Pulmanary Essay

1138 words - 5 pages

Pulmonary Problems
Chapter 10

Pneumonia is inflammation of the lungs resulting in consolidation
Obstruction in gas exchange on the alveolar level
Aspiration most common cause
2nd most frequent cause is droplet inhalation
Least likely cause is blood borne
Protein rich fluid move into the alveoli- complicated by production of the organism- result is decreased alveolar surface area-resulting in elevation of pco2 and a decrease in po2
Inspection-tachypnea and central cyanosis
Palpitation-tactile fremitus
Auscultation-crackles, rhonchi, wheezing, or egophony
Diagnosis-labs, chest xray
Ct not recommended unless anthrax is suspected
Bronch-immunocompromised ...view middle of the document...

EX albuterol
Sleep apnea- CSA and OSA
CSA- respiratory pause caused by lack of respiratory effort. Associated with cardiac failure or neurologic disease such as stroke
OSA- cessation or significant decrease in airflow in the presence of breathing effort. Most common cause of daytime sleepiness. Defined as having 5 or more obstructed breathing events per hour of sleep
Apnea is defined as breathing pauses lasting 10 seconds or longer
Pharyngeal muscles relax and the airway collapses on inspiration
Symptoms- snoring, sleepiness, and significant other report sleep apnea episodes
Management-CPAP- maintain opening airway pressures of 5 to 20
Weight reduction
STOP-BANG- snoring, tiredness during day, observed apnea, high blood pressure, body mass index, age, neck circumference, and gender
Pulmonary Hypertension
Elevation in pulmonary artery pressure
Normal 10-12
Pulmonary HTN-greater than 25 at rest or 30 during exercise
Increased pressure eventually lead to RV failure
PPH- unknown cause
SPH- caused by cardiac or pulmonary disorders EX COPD-die of right sided heart failure secondary to pulmonary hypertension (volume and pressure overload)
Cor pulmonale is a term used to indicate RV enlargement secondary to any underlying cardiac or pulmonary disease
Pulmonary hypertension is the most common cause of cor pulmonale and is associated with the development of RV failure
Other factors- interstitial lung disease, cystic fibrosis, sleep apnea, and PE
Common causes wordwide- sickle cell and HIV
Patho-fibrosis and thickening of the vessel wall
Average time from onset to diagnosis is 2 years
Systolic ejection murmur, high pitched systolic murmur of tricuspid regurg, hepatomegalt, a pulsatile liver, ascites, peripheral edema may occur in right sided heart failure
Management- Coumadin 1.5-2 times the normal, Digoxin, Diuretics, CCB (not if CI is less than 2 or right arterial pressure is above 15), Viagra
Lung Cancer
Squamous cell carcinoma- usually located in the central bronchi near the hilus. Tumor usually localized and do not metastasize until late in the disease. Surgical resection is the most successful treatment
Adenocarcinomas-tumor arising from glands of the lungs
Strongest link to smoking is small cell carcinomas. These tumors grow fast,...

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