RRT Clin Sims Study Guide

Pneumonia: CORRECT ANSWER - Collection and/or consolidation of sputum as a result of a bacterial or viral agent entering the lung on inhalation. - Presents with fever, dyspnea, chills, cyanosis, rhonchi and rales - CXR: scattered infiltrates - CBC: Increased WBC if bacterial, decrease WBC if viral - Interventions: O2 therapy first, suctioning and other bronchial hygiene efforts. - Antibiotics: Penicillin for gram positive organisms, Gentamycin, or other 'mycin antibiotics for gram negative organisms. Information gathering: Emphysema CORRECT ANSWER - Abnormal condition of the alveoli resulting destruction and loss of elasticity. - Can present with cyanosis, barrel chest, accessory muscle use, digital clubbing, dyspnea, and wheezing breath sounds - Due to significant hx of smoking and/or occupational exposure to smoke or asbestos, other pulm. irritant - CXR: ↑ A-P diameter, flattened diaphragms, hyperlucency, diminished pulmonary vascular markings. - CBC: polycythemia, increased WBC due to possible infection. - ABGs: Compensated respiratory acidosis (high PaCO2, normal pH), moderate to severe hypoxemia. - Sputum culture: often positive for bacteria. - PFT: flows are ↓ especially middle sized airways (FEF 25-75%) Fev1 & Fev1/FVC%, reduced DLCO (less than 20). Descision Making: Empysema CORRECT ANSWER - Tx: Oxygen therapy—low FIO2 (0.24 to 0.28) or 1 to 2 lpm nasal cannula. Oxygen conserving devices such as liquid oxygen or trans-tracheal oxygen. Bronchodilators medication via MDI or aerosol nebulizers, antibiotics for in