Respiratory RNSG2504
Terms
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- Cavitation
- The developmant of cavities in the lung tissue in pulmonary TB.
- Complement
- Protiens in the blood which act by directly lysing organisms. These proteins are dormant in the blood unless activated by either classic or alternative pathways.
- Consolidation
- The process of becoming solid. Consolidation of the lungs is caused by pathological engorgment of the lung tissue as occurs in pneumonia.
- Empyema
- A collection of inflamed, infected fluid in a body cavity, typically between the pleura.
- What is the etiology of empyema?
- Usually caused by spread of infection from a pneumonia or lung abcess, but may be caused by organisms brought to the pleural space via the blood or lymphatic system or an abcess extending upward from below the diaphragm.
- What are the S/S of Empyema?
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Fever, sweats, malaise, anorexia and fatigue.
Patients usually present tachycardia, cough, dyspnea, and pain at site.
Depending on the amount of pus or fluid present, there may be unequal chest expansion, dullness to percussion, decreased or absent breath sounds over involved area. - Fibrosis
- Results in the replacement of normal organ tissue with scar tissue.
- Macrophages
- Major phagocytic cells of the immune system, which have the ability to recognize and ingest foriegn antigens through receptors on the surface of their cell membranes. They are found in large quantities in the spleen, lymph nodes, alveoli, and tonsils. 50% are found in the liver as kupffer cells.
- Tension Pneumothorax
- Air drawn into the pleural space from a laceration or small hole in the chest wall. This creates a one-way valve effect. The air drawn in on each inspiration is trapped and cannot be expelled. With each breath the posiitve pressure inside the affected pleural space is increased causing the lung to colapse and the heart,great vessels, and trachea to shift towards the unaffected side (mediastinal shift). Due to increased intrathoracic pressure, both respiratory and circulatory fx are compromised.
- Tension Pneumothorax clinical manifestations
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Decreased venous return, decreased Cardiac Output, impairment of peripheral circulation. In extreme cases pulseless electrical activity (undetectable pulse).
Patient presents with air hunger, agitation, increased hypoxemia, central cyanosis, hypotension, tachycardia,profuse diaphoresis. - Medical management of Tension Pneumothorax
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Immediate high concentrations of O2 to treat hypoxemia, pulse ox to monitor oxygen saturation.
Use of a 14-guage needle inserted into the 2nd intercostal space, at mid-clavicular line of affected side can be used in an emergency situation to vent positive pressure to outside enviroment. - Traumatic pnuemothorax
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Results from air escaping from lung itself and entering pleural space or air entering the pleural space through wound.
Can occur with blunt trauma or penetrating chest trauma, diaphragmatic tears. Can also occur as a result of invasive thoracic procedures such as thoracentesis, transbronchial biopsy, insertion of a subclavian line, or as a result of mechanical ventilation (barotrauma). - Open Pneumothorax
- Occurs as a result of a wound that is large enough to allow air to pass freely in and out of thoracic cavity with each attempted respiration.
- Open pneumothorax (sucking chest wounds)
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The rush of air through the chest wall produces a "sucking sound".
In these patients the lung collapses, and the heart and great vessels shift towards uninjured side upon inspiration and the opposite direction upon expiration. This is termed mediastinal swing or flutter and produces serious circulatory problems.