Respiratory Case Studies Monday by Mélanie Filion https://padlet.com/melanie_filion/RespiratoryMonday en-us 2020-03-02 14:36:07 UTC 2023-02-03 08:01:18 UTC hello@padlet.com 3. Interpret RS laboratory results, How would his acid base disorder be classified- what does the Hct indicate- what is the most likely cause of his RBC alteration https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976098 Respiratory acidosis, his hematocrit is low due to low oxygenation due to high carbon dioxide within the body because of COPD ]]> 2020-03-02 14:40:16 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976098 1. Explain what is happening with T.R. Explain the manifestations. https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976247 Hypoxemia: after 5 minutes r/t impaired gas exchange. ⬇ Oxygen RR =36/min, SpO2 =91% (low tissue perfusion).

Dyspnea = Intercostal muscle use, nasal flaring, retraction + thrashing.]]> 2020-03-02 14:40:29 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976247 2. What do the above signs indicate? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976408 Severe Pulmonary Edema.
MANIFESTATIONS
•Dyspnea
•Crackles on auscultation and dullness on percussion d/t fluid in lung interstitial tissue
•Hypoxemia
•Severe edema = pink, frothy sputum
]]> 2020-03-02 14:40:43 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976408 3. Describe the pathophysiology mechanism contributing to T.R.'s problem #2. https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976923 Inability to remove excess fluid build up (r/t anesthetic) ➙ causes fluid in interstitial space = Pulmonary edema. ]]> 2020-03-02 14:41:24 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452976923 1) discuss the pathophysiology underlying https://padlet.com/melanie_filion/RespiratoryMonday/wish/452977168 COPD is characterized by a limitation in air entry to lungs that is not fully reversible and is normally progressive but is treatable. COPD is the name associated to a variety of lung conditions. The cause of COPD is an enhanced inflammatory response in air way and lungs to particles or gases; which can be the result of family history of COPD, frequent lung infections and or smoking history. The clinical manifestations of COPD may include conditions that cause air obstruction such as emphysema. Symptoms of COPD are shortness of breath and cough; coughs are long lasting and contain mucus. Dyspnea is also a symptom that may worsen with progression and effect an individual’s activity tolerance and food intake. In COPD accessory muscles are used to breathe; increasing risk for respiratory infection and respiratory failure. As COPD progresses the symptoms or number of symptoms progress as well. Airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. The inflammatory response occurs throughout the airways. Due to chronic inflammation and the body’s attempts to repair it, narrowing occurs in the small peripheral airways. Over time, this injury-and-repair process causes scar tissue formation and
 narrowing of the airway. ]]> 2020-03-02 14:41:47 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452977168 4. Later that day, the nurse reports decreased air entry to the right medial lobe and T.R. reports dyspnea with RR 28 breaths per minute and shallow. A CXR is ordered and reveals an area of atelectasis. T.R. asks what that means? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452977189 Pt has Absorption Atelectasis - the collapse of lung tissue r/t impaired removal of air from aveoli from the anesthetic. ]]> 2020-03-02 14:41:49 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452977189 1. What is the most likely cause of JC's m/f? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452977528 The most likely cause of her manifestations are pneumothorax, or collapsed lung (i.e. increase in respirations but absent breath sounds)]]> 2020-03-02 14:42:14 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452977528 2. Explain the pathophysiology and m/f underlying this cause. Discuss the different types. https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978481 - The presence of air or gas in pleural space caused by a rupture in the visceral pleural (which surrounds the lungs) or the parietal pleura and chest wall (can occur from an external or internal buildup of air)
- Loss of negative pressure → Collapse of all or part of a lung that occurs when air or another gas enters the pleural space surrounding the lungs
Manifestations: 
  • Bluish skin
  • Chest pain
  • Coughing
  • Fatigue
  • Fast breathing
  • Fast heartbeat
  • Shortness of breath
Types:
1. Open pneumothorax 
2. Tension pneumothorax 
3. Spontaneous pneumothorax 
4. Secondary pneumothorax 
]]> 2020-03-02 14:43:37 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978481 melanie_filion https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978510 2020-03-02 14:43:39 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978510 1. State the cause of pneumonia and describe how it affects the lungs. https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978525 Infect the lungs through inhalation of aerosolized bacterial or more commonly by aspiration of colonized oropharyngeal secretions. They have several virulence factors:
-Capsules that make phagocytosis by alveolar macrophages difficult and release toxins
-Intense inflammatory response is initiates with release of TNF-Alpha and IL-1
-Neutrophils and inflammatory exudates cause alveolar edema
]]> 2020-03-02 14:43:40 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978525 5. In what position would RS have the worst ventilation-perfusion matching https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978532 Lying on the right side


