Respiratory Lecture 2

1. 1 Respiratory Lecture #2 Dr. Kathleen Ethridge Northeast Texas Community College

2. 2 Management of Lower Airway and Pulmonary Vessel Disorders

3. 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. 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. 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. 6 Chronic Obstructive Pulmonary Disease

7. 7 Chronic Obstructive Pulmonary Disease Chronic Bronchitis Emphysema

8. 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. 9 Chronic Bronchitis increased secretions edema bronchospasm thickened bronchial walls

10. 10

11. 11 COPD Treatment Prevention of infections Bronchodilators Low flow oxygen Corticosteroids Balance of activities Teach self-care

12. 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. 13 Croup Acute epiglottitis Acute laryngotracheobronchitis (LTB Acute spasmodic laryngitis Note: Do not examine child’s throat, as it may cause airway spasm (especially in epiglottitis)

14. 14 Pulmonary Embolus Obstruction of a pulmonary artery caused by air, fat, or emboli Treatment bed rest oxygen, ventilator anticoagulants

15. 15 Pulmonary Hypertension Mean Pulmonary Artery Pressure > 25 Poor Prognosis Symptoms dyspnea fatigue chest pain

16. 16 Management of Clients with Parenchymal and Pleural Disorders

17. 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. 18 Influenza Viral infection of respiratory tract Spread by droplet Sudden onset Causes fever, muscle aches and cough

19. 19 Pneumonia Lobar pneumonia consolidation in one lobe of one lung Lobular or bronchopneumonia patchy consolidation throughtout lobes of one or both lungs

20. 20 Community-acquired Pneumonia Treatment outpatient or inpatient obtain culture speciments appropriate antibiotics

21. 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. 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. 23 Pneumonia Continued Fungal pneumonia usually asymptomatic resembles influenza Parasitic pneumonia immunocompromised client cough, dyspnea, chest pain, fever, crackles, night sweats

24. 24 Lung Abscess Pus within the lung tissue Bad odor Sputum will have a foul taste

25. 25 Tuberculosis Causes and Prevention Pathophysiology Treatment

26. 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. 27 Medications for Tuberculosis First-Line Drugs Isoniazid (INH) Rifampin Rifapentine

28. 28 Medications Continued Second-Line Drugs Capreomycin Ethionamide

29. 29 Prevention of Transmission in Hospitals Early identification Promptly initiate multidrug therapy Isolation Particulate respirators

30. 30 Surveillance for TB Transmissions Routine TB skin testing Surveillance of cases Therapeutic regiments based on clinical history and drug-resistance data

31. 31 TB skin testing 0-4 mm induration is not significant 5mm or greater may be 10mm or greater is usually considered significant

32. 32 Fungal Pulmonary Diseases Coccidioidomycosis Histoplasmosis

33. 33 Cystic Fibrosis Definition dysfunction precipitated by an obstruction of the exocrine gland ducts, causing thick mucous secretions Symptoms Treatment

34. 34 Interstitial Lung Disease Group of inflammatory lung diseases The alveolar wall becomes thick and fibrotic

35. 35 Sarcoidosis Characterized by the formation of widespread granulomatous lesions Cause is unknown

36. 36 The End