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Respiratory Diseases

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Respiratory Diseases S & S Hypoxemia Crackles & sonorous wheezes Blood Tests Show Respiratory acidosis (increase CO2) Show Metabolic acidosis (decrease bicarb ... – PowerPoint PPT presentation

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Title: Respiratory Diseases


1
Respiratory Diseases
2
Respiratory Review
  • What are the parts of the Upper Respiratory
    Tract?
  • What are the parts of the lower respiratory
    tract?
  • Where are the conchae?
  • What does the epiglottis do?
  • What is the lining around the lung?

3
Parts of the Respiratory System
  • Upper Respiratory Tract
  • Nose
  • Mouth Pharynx
  • Trachea to larynx
  • Lower Respiratory Tract
  • Lower trachea
  • Lungs

4
Functions of the Respiratory System
  • Oxygen Transport
  • Oxygen delivered to the cell
  • CO2 removed
  • Capillaries are close to cells 02 diffuses from
    blood into interstitial tissue cells
  • Respiration gas exchange between atmospheric
    air blood blood cell
  • Blood enters systemic vein to pulmonary
    circulation 02 level is lower than in alveoli
    O2 diffuses into circulation
  • CO2 is higher in blood diffuses into alveoli

5
Pulmonary Perfusion
  • Actual blood flow through the lungs
  • What part of the heart sends blood to the lungs?
  • About 2 of the blood in the body never
    participates in gas exchange enters the left
    side of the heart un-oxygenated
  • Pulmonary circulation is a low pressure system
  • Normal Systole 20 30
  • Diasole 5 15 in Pulm artery

6
Gas Exchange
  • What element is the highest concentration in the
    air that we breathe?
  • Atmospheric pressure at sea level is 760 mm Hg.
    High elevation?

7
Respiratory Disease
  • Main symptoms of most respiratory diseases to
    assess
  • Dyspnea
  • Cough
  • Sputum
  • Chest pain
  • Wheezing
  • Clubbing
  • Hemoptysis
  • cyanosis

8
Dyspnea
  • Difficulty breathing/shortness of breath
  • Acute diseases of the lungs produce more dyspnea
    than chronic
  • Orthopnea difficulty breathing laying down
  • Identify causes to treat

9
Cough
  • Irritation of the mucous membranes in the
    respiratory tract
  • Causes by infection or airborne irritant
  • Chief protection against excess secretions in
    bronchi bronchioles
  • May indicate serious disease

10
TYPES
  • Dry hacky
  • Upper respiratory infection /viral
  • Irritated, high pitch
  • laryngotracheitis
  • Brassy tracheal lesions
  • Wet, loose - bronchitis
  • Coughing at night may indicate left sided heart
    failure or bronchial asthma

11
  • Cough worse when lying down - post-nasal drip
    (sinusitis)
  • Cough after eating - aspiration

12
Sputum production
  • Thick, yellow or greenish indicate bacterial
    infection
  • Thin, clear indicates viral
  • Pink-tinged tumor
  • Profuse, frothy, pink pulmonary edema
  • Foul smelling lung abscess, fungal or
    anaerobic infection

13
Chest pain
  • Usually on the side of the issue
  • Occurs with
  • Pneumonia
  • Pulmonary embolism
  • Pleurisy
  • Patients usually state that is feels like
    stabbing like a knife

14
Wheezing
  • Bronchial constriction
  • Airway narrowing
  • High pitched, musical

15
Hemoptysis
  • Coughing or expelling blood from the respiratory
    tract
  • Usual causes
  • Infection
  • Lung cancer
  • Lung vessel issues
  • Abnormal pulmonary artery/vein
  • Pulmonary emboli

16
Adventitious sounds
  • Crackles
  • Discrete, non-continuous
  • Delayed reopening of the deflated airways
  • Heard at end of inspiration
  • Sounds like rubbing hairs together
  • Pneumonia, bronchitis, CHF, pulmonary fibrosis
  • Wheezes

17
  • Sonorous wheezes
  • Larger bronchi or trachea
  • Heard in increased secretions
  • Like rubbing thumb index finger together
  • From inflammation of pleural surface
  • Heard on inspiration expiration

18
Upper Respiratory Tract Disorders
  • Cold
  • Sinusitis
  • Pharyngitis

19
Cold
  • Called a cold because there is usually no fever
  • Infectious inflammation of the mucous membranes
  • Contagious because can be transmitted approx. 2
    days before symptoms occur
  • Most common 3 x /year
  • September
  • Late January
  • End of April

20
S S
  • Nasal congestion
  • Scratchy/sore throat
  • Sneezing
  • Tearing, watery eyes
  • Malaise
  • Fever
  • Chills
  • HA
  • Muscle aches

21
  • Cough sometimes due to mucous drainage
  • Cold virus tends to aggravate the herpes simplex
    virus
  • Symptoms lasts 5 days 2 weeks
  • Fever indicates different URI
  • Caused by 100s different viruses but most common
    is the RHINOVIRUS

