Overview
This lecture covers key points about lung cancer risk factors and prevention, flu precautions and treatment, asthma pathophysiology and management, and an in-depth case study on pneumonia assessment and care.
Lung Cancer: Risk Factors & Prevention
- Smoking is the main risk factor for lung cancer; others include COPD, obesity, and inhaled irritants.
- Prevention focuses on smoking cessation and using protective filters or masks when exposed to chemicals/irritants.
- Treatment involves chemotherapy, radiation (including brachytherapy), and/or surgical removal (e.g., lobectomy via thoracotomy).
- Post-surgical care includes monitoring the incision and possible chest tube management.
Influenza (Flu): Precautions & Management
- Flu is transmitted via droplets; wear a surgical mask within 3–6 feet of the patient.
- Test specimens for flu are often kept on ice before lab analysis.
- Antivirals are effective within 48 hours but often have significant side effects.
- Pneumonia is a serious complication of the flu.
- Prevention includes annual vaccination, hand hygiene, and avoiding crowds.
- Avian flu (H5N1) requires airborne precautions due to high contagion and potential lethality.
Asthma: Pathophysiology & Case Study
- Asthma is characterized by bronchospasm, airway edema (swelling), and increased mucus production.
- Peak flow meters help patients monitor airflow and recognize when to adjust treatment before symptoms worsen.
- Acute asthma assessment focuses on respiratory rate, oxygenation, accessory muscle use, and signs of distress.
- ABGs (arterial blood gases): low SaO2/PaO2 and high PaCO2 indicate impaired gas exchange and risk for respiratory failure.
- Treatments include bronchodilators (e.g., albuterol), anticholinergics (e.g., ipratropium), and corticosteroids (e.g., fluticasone).
- Inhaler use: bronchodilators are taken first, followed by other medications for better effectiveness.
- Proper inhaler technique is essential; use spacers if coordination is an issue, and rinse mouth after steroid inhalers.
Pneumonia: Clinical Assessment & Management
- Pneumonia causes excess fluid in the lungs and is identified by consolidation (decreased air movement from fluid/inflammation).
- Can be bacterial, viral, or from inhaled irritants; may be community or hospital acquired.
- Vaccination is recommended for those 65+ years old.
- Clinical assessment includes history, oxygen saturation, use of accessory muscles, breath sounds (e.g., crackles, diminished sounds), and respiratory distress.
- Lab findings: elevated WBCs, bands, and neutrophils indicate infection; high CO2 and low PaO2/SaO2 signal impaired gas exchange.
- High lactate indicates anaerobic metabolism due to hypoxia.
- Common interventions: oxygen, bronchodilators, steroids, antibiotics, antipyretics, and anxiety management.
Key Terms & Definitions
- Bronchospasm — sudden constriction of the muscles in the walls of the bronchioles.
- Edema — swelling caused by fluid accumulation.
- Peak flow meter — device that measures maximum speed of exhalation to monitor asthma.
- SaO2 (arterial oxygen saturation) — percentage of hemoglobin binding sites in the bloodstream occupied by oxygen.
- PaO2 — partial pressure of oxygen dissolved in plasma (normal: 80-100 mm Hg).
- PaCO2 — partial pressure of carbon dioxide in plasma (normal: 35-45 mm Hg).
- Consolidation — solidification of lung tissue due to accumulation of fluid, often seen in pneumonia.
- Bands — immature neutrophils, increased in acute infection.
- Respiratory failure — inadequate gas exchange (low O2, high CO2).
Action Items / Next Steps
- Review chest tube care and thoracotomy for next week.
- Practice interpreting ABGs and reviewing inhaler techniques.
- Complete reading and case studies assigned in Brightspace.
- Prepare for continued discussion of pneumonia and respiratory failure management.