Pulmonary Diseases II

Chronic Bronchitis

Excerssive mucas production

(starts in the upper-moves lower)

Hyperplasma & hypertrophy mucus-producing glands

prolonged exposure to irritants

Chronic Bronchitis

Diagnosis

 

Cought

Sputum

Effect on the alveoli

Normal diffusion

open to infection

Chronic Bronchitis

SxS

Dyspnea w/ airway resistance

Productive cough

Rhonchi

(Rhonchi in the Bronchi)

Peripheral edema (R sided HF-goes into lungs because the lungs are shot)

Cyanosis “Blue bloaters”

Finger clubbing;Hypoxema: overproduction of RBC

Chronic Bronchitis

Findings

Bulbous finger tips

Hypoxemia

Ploycythemia

Emphyseam

Slow progression 

smoking

allergens

respiratory infection

Emphysema

 

results

Decreased in alveolar surface

increase residual volume

reduction in arterial PO2

 

Effects of decreased alveoli surface area

Loss of surfacant

failure on supporting structures

increase in PCO2

‘Barrel chested”

Emphysema

SxS

Pursed lip breathing

cough

wheezing & rhonchi

“Pink puffer”

dreased breath sounds

Emphysema

 

Initial assesment

worsting dyspena

Paroxysmall noturnal dyspnea (PND)

 

sputum production

generalized malaise

Emphyseam 

appearance

orthopnea

tripod position

purse-lipped breathing

accessory muscle use

Emphysema

 

management

IV access

O2

monitor VS, cad rhythms

visualize sputum is productive cough

assist ventilations

 

COPD adds to the wkload of the heart

 

Emphysema

 

meds

 

 

Albuterol

Alupent

Asthma

 

Exacebrating factors

Reactive airway disease

 

Extrinsic: Pollen, dust, pet dandra 2nd hand smoke

(little kids)

 

Instrinsic: Stress, fatague, physical exhertion)

(adults)

Asthma

 

Pathoohysiology

Acute eposides

Reversible airflow obstruction

-Bronchospasm

-Excess mucus

-Inflammation

 

Increase on resp system results in:

increase in ass muscle use & respiratory fatigue

 

Asthma 

 

SxS

 

 

Breath sounds

Tripod pos

Resp distress

ALOC

 

 

 

Expir & Insp wheezing

Asthma

 

advanced SxS

Diaphoresis & pallor

chest tight

short word strings

tachypnea

tachyvcardia

elveted BP

Asthma

 

meds

albuterol HHN

Epinephrine 1:1000 SQ

Pulmonary function test (PFT)

 

test the severity of an asthma exacebration

measure the effectiveness of treatment

 

PFT based on patients

Age/sex/weight/respiratory effort

PFT can be an early detector to pending atk…

Asthma

 

care

 

meds

IV

high low O2

Assit vent

 

Albuterol HHN

Epinephrine SQ

 

Pneumonia

 

causes

Bacterial

Viral

Mycoplasmal

Aspiration

 

Risk factors

Cig smoking

prolonged exposure to cold: (homeless)

 

Pneumonia

Viral & Mycoplasmal

 

pathophysiology

Inflammation

Congestion

Hemorrhage

Pneumonia

Viral

Influenza A

Happens w/in small groups (i.e. soilders in barracks)

secondary bacterial infection

 

Pheumonia

Mycoplasma

Transmission: droplets (fungus)

Occurance: Yong adults, familes, households

RX: antibiotics

2ndary bacterial pneuonia

Pneumonia

 

Haemophilus Influenza (type A)

 

Viral pneumonia

 

SxS

cough

Pleurtic chest pain (chest tied in w/ breathing pattern, hard w/ this pattern)

 fever w/ chills

Pneumonia

bacterial

 

Pathophysiology

Sterptococcus Pneumoniae bacillus (aka strep throat)

 

 

Infection in the alveoli

Fluid & purulant sputum

Aspiration

 

SxS: Green / Yellow sputum

 

 

 

Pneumonia

Aspiration

 

 

Pathophysiology

Foreign material

 

Inflammation

 

 

Physiology effects

-Volume

-pH

Pneumonia

nonbacterial

Aspiration of:

Stomach contents

Toxic materials, chemical or inhalants

 

Bacterial:

Secondary complications

mortality

Pneumonia

Aspiration

 

Predisposing risk factors

ALOC

Head injury

seizure activity

AODA

depressed cough reflex

intubated patients

anesthesia

infection

shock /FB aspiration/near drowning

 

Pneumonia

Aspiration

 

SxS

Dyspnea

Cough

Bronchospasm

Decrease breath sounds

Wheezing/rhonchi/rales

Cyanosis

Pheumona

aspiration

 

 

treatment

ABC’s

Airway support

High flow o2

ventilation ass PRN

IV fluids

 

Continious Positive Airway Pressure

CPAP

 

Purpose

To prevent airway collapse

to improve oxygenation & ventillation

transmits positive pressure throughout the respiratory cycle

CPAP

 

when used

CHF

pulmonary edema

Acute respiratory distress syndrome (ARDS)

sleep apnea

COPD

asthma

drwning pneumonia

CPAP equipment

 

CPAP ventilator

CPAP face mask w/straps

endotracheal tube

oxygen source w/connecting tubing

CPAP

proceedures

Resp setting

resp rate

Oxygen concentration (FiO2)

Tital Volume 

Peak pressure settings

Presure relief valve

PEEP

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