22
Treatment
  • No cure
  • Treat symptoms
  • Increase fluid intake
  • Rest
  • Prevention of chilling
  • Decongestants
  • Antihistamines
  • Vitamin C

23
  • HA Muscle aches
  • Ibuprofen
  • acetominophen
  • Sore throat
  • Warm salt gargle

24
Sinusitis
  • Where are the sinuses?
  • Acute
  • Begins as a URI or allergic rhinitis
  • Nasal congestion blocks the sinus cavities which
    causes bacteria to grow
  • Most common Streptococcus pneumoniae, H
    influenza
  • S S
  • Pressure
  • Pain
  • Purulent sinus drainage

25
  • Treatment
  • Decrease mucus membranes swelling with a
    decongestant
  • Guaifenisin to expel mucus
  • Antibiotics of choice for 7 10 days
  • Amoxicillin
  • Augmentin
  • Bactrim

26
Guaifenesin
  • Brand name Mucinex
  • Given PO
  • Thins secretions to be expels easier
  • CI children under 4 Pregnancy
  • Precautions drink plenty of water/fluid
  • SE HA, N V

27
Acute Pharyngitis
  • Febrile inflammation of the throat
  • Usually caused by a virus
  • If caused by Streptococcus A what is it called?
  • Symptoms
  • Fiery, red throat pyrexia
  • Swollen tonsils (exudate) malaise
  • hoarseness

28
  • Treatment
  • Viral
  • Analgesic (Tylenol, Ibuprofen)
  • Bacterial
  • PCN
  • Erythromycin
  • Cephlasporin
  • Patient should throw away his/her toothbrush at
    risk for re-contamination

29
Tonsillitis Adenoiditis
  • Tonsils Adenoids
  • Both contain lymphatic tissue
  • Tonsils are in the oropharynx
  • Adenoids are in the nasopharynx
  • Infections in the adenoids usually accompany
    infections of the tonsils

30
  • Causes
  • Group A streptococci is most common
  • S S
  • Sore throat
  • Fever
  • Snoring
  • Difficulty swallowing

31
  • Enlarged adenoids causes
  • Mouth breathing
  • Earaches
  • Draining ears
  • Frequent colds
  • Bronchitis
  • Foul smelling breath
  • Noisy respiration

32
  • Treatment
  • Chronic tonsillitis tonsillectomy
  • Numerous otitis media - adenoidectomy
  • Penicillin is the drug of choice for infection
  • Hemorrhage is a potential complication
  • Monitor HR
  • Monitor temperature
  • Evaluate vomitus

33
Acute Respiratory Distress Syndrome
  • May become fatal within 48 hours of diagnosis
  • Usually results from another type of trauma
  • Fracture
  • Fat emboli
  • Pulmonary contusion
  • Form of pulmonary edema

34
  • S S
  • Hypoxemia
  • Crackles sonorous wheezes
  • Blood Tests
  • Show Respiratory acidosis (increase CO2)
  • Show Metabolic acidosis (decrease bicarb)
  • Decling O2 sat

35
COPD
  • Chronic Obstructive Pulmonary Disease
  • Long term pulmonary disorders with air flow
    resistance
  • Include Asthma, chronic bronchitis, emphysema
  • Contributing factors smoking, allergies, family
    history

36
Asthma
  • Classified as Mild, Moderate, or Severe
  • Mild occurrence less than 2 x/week
  • S S
  • Cough dyspnea
  • Wheezing
  • Chest tightness

37
  • Moderate daily
  • Nighttime symptoms 5x/month
  • Normal or below normal gas exchange
  • Cough Wheezing
  • Chest tightness dyspnea
  • Severe greatly affects activity
  • Below normal air exchange
  • Continuous
  • Cough Wheezing
  • Chest tightness Dyspnea

38
  • Tests
  • Pulmonary function test
  • IgE - elevated in allergic reaction
  • Chest X ray
  • Treatment
  • Long acting inhalers
  • Corticosteroids
  • Albuterol (attacks)

39
Albuterol
  • Bronchodilator
  • Prevents bronchospasms related to exercise
    induced asthma
  • May be inhaled or given PO
  • CI hypersensitivity, CV disorders,
    hyperthyroidism, DM
  • SE nervousness, tremors, dizziness, insomnia,
    HA, tachycardia, palpitations, N V,
    hypokalemia, muscle cramps
  • Interactions MAO inhibitors, antidepressants,
    beta blockers

40
Emphysema
  • Abnormal, permanent enlargement of the air space
    that destroys alveoli
  • Affects tissue changes unlike asthma bronchitis
  • Results from Deficiency of protein or smoking
  • S S
  • Dyspnea on exertion
  • Barrel shaped chest
  • Prolonged expiration
  • Decreased breath sounds

41
  • Treatment
  • Bronchodialators
  • Mucolytics to thin secretions
  • Antibiotics for any infections
  • O2 therapy
  • corticosteroids
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