What causes polycythemia in a patient with lung disease?
Chromic hypoxia, causes increase in hematocrit
What conditions are seen most in patients with lung disease?
Hypoxia and hypoxemia
Tension pneumothorax clinical manifestations:
Mediastinal shift / compression
Decreased cardiac output
To get someone ready for hemodialysis what do we do in their arm?
AV fistula
BUN labs
8-20 mg/dL
Creatinine labs
0.6-1.2 mg/dL
GFR labs
90-120 ml/min/1.73m2
Which lab value would we expect to be decreased with chronic renal disease?
GFR
Who would be most at risk for adelectasis?
Surgery, pain meds, anesthetics, infection
What is atelectasis?
Incomplete expansion of lung
hemoptysis
bloody sputum
hypercapnia
excessive carbon dioxide in the blood
WILL BE ACIDOTIC
What is the mechanical effect of pleural effusion?
Compression
What pathological process could cause Kussmaul's breathing?
Metabolic acidosis
Kussmaul breathing
rapid deep breathing
What causes clubbing of the fingers?
chronic hypoxemia, lack of oxygen
Why is tension pneumothorax life-threatening?
Air enters the pleural space during inhalation and does not exit with exhalation. Air accumulates increasing pressure and can collapse lung
What is central cyanosis?
Lips, tongue, tip of nose
SA: clinical manifestations of pleural effusion
Atelectasis
SOA
Pleuritic pain from inflammation
Absent breath sounds at site of effusion
Non-productive cough
Pleural friction rub over areas of effusion
Impaired ventilation
Mediastinal shift
Fluid in pleural space
How do we treat a pneumothorax? How do we get the air out?
Large bore needle or chest tube on the affected side along with one way valve drainage or suction to aid in re-expansion
Who is most at risk for spontaneous pneumothorax?
Men ages 10-30 that are tall and thin
What is the adaptive mechanism of hypoxemia?
Increased heart rate and respiratory rate in order to circulate blood
Hypoxia
Decreased oxygen of cells of tissues
Emphysema
Loss of lung elasticity and hyperinflation of lungs resulting in air trapping, flat diaphragm, Bullae formation, increased work of breathing, and air hunger
hypoxemia
Below normal level of oxygen in your blood, specifically in the arteries
What do you see in a patient with subcutaneous emphysema?
Gas or air travels and is trapped under the skin
What causes respiratory alkalosis?
hyperventilation
What is the major cause of acute respiratory acidosis?
Hypoventilation
In hypoxia, what might the body do to get more oxygen circulating
Increase in RBC count
You are auscultating a patient that had surgery and they are SOA, respirations are high and labored, listening to lung there is an absence of breath sounds. The patient has
Pneumothorax
Best way to get a definitive diagnosis for TB
Obtaining a culture (sputum, GI secretions, bronchial washings)
How does TB transfer?
Airborne, droplet with cough and sneeze
Pathophysiology of bronchiectasis
Permanent dilation of bronchi and bronchioles from muscle and elastic support caused by frequent infection and inflammation
How to test and treat TB?
Treatment: INH most frequently used
What is the best way to manage the spread of TB?
Testing and vaccines
Major risk factor for lung cancer
Smoking, age
Clinical manifestations of renal cell carcinoma
Hematuria, flank pain, flank mass, edema, urine output
Tumor often large when detected
May involve inferior vena cava
Assessment data that would suggest nephrotic syndrome
Massive proteinuria and lipiduria, hypoalbuminemia, edema, hyperlipidemia, generalized edema from decreased colloid osmotic pressure from hypoalbuminemia
Also sodium and water retention resulting systemic and pulmonary edema
Glomerular filtration rate is
Beta Strep infection causes what renal pathology
Renal postinfectious glomerulonephritis
What is the prerenal cause of renal failure
Decreased blood flow to kidneys
What is the post renal cause of renal failure
Obstruction to urine flow from the kidneys- resulting in hydronephrosis (prostate obstruction)
Why does anemia occur with chronic renal failure
Erythropoietin deficiency
What is the bacteria that causes acute cystitis
E. Coli
What is azotemia?
Increase in serum urea, Uric acid, and creatinine
What causes azotemia?
Acute renal injury indicator
Pathophysiology of hydronephrosis
Urine dilates pelvis and calyces of kidney resulting in renal atrophy
GFR
The flow rate of filtered fluid through the kidney each minute
community acquired pneumonia
Onset outside of hospital or within 48 hours of hospital admission
Pathophysiology of asthma
Bronchoconstriction with inflammation
Pathophysiology of pneumothorax
Air in pleural space- from rupture of visceral pleura or parietal pleura and chest wall