Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep. There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring. Treatments for obstructive sleep apnea are available. One treatment involves using a device that uses positive pressure to keep your airway open while you sleep. Another option is a mouthpiece to thrust your lower jaw forward during sleep. In some cases, surgery may be an option too.
CCRN Obstructive Sleep Apnea Review - Signs and Symptoms
Excessive daytime sleepiness
Observed episodes of stopped breathing during sleep
Abrupt awakenings accompanied by gasping or choking
Awakening with a dry mouth or sore throat
Difficulty concentrating during the day
Experiencing mood changes, such as depression or irritability
High blood pressure
CCRN Obstructive Sleep Apnea Review - Causes
Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the back of the roof of your mouth (soft palate), the triangular piece of tissue hanging from the soft palate (uvula), the tonsils and the tongue. When the muscles relax, your airway narrows or closes as you breathe in and breathing may be inadequate for 10 seconds or longer. This may lower the level of oxygen in your blood and cause a buildup of carbon dioxide. Your brain senses this impaired breathing and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it. You can awaken with shortness of breath that corrects itself quickly, within one or two deep breaths. You may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you'll probably feel sleepy during your waking hours. People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they slept well all night.
During this sleep study, you're hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
Home sleep apnea testing
Under certain circumstances, your doctor may provide you with an at-home version of polysomnography to diagnose obstructive sleep apnea. This test usually involves measurement of airflow, breathing patterns and blood oxygen levels, and possibly limb movements and snoring intensity.
CCRN Obstructive Sleep Apnea Review (2020) - Other CCRN Related Courses
Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.
CCRN Asthma Review - Signs and Symptoms
Shortness of breath
Chest tightness or pain
Trouble sleeping caused by shortness of breath, coughing or wheezing
A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu
CCRN Asthma Review - Causes
Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:
Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
Respiratory infections, such as the common cold
Physical activity (exercise-induced asthma)
Air pollutants and irritants, such as smoke
Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
Strong emotions and stress
Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
CCRN Asthma Review - Risk Factors
Having a blood relative (such as a parent or sibling) with asthma
Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
Being a smoker
Exposure to secondhand smoke
Exposure to exhaust fumes or other types of pollution
Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
CCRN Asthma Review - Complications
Signs and symptoms that interfere with sleep, work or recreational activities
Sick days from work or school during asthma flare-ups
Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe
Emergency room visits and hospitalizations for severe asthma attacks
Side effects from long-term use of some medications used to stabilize severe asthma
CCRN Asthma Review - Treatments
Prevention and long-term control are key in stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler, such as albuterol.
CCRN Asthma Review (2020) - Other CCRN Related Courses
A pneumonectomy is a type of surgery to remove one of your lungs because of cancer, trauma, or some other condition.
You have two lungs: a right lung and a left lung. These lungs connect to your mouth through a series of tubes. Through these tubes, the lungs bring oxygen into the body and remove carbon dioxide from the body. Oxygen is necessary for all functions of your body. Carbon dioxide is a waste product that the body needs to get rid of. Most people can get by with only one lung instead of two, if needed. Usually, one lung can provide enough oxygen and remove enough carbon dioxide, unless the other lung is damaged.
CCRN Pneumonectomy Review - Indications For Surgery
The most common reason for a pneumonectomy is to remove tumorous tissue arising from lung cancer. In the days prior to the use of antibiotics in tuberculosis treatment, tuberculosis was sometimes treated surgically by pneumonectomy.
The operation will reduce the respiratory capacity of the patient; before conducting a pneumonectomy, the surgeon will evaluate the ability of the patient to function after the lung tissue is removed. After the operation, patients are often given an incentive spirometer to help exercise their remaining lung and to improve breathing function.
A rib or two is sometimes removed to allow the surgeon better access to the lung.
