RRT- Lindsey Jones Rated 100% Correct!!

Emphysema : Obstructive Definition, Clinical Evidence, Chest Xray, CBC, ABG, PFT & Key interventions **EXAM Challenge: You may be tempted to utilize high FiO2 because of the severity of hypoxemia. You may also be tested with an emergency, the only time it is appropriate to use 100% O2 on a COPD patient - D: Abnormal condition of the alveoli resulting destruction and loss of elasticity C.E.: Barrel chest, Access. musc. use, Clubbing, Smoking hx, Occupational hazard (smoke, asbestos, other pulm. irritant) XR: ^ AP diameter, flattened diaphragm, hyperlucency, diminished pulmonary markings. CBC: Polycythemia, ^ WBC - possible infection ABG: Comp. Resp. Acidosis (H PaCO2, N pH) & Hypoxemia PFT: flows are decreased (FEF 25-75% & FEV1), wheeze, dim. K.I.: O2 (L FiO2 0.24-0.28), Liq. O2 or trans-trach cannula, home care education, aids to quit smoking, bronchodilators & corticosteroids Chronic Bronchitis : Obstructive Definition, Clinical Evidence, Chest xray, CBC, ABG,PFT & Key interventions **EXAM Challenge: The most distinguishing characteristic is that the cough is productive and has been so for a good portion of the year. - D: Condition where the patient has a productive cough 25% of the year, for at least 2 consecutive years. C.E.: Productive cough, purulent sputum, exposure to pulm. irritants, frequent infections. XR: May be normal, may show hyperlucency, diminished pulmonary markings CBC: Possible increased WBC due to possible infection ABG: May be normal, may show slight Resp. Acidosis & hypox. PFT: flows are decreased (FEF 25-75% & FEV1 K.I.: Anything that promotes good pulm. hygiene, fluid therapy if dyhyd, O2 if hypox, bronchodialator, TetracyclineBronchiectasis : Obstructive Definition, Clinical Evidence, Chest xray, Sputum Culture, Bronchogram & Key interventions - D: Abnormal condition where the bronchi secrete large volumes of pus during abnormal dilation C.E.: Productive cough, often bloody, clubbing, recurrent infections, dyspnea XR: generally normal S.C.: gram negative bacteria Bronchogram: Primary test. "tree in winter pattern" K.I.: Chest Physio, hydration therapy (thick sputum), fluid therapy (dehydrated), O2 therapy, bronchodilator, Surgical intervention Obstructive & Central Sleep Apnea Definition, Clinical Evidence, ABG,Polysomnography & Key interventions **EXAM Challenge: It is important to remember to avoid sending the patient home without some sort of ventilatory support. - D: The cessation of breathing during sleep. Most commonly obstructive in nature, can be central, or both. (mixed) C.E.: Spouse complains of snoring and witnessed apnea for 10 second or longer. Excessive upper airway tissue, obesity or thick neck. Ability to fall asleep quickly. Dyspnea, Frequent urination during sleeping hours ABG: Could be normal, or show slight resp. acid. or hypoxemia P.: Determines OSA or CSA. If no nasal flow AND no chest movement = CSA, If no nasal flow WITH chest mvmt. = OSA K.I.: CSA= ventilatory stim. meds (Doxapram) OSA= use of CPAP or BiPAP, initially indicated follow up weight loss or upper airway tissue removal. Must be corrected immediately.. If sending home, send equipment. in the absence of titration studies initial order Pressure is 10-20 cmH2O Asthma : Obstructive Definition, Clinical Evidence, Chest xray, CBC, ABG,PFT & Key interventions **EXAM Challenge: When doing PFTs, always do a pre & post bronchodilator study. Consider effective if 12% or more improvement is noted. Always start oxygen first when presenting in the ER-- part of the national Asthma Guidelines - D: Abnormal construction of the bronchial's resulting in sputum production and narrowed airways.