Comprehensive Review of Pulmonary Conditions: Lung Cancer, Pneumothorax, Asthma, COPD, and More

What are the five requirements for adequate oxygenation?

Patent airway, adequate breathing, effective gas exchange, adequate tissue perfusion, sufficient hemoglobin

What subjective data may indicate impaired oxygenation?

Shortness of breath, chest tightness, fatigue, anxiety

What objective findings are used to assess oxygenation?

Vital signs, SpO₂ or ABGs, skin color, level of consciousness, respiratory and cardiac assessment, peripheral perfusion

What is the average age of lung cancer diagnosis?

71 years

What is the approximate 5-year survival rate of lung cancer?

About 20%

What is the most significant risk factor for lung cancer?

Cigarette smoking (≈80% of cases)

What other risk factors increase lung cancer risk?

Asbestos exposure, radon, genetic predisposition

What are the two major categories of lung cancer cell types?

Small cell and non-small cell

What are the common non-small cell lung cancers?

Squamous cell carcinoma and adenocarcinoma

What is the earliest and most common symptom of lung cancer?

Persistent cough

What symptoms suggest advanced lung cancer?

Pain, hemoptysis, dyspnea, airway obstruction, metastasis symptoms

Why is chest X-ray not effective for lung cancer screening?

It often misses early-stage disease

What imaging is recommended for lung cancer screening?

CT scan

How is lung cancer definitively diagnosed?

Bronchoscopy with biopsy

What additional imaging is used for staging lung cancer?

CT, MRI, PET scan

What treatment offers the best chance of cure for lung cancer?

Surgical resection if the tumor is operable

What medical treatments are used for lung cancer?

Chemotherapy, radiation, targeted therapy, immunotherapy

How do PD-1 inhibitors work?

They block cancer cells from avoiding destruction by T-cells

What is a pleural effusion?

Accumulation of fluid in the pleural space

What causes a transudative pleural effusion?

Increased hydrostatic pressure or low albumin (e.g., heart failure)

What causes an exudative pleural effusion?

Infection, malignancy, capillary damage, empyema

What symptoms occur with pleural effusion?

Dyspnea, diminished breath sounds, dullness to percussion

How is pleural effusion diagnosed?

Chest X-ray or CT scan

What is thoracentesis used for?

Diagnostic and therapeutic fluid removal

What is pleurodesis?

Procedure that adheres the lung to the chest wall to prevent recurrence

What patient position is required for thoracentesis?

Sitting upright

What is a key nursing responsibility after thoracentesis?

Monitor for pneumothorax

What is a pneumothorax?

Air in the pleural space causing lung collapse

What causes spontaneous pneumothorax?

Ruptured bleb, often in tall, thin males or smokers

What causes secondary pneumothorax?

Underlying lung disease such as emphysema

What are common symptoms of pneumothorax?

Sudden chest pain, dyspnea, tachypnea

What assessment findings indicate pneumothorax?

Unequal chest expansion, absent breath sounds, hyperresonance

How is pneumothorax diagnosed?

Chest X-ray

How is a small pneumothorax treated?

Observation and supplemental oxygen

How is a large pneumothorax treated?

Chest tube insertion

What defines a tension pneumothorax?

Air enters pleural space but cannot escape

Why is tension pneumothorax life-threatening?

Pressure compresses the mediastinum and major vessels

What are signs of tension pneumothorax?

Tracheal deviation, hypotension, muffled heart sounds, shock

What is the treatment for tension pneumothorax?

Immediate needle decompression or chest tube

What is atelectasis?

Collapse of alveoli in lung segments

What commonly causes atelectasis postoperatively?

Anesthesia, hypoventilation, diaphragmatic dysfunction

How does airway obstruction cause atelectasis?

Trapped air is absorbed, causing alveolar collapse

What symptoms are associated with atelectasis?

Fever, dyspnea, crackles, decreased SpO₂

How is atelectasis diagnosed?

Clinical exam and chest X-ray

How is atelectasis prevented?

Incentive spirometry, early ambulation, coughing, hydration

How is asthma classified?

Reversible obstructive airway disease

What causes asthma airway obstruction?

Inflammation, bronchoconstriction, mucus hypersecretion

What immune mechanism is involved in asthma?

