RRT- Lindsey Jones: Disease Review for Clinical
Simulations (Questions With Complete Solutions)
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Terms in this set (41)
Emphysema : Obstructive D: Abnormal condition of the alveoli resulting
Definition, Clinical Evidence, Chest destruction and loss of elasticity
Xray, CBC, ABG, PFT & Key C.E.: Barrel chest, Access. musc. use, Clubbing,
interventions Smoking hx, Occupational hazard (smoke, asbestos,
other pulm. irritant)
**EXAM Challenge: You may be XR: ^ AP diameter, flattened diaphragm,
tempted to utilize high FiO2 because hyperlucency, diminished pulmonary markings.
of the severity of hypoxemia. You may CBC: Polycythemia, ^ WBC - possible infection
also be tested with an emergency, the ABG: Comp. Resp. Acidosis (H PaCO2, N pH) &
only time it is appropriate to use 100% Hypoxemia
O2 on a COPD patient 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 D: Condition where the patient has a productive
Definition, Clinical Evidence, Chest cough 25% of the year, for at least 2 consecutive
xray, CBC, ABG,PFT & Key years.
interventions C.E.: Productive cough, purulent sputum, exposure to
pulm. irritants, frequent infections.
**EXAM Challenge: The most XR: May be normal, may show hyperlucency,
distinguishing characteristic is that the diminished pulmonary markings
cough is productive and has been so CBC: Possible increased WBC due to possible
for a good portion of the year. 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,
Tetracycline
,Bronchiectasis : Obstructive D: Abnormal condition where the bronchi secrete
Definition, Clinical Evidence, Chest large volumes of pus during abnormal dilation
xray, Sputum Culture, Bronchogram & C.E.: Productive cough, often bloody, clubbing,
Key interventions 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 D: The cessation of breathing during sleep. Most
Definition, Clinical Evidence, commonly obstructive in nature, can be central, or
ABG,Polysomnography & Key both. (mixed)
interventions C.E.: Spouse complains of snoring and witnessed
apnea for 10 second or longer. Excessive upper
**EXAM Challenge: It is important to airway tissue, obesity or thick neck. Ability to fall
remember to avoid sending the asleep quickly. Dyspnea, Frequent urination during
patient home without some sort of sleeping hours
ventilatory support. 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 D: Abnormal construction of the bronchial's resulting
Definition, Clinical Evidence, Chest in sputum production and narrowed airways.
xray, CBC, ABG,PFT & Key C.E.: Accessory muscle use, Tachycardia, dyspnea,
interventions wheezing, congested cough, wet-clammy skin
XR: hyperinflation, scattered infiltrates, flat
**EXAM Challenge: When doing PFTs, diaphragm
always do a pre & post bronchodilator CBC- Allergic cases, maybe elevate eosinophils ->
study. Consider effective if 12% or yellow sput.
more improvement is noted. Always ABG: possible Resp. Acid, could be hypoxic
start oxygen first when presenting in PFT: Decreased flows in FEV1 but diffusion is normal
the ER-- part of the national Asthma (DLCO)
Guidelines K.I.: O2 therapy, bronchodilator, xanthenes via IV,
pulm. hyg, if repeated bronchodilator use doesnt
work think status asthmaticus, patient asthma action
plan!!
Status Asthmaticus: D: Asthma that will not respond to bronchodilators,
Definition, Clinical Evidence, Chest persists 24'
xray, ABG,PFT & Key interventions C.E.: HX non-response to bronodilators "needs many
tx" to feel better, acc. musc. use and retractions,
**EXAM Challenge: Questions on this dyspnea, wheezing, congested cough, wet-clammy
will challenge your ability to skin, pulses paradoxes
recognize impending vent. failure. It is XR: hyperinflation, scatter infiltrates, flat diaphragm
very important that you treat it before ABG: Pos. Resp. Acid., alkalosis due to anxiety, maybe
full vent failure. There is a frequent hypoxic
need to repeat actions, such as K.I.: May deteriorate quickly, intubate and MV before
bronchodilator treatments, which may full vent fail. Use sub-cue epi-- 1mL of 1:1000 strength,
make you uncomfortable. Do not be may need to give Q 20min for up to 3 consecutive
afraid to administer several doses. Address 3 parts of asthma
bronchdilators in succesion. The same INFLAMMATION- corticosteroids
is true of the subcutaneous BRONCHOCONSTRICTION- bronchodilators
epinephrine. If you give one dose, you SPUTUM- airway clearance, hydration, thinning of
will likely have to give another, and sputum if needed.
possible another. Continue if
symptoms show no signs of relief.
