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Respiratory Disorders

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Pathology | Nurse Practitioner (NP) School Study Aid

Respiratory Disorders
42 Picmonics to Learn | 1 hr 25 mins
Hypoxia (Early Symptoms)
Diaphoresis
Restlessness
Tachypnea
Dyspnea on Exertion
Tachycardia
Hypertension
Arrhythmias
Decreased Urine Output
Unexplained Fatigue
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1 min
Hypoxia (Late Symptoms)
Cyanosis
Cool, Clammy Skin
Use of Accessory Muscles
Retractions
Hypotension
Arrhythmias
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2 mins
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
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2 mins
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
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2 mins
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
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51 secs
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
Causes
Inhaled Toxins
Smoking
AAT Deficiency
Assessment
Emphysema
Chronic Bronchitis
Asthma
Considerations
Spirometry
Slow Progression
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2 mins
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
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2 mins
Asthma Implementation and Education
Medication
Oxygen
Corticosteroids
Ipratropium (Anticholinergic)
Albuterol
Implementation
Inhaler/nebulizer
Pulse Oximetry
Pursed Lip Breathing
Education
Carry Inhaler
Rinse Mouth after Inhaler
Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
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2 mins
Chronic Bronchitis
Pathophysiology
Chronic Inflammation of Bronchi
Signs and Symptoms
Early-Onset Cyanosis
Blue Bloaters
Productive Cough
Wheezing
Chronic Obstructive Pulmonary Disease (COPD)
Late-Onset Dyspnea
Crackles
Diagnosis
Reid Index > 50%
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2 mins
Chronic Bronchitis Interventions
Tripod Position
Humidified Oxygen
Pursed Lip Breathing
Increase Fluid Intake
ABGs
Early Detection of Exacerbation
Considerations
Lowest O2 Therapy
Assisted Ventilation
Increased Infection Risk
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2 mins
Bronchiectasis
Obstructive Lung Disease
Chronic Necrotizing Infection
Permanent Airway Dilation
Poor Ciliary Motility
Kartagener's Syndrome
Cystic Fibrosis
Allergic Bronchopulmonary Aspergillosis
Hemoptysis
Increased Sputum
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2 mins
Emphysema
Clinical Features
Pink Puffer
Exhale through Pursed Lips
Barrel Chest
Pathophysiology
Obstructive Lung Disease
Increased Lung Compliance
Types
Centriacinar
Panacinar
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2 mins
Pneumonia Assessment
Risk Factors
Older Adult
Immunocompromised
Long Term Care
Assessment
Shortness of Breath (SOB)
Hypoxemia
Cough and Sputum Production
Wheezing or Crackles
Fever
Pleuritic Pain
Diagnosis
Chest X-ray
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2 mins
Pneumonia Intervention
Interventions
Humidified Oxygen
Deep Breathing Exercises
Position of Comfort
Increase Fluid Intake
Manage Fever
Medications
Antibiotics
Mucolytics
Expectorants
Considerations
Pneumococcal Vaccine
Sepsis
Acute Respiratory Failure (ARF)
Prevention Education
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2 mins
Mycobacterium Tuberculosis Characteristics
Characteristics
Mycolic Acid Cell Wall
Acid-fast
Carbolfuchsin Stain Red
Lowenstein-Jensen Agar
Serpentine Cord Factor
Primary TB
Primary TB
Caseating Granuloma
Ghon Focus
Hilar Lymph Nodes
Ghon Complex
Reactivation TB
Reactivation TB
Reactivation in Apex
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3 mins
Mycobacterium Tuberculosis Disease
CONSTITUTIONAL SYMPTOMS/PULMONARY TUBERCULOSIS
Fever
Night Sweats
Weight Loss
Hemoptysis
EXTRA-PULMONARY TUBERCULOSIS
Extrapulmonary Disease
Addison's Disease
CNS
Liver
Kidneys
GI
Bones
Pott's Disease
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3 mins
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
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2 mins
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
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2 mins
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
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1 min
Cystic Fibrosis Diagnosis and Treatment
Diagnosis
Sweat Chloride Test > 60 mmol/L
Meconium Ileus
Treatment
N-acetylcysteine
Antibiotic Prophylaxis
Pulmonary Maintenance
Lung Transplant
Vitamin Replacement
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1 min
Tension Pneumothorax
Mechanism
Air Enters Pleural Space, but Can't Exit
Trauma or Infection
Signs and Symptoms
Decreased Breath Sounds
Trachea Deviates Away from Affected Side
Chest Pain
Tachycardia
Tachypnea
Hypotension
Hypoxemia
Hyperresonance
Emergency
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2 mins
Spontaneous Pneumothorax
Mechanism
Accumulation of Air in Pleural Space
Tall and Thin Young Males
Bleb or Bulla Rupture
Underlying Disease
Signs and Symptoms
Hypoxemia
Chest Pain
Decreased Breath Sounds
Hyperresonance
Shortness of Breath (SOB)
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1 min
Pulmonary Embolism Presentation and Diagnosis
Presentation
Sudden onset Shortness of Breath (S.O.B.)
Tachypnea
Pleuritic Chest Pain
Hemoptysis
Hypoxemia
Sudden Death
Diagnosis
Gold Standard: CT Pulmonary Angiography
X-Ray
D-Dimer
V/Q Scan
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1 min
Pulmonary Embolism Causes
Causes
FAT BAT Mnemonic
Fat
Air
