2)med surg- resp

laryngeal cancer risk factors

tobacco, alc, genetic, age, vitamin deficiency, weak immune system

laryngeal cancer findings

hoarseness, cough, lump in neck, dysphagia, dysonea, ulceration, foul breath

laryngeal cancer diagnostics

laryngoscopy, FNA biopsy, CT/MRI, PET scan, barium swallow

laryngeal cancer surgical management

partial laryngectomy, total laryngectomy, vocal cord stripping, cordectomy, laser surgery

post-laryngectomy care

larygectomy tube (airway), srtificial larynx, aspiration risk, infection risk, hemorrhage risk

external radiation

teletherapy

internal radiation

brachytherapy

teletherapy side effects

skin reaction, fatigue, xerostomia, loss of tast, mucositis

lung cancer risk factors

smoking, environment, genetics, diet, scars in lungs

lung cancer findings

cough, dyspnea, hemoptysis, chest pain, recurring fever, repeat upper resp infections, pleural effusion

lung cancer diagnostics

CXR, CT, US, MRI, sputum sytology, bronchoscopy, biopsy

lung cancer surgery

pneumonectomy, lobectomy, segmentectomy, wedge resection

chest surgery: assess for

drainage, fluctation, bubbling, crepitus

pleural effusion

collection of fluid in pleural space

pleural effusion: usually ______ to other disease process

secondary

pleural effusion findings

dyspnea, cough, dec breath sounds, fremitus, dull flat chest percussion, dec chest wall expansion

pleural effusion: trachial deviation to

unaffected side

pleural effusion diagnositcs

CXR, CT, thoracentesis, pleural fluid anaysis, pleural biopsy

pleural effusion management

thoracentesis, pleurodesis, surgical pleurectomy, pleuroperitoneal shunt

pulmonary embolus

obstruction of pulmonary artery

types of pulmonary embolus

blood, air, fat, amniotic fluid, septic

pulmonary embolus risk factors

DVT, trauma, surgery, pregnancy, a fib, HF, hypercoagulability, immobility

pulmonary embolus subjective findings

dyspnea, air hunger, syncope, chest pain (on inspiration), anxiety, chest wall tenderness

pulmonary embolus objective data

tachycardia, tachypnea, dec O2, fever, hypotension, heart murmur, diaphoresis, pleural effusion, hemoptysis

pulmonary emboluc diagnostics

pulmonary angiography, V/Q scan, CXR, ECG, ABG, D-dimer assay, spiral chest CT

pulmonary embolus meds

anticoagulant (heparin, warfarin, enoxaparin, rivaroxaban), thrombolytic (urokinase, streptokinase, alteplase)

pulmonary embolus emergency meds

O2, dobutamine/dopamine, cardiac glycosides, morphine, sedatives

Heparin PTT lab

60-70

Heparin aPTT lab

20-39

warfarin INR lab

1

warfarin PT lab

9-12.5

TB: risk of transmission decreases after _________ of anti-TB therapy

2-3 w

TB risk factors

immunocompromised status, low socioeconomic, crowded environment, age, immigration

TB findings

cough (>3 weeks), night sweats, fever, fatigue, weight loss, purulent blood tinged sputum

TB diagnostics

two step PPD/Mantoux test, EBP, CXR, acid-fast bacilli smear/culture

two-sep PPD/Mantoux test lab (+ TB)

>10 mm (> 5 immunocompromised)

acid-fast bacilli smear/culture: when and where to take

3 early morning; neg airflow room

TB meds

Rifampin,

Isoniazid,

Pyrazinamide,

Ethambutol

TB treatment lasts for

6-12 m

TB: initial intensive regimen lasts for

8 weeks