MT M 5.6 Common Respiratory Medical Procedures/Conditions

Question 1

Asthma

Answer 1

Asthma is a disease where various triggers, such as dust, an infection, pollutants in the air, or certain drugs, can trigger a spasm in the bronchial tree. It is slightly more common in children and can affect up to 10% of the population. An asthma attack can progress to a medical emergency and may require treatment in an Emergency Department.

Question 2

Allergic asthma

There are various subtypes of asthma

Answer 2

Allergic asthma is common in children and patients who inhale an allergen that initiates the asthma attack.

Question 3

Occupational asthma

There are various subtypes of asthma

Answer 3

Occupational asthma is triggered by workplace agents, such as plastics, metals, wood, or grains. Asthma can be associated with air pollution, obesity, or exercise.

Question 4

During an asthma attack

Answer 4

During an asthma attack, the patient will experience cough, chest tightness, and shortness of breath. The bronchioles become swollen and full of excessive amounts of mucus. Figure 5.25 shows a healthy bronchiole and a swollen bronchiole that occurs during an asthma attack. This decreases the air flow to the lungs, and the patient feels short of breath. Examination of the lungs will reveal wheezing and a prolonged expiration.

Question 5

Bronchodilators

Answer 5

Bronchodilators are inhaled medications that dilate the bronchioles to improve the flow of air. Patients with asthma may require daily medication to control their symptoms and decrease the frequency of asthma attacks.

Question 6

spirometry

asthma

Answer 6

Patients will be assessed with spirometry to measure the forced expiratory volume of the lungs in 1 second and the forced vital capacity. Figure 5.26 shows a patient using a spirometer to assess her lung volumes. These measurements will be taken before and after treatment with a bronchodilator.

Question 7

Inhaled corticosteroids

Answer 7

Inhaled corticosteroids are steroid medications that are inhaled daily to control the inflammation in the airway. Depending upon the patient’s asthma severity, they may also require systemic steroids and other medications to control their asthma symptoms.

Question 8

Pneumonia

Answer 8

Pneumonia is a bacterial infection of the lungs. It can be described by where the infection was obtained.

Question 9

Community-acquired pneumonia

Pneumonia

Answer 9

Community-acquired pneumonia is pneumonia that occurs outside of the hospital.

Question 10

Hospital-acquired pneumonia and ventilator-acquired pneumonia

Pneumonia

Answer 10

Hospital-acquired pneumonia and ventilator-acquired pneumonia are nosocomial infections.

Question 11

Nosocomial

Pneumonia

Answer 11

Nosocomial is a term that means relating to a hospital; therefore, these types of pneumonia occur within the hospital.

Question 11

S pneumoniae

Pneumonia

Answer 11

Pneumonia can also be defined by the name of the bacteria that is causing the infection. S pneumoniae is the most common bacterial species that causes community-acquired pneumonia.

Question 12

pneumonia will experience

Answer 12

Patients with pneumonia will experience a fever, cough, and shortness of breath. They also may experience sweating, chills, chest pain, myalgias, headache, or abdominal pain. On physical examination, they may have a fever, tachypnea, tachycardia, and a decrease in the O2 saturation percentage in the blood.

Question 13

diagnosis of pneumonia

pneumonia diagnosis

Answer 13

The diagnosis of pneumonia is made with a chest x-ray. Pneumonia will appear as a cloudy consolidation on the chest x-ray. Patients are treated with antibiotics.

Question 14

respiratory crackles

pneumonia symptoms

Answer 14

When a practitioner listens to the lungs, there will be decreased breath sounds over the area of the infection, and respiratory crackles may be heard. Crackles are short, sharp, or rough breath sounds that are caused by excessive fluid in the lungs.

Question 14

severely ill with pneumonia and thoracentesis

Answer 14

In patients who are severely ill with pneumonia, they may have fluid begin to collect within their pleural space. In this situation, a thoracentesis is appropriate. Figure 5.27 shows a patient undergoing a thoracentesis. A needle is inserted into the pleural space, and fluid is removed. This allows the lungs to expand further and allows the medical team to perform a bacterial culture and sensitivity on the pleural fluid.

Question 15

COPD stands for chronic obstructive pulmonary disease,

Answer 15

COPD stands for chronic obstructive pulmonary disease, and it is a common, preventable lung disease where airflow is limited in the airway and alveoli. This is due to damage done to the airway and alveoli largely through exposure to cigarette smoke. It is a disabling disease and the third cause of death worldwide.

Question 16

Emphysema

COPD

Answer 16

Emphysema is a condition where the walls of the alveoli become distended and damaged. Patients will have difficulty exhaling air from the lungs. This leads to air trapping and **dead space ventilation, ** where air is trapped in the damaged alveoli and is unable to leave the lungs. Patients will have to use accessory muscles to help them breathe.

