Disease Paths FINAL EXAM: Exam 2 content (2)

shock, respiratory disorders blood disorders

what is hypovolemic shock

shock resulting from loss of circulating blood flow

what is cardiogenic shock

inability of heart to maintain cardiac output for circulation

what types of shock are due to changes in peripheral resistance due to massive vasodilation which leads to pooling of blood in the periphery

distributive

vasogenic

neurogenic

septic

anaphylactic

Shock Compensatory Mechanisms:

___ and ________ ________ stimulate to increase __, _________, and systemic ____________.

SNS

adrenal medulla

HR

contractility

vasoconstriction

Shock Compensatory Mechanisms:

Increased ____, ___, and _______________ secretion.

renin

ADH

Glucocorticoid

Shock Compensatory Mechanisms:

Acidosis stimulates increased _________. Prolonged shock results in diminished _______ __________, so ______ is not removed. This lead to decreased __.

respiration

cell metabolism

waste

pH

what are s/s of early shock

restlessness

thirst

tachycardia

what are the progressive s/s of shock

Lethargy, weakness

Cool, moist, pale skin

Low BP

Tachycardia

Weak pulse

Tachypnea

Oliguria

Metabolic acidosis

what are the decompensated s/s of shock

Stupor, confusion

Arrhythmias

Weak pulse

Metabolic acidosis

Acute respiratory distress syndrome

multiple thrombi

Acute liver and renal failure

Paralytic ileus

GI hemorrhage

unconscious

Why are patients anxious in the early stages of shock

not getting enough oxygenated blood to the brain

In the progressive stage of shock why is skin cool

blood flow lacking to skin

When atmospheric pressure is higher than the pressure in the alveoli __________ occurs due to ________ _______ within the lungs.

inspiration

negative pressure

When pressure in the alveoli is higher than the atmosphere _____________ occurs due to ________ ________ in the lungs.

expiration

positive pressure

what is title volume

amount of air exchanged with quiet inspiration and expiration

what is residual volume

volume of air remaining in the lungs after maximum expiration

what is vital capacity

maximum amount of air that can be moved in and out of the lungs with a single forced inspiration and expiration

What is a normal title volume for women

450-500

what is normal title volume for men

500-700

what is hypercapnia

excessive co2 in blood

Hypercapnia occurs when CO2 levels in the _______ and ___ increase.

blood CSF

what is hypoxemia

marked by decrease in oxygen in the blood

what occurs in individuals with chronic lung disease

hypoxic drive

what is hypocapnia

low co2 concentration in blood

yellowish-green sputum indications

bacterial infection

rusty or dark sputum indicates

pneumonia

purulent sputum with foul odor indicates

bronchiectasis

thich, tenacious sputum indicates

asthma

cystic fibrosis

hemoptysis sputum indicates

pulmonary edema

bleeding

what is eupnea

normal breathing

what are kussmaul respirations

deep, rapid respirations typical of acidosis; can follow exercise

what is orthopnea

difficulty breathing when lying down usually due to pulmonary congestion

what is paroxysmal nocturnal dyspnea

refers to attacks of severe shortness of breath and coughing that generally occur at night. It usually awakens the person from sleep, and may be quite frightening

what is paroxysmal nocturnal dyspnea indicative of

left sided CHF

what is pleural pain

results from inflammation or infection of parietal pleura

what is friction rub

Soft sound produced as rough inflamed or \n scarred pleural move against each other

what are clubbed fingers

Result from chronic hypoxia associated \n with respiratory or cardiovascular diseases

name five common upper respiratory infection

cold

sinusitis

croup

epiglottitis

influenza

what is croup

acute viral infection of infants and children with obstruction of the larynx, accompanied by barking cough and stridor

what is epiglottitis

viral inflammation of the epiglottis usually affecting children ages 3-7. It is characterized by difficulty breathing, drooling, and tachycardia

what is bronchiolitis

most commonly caused by RSV

what is lobar pneumonia

pertaining to the lobes

diseased state of the lung

what is bronchopneumonia

a localized form of pneumonia that often affects the bronchioles and surrounding alveoli; many spots seen throughout the lungs

what is legionaries disease

bacterial pneumonia found in moist areas

what is primary atypical pneumonia

mycoplasma pneumonia found in tissue around the alveoli making it hard to treat

what is pneumocystis carinii pneumonia

fungal pneumonia that is opportunistic

what is barrel chest

a condition characterized by increased anterior-posterior chest diameter (1:1 ratio) caused by increased functional residual capacity due to air trapping from small airway collapse

How is TB transmitted

oral droplets

TB occurs frequently in people who live in _________ conditions and are _____________.

crowded

immunocompromised

what is primary TB infection

when the organism first enters the lungs and is multiplying

what is secondary TB infection

TB mycobacterium that were engulfed by tubercles begin to reproduce and re-infect the lungs

what can cause TB to reactivate in the case of a secondary TB infection

stress

malnutrition

HIV infection

age

TB can _________ lung tissue and get into _____ ________, causing other organs to be affected.

erode

blood vessels

what is cystic fibrosis

inherited EXOCRINE disorder carried on chromosome seven

what organs does CF effect

lungs pancreas

what is aspiration

food, fluid, emesis, or another foreign object entering the trachea and lungs that may result in obstruction, inflammation, and predisposition for pneumonia

name the four signs of aspiration

loss of voice

stridor

tachycardia

hypoxia

what is obstructive sleep apnea

pharyngeal tissue collapsing during sleep possibly caused by high BMI, anatomy, etc.

