Respiratory Lecture

1
Respiratory Lecture 2

• Dr. Kathleen Ethridge
• Northeast Texas Community College

2
Management of Lower Airway and Pulmonary Vessel
Disorders
3
Asthma

• In asthma, the airways overreact to a stimulus
  which causes bronchospasm, edematous swelling of
  mucous membranes, and copious production of thick
  mucus.

4
Peak Flowmeter

• Measures peak expiratory flow volume.
• Normal peak flow for adults range from 300 to 700
  L/min
• Baseline values are needed for comparison

5
Critical Monitoring

• For client with asthma, notify the physician for
  symptoms after treatment
• Anxiety
• Increased effort of respirations
• Continuous cough
• Respiratory distress
• nasal flaring
• accessory muscles
• pursed lip breathing
• cyanosis

6
Chronic Obstructive Pulmonary Disease
7
Chronic Obstructive Pulmonary Disease

• Chronic Bronchitis
• Emphysema

8

• Chronic Bronchitis
• Age 40 to 50 year
• Stocky build with no history of weight loss
• Barrel chest
• cyanotic
• Emphysema
• Age 50 to 75
• Cachectic appearance
• Tachypnea
• pink skin color

9

• Chronic Bronchitis
• increased secretions
• edema
• bronchospasm
• thickened bronchial walls

10
Emphysema abnormal distention of the lower
airways bronchioles alveoli
11
COPD Treatment

• Prevention of infections
• Bronchodilators
• Low flow oxygen
• Corticosteroids
• Balance of activities
• Teach self-care

12
Acute Tracheobronchitis

• Acute inflammation of the mucous membranes with
  raw burning pain in anterior chest region
• Caused by
• inhalation of noxious gases or smoke
• overvigorous suctioning
• harsh coughing
• observe for cough-related syncope
• Treatment is focused on the cause

13
Croup

• Acute epiglottitis
• Acute laryngotracheobronchitis (LTB
• Acute spasmodic laryngitis
• Note
• Do not examine childs throat, as it may cause
  airway spasm (especially in epiglottitis)

14
Pulmonary Embolus

• Obstruction of a pulmonary artery
• caused by air, fat, or emboli
• Treatment
• bed rest
• oxygen, ventilator
• anticoagulants

15
Pulmonary Hypertension

• Mean Pulmonary Artery Pressure gt 25
• Poor Prognosis
• Symptoms
• dyspnea
• fatigue
• chest pain

16
Management of Clients with Parenchymal and
Pleural Disorders
17
Atelectasis

• Definition
• Collapse of lung tissue
• Causes
• Develops when interference of lungs expanding
• pleural effusion tumor, pneumothorax
• chest wall disorders
• airway obstruction
• insufficient pulmonary surfactant
• increased elastic recoil

18
Influenza

• Viral infection of respiratory tract
• Spread by droplet
• Sudden onset
• Causes fever, muscle aches and cough

19
Pneumonia

• Lobar pneumonia
• consolidation in one lobe of one lung
• Lobular or bronchopneumonia
• patchy consolidation throughtout lobes of one or
  both lungs

20
Community-acquired Pneumonia

• Treatment
• outpatient or inpatient
• obtain culture speciments
• appropriate antibiotics

21
Assessment of Pneumonia

• Pneumococcal pneumonia
• sudden onset, chill, fever, chest pain, cough
• Staphylococcal pneumonia
• sudden onset, fever, chills, pain, cough
• Influenzal pneumonia
• cough, green sputum
• Gram-negative
• sudden onset, high fever, chills, pain, dyspnea

22
Pneumonia Continued

• Anaerobic bacterial pneumonia
• low-grade fever, dyspnea, crackles, cyanosis
• Legionnaires disease
• fever, headache 48 hrs then high fever, dyspnea
• Mycoplasma pneumonia
• slowly rising fever, headache, cough
• Viral pneumonia
• headache, myalgia followed by high fever,
  dyspnea, cough

23
Pneumonia Continued

• Fungal pneumonia
• usually asymptomatic
• resembles influenza
• Parasitic pneumonia
• immunocompromised client
• cough, dyspnea, chest pain, fever, crackles,
  night sweats

24
Lung Abscess

• Pus within the lung tissue
• Bad odor
• Sputum will have a foul taste

25
Tuberculosis

• Causes and Prevention
• Pathophysiology
• Treatment

26
Treatment of Tuberculosis

• Basic treatment
• 2 months of daily doses of isoniazid and rifampin
• plus 1 or 2 additional drugs
• followed with 4 months of isoniazid and refampin
• at least 2 medications are added to a failing TB
  treatment program

27
Medications for Tuberculosis

• First-Line Drugs
• Isoniazid (INH)
• Rifampin
• Rifapentine

28
Medications Continued

• Second-Line Drugs
• Capreomycin
• Ethionamide

29
Prevention of Transmission in Hospitals

• Early identification
• Promptly initiate multidrug therapy
• Isolation
• Particulate respirators

30
Surveillance for TB Transmissions

• Routine TB skin testing
• Surveillance of cases
• Therapeutic regiments based on clinical history
  and drug-resistance data

31
TB skin testing

• 0-4 mm induration is not significant
• 5mm or greater may be
• 10mm or greater is usually considered significant

32
Fungal Pulmonary Diseases

• Coccidioidomycosis
• Histoplasmosis

33
Cystic Fibrosis

• Definition
• dysfunction precipitated by an obstruction of the
  exocrine gland ducts, causing thick mucous
  secretions
• Symptoms
• Treatment

34
Interstitial Lung Disease

• Group of inflammatory lung diseases
• The alveolar wall becomes thick and fibrotic

35
Sarcoidosis

• Characterized by the formation of widespread
  granulomatous lesions
• Cause is unknown

36
The End