Overview
what is the difference between hypopnea and hyperpnea?
hypo = shallow breathing
hyper = increased depth
Obstructive lung disease is due to a difficulty with...
exhalation
What test is used to describe the how well a patient can force the air out of the lungs?
peak flow
These are risk factors for what?
age-spectrum, immunocompromised, underlying lung disease, alcoholism, smoking, endotracheal intubation, malnutrition, and immobilization
pneumonia
supraclavicular, substernal, and intercostal muscles "sucking in" upon expiration to help get air out of the lungs.
retractions
What are the accessory muscles that can be used for breathing?
***DOUBLE: When is it normal vs problematic?
diaphragm & intercostal muscles
** normal = inhalation; problematic = exhalation
What is the best example of community-acquired pneumonia?
"walking pneumonia"
What is considered the best course of treatment for COPD?
cessation of smoking
giving O2 appropriately
bronchodilators
sometimes steroids
tension pneumothorax
inflammatory/infectious debris accumulate in alveoli and surround tissue
infiltrate
Etiology: neuromuscular &/or CNS problems like an intracranial bleed, putting pressure on the respiratory center.
RR <12
hypoventilation
Patient: 6 mo old M
S&S: fever, increased RR, barking cough, stridor
Order: cool mist and steroids
What is this be used to treat?
coup
(laryngotracheobronchitis)
Your patient is presenting with a barrel chest and is extremely thin. You notice they are sitting with their hands on their knees, bent over to breathe. What is that position called and what lung disease might they be experiencing?
tripod position
emphysema
The patient is presenting with chills, fever, pleuritic pain, and shallow respirations. What is most likely happening here?
***DOUBLE: What is the cause?
pleural effusion
***Cancer cells in the lung or heavy coughing from bronchitis, pneumonia, etc.
right-sided heart failure due to lung disease
cor pulmonale
What does the abbreviation V/Q mean and during what part of the breathing process does this occur?
Ventilation: when air passes into bronchi and alveoli (lung tissue)
Perfusion: BV in the lungs bring CO2 to the alveoli and take away O2 to pass on the rest of the body.
INSPIRATION
What are the steps to identify the bronchogenic cancer?
What are the classifications?
biopsy
Small cell lung cancer & non-small cell
Your patient comes in complaining of an exacerbation of their asthma and are seeking treatment. What would you use to treat then?
***DOUBLE: give me 3 S&S of an asthma exacerbation.
monitor daily status with baseline pulmonary function readings and medications like bronchodilators.
*** wheezing on EXPIRATION, accessory muscle use, respiratory alkalosis
S&S: cough, fatigue, WL, anorexia, low-grade fever, night sweats.
Develops a purulent sputum and hemoptysis.
What is this, and how would we diagnose this?
tuberculosis
Dx: positive skin test, sputum culture, and chest X-ray
dyspnea upon lying down
**DOUBLE: sudden awakening at night feeling SOB
orthopnea
*** Paroxysmal nocturnal dyspnea
Hemoptysis is usually bright red or pink because there is fluid In the alveoli from inflammatory or congestive processes.
What are the two things this can possibly result from?
1. local infection or inflammation that damages the bronchi
2. generalized problem throughout lung tissue
What are the three different types of pneumothorax and what is considered the basic treatment for these patients?
traumatic, spontaneous, and tension
re-establish negative pressure
defined as: hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years.
Experiences cyanosis and clubbing of the fingers.
What is this diagnosis, and what other disease is combined with this to create a bigger problem?
chronic bronchitis
CB + emphysema = COPD
What is the non-cardiogenic etiology for pulmonary edema?
What are the two main causes of atelectasis?
1. injury to capillary endothelium, which inevitably leads to the decreased production of surfactant, causing atelectasis.
2. blockage of mucous or lack of surfactant
long-term increase in partial pressure of carbon dioxide (PaCO2) above 45 mm Hg
***DOUBLE: What condition Is this usually seen in?
chronic hypercapnia
*** chronic bronchitis