Deep Vein Thrombosis (DVT)
Bacteria
Amniotic Fluid
Tumor
Risk Factors
Hypercoagulable
Central Venous Lines
Immobilized
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1 min
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
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2 mins
Obstructive Sleep Apnea (OSA)
Cause/Mechanism
Narrowed or Obstructed Air Passage
Assessment
Apnea
Loud Snoring
Startle Response
Daytime Drowsiness
Interventions
Positional Therapy
Oral Appliance
Continuous Positive Airway Pressure (CPAP)
Surgery
Considerations
Weight Loss
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3 mins
Acute Respiratory Distress Syndrome (ARDS) Assessment
Cause
Damaged Alveolar-Capillary Membrane
Assessment
Restlessness
Dyspnea
Refractory Hypoxemia
Decreased PaO2
Diffuse Pulmonary Infiltrates
Atelectasis
Pulmonary Hypertension
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2 mins
Acute Respiratory Distress Syndrome (ARDS) Interventions
Interventions
Closely Monitor Patient
ABG's (Arterial Blood Gases)
Oxygen
Assess for O2 Toxicity
Mechanical Ventilation
PEEP
Assess for Pneumothorax
Permissive Hypercapnia
Considerations
High Mortality Rate
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2 mins
Deep Vein Thrombosis (DVT) Characteristics
Mechanism
Virchow's Triad
Venous Stasis
Endothelial Damage
Hypercoagulability
Symptoms
Tenderness
Homan's Sign
Warmth
Redness
Swelling
Asymptomatic
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1 min
Deep Vein Thrombosis (DVT) Management
Diagnosis
Compression Ultrasound (CUS) with Doppler
D-Dimer
Contrast Venography
Treatment
IVC Filter
Heparin for Acute Management
Warfarin for Long-term Management
Thrombectomy/Thrombolysis
Stockings
Walking
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4 mins
Sarcoidosis Symptoms
Black Females
Symptoms
Asymptomatic
Uveitis
Interstitial Fibrosis
Erythema Nodosum
Hepatomegaly
Myocardial Sarcoidosis
Lupus Pernio
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1 min
Sarcoidosis Characteristics and Labs
Mechanism
Unknown Mechanism
Immune-mediated
Noncaseating granulomas
Vitamin D activation
Labs
Hypercalcemia
Elevated ACE
Asteroid bodies
X-Ray shows Bilateral hilar lymphadenopathy
Treatment
Corticosteroids
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1 min
Cyanide Poisoning: Pathophysiology and Clinical Manifestation
Pathophysiology
Inhibits Complex IV of Oxidative Phosphorylation
Forces Cells Into Anaerobic Metabolism
Presentation
Exposure to Fire Fumes
Industrial Exposure
Headache and Confusion
Arrhythmias
"Cherry Red" Skin
Almond Breath/Taste
Acute Renal Failure
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4 mins
Cyanide Poisoning Diagnosis and Treatment
Lab Findings
Lactic Acidosis
Elevated Venous PO2
Check Carboxyhemoglobin
Management
Sodium Nitrate PLUS Sodium Thiosulfate
Methemoglobinemia
OR Hydroxocobalamin (First Line)
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4 mins
Pulmonary Hypertension Diagnosis and Management
Diagnosis
Echocardiogram
Right Heart Cathetherization
> 20 mmHg at Rest
Chest X-Ray
MANAGEMENT
Treat Underlying Disorder
Calcium Channel Blockers
Endothelin Receptor Antagonists
Prostacyclin Analogs
PDE-5 inhibitors
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2 mins
Pulmonary Hypertension Classification (WHO)
Group 1
Pulmonary Arterial Hypertension
Idiopathic
Hereditary
BMPR2 Mutation
Group 2
Left Heart Disease
Group 3
Lung Diseases or Hypoxia
COPD
Obstructive Sleep Apnea
Group 4
Chronic Pulmonary Emboli
Group 5
Multifactorial
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2 mins
Mesothelioma
Characteristics
Malignant Pleural Tumor
Asbestos Exposure
Presentation
Dyspnea
Decreased Breath Sounds
Constitutional B Symptoms
Diagnosis 
Hemorrhagic Pleural Effusion
Pleural Thickening
Psammoma Bodies
Calretinin
Interventions
Surgery
Chemotherapy
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2 mins
Atypical Pneumonia
CHARACTERISTICS
Diffuse Patchy Inflammation
Interstitial Pattern
"Walking Pneumonia"
Etiologies
Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumophila
Adenovirus
Respiratory Syncytial Virus (RSV)
Cytomegalovirus (CMV)
Influenza
Presentation
Dry Cough
Treatment
Macrolides
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2 mins
Pneumothorax
Mechanism
Air Enters Pleural Space
Assessment
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
Considerations
High Fowler's Position With Oxygen
Prepare For Chest Tube Placement
Educate High Risk Patients
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2 mins
Flail Chest
Cause/Mechanism
Trauma
Assessment
Shallow Respirations
Chest Pain
Paradoxical Chest Movement
Interventions
Mechanical Ventilation
Analgesics
Intercostal Nerve Blocks
Considerations
Surgical Rib Fixation
Monitor Pulmonary Contusion
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2 mins
Alpha 1 Antitrypsin Deficiency
Characteristics
Decreased Alpha Anti Trypsin
Increased Elastase Activity
Decreased Elastic Tissue
Misfolded Protein Aggregates
PAS+ Globules
Clinical Features
Panacinar Emphysema
Dyspnea
Cirrhosis
Hepatocellular Carcinoma
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2 mins
Idiopathic Pulmonary Fibrosis
Interstitial Restrictive Lung Disease
Age over 50 years, Males, Tobacco
CLINICAL FEATURES
Dyspnea and Cough
Fatigue
Crackles
Digital Clubbing
DIAGNOSIS
Bronchiectasis
Honeycomb Pattern
Restrictive Pattern
COMPLICATIONS
Respiratory Failure
Right Heart Failure
TREATMENT
Oxygen
Antifibrotic Medications
Lung Transplant
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5 mins

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