]]> 2020-03-02 14:43:41 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978532 4) RS is admitted with his third exacerbation of dyspnea and a respiratory infection this year. His family is very concerned and do not understand what is causing his dyspnea and recurrent. infections what would you tell them? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978968 Dyspnea (SOB) is common with COPD as COPD enhances the inflammatory response to particles and gasses.  Infection are also common with COPD they have difficulty clearing their lungs of bacteria, dusts and other pollutants in the air. This makes them at risk for lung infections that may cause further damage to the lungs.]]> 2020-03-02 14:44:16 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452978968 2. D.P. reports rust colour sputum. What does this information reveal? Explain D.P.s other manifestations. https://padlet.com/melanie_filion/RespiratoryMonday/wish/452979518 it is often a sign of old blood in mucus. Usually caused by Streptococcus pneumonia.
Other manifestations: fever, chest pain, SOB, cough, drowsiness, and shaking.]]> 2020-03-02 14:45:02 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452979518 2. What clinical findings are likely in RS as consequence of his bronchitic COPD? How would these differ from those of emphysematous COPD? What are the similarities and differences between emphysema and chronic bronchitis? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452980645 a) Dyspnea, hypersecretion, mucous is thicker than usual, chronic productive cough.

b) Not as much secretions, the impairment of gas exchange is d/t damaged airway walls, clubbed fingers are present, CHF could be present.

