Chapter 17: Respiratory Emergencies Flashcards
Name the structures of the Respiratory System
Adequate Respiration Rates
- Adult: 12-20/min
- Child: 15-30/min
- Infant: 25-50/min
CPAP Contraindications
- Severely depressed mental status
- Lack of normal respiratory rate
- Inability to sit up
- Hypotension below 90mmHg
- Penetrating chest trauma
- Upper gastrointestinal bleeding or recent surgery
Chronic Obstuctive Pulmonary Disease (COPD)
Two most common forms of COPD:
- Emphysema
- Chronic Bronchitis
https://www.youtube.com/watch?v=BIdHQQEXPDk&feature=youtu.be
Pathophysiology of Chronic Bronchitis
Pathophysiology: Bronchiole lining is inflamed and excess mucus is formed. Often because the cilia of the cells is damaged or destroyed.
Signs/Symptoms:
- Wheezing
- Cyanosis in lips and extremities
- Chronic cough that produces sputum
- Frequent Respiratory infections
- Pedal edema
Treatments: https://www.nhlbi.nih.gov/health/health-topics/topics/copd/treatment
- Bronchodilators
- Corticosteroids
Pathophysiology of Emphysema
Pathophysiology: Wall of the Alveoli break down decreasing surface area for respiratory exchange. Lung elasticity is lost and stale air is trapped in the lungs.
Signs/Symptoms:
- Shortness of Breath
- Cyanosis
- Altered Mental Status
- Increased Pulmonary pressure can weaken the heart leading to edema
Treatments: See Chronic Bronchitis
Pathophysiology of Asthma
Pathophysiology: Asthma is an acute onset of bronchiole constriction. These can be precipitated by stings, air pollutants, infections, and exercise.
Signs/Symptoms:
- Wheezing
- Chest tightness
- Shortness of breath
Treatment:https://www.nhlbi.nih.gov/health/health-topics/topics/asthma/treatment
- Bronchodilators
- Corticosteroids
- Small Volume Nebulizer (SVN)
Pathophysiology of Pulmonary Edema
Pathophysiology: The abnormal accumulation of fluid in the lungs. Most commonly associated with Heart Failure.
Signs/Symptoms:
- Edema in the lower extremities
- Sacral edema in bed ridden patients
- JVD
- Abdominal bloating from fluid accumulation (rapid weight gain especially in the abdominal area)
- Ronchi or Crackles on auscultation
Treatment:
- CPAP may help to force fluid buildup out of the lungs
- Keep legs in a Dependent position (hanging down) to prevent further fluid overloading
Pathophysiology of Pneumonia
Pathophysiology: Infection of of the lungs by bacteria, virus, or fungi.
Signs/Symptoms:
- Coughing (mucus can be green, yellow, or bloody)
- Fever
- Chest Pain
- Severe Chills
- Often Shortness of Breath
- Confusion especially in elderly patients
- Crackles on auscultation
Treatment:
- May receive antibiotics or other medications at the ER if bacterial/fungal infection is determined
Pathophysiology of Spontaneous Pneumothorax
Pathophysiology: Lung collapse usually caused by the spontaneous rupture of a weakened section of the lung called a bleb.
Signs/Symptoms:
- Sharp Pleuritic pain
- Shortness of Breath
- Can present with decreased or absent lung sounds
Treatment:
- Some may need a small catheter or larger chest tube inserted into pleural space via intercostal space to relieve pressure.
Pathophysiology of Pulmonary Embolism
Pathophysiology: Blockage of the Pulmonary Artery. Often via blood clot originating elsewhere in the body (DVT), fat, or air.
Signs/Symptoms: Extremely difficult to diagnose
- Bloody Sputum
- Pain and Swelling in one or both legs
- Dizzyness
- Wheezing on auscultation
- Hypotension
- Cardiac arrest
Pathophysiology of Epiglottitis
Pathophysiology: Infection that inflames the area around the epiglottis that can occlude the airway.
Signs/Symptoms:
- Sick appearance
- Tripoding
- Muffled voice
- Sore throat
- Drooling because of painful swallowing
- Fever
Treatment:
- Calm patient as much as possible and Administer O2
- Lights and Sirens if necessary especially for children
Pathophysiology of Cystic Fibrosis
Pathophysiology: Childhood disease that causes mucus build up in the lungs and gastrointestinal system
Signs/Symptoms:
- Coughing with large amounts of mucus
- Frequent Pneumonia
- Abdominal distention and pain (CF also affects GI)
- Bloody Sputum
- Nausea
- Weight Loss/Appetite Loss
Treatment: Most parents will know what works best for their children. Use their knowledge to your advantage
Side Effects of Prescribed Inhalers
- Increased Pulse
- Tremors
- Nervousness
