DEFINITIONS
WHAT IS VENTILATION?
MECHANICAL MOVEMENT OF AIR IN AND OUT OF THE LUNGS
TIGHTENING OF THE SMOOTH MUSCLE
"STATUS" IS LIFE THREATENING
SILENT CHEST IS OMINOUS SIGHN
ASTHMA: CHRONIC REVERSABLE INFLAMMATORY AIRWAY DISORDER
(BRONCHOCONSTRICTION REQUIRES A BRONCHO DILAOR- SABA FOR ACUTE SYMPTOMS)
A NASAL CANNULA CAN DELIVER HOW MANY LITERS OF FLOW?
HOW MUCH FiO2?
1-6
24%-44%
LEADING CAUSE OF CANCER DEATH (WHAT TYPE)
NON-SMALL CELL (85%)
SMALL CELL (15%)
90% IS SMOKING RELATED: chronic cough, hemoptysis, dyspnea, weight loss, chest pain, pleural effusions, SVC syndrome
WHAT MEDICATIONS ARE USED FOR ASTHMA (THINK A.I.M.)
1. ASTHMA (SABA)**** 2 A's in Asthma 2 A's in SABA SHORT ACTING RESCUE INHALER
2. IPATROPIUM (ATROVENT), TIOTROPIUM (SPIRIVA) ANTICHOLINERGIC "OPIUM---->DRY MOUTH"
3. METHYLPREDNISOLONE (systemic STEROID), PREDNISONE- "TAPER THE DOSE it does the Most (to the blood sugar and immune system)
WHAT IS HYPOXEMIA?
WHAT IS HYPOXIA?
LOW ARTERIAL OXYGENATION Pa <80
DECREASED TISSUE OXYGENATION (THINK SpO2)
50-79% OF PERSONAL BEST (ASTHMA ACTION PLAN)
IS WHAT ZONE?????
YELLOW ZONE: 50-79%
GREEN (HAS TO BE 80+)
RED HAS TO BE <50
***REMEMBER YOUR YELLOW***
ENCOURAGES DEEP INSPIRATION AND PREVENTS ATELECTASIS
INSENTTIVE SPIROMETERY
**INHALE 1,2,3,4,5 (BALL GOES UP)**
SIT UP RIGHT DO NOT EXHALE
GENETIC ENDOCRINE DISORDER THAT LEADS TO RECURRENT LUNG INFECTIONS AND MALABSORPTION. DIAGNOSTICS INCLDUE A SWEAT CHLORIDE TEST, GENETIC TESTING AND POSITIVE SPUTUM CULTURE
CYSTIC FIBROSIS: leads to recurrent lung infections, steatorrhea (greasy stools), poor weight gain, CLUBBING, HYPOXEMIA
INHALED CORTICOSTEROIDS
1. FLUTICASONE (FLOVENT)
2. BUDESONIDE (PULMICORT)
THESE WILL CAUSE THRUST
1. CRACKLES (FLUID)
2. WHEEZES (MUSICAL)
3. RHONCHI (SNORING SOUND)
4. STRIDOR (HIGH-PITCHED THINK EMERGENCY)
PANCREATIC ENZYME REPLACEMENT WITH ALL MEALS WITH MEALS AND SNACKS
NEB MEDS: BRONCHODIALORS>HYPERTONIC SALINE>MUCOLYTICS
CPT AN HOUR BEFORE MEALS
HIGH CALORIE, HIGH PROTEIN DIET, HIGH FAT, VIT A-D-E-K (THINK: KADE, DAKE, DEAK, KEDA)
INFECTION PREVENTION! HAND HAND HYGIENE
THIS OXYGEN DELIVERS 5-10L, FOR SHORT TERM USE
SIMPLE MASK
WHAT CAUSES (NAME 3): FEVER, CHILLS, PLEURITIC CHEST PAIN!!!, CRACKELS, WHEEZES, DIMINISHED, FATIGUE, MYALGIA
1. COMMUNITY ACQUIRED (CAP)
2. HOSPITAL-ACQUIRED (HAP)
3. ASPIRATION PNEMONIA
THIS IS A LEUKOTRIENE (LEUKO-TREEN) RECEPTOR THAT IS TAKEN DAILY AT BEDTIME AND NOT FOR ACUTE USE
MONTELUKAST (SINGULAR)
THINK LUKA, LEUKO
DESCRIBE PINK PUFFER AND BLUE BLOATER
COPD:
PINK PUFFER: EMPHYSEMA (AIR TRAPPING, BARREL CHEST, THIN BODY, PURSED LIP BREATHING)
BLUE BLOATER: CHRONIC BRONCHITIS (MUCUS HYPERSECRETION & PRODUCTIVE COUGH)
INDURATION > 10MM IS MOST LIKELY WHAT?
PPD READ IN 48-72 HOURS >10MM INDURATION POSITIVE TB TEST
NAME 4 COMPLICATIONS OF OXYGEN THERAPY
1. OXYGEN TOXICITY (LUNG DAMAGE)
2. ABSORBTION ATELECTASIS (ALVEOLI COLLAPSE)
3. DRY MUCOUS MEMBRANES (HUMIDIFICATION >4L)
4. CO2 RETENTION (TOO MUCH O2 SUPPRESSES PT'S WITH COPD'S DRIVE TO BREATHE)
INFLAMMATION OF NASAL AND PARANASAL SINUS MUCOSA
CAUSES FACIAL PRESSURE, FEVER, COUGH, SORE THROAT
RHINOSINUSISIS (USUSALLY FOLLOWS URI) THINK RHINO-NOSE-SINUS
***NASAL RINSES, HUMIDFIED AIR***
WHAT IS THE 4 DRUG REGIMEN FOR TUBURCULOSIS
1. RIFAMPIN**ORANGE
2. ISONIAZID
3. PYRAZINAMIDE
4. ETHAMBUTOL (6-12M)
***AIRBORNE ISOLATION****
***WEAR MASK IN PUBLIC***
***REPORT JAUNDICE***
NORMAL ABG VALUES
PH: 7.35-7.45
PaCO2: 35-45 mmHg
PaO2: 80-100mmgHg
SaO2: 95-100%
MOST ACCURATE O2 MODALITY DELIVERS FLOW OF 2-15, FiO2 of 24-60%, ideal for COPD and adjustable
VENTURI MASK
THIS OXYGEN MODALITY IS A ONE-WAY VALVE USED FOR SEVERE HYPOXIA. IT DELIVERS UP TO 90% FiO2
Non-Rebreather Mask
this condition requires positive pressure, weight loss and cessation. risk factors include heart failure, males 40-65, atrial fib, diabetes
OBSTRUCTIVE SLEEP APNEA
***hypoxemia, hypercapnia***
hyper CAP NIA (APNEA)
NAME THE FIRST LINE DRUGS FOR SMOKING CESSATION
1. NICOTINE (PATCH, GUM, LOZENGE)
2. BUPROPION (ZYBAN) CRAVING REDUCTION
3. VARENICLINE (CHANTIX) REDUTION IN REWARD