Hypoxia (Early Symptoms)
- Diaphoresis
- Restlessness
- Tachypnea
- Dyspnea on Exertion
- Tachycardia
- Hypertension
- Arrhythmias
- Decreased Urine Output
- Unexplained Fatigue
Hypoxia (Late Symptoms)
- Cyanosis
- Cool, Clammy Skin
- Use of Accessory Muscles
- Retractions
- Hypotension
- Arrhythmias
Restrictive vs. Obstructive Lung Diseases
- Restrictive Lung Disease
- Decreased Lung Volume
- FEV1/FVC Ratio Normal to Increased
- Obstructive Lung Disease
- Increased Lung Volume
- Decreased FEV1/FVC Ratio
Restrictive Lung Diseases
- Poor Breathing Mechanics
- Interstitial Lung Diseases
- Goodpasture's Syndrome
- Eosinophilic Granuloma
- Granulomatosis with Polyangiitis
- Sarcoidosis
- Pneumoconiosis
- Idiopathic Pulmonary Fibrosis
- Drug Toxicity
- Acute Respiratory Distress Syndrome (ARDS)
- Neonatal Respiratory Distress Syndrome
Obstructive Lung Disease
- Blocked Airflow
- Increased residual volume
- V/Q Mismatch
- Decreased forced vital capacity (FVC)
- Decreased FEV1/FVC ratio
- Asthma
- Bronchiectasis
- Chronic bronchitis
- Emphysema
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
- Inhaled Toxins
- Smoking
- AAT Deficiency
- Emphysema
- Chronic Bronchitis
- Asthma
- Spirometry
- Slow Progression
Asthma
- Obstructive lung disease
- Bronchial Hyperresponsiveness
- History of Atopic Disease
- Beta2 agonists
- Corticosteroids
- Curschmann's spirals
- Hypertrophy of smooth muscle
- Reversible
- Charcot Leyden crystals
- Methacholine challenge
- Wheezing
- Cough
- Initially decreased PaCO2
- Pulsus paradoxus
Intermittent Asthma
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use ≤ 2 / Week
- No Interference With ADLs
- Nighttime Awakening < 2 / Month
- > 80 % of Predicted FEV1
Persistent Moderate Asthma
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use Daily
- Nighttime Awakening > 1 / Week
- 60-80% Predicted FEV1
- FEV1/FVC Decreased 5%
Persistent Severe Asthma
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use: Multiple/ Day
- With Minimal Activity
- Nighttime Awakening: Nightly
- < 60% Predicted FEV1
- > 5% Decrease FEV1/FVC
Asthma Implementation and Education
- Oxygen
- Corticosteroids
- Ipratropium (Anticholinergic)
- Albuterol
- Inhaler/nebulizer
- Pulse Oximetry
- Pursed Lip Breathing
- Carry Inhaler
- Rinse Mouth after Inhaler
- Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Chronic Bronchitis
- Chronic Inflammation of Bronchi
- Early-Onset Cyanosis
- Blue Bloaters
- Productive Cough
- Wheezing
- Chronic Obstructive Pulmonary Disease (COPD)
- Late-Onset Dyspnea
- Crackles
- Reid Index > 50%
Chronic Bronchitis Interventions
- Tripod Position
- Humidified Oxygen
- Pursed Lip Breathing
- Increase Fluid Intake
- ABGs
- Early Detection of Exacerbation
- Lowest O2 Therapy
- Assisted Ventilation
- Increased Infection Risk
Bronchiectasis
- Obstructive Lung Disease
- Chronic Necrotizing Infection
- Permanent Airway Dilation
- Poor Ciliary Motility
- Kartagener's Syndrome
- Cystic Fibrosis
- Allergic Bronchopulmonary Aspergillosis
- Hemoptysis
- Increased Sputum
Emphysema
- Pink Puffer
- Exhale through Pursed Lips
- Barrel Chest
- Obstructive Lung Disease
- Increased Lung Compliance
- Centriacinar
- Panacinar
Pneumonia Assessment
- Older Adult
- Immunocompromised
- Long Term Care
- Shortness of Breath (SOB)
- Hypoxemia
- Cough and Sputum Production
- Wheezing or Crackles
- Fever
