Chapter 15-Respiratory Emergencies Flashcards
What is dyspnea?
Shortness of breath or difficulty breathing
What structures are part of the upper airway?
Nose, mouth, oral cavity, jaw, pharynx (nasopharynx, oropharynx, laryngopharynx), and larynx
What do the nose and oral cavity do to the air as it enters?
Filter, warm, and humidify it
Where is the epiglottis located and what is its function?
Top of the larynx, it folds over the larynx during swallowing so food and water don’t enter the lower airway
What is the principle function of the lungs?
Respiration/gas exchange
The upper airway consists of all the structures located above the _____.
Vocal chords
What is the path of air as it enters the lower airway?
Passes through trachea, which splits at the carina. Then passes into left and right main bronchi, then goes into bronchioles, and finally goes to elastic air sacs called alveoli where actual gas exchange occurs.
What is pathophysiology of respiration?
Conditions that interfere with normal respiration
What is altered mental status a sign of?
Hypoxia, the brain and possibly other organs aren’t getting enough oxygen to function
What is pulmonary edema?
The alveoli fill with fluid because the left side of the heart isn’t pumping as heart as the right side (congestive heart failure) so fluid backs up into the lungs
What respiratory condition has congestive heart failure as an underlying cause
Pulmonary edema
What cause of dyspnea can also produce frothy pink sputum at the mouth and nose
pulmonary edema
What conditions are likely to trigger acute pulmonary edema?
High blood pressure and coronary artery disease and atrial fibrillation
What can trigger acute pulmonary edema in patients with a history of it?
Stopping medications, eating salty food, has a stressful illness, a heart attack, or an abnormal heart rhythm
What might show up in a patient assessment that would indicate pulmonary edema?
cool, diaphoretic, cyanotic skin, crackles or wheezing in their breath, tachycardia, early hypertension and late hypotension
What are signs/symptoms to look for associated with dyspnea?
rate of breathing, use of accessory muscles, tripod position, coloring of skin
Gas exchange can be hindered by four types of problems; list them
Conditions affecting airway anatomy, diseases, trauma, and abnormal blood vessels
What is asthma?
Asthma is an acute spasm of the bronchioles due to excess mucus and swelling of the mucus lining of the respiratory passages
What is a characteristic sign of asthma?
Wheezing
What is wheezing indicative of?
lower airway obstruction
What can trigger an acute asthma attack?
Allergies, emotional stress, exercise, and respiratory infections
What is hay fever?
cold like symptoms triggered by allergens (usually outdoor and airborne)
What are the symptoms associated with hay fever?
runny nose, sneezing, congestion, and sinus pressure
What is anaphylaxis?
A sever allergic reaction characterized by airway swelling and dilation of blood vessels all over the body (resulting in lowered blood pressure)
How soon after exposure to the allergen does anaphylaxis usually occur?
30 minutes
What is the treatment of choice for anaphylaxis?
Epinephrine, antihistamines and oxygen are also useful
What is a pleural effusion?
When fluid collects outside of the lung (on one or both sides) and compresses the lungs causing dyspnea
How long does it take for a pleural effusion to build up?
Can take days or weeks, but more often it comes on suddenly
What are some causes of pleural effusions?
cancer, congestive heart failure, infection, or irritaion
What should you listen for when listening to the breaths of a patient with a pleural effusion?
decreased breath sounds in the regions where there is fluid between the chest wall and lung
What can alleviate (but not resolve) the symptoms of a pleural effusion?
sitting upright
What are some things that can mechanically obstruct the airway?
Vomit, tongue, foreign object
If someone is choking on something, its most likely an obstruction of the _____ airway
upper
What is a pulmonary embolism?
