upper respiratory tract
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Questions and Answers

What is the main cause of Absorptive Atelectasis?

  • External forces compress on pleural lung tissue
  • Blockage that impedes on the passage of air to and from the alveoli
  • Surfactant ration infatuation or decreased levels (correct)
  • Inhaled oxygen levels

    • What is the worst scenario in respiratory assessment?

  • Absorptive Atelectasis (correct)
  • Compressive Atelectasis
  • Obstructive Atelectasis
  • Pleural effusion

    • What is a common clinical manifestation of Atelectasis?

  • Tachycardia
  • Chest pain
  • Hypertension
  • Increasing dyspnea (correct)

    • What is a risk factor for Atelectasis?

    <p>Surgery: esp abdominal and thoracic surgery</p> Signup and view all the answers

    What is a diagnostic study used to diagnose Atelectasis?

    <p>CXR</p> Signup and view all the answers

    What is the best way to prevent Atelectasis?

    <p>Move, move, move!!</p> Signup and view all the answers

    What is an example of Compressive Atelectasis?

    <p>All of the above</p> Signup and view all the answers

    What is an example of Obstructive Atelectasis?

    <p>Secretions</p> Signup and view all the answers

    What are some risk factors for aspiration?

    <p>All of the above</p> Signup and view all the answers

    What is the primary cause of pulmonary edema?

    <p>All of the above</p> Signup and view all the answers

    What is the normal amount of fluid in the pleural space?

    <p>20-25 mL</p> Signup and view all the answers

    What is the treatment for pulmonary edema?

    <p>All of the above</p> Signup and view all the answers

    What is the term for fluid accumulation in the pleural space?

    <p>Pleural effusion</p> Signup and view all the answers

    What is one of the criteria for hospital-acquired pneumonia?

    <p>Acute hospitalization for 2 or more days in the last 90 days</p> Signup and view all the answers

    What is the term for life-threatening pulmonary edema?

    <p>Flash edema</p> Signup and view all the answers

    What is a common risk factor for Pulmonary Tuberculosis?

    <p>Born in a country with high TB rate</p> Signup and view all the answers

    What is the treatment for aspiration?

    <p>All of the above</p> Signup and view all the answers

    What is the primary method of transmission for Pulmonary Tuberculosis?

    <p>Airborne transmission</p> Signup and view all the answers

    What is the term for fluid accumulation in the alveolar space?

    <p>Pulmonary edema</p> Signup and view all the answers

    What is the name of the test used to diagnose Pulmonary Tuberculosis?

    <p>Mantoux test</p> Signup and view all the answers

    What is the result of the initial infection of Pulmonary Tuberculosis?

    <p>Granulomas form and become necrotic and dormant</p> Signup and view all the answers

    What is a complication of Aspiration?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment for Community-Acquired Pneumonia?

    <p>Antibiotics based on type of PNA</p> Signup and view all the answers

    What is a characteristic of Pneumonia in immunocompromised patients?

    <p>Fever, cough, and leukocytosis</p> Signup and view all the answers

    What is a risk factor for spontaneous pneumothorax?

    <p>Genetic predisposition</p> Signup and view all the answers

    What is a characteristic of tension pneumothorax?

    <p>Air is trapped, causing positive pressure</p> Signup and view all the answers

    What is a common symptom of pneumothorax?

    <p>Sudden pain</p> Signup and view all the answers

    What is a diagnostic study used to diagnose ARDS?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of ARDS?

    <p>Bilateral infiltrates</p> Signup and view all the answers

    What is a risk factor for ARDS?

    <p>Sepsis</p> Signup and view all the answers

    What is a complication of pneumothorax?

    <p>Tracheal deviation to the unaffected side</p> Signup and view all the answers

    What is a contributing factor to asthma?

    <p>Respiratory infection</p> Signup and view all the answers

    What is a type of pneumothorax?

    <p>All of the above</p> Signup and view all the answers

    What is a symptom of a severe asthma attack?

    <p>Accessory muscle use</p> Signup and view all the answers

    What is the maximum flow rate for a nasal cannula?

    <p>6 L/min</p> Signup and view all the answers

    What is a risk factor for ARDS?

    <p>Sepsis</p> Signup and view all the answers

    What is a characteristic of COPD?

    <p>Chronic bronchitis and emphysema</p> Signup and view all the answers

    What is a type of pneumothorax?

    <p>All of the above</p> Signup and view all the answers

    What is a trigger for asthma?