- Pleuritic Pain
- Chest X-ray
Pneumonia Intervention
- Humidified Oxygen
- Deep Breathing Exercises
- Position of Comfort
- Increase Fluid Intake
- Manage Fever
- Antibiotics
- Mucolytics
- Expectorants
- Pneumococcal Vaccine
- Sepsis
- Acute Respiratory Failure (ARF)
- Prevention Education
Mycobacterium Tuberculosis Characteristics
- Mycolic Acid Cell Wall
- Acid-fast
- Carbolfuchsin Stain Red
- Lowenstein-Jensen Agar
- Serpentine Cord Factor
- Primary TB
- Caseating Granuloma
- Ghon Focus
- Hilar Lymph Nodes
- Ghon Complex
- Reactivation TB
- Reactivation in Apex
Mycobacterium Tuberculosis Disease
- Fever
- Night Sweats
- Weight Loss
- Hemoptysis
- Extrapulmonary Disease
- Addison's Disease
- CNS
- Liver
- Kidneys
- GI
- Bones
- Pott's Disease
Tuberculosis Intervention
- Airborne Isolation
- Combination Drug Therapy (RIPE)
- 6-12 Months
- DOT
- BCG Vaccination
- Medication Education
- 3 Negative Sputum Specimens
- Infection Control
Cystic Fibrosis Mechanisms
- Autosomal Recessive
- CFTR Chromosome 7
- Cl- channel Defect
- Decreased Chloride Secretion
- Increased Na and Water Reabsorption
- Increased Na and Cl in Sweat
- Dehydration of Mucous Layers
Cystic Fibrosis Symptoms and Complications
- Recurrent Pulmonary Infections
- Chronic Bronchitis
- Nasal Polyps
- Pancreatic Insufficiency
- Intestinal Obstruction
- Malabsorption and Diarrhea
- Vitamin Deficiencies
- Chronic Hepatic Disease
- Infertility in Males
Cystic Fibrosis Diagnosis and Treatment
- Sweat Chloride Test > 60 mmol/L
- Meconium Ileus
- N-acetylcysteine
- Antibiotic Prophylaxis
- Pulmonary Maintenance
- Lung Transplant
- Vitamin Replacement
Tension Pneumothorax
- Air Enters Pleural Space, but Can't Exit
- Trauma or Infection
- Decreased Breath Sounds
- Trachea Deviates Away from Affected Side
- Chest Pain
- Tachycardia
- Tachypnea
- Hypotension
- Hypoxemia
- Hyperresonance
- Emergency
Spontaneous Pneumothorax
- Accumulation of Air in Pleural Space
- Tall and Thin Young Males
- Bleb or Bulla Rupture
- Underlying Disease
- Hypoxemia
- Chest Pain
- Decreased Breath Sounds
- Hyperresonance
- Shortness of Breath (SOB)
Pulmonary Embolism Presentation and Diagnosis
- Sudden onset Shortness of Breath (S.O.B.)
- Tachypnea
- Pleuritic Chest Pain
- Hemoptysis
- Hypoxemia
- Sudden Death
- Gold Standard: CT Pulmonary Angiography
- X-Ray
- D-Dimer
- V/Q Scan
Pulmonary Embolism Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Hypercoagulable
- Central Venous Lines
- Immobilized
Croup (Laryngotracheobronchitis)
- Parainfluenza Virus
- 3 Months to 3 Years
- Nighttime
- Barking Seal Cough
- Inspiratory Stridor
- Cool Humidified Air
- Dexamethasone
- Racemic Epinephrine
Obstructive Sleep Apnea (OSA)
- Narrowed or Obstructed Air Passage
- Apnea
- Loud Snoring
- Startle Response
- Daytime Drowsiness
- Positional Therapy
- Oral Appliance
- Continuous Positive Airway Pressure (CPAP)
- Surgery
- Weight Loss
Acute Respiratory Distress Syndrome (ARDS) Assessment
- Damaged Alveolar-Capillary Membrane
- Restlessness
- Dyspnea
- Refractory Hypoxemia
- Decreased PaO2
- Diffuse Pulmonary Infiltrates
- Atelectasis
- Pulmonary Hypertension
Acute Respiratory Distress Syndrome (ARDS) Interventions
- Closely Monitor Patient
- ABG's (Arterial Blood Gases)
- Oxygen
- Assess for O2 Toxicity
- Mechanical Ventilation
- PEEP
- Assess for Pneumothorax
- Permissive Hypercapnia