IgE-mediated allergic response

What triggers asthma exacerbations?

Allergens, cold air, viral infections, smoke, NSAIDs, GERD, anxiety

What are classic asthma symptoms?

Wheezing, cough, dyspnea, chest tightness, prolonged expiration

How is asthma diagnosed?

Clinical history, spirometry, methacholine challenge

What spirometry findings indicate obstructive disease?

Decreased FEV₁ and peak expiratory flow

What is the purpose of short-acting beta-agonists?

Rapid bronchodilation for acute symptoms

What is the mainstay treatment for persistent asthma?

Inhaled corticosteroids

Why must patients rinse their mouth after inhaled steroids?

To prevent oral candidiasis

What is status asthmaticus?

Life-threatening asthma unresponsive to usual treatment

What early ABG changes occur in status asthmaticus?

↓ PO₂, ↓ PCO₂, ↑ pH

What late ABG changes indicate respiratory failure?

↓ PO₂, ↑ PCO₂, ↓ pH

Why is a "silent chest" dangerous?

Indicates minimal airflow and impending failure

What does peak expiratory flow measure?

How fast air can be exhaled

How is peak flow used in asthma management?

Monitoring control and guiding treatment decisions

What defines the green zone on peak flow?

≥80% of personal best

What defines the yellow zone on peak flow?

60-80% of personal best

What defines the red zone on peak flow?

<60% of personal best and requires emergency care

How is COPD defined?

Chronic airflow obstruction that is not fully reversible

What are major COPD risk factors?

Tobacco smoke and occupational exposure

What defines chronic bronchitis?

Productive cough for 3 months over 2 consecutive years

What causes emphysema?

Alveolar destruction and air trapping

How does alpha-1 antitrypsin deficiency affect COPD?

Increases risk due to unopposed protease activity

What physical findings are seen in emphysema?

Barrel chest, accessory muscle use, minimal cyanosis

What physical findings are seen in chronic bronchitis?

Cyanosis, edema, frequent infections

Why does chronic bronchitis cause polycythemia?

Chronic hypoxia stimulates RBC production

What are key COPD treatments?

Smoking cessation, bronchodilators, steroids, oxygen

Why must oxygen be used cautiously in COPD?

High oxygen can suppress respiratory drive

What type of genetic disorder is cystic fibrosis?

Autosomal recessive

What ion transport problem occurs in cystic fibrosis?

Impaired chloride transport

What results from thick mucus in cystic fibrosis?

Recurrent infections, bronchiectasis

What organism commonly infects CF lungs?

Pseudomonas

How is cystic fibrosis diagnosed?

Sweat chloride test and genetic testing

How is ILD classified?

Restrictive lung disease

What causes ILD?

Occupational inhalants, drugs, autoimmune disease, idiopathic

What symptoms are seen in ILD?

Dry cough, exertional dyspnea, fine crackles

What PFT pattern is seen in restrictive disease?

Decreased FVC and DLCO

What is a pulmonary embolism?

Blockage of pulmonary artery by clot, fat, or air

Where do most emboli originate?

Deep veins of the legs

What is Virchow's triad?

Venous stasis, endothelial damage, hypercoagulability

Why does PE cause hypoxemia?

Ventilation-perfusion mismatch

What are classic PE symptoms?

Sudden dyspnea, chest pain, anxiety, hemoptysis

How is PE diagnosed?

CT angiogram, V/Q scan, D-dimer

How is PE treated?

Anticoagulation, oxygen, possible IVC filter

What is hypoxemic respiratory failure?

Low oxygen levels despite ventilation

What causes hypoxemic respiratory failure?

PE, ARDS, pneumonia

What is hypercapnic respiratory failure?

Elevated CO₂ due to hypoventilation

What causes hypercapnic respiratory failure?

COPD, asthma, neuromuscular disorders

What is ARDS?

Severe inflammatory damage to alveolar-capillary membrane

What happens in the alveoli during ARDS?

Fluid accumulation, loss of surfactant, collapse

What causes ARDS?

Sepsis, trauma, aspiration, pneumonia

What is seen on chest X-ray in ARDS?

Diffuse bilateral infiltrates ("white-out")

How is ARDS treated?

Mechanical ventilation, proning, treating underlying cause