Spring 2025 Exam 3

COPD

a progressive lung disease characterized by increasing breathlessness, Irreversible, combination of emphysema and chronic bronchitis

• asthma usually associated

Acute Bronchitis

A sudden inflammation of the bronchial tubes, often caused by viral infections, leading to coughing, mucus production, and difficulty breathing ( lasts a few days)

• Cough can last a few weeks

Chronic Bronchitis

A long-term inflammation of the bronchial tubes, often associated with smoking or pollution, resulting in persistent cough and mucus production

• No barrel chest, Peripheral edema

• wet loose cough

• first sign is dyspnea on exertion

• Bloated, Obsese, ventilation is okay

Ventilation

Movement of air in and out of the alveoli

Perfusion

blood flow to the aveoli to promote gas exchange

Emphyesma

a destruction or collapse of the alveoli

• Dry cough, Thin

• Hyperventilation

• Air Trapping, Cold Extremities, Perfusion Issues

FEV1

forced expiratory volume in 1 second, less than 80% is reduced

CBC

used to check for infection and chronic hypoxia can cause increased hemoglobin

ABG

tells the nurse wether the paitent was acidic or alkalosis

Nursing Interventions of COPD

Small frequent meals

Flowlers position , relaxing the pt

Fluids, Telemetry( risk for heart failure and tachycardia)

supplemental Oxygen , but not too much ( 88-92) the lungs stilll need to do some work

Complications of COPD

Pneumothorax

Right sided heart failure with preserved EF

Asthma

Chronic inflammatory disorder that is reversible constriction of the bronchioles

• NSAIDS& Asprin can trigger attacks

• geentics , AAT deficiency

• premature babies are at risk, lungs are last to develop

• Wheezing, Cough, SOB, Pale/wet skin, Tachycardia

CBC

high in eosinophils and neutrophils indicate a relation to allergies

Nursing Intervention of asthma

Stay with them

fowlers position

Listen to lung sounds, supplemental oxygen

IV access, ( limited airway means they cannot swallow medications)

Pet removal, removal of carpets, controlling dust, covering mattresss

Agonist

A drug that gets in space of receptor and activates cell

Antagonist

A drug that gets in the space of receptor and blocks the activation of cells

Antagonist& Agonist Medication

Drugs that block and activate specific cells

Sympathetic nervous system

Fight or flight response

Parasympathetic

Rest and digest , your bronchi will constrict since your body requires less oxygen and slow heart rate

Acetylcholine

acts as a neurotransmitter, to cause broncoconstriction

SABA

Short acting beta agonist

Albuterol - lasts 4-6 hours

consider heart issues because it will increase heart rate, widening vessels

Bronchodialtion, Adrenegeric

LABA

Salmuterol -12-24 hours

reaxes smooth muscle in the lungs

Broncodialator, Adrenegeric

Theophylline

Methlxanthines

Taken by mouth( pill) can become toxic

Inhibits cell mediator, decreases the response of histamines( relaxing the immune system)

Greater chance of infection

Histamines

Mainly known for causing allergy symptoms

Steroids

ends in osone or onide

Can cause thrush , rinse after use

abruptly stopping can cause adrenal insufficiency

Monitor for headache, dizziness, liver function, mood changes

Use if SABA is used more than 2 times a week

Montelukast

Antagonist, blockig leukotrines

CANNOT CRUSH

good for people with allergy triggers

prevents wheezing , tightness, and coughing ( prevent broncospams)

Status Asthmaticus

Exaggerated asthma attack

distended jugular vein, accessory muscle use , coma, silent chest , bradycardia

Inerventions- Fowlers, intubation, oxygen, steroid

Pediatric Respiratory

Narrower

flexible ribs

oxygen at a high consumption

more rapid

Peak Flow Meter

You take a deep breath in and blow as hard as you can in one second , on a good day you use your best numbers

Lower respiratory tract

Trachea, Bronchioles, Lungs

RSV

a viral infection affecting the bronchioles and alveoli

Rhinorrhea

thin, clear, mucus discharge from

Bronchiolitis

Lower respiratory tract illness leads to inflammation and obstruction of the bronchioles

• Usually caused by rsv

Normal PH Range

7.35-7.45

Antivirals

Ribavirin

Palivizumab/synagis

Antipyretics

Tylenol above 6 months , Asprin

DO NOT GIVE Asprin to Children

Nursing Interventions for RSV

Hydration

Suction

Humidified oxygen

Maintaining o2 over 90%

Croup

inflammation of the tissues within the trachea

Upper respiratory infection

• virus ,usually caused by parainfluenza virus

• can be caused by severe acid reflux and seasonal allergies

Manifestations of Croup

Loud barking cough

snoring

loud breathing

Stridor

Glucocorticoid

Reduce inflammation in the airway, onset is 6 hours

Dexamethasone

Long lasting effects of steroids, reducing inflammation ( 72 hours )

