Chapter 13: Respiratory Emergencies Flashcards
Define
Dyspnea
Shortness of breath (SOB) or difficulty breathing
Define
Respiration
Exchange of oxygen and CO2
Define
CO2 retention
Chronically high blood CO2 –> respiratory center no longer responds to high blood levels of CO2. From impaired exhalation or producing too much.
Define
Acidosis
Buildup of excess acid in the blood or tissues resulting from primary illness
Define
Adventitious breath sounds
Abnormal breath sounds: wheezing, rhonchi, rales
Define
Alkalosis
Build of of base in body fluids
Define
Anaphylaxis
Systemic allergic reaction, possibly including shock and respiratory failure. Usually within 30 minutes of exposure to allergen.
Define
Asthma
Acute spasm of bronchioles, associated with excess mucus production and swelling of mucous lining.
Ask: have you been hospitalized for this before?
Define
Atelectasis
Collapse of alveolar spaces
Define
Bronchial breath sounds
Normal sounds of air moving through bronchi
Define
Bronchiolitis
Inflammation of bronchioles usually in children <2 yo, often caused by respiratory syncytial virus
Define
Bronchitis
- Acute or chronic inflammation of the lung that may damage tissue
- associated with cough and production of sputum
- sometimes fever depending on cause
Define
Chronic bronchitis
Irritation of major lung passageways from infectious disease or smoke
Define
COPD
Chronic obstructive pulmonary disease. Slow process of dilation and disruption of airways and alveoli cuased by chronic bronchial obstruction
Define
Common cold
Viral infection. Swollen nasal mucous membranes and production of fluid in sinuses and nose
Define
Croup
- Inflammatory disease of upper respiratory system
- may cause partial airway obstruction
- characterized by barking cough and stridor.
- Usually in children.
Define
Diphtheria
Infectious disease in which a membrane forms, lining the pharynx. It can severely obstruct the passage of air into the larynx.
Define
Embolus
Blood clot or other substance in circulatory system that can cause blockage
Define
Emphysema
Disease of lungs with extreme dilation and eventual destruction of pulmonary alveoli. Loss of elastic material around alveoli because inflamed airways prevent easy exhalation. Poor gas exchange. One form of COPD. Beware of suppressing hypoxic drive with O2.
Define
Hay fever
Allergic response usually to outdoor airborne allergens. Also called allergic rhinitis.
Define
Hyperventilation
Rapid/deep breathing that causes blood alkalosis. Verbally instruct pt to slow their breathing, give supplemental O2. Moral support.
Define
Hyperventilation syndrome
Occurs in absence of physical problems. RR as high as 40 shallow breaths/min or low as 20 deep breaths/min
Define
Hypoxia
Not enough oxygen in body’s cells
Describe
Hypoxic drive
Backup system to control respirations when oxygen levels fall. In pt’s with no CO2 reflex, giving too much O2 can depress breathing. Unless the pt is unconcious, use low flow and slowly adjust higher until symptoms improve. Shaun says: ALWAYS GIVE O2
Define
Influenza type A
Crossed animal/human barrier. H1N1 is a strain.
Define
MDI
Metered dose inhaler. Spray can used to direct meds though mouth into lungs
Define
Oxygenation
Process of delivering O2 to blood
Define
Pandemic
Outbreak that occurs on global scale
Define
Pleural effusion
Collection of fluid between the lung and chest wall that may compress lung. Response to irritation, infection, CHF, or cancer. Dyspnea typically comes on suddenly.
Define
Pleuritic chest pain
Sharp stabbing pain in the chest worsened by deep breath or other chest wal movement, often caused by inflammation of irritation of the pleura
Define
Pneumonia
Infectious disease of the lung that damages lung tissue. Often associated with immune system compromise.
Define
Pneumonitis
Inflammation of the lung
Define
Pneumothorax
Partial or complete accumulation of air in pleural space
Define
Pulmonary edema
Buildup of fluid in the lungs, usually a result of CHF
Define
Pulmonary embolism
Blood clot that breaks off from large vein and lodges in lung, cutting of blood flow.
S/S: dyspnea, chest pain, hemoptysis, cyanosis, tacypnea, hypoxia. May cause cardiac arrest
Define
Rales
Crackling, rattling breath sounds signaling fluid in the alveoli
Define
RSV
Respiratory syncytial virus.
