Management of Patients with Acute Disorders of the Chest and Lower Respiratory Tract

Vocabulary flashcards covering atelectasis, tracheobronchitis, pneumonia classifications and bundles, respiratory failure, intubation, tracheostomy, ARDS, chest trauma, pneumothorax, and ICU care bundles based on Chapter 19.

Atelectasis

A condition occurring when the tiny air sacs (alveoli) in the lungs collapse or do not fully open, commonly caused by shallow breathing, mucus, or retained secretions postoperatively.

Obstructive Atelectasis

The most common form of atelectasis, caused by an airway blockage (such as mucus, tumor, or foreign body) that impedes air passage and leads to alveolar collapse due to gas reabsorption.

Nonobstructive Atelectasis

A type of atelectasis caused primarily by reduced ventilation to the lungs rather than a physical airway blockage.

Acute Tracheobronchitis

An acute inflammation of the mucous membranes of the trachea and bronchial tree, usually caused by a viral infection (e.g., cold or flu) and characterized by mucopurulent sputum production.

Pneumonia

An inflammation of the lung parenchyma caused by various infectious microorganisms, including bacteria, mycobacteria, fungi, and viruses.

Community-Acquired Pneumonia (CAP)

Pneumonia occurring in the community setting or test within 48 of hospital admission in patients who do not meet criteria for health care-associated pneumonia.

Health Care–Associated Pneumonia (HCAP)

Pneumonia occurring in a nonhospitalized patient with extensive health care contact, such as recent acute care hospitalization, nursing home residency, recent chemotherapy/antibiotic therapy, or hemodialysis.

Hospital-Acquired Pneumonia (HAP)

Pneumonia occurring $\ge 48\, \text{hours}$ after hospital admission that was not incubating at the time of admission.

Ventilator-Associated Pneumonia (VAP)

A subtype of hospital-acquired pneumonia that develops $\ge 48\, \text{hours}$ after endotracheal tube intubation and initiation of mechanical ventilation.

VAP Bundle

A group of five evidence-based collaborative interventions to prevent VAP: head-of-bed elevation ($30^\circ \text{ to } 45^\circ$), daily sedation vacations with extubation readiness assessment, peptic ulcer disease prophylaxis, DVT prophylaxis, and daily oral care with $0.12\%$ chlorhexidine.

Lobar Pneumonia vs. Bronchopneumonia

Lobar pneumonia produces consolidation affecting a large portion or entire lobe of the lung, whereas bronchopneumonia causes patchy, scattered areas of infection that originate in the bronchi and extend into surrounding lung tissue.

Aspiration

The accidental entry or inhalation of foreign material, such as oropharyngeal secretions or gastric contents, into the lower respiratory tract.

Acute Respiratory Failure (ARF)

A sudden and life-threatening impairment of gas exchange characterized by hypoxemia ($\text{PaO}_2 < 60\, \text{mm Hg}$) or hypercapnia ($\text{PaCO}_2 > 50\, \text{mm Hg}$ with an arterial $\text{pH} < 7.35$).

Endotracheal Tube Cuff Pressure

The target inflation pressure for an endotracheal tube cuff, which must be maintained between $20 \text{ and } 25\, \text{mm Hg}$ to prevent tracheal wall damage while sealing the airway against aspiration.

Types of Tracheostomy Tubes

Tracheostomy tube designs including fenestrated tubes (which feature an opening allowing air passage to enable speech) and double-cuffed tubes (which allow alternating cuff inflation to minimize mucosal tracheal damage).

Acute Respiratory Distress Syndrome (ARDS)

A severe form of acute lung injury characterized by diffuse alveolar damage, sudden progressive noncardiogenic pulmonary edema, bilateral lung infiltrates on chest X-ray, and severe hypoxemia refractory to supplemental oxygen.

Flail Chest

A severe complication of blunt chest trauma occurring when $3 \text{ or more}$ adjacent ribs are fractured in $2 \text{ or more}$ places, creating a loose, unstable segment of the chest wall that displays paradoxical movement during breathing.

Pulmonary Contusion

A hemorrhage or bruising of lung parenchyma caused by blunt chest trauma, leading to localized edema and bleeding that impairs gas exchange.

Pneumothorax

A condition occurring when the visceral or parietal pleura is breached, exposing the negative-pressure pleural space to positive atmospheric pressure and resulting in partial or total lung collapse.

Chest Drainage Systems

Devices used to evacuate air or fluid from the pleural space; water-seal systems regulate suction based on the height of a water column (typically $-20\, \text{cm H}_2\text{O}$), while dry suction systems utilize a mechanical vacuum regulator dial.

CEASE Bundle

A nursing practice bundle designed to prevent alarm fatigue in critical care: Communication, Electrodes, Appropriateness, Set-up, and Education.

ABCDEF Bundle

An evidence-based ICU bundle designed to minimize delirium, weakness, and complications: Assess, Prevent, and Manage Pain; Both SAT & SBT (spontaneous awakening & breathing trials); Choice of Analgesia & Sedation; Delirium Assessment/Management; Early Mobility; and Family Engagement.