Traumatic lung injury
Fungal infections of the lung
Congenital lung disease
Bronchial blockage with a destroyed lung
Pulmonary metastases (cancer that has spread to the lungs from another site in the body)
CCRN Pneumonectomy Review - Surgical Risks
Blood clot in the lung (pulmonary embolism)
Complications from anesthesia
Too much bleeding
Abnormal heart rhythms
Reduced blood flow to the heart
CCRN Pneumonectomy Review (2020) - Other CCRN Related Courses
Unstable angina is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead to a heart attack. Angina is a type of chest discomfort caused by poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). Angina, which may also be called angina pectoris, is often described as squeezing, pressure, heaviness, tightness or pain in your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. Angina may be a new pain that needs evaluation by a doctor, or recurring pain that goes away with treatment. Although angina is relatively common, it can still be hard to distinguish from other types of chest pain, such as the pain or discomfort of indigestion. If you have unexplained chest pain, seek medical attention right away.
PCCN Unstable Angina Review - Signs and Symptoms
Chest pain or discomfort, possibly described as pressure, squeezing, burning or fullness
Pain in your arms, neck, jaw, shoulder or back accompanying chest pain
Shortness of breath
PCCN Unstable Angina Review - Causes
The main cause is CAD.
PCCN Unstable Angina Review - Risk Factors
Lack of Exercise
PCCN Unstable Angina Review - Treatment
There are many options for angina treatment, including lifestyle changes, medications, angioplasty and stenting, or coronary bypass surgery. The goals of treatment are to reduce the frequency and severity of your symptoms and to lower your risk of a heart attack and death.
PCCN Unstable Angina Review (2020) - Most Current PCCN Exam Updates
Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure. This means the kidneys cannot remove waste and concentrated urine. In rare cases, rhabdomyolysis can even cause death.
PCCN Rhabdomyolysis Review - Signs and Symptoms
Dark, red, or cola-colored urine
Decreased urine output
Muscle stiffness or aching (myalgia)
Weakness of the affected muscles
Weight gain (unintentional)
PCCN Rhabdomyolysis Review - Causes
When muscle is damaged, a protein called myoglobin is released into the bloodstream. It is then filtered out of the body by the kidneys. Myoglobin breaks down into substances that can damage kidney cells.
Rhabdomyolysis may be caused by injury or any other condition that damages skeletal muscle.
Problems that may lead to this disease include:
Trauma or crush injuries
Use of drugs such as cocaine, amphetamines, statins, heroin, or PCP
Genetic muscle diseases
Extremes of body temperature
Ischemia or death of muscle tissue
Low phosphate levels
Seizures or muscle tremors
Severe exertion, such as marathon running or calisthenics
Lengthy surgical procedures
PCCN Rhabdomyolysis Review - Treatment
Treatment depends on the severity of the case, symptoms, and presence of additional health complications that may increase the risk of kidney damage. In severe cases, kidney damage can be irreversible without early treatment. One treatment method is intravenous fluid therapy. Large volumes of water are often administered to the veins for long time in order to rehydrate the body and flush out any myoglobin. Other treatment options for severe rhabdomyolysis include:
filtration of the blood (in very severe cases)
PCCN Rhabdomyolysis Review (2020) - Most Current PCCN Exam Updates
Acute coronary syndrome is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart. One such condition is a heart attack (myocardial infarction) — when cell death results in damaged or destroyed heart tissue. Even when acute coronary syndrome causes no cell death, the reduced blood flow changes how your heart works and is a sign of a high risk of heart attack. Acute coronary syndrome often causes severe chest pain or discomfort. It is a medical emergency that requires prompt diagnosis and care. The goals of treatment include improving blood flow, treating complications and preventing future problems.