- Virus that causes lung/passages infection.
- Can lead to other illnesses, like bronchiolitis and pneumonia.
- Highly contagious
- spread through droplets.
- Infants with RSV often refuse fluids and get dehydrated.
Define
Rhonchi
Coarse breath sounds heard in pt’s with chronic mucus in airways.
Define
Small volume nebulizer
Device that turns liquid medicine into mist for inhalation. Treats stuff like asthma.
Define
Stridor
A harsh, high pitched, barking inspiratory sound often heard in acute laryngeal obstruction.
Define
Vesicular breath sounds
Normal breath sounds from alveoli
Define
Wheezing
High pitched, whistling breath sound, usually on expiration, in pt’s with asthma or COPD
Discuss
List possible problems with lungs (actual physical problems that can arise from diseases)
- Gas exchange in alveoli hindered by fluid, infection, or collapsed alveoli (atelectasis)
- Alveolar wall itself damaged, interrupting gas exchange
- Air passages obstructed (muscle spasm, mucus, floppy wall)
- Blood flow obstructed by clots
- Filled pleural space inhibits expansion
Discuss
Define
Epliglottitis
Disease in which epiglottis becomes inflamed and enlarged. May cause upper airway obstruction. DO NOT SUCTION AIRWAYS WITH EPIGLOTTITIS (could cause more swelling and result in complete airway obstruction).
Discuss
Acute pulmonary edema
- Fluid buildup in lung.
- laying pt down will kill him (orthopnea)
- Often from CHF (look for telltale hypertension)
- Ask: how many pillows do you sleep with?
Discuss
Wet lung sounds vs. dry lung sounds
Wet lung sounds: often pulmonary edema. Dry lung sounds: often COPD. Not always.
Discuss
Spontaneous pneumothorax
Pt’s with emphysema or asthma are at higher risk, often during severe coughing. Sometimes in tall skinny people.
Discuss
Status epilepticus
Prolonged seizure. Seizures every few minutes without regaining consciousness or seizure lasting longer than 30 minutes could be life threatening. Pt needs meds to stop seizure and manage airway. NEEDS ALS OR HOSPITAL
Discuss
Carbon monoxide poisoning
Pt may think they have the flu: headache, dizziness, fatigue, nausea, vomiting
Discuss
How to perform focused breathing assessment
PASTE
- P: Progression
- A: Associated chest pain
- S: Sputum
- T: Talking tiredness
- E: Exercise tolerance
Discuss
Cystic fibrosis
Body’s salt/water balance messed up, so mucus becomes thicker and more difficult to move, causing frequent infection in lungs.
Discuss
CPAP
Continuous positive airway pressure device. Indications: moderate to severe resp distress from pulmonary edema or COPD, able to follow commands, RR >26 or pulse ox <90%. Contraindication: low BP, resp arrest, s/s of pneumothorax or chest injury, tracheostomy, decreased LOC, gastrointestinal bleeding.
S/S
Asthma
Wheezing, bronchospasm
S/S
Anaphylaxis
Flushed skin, urticaria (hives), generalized edema, low BP, laryngeal edema
S/S
Bronchitis
Chronic cough, wheezing, cyanosis, productive cough
S/S
CHF
- Dependent edema,
- rales
- paroxysmal nocturnal dyspnea (waking up because of dyspnea, often relieved by sitting upright)
S/S
Croup
- Fever,
- barking cough,
- pediatric pt
S/S
Emphysema
Barrel chest, pursed lip breathing, dyspnea on exertion
S/S
Pneumonia
- Dyspnea
- chills and fever
- cough
- dark sputum
S/S
Pneumothorax
Sudden chest pain w dyspnea, unilateral decreased lung sounds
S/S
Pulmonary embolism
Sharp pinpoint pain, dyspnea, sudden onset, after surgery or childbirth
S/S
Tension pneumothorax
Progressive SOB, decreasing LOC, JVD, tracheal deviation
S/S
Pertussis
- Coughing spells,
- whooping sounds,
- fever,
- pediatric pt’s
Discuss
What’s a key question to ask an asthma pt?
Have you ever been hospitalized for this before?
