Pneumonia/Restrictive Diseases Flashcards

1
Q

What are the 4 general types of restrictive lung disease?

A

Primary lung: stiff, decreased compliance of parenchyma
-fibrosis

Pleural abnormality
-pleural effusion

Thoracic abnormality: decreased chest wall mobility
-kyphoscoliosis

Limited space for expansion
-obese, pregnant

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2
Q

What is the pathology of pneumonia?

A

Inflammatory response of bronchioles/alveolar space to infectious agent

  • excessive mucous in alveoli
  • inflamed bronchiole

Falls under multiple categories of disorder:
obstructive (hard to get air in)
lung tissue diffusion(decreased from mucus)
compliance (decreased alveoli)
pleural space (fluid; severe leads to effusion)

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3
Q

What sx/chart lab values are characteristic of pneumonia?

A

Sx:
SOB, productive cough, fever, chills

Chart:
High WBC
Increased temp
High HR/RR

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4
Q

What are symptoms of chronic hypoxemia?

A

Cyanosis
Digital clubbing
Hypertension
Accessory muscle use

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5
Q

What are pulmonary function test volumes for restrictive diseases?

A
Decreased:
TLC
VC
IC
RV (or normal)

All result in:
Impaired pulmonary function-> hypoventilation
Decreased gas exchange-> hypoxemic
Desaturation with activity

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6
Q

What are normal auscultation results in pneumonia?

A

Crackles, bronchiole sounds over middle/lower lobes
Listen to cough/huff
Bronchophony= increased sound (from consolidation)
Mediate percusion= dull in affected area (should be resonant)
Increased tactile fremitus

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7
Q

When do you stop assesing/treating based off of their SpO2 levels with 6MWT/treatment?

A

Perform 6MWT at baseline oxygen (air)

If

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8
Q

What airways clearance techniques are best for respiratory problems?

A

Incentive Spireometor
Active airway clearance techniques
Coughing mechanics

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9
Q

What are the goals of airway clearance?

A

Decrease obstruction from secretions
Increase ventilation
Increase gas exchange

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10
Q

Who do you perform airway clearnace on?

A

Atelectasis, secretions:

  • impaired cilliary motion
  • decreased inflation
  • decreased elasticity
  • decreased chest wall mobility
  • weak/fatigued respiratory muscles
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11
Q

What are types of non-active clearing techniques

A

Post drain
percussion
increase frequency osculations
PEP devices

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12
Q

When do you perform Active Airway Clearance?

A

30-1hr after meals
Premedicate
Bronchioldilator meds 20-30min before to help secretion removal
Antibiotics AFTER so don’t clear them out

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13
Q

What is the first stage of AAC?

A

Breath Control

  • gentle tidal with relaxed muscles
  • prevents bronchospasm
  • lasts long enough for pt to relax
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14
Q

What is the second stage of AAC?

A

Thoracic Expansion Exercise

  • deep inspiration helps loosen secretion
  • air gets behind secretions to assist in mob
  • can use I.S. for this part
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15
Q

What is the last stage of AAC?

A

Forced Expiratory Technique

  • huff moves secretions from small to large airways and then cough to get out
  • important to cough only when secretions reach conducting zone (zone 6-7; terminal bronchioles and up)

Periph secretions: LONG quiet huff after MEDIUM inspiration
Large airway secretions: SHORT loud huff after DEEP inspiration

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16
Q

What adjustments can you make in each stage of AAC depending on the condition?

A

Increase time in breathing control for patients with reactive airways/anxious (wheezes)

Increase time in TEE for patients with atelectasis to pop open alveoli

Increase time in FET for patients with sputum production