name two treatments for OSA

CPAP

oral appliances

name four signs and symptoms of asthma

cough

rapid breathing

tachycardia

wheezing

what is COPD

group of chronic respiratory disorders that causes irreversible, progressive damage to the lungs and possibly respiratory failure

what is emphysema

destruction of alveolar walls and septae leading to large, permanently inflated alveolar air spaces

Emphysema causes the integrity of ________ ________ to decrease which leads to their ________ on ________. This results in ___ _______.

bronchial walls

collapse

expiration

air trapping

People with emphysema are often called ____ ________ because they get enough ___________ on inspiration, resulting in ____ skin, and they ________ _______ on expiration.

pink puffers

oxygen

pink

purse lips

name six signs and symptoms of emphysema

dyspnea

hyperventilation

anorexia

fatigue

weight loss

clubbed fingers

what is chronic bronchitis

inflammation, obstruction, repeated infection, or chronic coughing occurring twice for 3 months or longer in 2 years

what two things can chronic bronchitis result in

pulmonary hypertension

cor pulmonale

People with chronic bronchitis are often called _____ ________ because oxygen cannot reach _________ resulting in poor _______ and ________.

blue bloaters

alveoli

perfusion

cyanosis

what are the six s/s of chronic bronchitis

productive cough

thick/purluent mucus

tachypnea

polycythemia

weight loss

what is pulmonary edema

fluid collecting in alveoli and interstitial areas

In pulmonary edema, __ cannot diffuse through water into ____________. Additionally, ___ diffuses poorly, which may result in ___________.

O2

capillaries

CO2

hypercapnia

name four signs and symptoms of pulmonary edema

cough

orthopnea rales

hemoptysis

frothy/blood sputum

what is a pulmonary embolus

blood clot or mass that obstructs the pulmonary artery of a branch thereof

Effect of a PE depends on ________,__ ________, and ______ . A small PE may be "______" unless it involves a large area of the lung.

material

size

location

silent

A large PE may cause ______ ______. An example of this is a _______ __ which blocks _____ ____ to the heart and lungs.

sudden death

saddle PE

blood flow

s/s of a small PE

transient chest pain

cough

dyspnea

s/s of an early, large PE

increased chest pain

cough

deep breathing

tachypnea

dyspnea

s/s of a late large PE

hemoptysis

fever

\
what is atelectasis

nonaeration/collapse of a lung or part of a lung causing decreased gas exchange and hypoxia

With atelectasis, _______ become airless and ______. ________ or ______ can occur.

alveoli

collapse

inflammation

atrophy

Atelectasis is sometimes ________, as with _______. It can also be due to ______, a _________ injury, or lung ______.

normal

sleeping

liquid

crushing

cancer

what is pleural effusion

presence of excessive fluid in the pleural cavity causing increased pressure and separation of pleural membranes

in a severe case of pleural effusion, what procedure may occur?

drain fluid

what is pneumothorax

air in pleural cavity

what is closed pneumothorax

air can enter pleural cavity from internal airways; there is no opening in the chest wall

what are the two types of closed pneumothorax

simple

spontaneous

secondary pneumothorax results from

rupture of an emphysematous bleb on the lung surface or erosion by a tumor or tubercular cavitation; associated with an underlying respiratory disease

what happens in an open pneumothorax

air enters pleural space through an opening in the thorax and parietal pleura

what is tension pneumothorax

air that enters the chest cavity is prevented from escaping resulting in a shift of the trachea and mediastinum to compress the unaffected lung; places pressure on heart

what is flail chest

results from 2-3 ribs fracturing and free floating, allowing them to move independently during respiration

Flail Chest During Inspiration:

1\. Flail section moves __________ due to ________ ______. This prevents expansion.

2\. Flail section can compress __________ lung tissue, pushing air our of the section and up the _______.

inward/negative pressure

adjacent/bronchus

Flail Chest During Expiration:

1\. Unstable flail section is moved _________ due to increased ____________ _______.

2\. Air from __________ lung moves into _________ lung.

outward/intrathoracic pressure

unaffected/affected

what is IRDS

lack of surfactant in the alveoli caused by premature birth

In IRDS, the alveoli become difficult to ________. Due to this, ________ _________ results. Additionally, decreased ________ ______ ____ occurs which causes pulmonary ____________ and _____.

inflate

diffuse atelectasis

pulmonary blood flow

hyper constriction

hypoxia

In IRDS, poor lung perfusion and lack of surfactant causes __________ capillary permeability and ________ membrane formation.

increased

hyaline

name six signs and symptoms of IRDS

shallow respiration

grunting

decreased BP

cyanosis

peripheral edema

hypoxemia

what is ARDS

results from injury to alveolar walls and capillary membranes

what is released after injury with ARDS

chemical mediators

Release of chemical mediators during ARDS results in...

1\. __________ permeability of alveolar capillary membranes

2\. ________ fluid and protein in interstitial area and alveoli

3\. Damage to ___*-*__ cells \\n 4. Diffuse ________ and ________, if the patient survives

increased

increased

surfactant-producing

necrosis/fibrosis

Name five s/s of ARDS

dyspnea

restlessness

rapid/shallow respirations

increased HR

respiratory/metabolic acidosis

With ARDS and acute respiratory failure, it is important to treat the ________ ______ and use supportive ________ ______.

underlying cause

respiratory therapy