Question 16

COPD develops in patients

COPD

Answer 16

COPD develops in patients when they are 50-60 years old. Patients will complain of excessive cough, sputum production, and shortness of breath. There are two types of COPD: emphysema and bronchitis.

Question 17

Bronchitis

COPD

Answer 17

Bronchitis is a condition of inflammation of the bronchioles. This inflammation of the bronchioles will cause chronic coughing with excess sputum production. These patients will tend to experience exacerbations of their dyspnea due to frequent infections.

Question 17

will develop cyanosis

Bronchitis (COPD)

Answer 17

They develop cyanosis and peripheral edema. Their lung exam will reveal rhonchi and wheezing.
cyanosis of the lips, a sign of the tissues being depleted of oxygen. This may be seen in a patient with bronchitis associated with COPD.

Question 18

Patients with COPD

COPD

Answer 18

Patients with COPD are encouraged to stop smoking as first-line therapy to prevent further damage to the lungs.

Question 19

supplemental oxygen,

COPD

Answer 19

They may require supplemental oxygen, where oxygen is provided through a tube or cannula that is inserted into the nose

Question 20

lung transplant

Severe COPD

Answer 20

Severe COPD with chronic respiratory failure may be treated with a lung transplant. This is where one or both lungs of a donor replace the damaged lungs of a COPD patient. After a lung transplant, patients are likely to experience improvement in their pulmonary function and exercise performance.

Question 20

Bronchodilators treat patients with COPD.

Answer 20

Bronchodilators are also commonly used to treat patients with COPD. Severe COPD with chronic respiratory failure may be treated with a lung transplant.

Question 21

pneumothorax

Answer 21

A pneumothorax is a medical condition where air collects in the pleural space.

Question 22

can be defined as a spontaneous pneumothorax

pneumothorax

Answer 22

It can be defined as a spontaneous pneumothorax, where the air collects in the pleural space without any underlying lung disease or trauma, or a secondary pneumothorax, where there is underlying lung disease.

Question 23

traumatic pneumothorax

Answer 23

A traumatic pneumothorax occurs because of trauma.

Question 24

iatrogenic pneumothorax

Answer 24

An iatrogenic pneumothorax results as an adverse outcome from a procedure, such as a bronchoscope, thoracentesis, lung biopsy, or central line placement.

Question 25

Symptons pneumothorax

Answer 25

Patients with a pneumothorax will feel short of breath and chest pain on the side of the pneumothorax. In mild cases, patients will have minimal symptoms. If the pneumothorax is large, the patient may have severe symptoms requiring intensive medical care. Air will be apparent on the chest x-ray.

Question 26

Treatment for a small, spontaneous pneumothorax

Answer 26

Treatment for a small, spontaneous pneumothorax will be observation, as it will resolve as the air is absorbed from the pleural space. A large pneumothorax may require placement of a chest tube that has a water seal and is attached to suction. As the patient inhales, the lung will expand and push the air in the pleural space out of the chest tube. The water seal will prevent the air from returning to the lungs.

Question 27

Acute respiratory distress syndrome (ARDS)

Answer 27

Acute respiratory distress syndrome (ARDS) is an emergent and life-threatening medical condition where a patient develops respiratory distress after an inciting event.

Question 28

conditions and situations that can lead to ARDS

Answer 28

Trauma, Sepsis and shock, Burns, CABG surgery, Drugs and drug overdose, Aspiration of stomach contents into the lungs, Near drowning Severe pneumonia

Question 29

Acute respiratory distress syndrome (ARDS)- Patients will present with

Answer 29

Patients will present with rapid progression of severe shortness of breath that occurs 12-48 hours after the inciting event. Physical examination of these patients will show labored breathing, tachypnea, and crackles.

Question 30

intercostal retractions

Acute respiratory distress syndrome (ARDS)- Patients will present with

Answer 30

Patients may also show intercostal retractions where the accessory muscles of breathing between the ribs will pull in as the patient breathes.

Question 31

Acute respiratory distress syndrome (ARDS) chest x-ray

Answer 31

The chest x-ray will show patchy diffuse infiltrates throughout the lung or a complete “white-out” where the infiltrates cover the entire lung.

Question 32

Treatment- Acute respiratory distress syndrome (ARDS)

Answer 32

Treatment involves identifying the underlying inciting event and treating that condition alongside the respiratory distress. Patients will usually require intubation and a mechanical ventilator. Intubation is a procedure where a tube, called an endotracheal tube, is entered through the mouth into the bronchial tree. The ET tube is attached to a mechanical ventilator, which is a machine that forces air into the lungs and assists the patient with breathing. If a patient fails to improve, they can undergo a tracheostomy and placement of the ET tube directly into the trachea in the neck. This is a semi-permanent placement of the ET tube and an indication that the patient may require mechanical ventilation for a longer period.