PCCN Acute Coronary Syndrome Review - Signs and Symptoms
Chest pain (angina) or discomfort, often described as aching, pressure, tightness or burning
Pain spreading from the chest to the shoulders, arms, upper abdomen, back, neck or jaw
Nausea or vomiting
Shortness of breath (dyspnea)
Sudden, heavy sweating (diaphoresis)
Lightheadedness, dizziness or fainting
Unusual or unexplained fatigue
Feeling restless or apprehensive
PCCN Acute Coronary Syndrome Review - Causes
Acute coronary syndrome usually results from the buildup of fatty deposits (plaques) in and on the walls of coronary arteries, the blood vessels delivering oxygen and nutrients to heart muscles. When a plaque deposit ruptures or splits, a blood clot forms. This clot blocks the flow of blood to heart muscles. When the supply of oxygen to cells is too low, cells of the heart muscles can die. The death of cells — resulting in damage to muscle tissues — is a heart attack (myocardial infarction). Even when there is no cell death, the decrease in oxygen still results in heart muscles that don't work the way they should. This change may be temporary or permanent. When acute coronary syndrome doesn't result in cell death, it is called unstable angina.
Family history of chest pain, heart disease or stroke
History of high blood pressure, preeclampsia or diabetes during pregnancy
PCCN Acute Coronary Syndrome Review - Treatment
The immediate goals of treatment for acute coronary syndrome are:
Relieve pain and distress
Improve blood flow
Restore heart function as quickly and as best as possible
Long-term treatment goals are to improve overall heart function, manage risk factors and lower the risk of a heart attack. A combination of drugs and surgical procedures may be used to meet these goals.
PCCN Acute Coronary Syndrome Review (2020) - Most Current PCCN Exam Updates
Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body. In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.
PCCN Chronic Renal Failure Review - Signs and Symptoms
Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include:
Loss of appetite
Fatigue and weakness
Changes in how much you urinate
Decreased mental sharpness
Muscle twitches and cramps
Swelling of feet and ankles
Chest pain, if fluid builds up around the lining of the heart
Shortness of breath, if fluid builds up in the lungs
High blood pressure (hypertension) that's difficult to control
Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.
PCCN Chronic Renal Failure Review - Causes
Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years.
Diseases and conditions that cause chronic kidney disease include:
Type 1 or type 2 diabetes
High blood pressure
Glomerulonephritis, an inflammation of the kidney's filtering units (glomeruli)
Interstitial nephritis, an inflammation of the kidney's tubules and surrounding structures
Polycystic kidney disease
Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
Vesicoureteral reflux, a condition that causes urine to back up into your kidneys
Recurrent kidney infection, also called pyelonephritis
PCCN Chronic Renal Failure Review - Risk Factors
Factors that may increase your risk of chronic kidney disease include:
High blood pressure
Heart and blood vessel (cardiovascular) disease
Being African-American, Native American or Asian-American
Family history of kidney disease
Abnormal kidney structure
PCCN Chronic Renal Failure Review - Complications
Chronic kidney disease can affect almost every part of your body. Potential complications may include:
Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart's ability to function and may be life-threatening
Heart and blood vessel (cardiovascular) disease
Weak bones and an increased risk of bone fractures
Decreased sex drive, erectile dysfunction or reduced fertility
Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
Decreased immune response, which makes you more vulnerable to infection
Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium)
Pregnancy complications that carry risks for the mother and the developing fetus
Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival
PCCN Chronic Renal Failure Review - Treatment
Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure. Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If your kidneys become severely damaged, you may need treatment for end-stage kidney disease.
PCCN Chronic Renal Failure Review (2020) - Most Current PCCN Exam Updates
Ischemic bowel disease results from inadequate flow of oxygenated blood to the intestines. The extent of ischemic bowel disease can range from mild to severe based on the amount of damage from lack of oxygenated blood. This is a potentially serious condition and immediate medical care. The sooner ischemic bowel disease is treated, the more favorable the outcome.