Simulations (Questions With Complete Solutions)
Save
Terms in this set (41)
Emphysema : Obstructive D: Abnormal condition of the alveoli resulting
Definition, Clinical Evidence, Chest destruction and loss of elasticity
Xray, CBC, ABG, PFT & Key C.E.: Barrel chest, Access. musc. use, Clubbing,
interventions Smoking hx, Occupational hazard (smoke, asbestos,
other pulm. irritant)
**EXAM Challenge: You may be XR: ^ AP diameter, flattened diaphragm,
tempted to utilize high FiO2 because hyperlucency, diminished pulmonary markings.
of the severity of hypoxemia. You may CBC: Polycythemia, ^ WBC - possible infection
also be tested with an emergency, the ABG: Comp. Resp. Acidosis (H PaCO2, N pH) &
only time it is appropriate to use 100% Hypoxemia
O2 on a COPD patient 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 D: Condition where the patient has a productive
Definition, Clinical Evidence, Chest cough 25% of the year, for at least 2 consecutive
xray, CBC, ABG,PFT & Key years.
interventions C.E.: Productive cough, purulent sputum, exposure to
pulm. irritants, frequent infections.
**EXAM Challenge: The most XR: May be normal, may show hyperlucency,
distinguishing characteristic is that the diminished pulmonary markings
cough is productive and has been so CBC: Possible increased WBC due to possible
for a good portion of the year. 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,
Tetracycline
,Bronchiectasis : Obstructive D: Abnormal condition where the bronchi secrete
Definition, Clinical Evidence, Chest large volumes of pus during abnormal dilation
xray, Sputum Culture, Bronchogram & C.E.: Productive cough, often bloody, clubbing,
Key interventions 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 D: The cessation of breathing during sleep. Most
Definition, Clinical Evidence, commonly obstructive in nature, can be central, or
ABG,Polysomnography & Key both. (mixed)
interventions C.E.: Spouse complains of snoring and witnessed
apnea for 10 second or longer. Excessive upper
**EXAM Challenge: It is important to airway tissue, obesity or thick neck. Ability to fall
remember to avoid sending the asleep quickly. Dyspnea, Frequent urination during
patient home without some sort of sleeping hours
ventilatory support. 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 D: Abnormal construction of the bronchial's resulting
Definition, Clinical Evidence, Chest in sputum production and narrowed airways.
xray, CBC, ABG,PFT & Key C.E.: Accessory muscle use, Tachycardia, dyspnea,
interventions wheezing, congested cough, wet-clammy skin
XR: hyperinflation, scattered infiltrates, flat
**EXAM Challenge: When doing PFTs, diaphragm
always do a pre & post bronchodilator CBC- Allergic cases, maybe elevate eosinophils ->
study. Consider effective if 12% or yellow sput.
more improvement is noted. Always ABG: possible Resp. Acid, could be hypoxic
start oxygen first when presenting in PFT: Decreased flows in FEV1 but diffusion is normal
the ER-- part of the national Asthma (DLCO)
Guidelines K.I.: O2 therapy, bronchodilator, xanthenes via IV,
pulm. hyg, if repeated bronchodilator use doesnt
work think status asthmaticus, patient asthma action
plan!!
Status Asthmaticus: D: Asthma that will not respond to bronchodilators,
Definition, Clinical Evidence, Chest persists 24'
xray, ABG,PFT & Key interventions C.E.: HX non-response to bronodilators "needs many
tx" to feel better, acc. musc. use and retractions,
**EXAM Challenge: Questions on this dyspnea, wheezing, congested cough, wet-clammy
will challenge your ability to skin, pulses paradoxes
recognize impending vent. failure. It is XR: hyperinflation, scatter infiltrates, flat diaphragm
very important that you treat it before ABG: Pos. Resp. Acid., alkalosis due to anxiety, maybe
full vent failure. There is a frequent hypoxic
need to repeat actions, such as K.I.: May deteriorate quickly, intubate and MV before
bronchodilator treatments, which may full vent fail. Use sub-cue epi-- 1mL of 1:1000 strength,
make you uncomfortable. Do not be may need to give Q 20min for up to 3 consecutive
afraid to administer several doses. Address 3 parts of asthma
bronchdilators in succesion. The same INFLAMMATION- corticosteroids
is true of the subcutaneous BRONCHOCONSTRICTION- bronchodilators
epinephrine. If you give one dose, you SPUTUM- airway clearance, hydration, thinning of
will likely have to give another, and sputum if needed.
possible another. Continue if
symptoms show no signs of relief.
