology
Progressive airway obstruction (asthma, emphysema, CF, chronic bronchitis), Altered lung parenchyma, MS NM or respiratory center dysfunction
Acute respiratory failure ABGs
pH<7.35, PaO2<50 mm Hg, PaCO2>50 mm Hg. Unable to compensate metabolically quick enough