    <p>GERD</p> Signup and view all the answers

    What is a medication used to manage asthma?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Lower Respiratory Tract Disorders

    • Atelectasis: collapse/closure of alveoli leading to loss of lung volume
      • Acute vs chronic
      • Commonly seen on CXR
      • Types:
        • Absorptive Atelectasis: worst scenario in respiratory assessment, occurs by surfactant ration or decreased levels of inhaled nitrogen
        • Compressive Atelectasis: external forces compress on pleural lung tissue (e.g., pleural effusion, lung tumor, pneumothorax, hemothorax, abdominal distension)
        • Obstructive Atelectasis: blockage that impedes passage of air to and from alveoli (e.g., secretions, mucus plugs, airway tumors, foreign body)
    • Clinical manifestations: increasing dyspnea, sputum production, cough, fever, egophony
    • Risk factors: surgery, opioid use, abdominal distension, NG tube
    • Diagnostic studies: O2 sat, CXR, CT chest, ABGs, Bronchoscopy

    Pneumonia

    • Pneumonia in immunocompromised patient:
      • Patients receiving immunosuppressive drugs, corticosteroids, broad-spectrum antibiotics, AIDS, genetic immune disorders, etc.
      • Types: Pneumocystis Pneumonia (PCP), Fungal, TB
    • Clinical manifestations: fever, cough, dyspnea, leukocytosis
    • Treatment: antibiotics based on type of pneumonia

    Pulmonary Tuberculosis

    • Caused by Mycobacterium tuberculosis
    • Airborne transmission
    • Patho: initial infection 2-10 weeks after exposure
      • Granulomas form, become necrotic and dormant
      • Primary TB: clinically silent
      • Miliary TB: spread of TB via lymph and blood to other parts of the body
    • Clinical manifestations: low-grade fever, fatigue, night sweats, cough, stiff neck
    • Risks: born/lived in country with high TB rate, comorbidities, low-income, homeless, overcrowded housing, healthcare workers, immunocompromised
    • Diagnostic test: Mantoux test (tubercle bacillus extract injected into forearm to form a bleb)

    Aspiration

    • Inhalation of foreign body material into lungs
    • Can lead to PNA, hypoxia, or death
    • Caused by acute inflammatory response in lung parenchyma, blockage of airway, or secondary infection
    • Risk factors: altered LOC, neurological disorders, dysphagia, recumbent positioning, NG tubes, advanced age, mechanical ventilation
    • Prevention: high-risk patients - high Fowler's position, 30-45 degree HOB, early mobilization, deep breathing and coughing, no straws, thickened liquids, assess NG tube with CXR

    Pulmonary Edema

    • Abnormal accumulation of fluid in lung tissue/alveolar space
    • Acute pulmonary edema or "Flash Edema" = life-threatening
    • Non-cardiogenic: ARDs, neurogenic, re-expansion, negative pressure
    • Cardiogenic: L-sided heart failure
    • Clinical manifestations: severe respiratory distress, foamy/frothy blood-tinged sputum, wheezing and crackling in the lungs (may be audible), confusion, tachycardia
    • Treatment: O2 therapy, intubation or mechanical ventilation, vasodilators, ACE inhibitors, diuretics, digoxin, opioids

    Pleural Effusion

    • Abnormal collection of fluid into pleural space
    • Normal amount: 20-25 mL
    • Usually secondary to other conditions (e.g., HF, PNA, Cancer, Ascites)
    • Transudate fluid: imbalance of oncotic pressures, non-diseased pleura
    • Exudate fluid: inflammatory bacterial products or tumors; empyemas
    • Clinical manifestations: dyspnea, tachypnea, sharp pleuritic chest pain, decreased/absent breath sounds
    • Primary: no underlying lung disease
    • Secondary: underlying lung disease

    Acute Respiratory Distress Syndrome (ARDS)

    • Severe form of acute lung injury with absence of L-sided heart failure
    • Needs mechanical ventilation with higher than normal airway pressures
    • Diffuse alveolar injury and pulmonary capillary injury
    • B/L infiltrates
    • Sudden progressive pulmonary edema
    • Severe hypoxia refractory to supplemental oxygen
    • Risk factors: sepsis, GERD, high fatty or spicy fluids, nasal polyps, stress, weather changes, menstrual cycle, and strong emotions

    Asthma

    • Patho: predisposing factors (atopy, genetic predisposition), causal factors (indoor/outdoor allergens, occupational), contributing factors (respiratory infection, air pollution, smoking, diet, premature birth)
    • Clinical manifestations: worse at night, can occur suddenly or over several hours, cough, dyspnea, wheezing, chest tightness, tachycardia
    • Management: patient education, know triggers and early sx, bronchodilators, inhaled corticosteroids/oral steroids, leukotriene receptor antagonists

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