PCCN Ischemic Bowel Review - Signs and Symptoms
Ischemic bowel disease may cause:
Cramping and abdominal pain
Frequent urge to defecate
Nausea or vomiting
PCCN Ischemic Bowel Review - Causes
Ischemic bowel disease occurs when an artery that supplies blood becomes blocked or narrowed. There are several possible causes of ischemic bowel disease, including:
Blockage in the arteries due to a tumor or blood clot
Narrowing of the arteries supplying blood to the bowel from atherosclerosis
Obstruction in the colon
Low blood pressure
Certain medications such as diuretics, chemotherapy drugs, or nonsteroidal anti-inflammatory drugs (NSAIDs)
PCCN Ischemic Bowel Review - Risk Factors
Ischemic bowel disease is more common in older adults. Other factors that may increase your chances of developing ischemic bowel disease include:
Shock induced by conditions such as blood stream infection and blood loss
Recent heart attack
Sustained heart arrhythmias
Peripheral artery disease (PAD)
Coronary artery bypass surgery (CABG) or other vascular surgeries
Certain medications that cause arteries to narrow
Sickle cell disease
PCCN Ischemic Bowel Review - Treatment
Treatment options depend on the severity of the ischemia and include the following:
PCCN Ischemic Bowel Review (2020) - Most Current PCCN Exam Updates
A heart attack occurs when the flow of blood to the heart is blocked. The blockage is most often a buildup of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The plaque eventually breaks away and forms a clot. The interrupted blood flow can damage or destroy part of the heart muscle.
PCCN Myocardial Infarction Review - Signs and Symptoms
Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back
Nausea, indigestion, heartburn or abdominal pain
Shortness of breath
Lightheadedness or sudden dizziness
PCCN Myocardial Infarction Review - Causes
A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks.
PCCN Myocardial Infarction Review - Risk Factors
Tobacco Use, HTN
Lack of Activity
Stress, Drug Use
PCCN Myocardial Infarction Review - Treatment
PCCN Myocardial Infarction Review (2020) - Most Current PCCN Exam Updates
Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat. Although hyperthyroidism can be serious if you ignore it, most people respond well once hyperthyroidism is diagnosed and treated.
PCCN Hyperthyroidism Review - Signs and Symptoms
Hyperthyroidism can mimic other health problems, which can make it difficult for your doctor to diagnose. It can also cause a wide variety of signs and symptoms, including:
Unintentional weight loss, even when your appetite and food intake stay the same or increase
Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute
Irregular heartbeat (arrhythmia)
Pounding of your heart (palpitations)
Nervousness, anxiety and irritability
Tremor — usually a fine trembling in your hands and fingers
Changes in menstrual patterns
Increased sensitivity to heat
Changes in bowel patterns, especially more frequent bowel movements
An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck
Fatigue, muscle weakness
Fine, brittle hair
Older adults are more likely to have either no signs or symptoms or subtle ones, such as an increased heart rate, heat intolerance and a tendency to become tired during ordinary activities.
PCCN Hyperthyroidism Review - Causes
Hyperthyroidism can be caused by a number of conditions, including Graves' disease, Plummer's disease and thyroiditis. Your thyroid is a small, butterfly-shaped gland at the base of your neck, just below your Adam's apple. The thyroid gland has an enormous impact on your health. Every aspect of your metabolism is regulated by thyroid hormones. Your thyroid gland produces two main hormones, thyroxine (T4) and triiodothyronine (T3), that influence every cell in your body. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate, and help regulate the production of protein. Your thyroid also produces a hormone that helps regulate the amount of calcium in your blood (calcitonin).
PCCN Hyperthyroidism Review - Risk Factors
Risk factors for hyperthyroidism, include:
A family history, particularly of Graves' disease
A personal history of certain chronic illnesses, such as type 1 diabetes, pernicious anemia and primary adrenal insufficiency
PCCN Hyperthyroidism Review - Complications
Red, swollen skin
PCCN Hyperthyroidism Review - Treatment
Several treatments for hyperthyroidism exist. The best approach for you depends on your age, physical condition, the underlying cause of the hyperthyroidism, personal preference and the severity of your disorder. Possible treatments include:
PCCN Hyperthyroidism Review (2020) - Most Current PCCN Exam Updates