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Author Question: In the emergency room, a chest tube was inserted into the left thorax with drainage under suction. ... (Read 84 times)

V@ndy87

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In the emergency room, a chest tube was inserted into the left thorax with drainage under suction. Subsequently the oropharynx was cleared. A resuscitation bag and mask were used to ventilate the patient with high-flow oxygen.
 
  Endotracheal intubation was then performed, using a laryngoscope so the trachea could be directly visualized to place a 8.0 endotracheal tube. The patient was then ventilated with the help of a volume-cycled ventilator. Initial ventilator settings are Assist-Control mode, frequency = 12 breaths/min, with an FiO2 of 100, a positive end-expiratory pressure (PEEP) of 6 cm H2O, and a tidal volume of 400 mL (8 cc/kg of his IBW). Daily chest radiographs and ABGs were used each AM to adjust the ventilator settings. Define the following terms found in the history and physical for Mr. Hayato.

Question 2

Mr. Hayato was diagnosed with emphysema more than 10 years ago. Define emphysema and explain its underlying pathophysiology.
 
  What will be an ideal response?



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trampas

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Answer to Question 1

a. Dyspnea: shortness of breath or difficulty breathing
b. Orthopnea: discomfort breathing brought on by or made worse by lying flat
c. Pneumothorax: presence of air or gas in the pleural cavity
d. Endotracheal intubation: insertion of a tube into the trachea for control of pulmonary ventilation
e. Cyanosis: dark blue or purple color due to decreased oxygenation of the tissues

Answer to Question 2

 Emphysema is part of a group of disorders called chronic obstructive pulmonary disease (COPD).
The other major category of COPD is chronic bronchitis.
These conditions lead to progressive damage to the lungs, which obstructs air flow and often results in respiratory failure.
 Emphysema results from irreversible destruction of lung tissue that causes loss of elasticity in the alveoli.
Healthy alveoli provide a rigid structure to bronchioles that allow the airways to remain open.
In emphysema, the tissue loses its elasticity and collapses when air is exhaled.
 This destruction is generally due to exposure to cigarette smoke, though genetics may play a role in susceptibility.
 Due to hyperinflation of the lungs to accommodate difficult expiration, a barrel chest and wasting of skeletal muscle mass occurs.





 

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