c) Similarities: dyspnea, cough, airway obstruction, hypoxemia.
Differences: Bronchitis - +++ secretions, obstruction is d/t secretions
Emphysema: Obstruction is d/t damage to airway walls and loss of elasticity. Because of the loss of elasticity, there is an increase in residual volume and an over inflated lung]]> 2020-03-02 14:46:38 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452980645 1. What is the underlying mechanism of R.J's asthma? What are the three airway responses that occur during an asthma episode? What mechanisms cause obstruction in asthma? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452981853 - IgE mediated (Hypersensitivity; allergy to cats and plant pollens); mast degranulation.
- Three airway responses: Constriction of airway (Bronchospasm), Airflow obstruction (mucus + constriction), Thickening / Edema
- Inflammation/constriction & mucus plug cause obstruction]]> 2020-03-02 14:48:13 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452981853 1. Considering T.V.'s history, what is the most likely cause of her respiratory distress? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452982926 Pulmonary embolism]]> 2020-03-02 14:49:38 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452982926 3. The patient is at risk for severe hypoxemia. What is hypoxemia? Explain why this is a possible complication for this patient? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452982971 Hypoxemia - An abnormally low level of oxygen in the blood due to problems with mechanisms of oxygen. Typically results in tissue dysfunction, or severe organ infarction.
JC is at risk for hypoxemia because of inadequate ventilation/perfusion imbalance from her collapsed lung. treatment is chest tubes to drain air or fluids. 
]]> 2020-03-02 14:49:41 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452982971 2. What risk factors, clinical and diagnostic findings would help confirm this diagnosis? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452983221 DVT, bed rest, post-op pt. dyspnea, respiratory alkalosis]]> 2020-03-02 14:49:59 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452983221 3. What do her ABG's reveal? What is the pathogenesis of the hypoxemia in this disorder? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452983801 Respiratory alkalosis
Hypoventilation to compensate for the respiratory alkalosis causes hypoxemia (reduced oxygenation arterial blood)]]> 2020-03-02 14:50:49 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452983801 4. How does pneumothorax differ from pleural effusion? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452983984 Pneumothorax - Air or gas in the pleural space (lung collapse)  
Pleural effusion - Fluid in the pleural space (no lung collapse - less oxygen exchange)]]> 2020-03-02 14:51:02 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452983984 7. This disease process has developed into adult respiratory distress syndrome (ARDS). What are the hallmark signs of this disorder? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452984259 Tachypnea 
Dyspnea
Retractions 
Hypoxia 
Tachycardia 
Crackles 
Atelectasis
]]> 2020-03-02 14:51:27 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452984259 2. Explain R.J's manifestations and ABG Results. https://padlet.com/melanie_filion/RespiratoryMonday/wish/452984608 - Wheezing, dyspneic, tachypnea (manifestations of asthma r/t above mechanisms)
- Second ABG: respiratory acidosis (Impending respiratory failure)]]> 2020-03-02 14:51:56 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452984608 3. How should R.J's current problems be managed? What parameters should be assessed to monitor response to therapy. https://padlet.com/melanie_filion/RespiratoryMonday/wish/452984878 Monitor peak flow meter readings
- Treatments: Anti-inflammatories, Corticosteroids, Inhaled beta-agonist, nebulizer]]> 2020-03-02 14:52:20 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452984878 3. Describe the normal mechanisms that defend against infection in the respiratory tract https://padlet.com/melanie_filion/RespiratoryMonday/wish/452986308 - Normal flora
- Respiratory epithelium
- Innate cells
- Mucous 
- Physiologic reflexes (e.g., cough, sneeze, vomit) 
- cilia ]]> 2020-03-02 14:54:09 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452986308 6. What do the ABGs reveal? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452987441 - Respiratory acidosis  - uncompensated]]> 2020-03-02 14:55:38 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452987441 4. What precautions could you take as nurses to reduce the risk of respiratory infection for yourself, you colleagues, and your pts? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452993557 Aseptic techniques, wash your hands, mask, gown, gloves, proper PPE for pathogen (ex: influenza - droplet precautions, in separate room from others)]]> 2020-03-02 15:03:51 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452993557 8. What is the most appropriate treatment for this pt? https://padlet.com/melanie_filion/RespiratoryMonday/wish/452995161 Antibiotic, NSAIDS (anti-inflammatory), cough suppressant medications, acetaminophen (reduce fever) ]]> 2020-03-02 15:06:08 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/452995161 5) Compare & contrast the path, cause, m/f, diagnostics, and treatment of viral and bacterial pneumonia, kayla_zuliani https://padlet.com/melanie_filion/RespiratoryMonday/wish/453000615 1)    Viral Pneumonia: 
-       Patho:
o   Set the stage for secondary bacterial infection by damaging ciliated epithelial cells
o   Destroy ciliated epithelial cells and invade the goblet cells and bronchial mucous glands
o   Seasonal and usually mild and self-limiting 
-       Cause: 
o   Virus (ex: flu, common cold)
-       m/f: 
o   fever
o   cough
o   SOB
o   Shaking/chills
o   Muscle aches
o   Fatigue 
o   Malaise
 
-       Diagnostic:
- chest X-ray
- ABG
- cultures of sputum 
-       Treatment: 
 
Bacterial Pneumonia: 
-       Patho: 
o   Infect the lungs through inhalation of aerosolized bacterial or more commonly by aspiration of colonized oropharyngeal secretions
o   They have several virulence factors:
      -Capsules that make phagocytosis by alveolar macrophages difficult and release toxins
      - Intense inflammatory response is initiates with release of TNF-Alpha and IL-1
      -  Neutrophils and inflammatory exudates cause alveolar edema
-       Cause: 
o   Bacteria – streptococcus pneumoniae 
 
-       M/f:
o   Cough with yellow/green/blood-tinged mucus
o   Chest pain
o   Chills
o   fever

-       Diagnostic:
-       Treatment: 
]]> 2020-03-02 15:12:51 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/453000615 8) What is the most appropriate treatment for this pt? kayla_zuliani https://padlet.com/melanie_filion/RespiratoryMonday/wish/453024246 - antibiotics
- will probably need to intubate ]]> 2020-03-02 15:42:56 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/453024246 melanie_filion https://padlet.com/melanie_filion/RespiratoryMonday/wish/453042511 2020-03-02 16:06:11 UTC https://padlet.com/melanie_filion/RespiratoryMonday/wish/453042511