A blot clot that has formed in a vein and that breaks off and circulates through the venous system until it gets lodged in a pulmonary artery
During pulmonary embolisms. ____continues, but _____ is hindered due to the blocked pulmonary artery
ventilation, respiration
What are three causes of pulmonary embolisms?
damage to the lining of a blood vessel, abnormally fast-clotting blood, and (mot often) reduced blood flow in the legs (usually caused by long-term bed rest) leading to vein collapse
What are risk factors for pulmonary emboli?
pregnancy, bed rest, and active cancer
What is hyperventilation?
overbreathing to the point that the level of carbon dioxide falls below normal
When a person hyperventilates due to an underlying condition, the body is attempting to compensate for ____.
Acidosis (the build up of excess acid in the blood or body tissue)
What are some possible sources of excess acid causing hyperventilation/
Overdose on aspirin, high blood glucose levels, severe infection
In an otherwise healthy person, hyperventilation results in ______.
Alkalosis (build up of excess base in the body fluids)
What are the symptoms associated with hyperventilation and what is the underlying cause of these symptoms?
dizziness, numbness, tingling in hands and feet, and carpopedal spasms; caused by alkalosis
What is the difference between hyperventilation and hyperventilation syndrome?
The first is caused by underlying physical problems and the syndrome is caused by emotional stress
What is the range for breathing rate associated with hyperventilation?
20-40 breaths per minute
What should you do for a patient who is hyperventilating?
Initially, instruct them to reduce their breathing rate; if that doesn’t work, give supplemental oxygen and transport to the hospital
What types of products/chemicals can be inhaled that cause dyspnea and would be considered environmental/industrial exposure?
Pesticides, cleaning solutions, chlorine, ammonia.
Inhalation injuries as a result of environmental/industrial exposure can cause ____, which leads to _____.
Pneumonia, pulmonary edema
What is a pneumothorax?
partial or complete accumulation of air in the pleural space
What is the most common cause of a pneumothorax?
trauma
If not caused by trauma, a pneumothorax can be caused by rupture of a part of the lung that has been weakened by ____, _____, or _____.
Infection, asthma, emphysema
What might a patient with a pneumothorax complain of?
dyspnea and pleuritic chest pain (sharp stabbing pain on one side of the chest that is worse during inspiration and expiration)
What is pneumonia?
infection of the lungs that impairs their ability to exchange oxygen and carbon dioxide
What does “pneumonia is a secondary infection” mean?
It begins after an upper respiratory tract infection
What are some causes of pneumonia?
Virus, bacteria, ingestion of chemicals, interventions such as tracheostomy
What predisposes someone to pneumonia?
Residing in nursing home/long-term care facility, recent hospitalization, chronic diesease, compromised immune system, history of COPD
What are the symptoms of pneumonia?
(in children) rapid/labored breathing, grunting, wheezing, cyanosis of lips and fingernails
(if infection is in lower lungs) fever, abdominal pain, and vomiting
Between viral and bacterial pneumonia, which one results in more severe an more quickly onset symptoms?
bacterial, also more likely to cause a high fever; viral pneumonia presents more gradually
What do the breaths of a patient with pneumonia sound like?
wheezing, crackling, rhonchi
What is the treatment for pneumonia?
airway support, and supplemental oxygen
What is chronic obstructive pulmonary disease?
slow dilation and disruption of airways and alveoli caused by chronic bronchial obstruction
COPD is an umbrella term used to describe several lung diseases such as ____.
emphysema, chronic bronchitis, and ongoing irritation of the trachea and bronchi
What causes COPD (generally)?
Generally: lung damage resulting from repeated infections or inhalation of toxic gases (aka smoking)
Tobacco causes COPD by causing what?
Chronic bronchitis
What is bronchitis?
Production of excess mucus that obstructs small airways and alveoli
What is the most common cause of COPD?
Emphysema
What is emphysema?
loss of elasticity in the lungs resulting from chronically stretching alveolar air spaces due to inflammation and obstruction of airflow
Patients with COPD will usually have what symptoms?
Producing sputum, chronic cough, difficulty expelling air from lungs, long expirations, wheezing, or decreased breath sounds