- High Mortality Rate
Influenza
- High Fever
- Cough
- Headache
- Muscle Aches
- Chills
- Vaccination
- Zanamivir (Relenza)
- Oseltamivir (Tamiflu)
Deep Vein Thrombosis (DVT) Characteristics
- Virchow's Triad
- Venous Stasis
- Endothelial Damage
- Hypercoagulability
- Tenderness
- Homan's Sign
- Warmth
- Redness
- Swelling
- Asymptomatic
Deep Vein Thrombosis (DVT) Management
- Compression Ultrasound (CUS) with Doppler
- D-Dimer
- Contrast Venography
- IVC Filter
- Heparin for Acute Management
- Warfarin for Long-term Management
- Thrombectomy/Thrombolysis
- Stockings
- Walking
Sarcoidosis Characteristics and Labs
- Unknown Mechanism
- Immune-mediated
- Noncaseating granulomas
- Vitamin D activation
- Hypercalcemia
- Elevated ACE
- Asteroid bodies
- X-Ray shows Bilateral hilar lymphadenopathy
- Corticosteroids
Sarcoidosis Symptoms
- Black Females
- Asymptomatic
- Uveitis
- Interstitial Fibrosis
- Erythema Nodosum
- Hepatomegaly
- Myocardial Sarcoidosis
- Lupus Pernio
Cyanide Poisoning: Pathophysiology and Clinical Manifestation
- Inhibits Complex IV of Oxidative Phosphorylation
- Forces Cells Into Anaerobic Metabolism
- Exposure to Fire Fumes
- Industrial Exposure
- Headache and Confusion
- Arrhythmias
- "Cherry Red" Skin
- Almond Breath/Taste
- Acute Renal Failure
Cyanide Poisoning Diagnosis and Treatment
- Lactic Acidosis
- Elevated Venous PO2
- Check Carboxyhemoglobin
- Sodium Nitrate PLUS Sodium Thiosulfate
- Methemoglobinemia
- OR Hydroxocobalamin (First Line)
Pulmonary Hypertension Diagnosis and Management
- Echocardiogram
- Right Heart Cathetherization
- > 20 mmHg at Rest
- Chest X-Ray
- Treat Underlying Disorder
- Calcium Channel Blockers
- Endothelin Receptor Antagonists
- Prostacyclin Analogs
- PDE-5 inhibitors
Pulmonary Hypertension Classification (WHO)
- Pulmonary Arterial Hypertension
- Idiopathic
- Hereditary
- BMPR2 Mutation
- Left Heart Disease
- Lung Diseases or Hypoxia
- COPD
- Obstructive Sleep Apnea
- Chronic Pulmonary Emboli
- Multifactorial
Mesothelioma
- Malignant Pleural Tumor
- Asbestos Exposure
- Dyspnea
- Decreased Breath Sounds
- Constitutional B Symptoms
- Hemorrhagic Pleural Effusion
- Pleural Thickening
- Psammoma Bodies
- Calretinin
- Surgery
- Chemotherapy
Atypical Pneumonia
- Diffuse Patchy Inflammation
- Interstitial Pattern
- "Walking Pneumonia"
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- Legionella pneumophila
- Adenovirus
- Respiratory Syncytial Virus (RSV)
- Cytomegalovirus (CMV)
- Influenza
- Dry Cough
- Macrolides
Pneumothorax
- Air Enters Pleural Space
- Sudden Dyspnea
- Absent or Restricted Movement on Affected Side
- Decreased or Absent Breath Sounds on Affected Side
- Chest Pain
- Tracheal Deviation
- Vital Sign Changes
- Crepitus
- High Fowler's Position With Oxygen
- Prepare For Chest Tube Placement
- Educate High Risk Patients
Flail Chest
- Trauma
- Shallow Respirations
- Chest Pain
- Paradoxical Chest Movement
- Mechanical Ventilation
- Analgesics
- Intercostal Nerve Blocks
- Surgical Rib Fixation
- Monitor Pulmonary Contusion
Idiopathic Pulmonary Fibrosis
- Interstitial Restrictive Lung Disease
- Age over 50 years, Males, Tobacco
- Dyspnea and Cough
- Fatigue
- Crackles
- Digital Clubbing
- Bronchiectasis
- Honeycomb Pattern
- Restrictive Pattern
- Respiratory Failure
- Right Heart Failure
- Oxygen
- Antifibrotic Medications
- Lung Transplant