Anti inflammatory

Epinephrine

Reduces airway inflammation, fast acting , short duration

Covid 19

Gets into the lung epithelium

Stay at least 6 feet away

no proper cure, clotting is a risk

hand hygiene

Pertussis

Mostly infants and adolescents

droplet precautions, caused by bacteria

small frequent meals, phenomena/ atelactsis watch, cardiac monitoring

Early signs of Pertussis

dyspnea , runny nose, fever

Later signs of pertussis

coughing fits ( whopping) , vomiting , exhaustion , rib breaking

DTaP vaccine

usually given to kids to protect against diphtheria, pertusis ,a and tetanus

given to children

Tdap

Given to children 8 and up and used more as a booster for tetanus

Pharmacologic Treatment of Pertussis

ending in myosin for the treatment of one month or older

Sulfanides for 2 months or older

Pneumonia

inflammation of the parenchymas

infection of the lower respiratory system, ventilation, and maintaining airways

Milliary Pneumonia

Means that the infection is spread all over the respiratory system

Community acquired pneumonia

gram positive

easier to treat

Streptococcus Pnemuonae

Healthcare acquired pneumonia

gram negative

Staphylococcus aureus

harder to fight because f the lipid layer surround the membrane makes it harder to infiltrate

Opportunistic Pneumonia

Only affects the immunocompromised

Jirovecii

Doxycycline

Shouldn’t be in the sun when taking medication due to the increased sensitivity of the sun

Guaifenesun

mucolytic

Used to break up mucus and get rid of it

Acute Bacteria Pnemonia

bacteria resides in the upper respiratory system

• aveolar edema

• Consolidation of lung tissue

Legionnaire Disease

gram negative bacteria , found in warm/ standing still water

• usually not fatal and usually affects the elderly with preexsiting health problems

• Most commonly spread from AC

Walking pneumonia

Mycoplasma Pneumoniae

Highly contagious

Patchy inflammatory changes in avelolar suptun

Viral Pneumonia

Typically mild

usually caused by adenovirus and influenza

risk of bacterial increases when you have _

Fungal Pneumonia

more common in the chronic health issue population or reduced immune system

Aspiration Pneumonia

Results in chemical and bacteria pneumonia

a foreign object is inhaled into lungs

Pleuritis

Inflammation of the pleural space of the tissue

Pleural Effusion

Excess accumulation of fluid in the pleural space

Lung Abscess

pus filled cavity

Thoracentesis

remove fluid or air from around the lungs

Empyema

Collection of pus in the pleural space

Fiberoptic Bronchoscopy

allows for visual examination of the bronchi

Diagnostic Tests for Pneumonia

Antibiotics after gram stain( TO DETECT HOW TO TREAT)

Chest x ray

Sympathomimetic drugs( stimulates the sympathetic nervous system or methylxanthines( bronchodialator)

Cellulitis

Bacterial infection of the dermis and connective tissue

Staphyloccocus aureus - common cause

Group A Streptococcus - second most common cause

Pharmacologic Therapy for celulitis

oral antibiotics

face/severe cases - hospitalization, systemic antibiotics

• can lead to osetomylitis or systemic infection

• rest, elevation, infection control

Risk Factors of Cellulitis

• history of impetigo, folliculitis, insect bites

• weakene immune system

• less elastic skin

Otitis Media

an infection of the middle ear ( eschian tube)

usually caused by an upper respiratory infection , H. FLu/ Streptococcus

common in children under 5 ,

Serous OM

prolonged Eustachian tube obstruction, build up of fluid

Acute OM

Fluids have sat there and the tube provides entry for bacteria

Tympanic membrane

a protecting barrier , pressure, known as the ear drum

Chronic OM

causes a hole in the ear drum and results in pus

Complications of OM

Mastoiditis

Loss of speech development

Facial nerve paralysis

Prevention of Otitis media

Being breast fed in the upright position

Avoid irritants

vaccinations

Tympanostomy

tubes job is to drain the fluid in the ear to further prevent infections and to equalize pressure

Antibiotics for Otitis Media

Amoxicillian

• Substitute is Macrolides ending in myosin

Ofloxain( Otic solution) - for years 1 and up

>2 years, we can wait and watch