respiration Flashcards
Completed
COPD stands for
chronic obstructive pulmonary disease.
name two common obstructive airway conditions
asthma, copd
name the 2 most common copd
emphsema and chronic bronchitis
copd costs the nhs how much p/y
6.6 billion
acute bronchitis is… lived due to …
short, infection
chronic bronchitis is where… glands secrete excess … which can block the airway
mucous, mucus
lung damage may results in…
heart failure
name as may signs and symptoms of bronchitis as you can.
productive cough, usually cyanotic(blue), tachycardia, tachypnoea, dyspnoea, use of accessory muscles, pupils dilated/ slow to react (uncommon), oedema (fluid build up), normal to high BP, slow capillary refill, decreased SPO2, auscultation may reveal rhonchi and wheezes, use of domiciliary O2, level of consciousness may be reduced if hypoxia is severe.
In COPD patients what is normal O2 saturation.
88-94%
management of bronchitis
ensure open airway (suction possible), administer O2 (JRCalc), consider salbutamol and ipatpropium, maintain as upright as possible, be prepared to ventilate, encourage coughing.
In COPD salbutamol should be on what ltr of O2 and for how long?
6 litres for only 6 minutes.
what is emphysema
distension of the alveoli and destructive changes in the membranes.
what is a common cause of emphysema
smoking- lung tissue looses elasticity.
Are emphysema patients usually cyanotic?
no usually just hypoxic.
name as many emphysema signs and symptoms as possible
usually thin, large chest, normal skin colour, tachycardia, tachypnoea, dyspnoea, use of accesory muscles, elevated BP cyanosis in acute attack, pursed lips on expiration, confusion and anxiety due to hypoxia, wheezing and crackles on auscultation on cardiac dysrhythmias, may have oedema.
emphysema management
open airway, salbutimol and ipapropium, give O2, maintain as close to upright as possible, be prepared to ventilate.
what is asthma
narrowing of medium to small airways due to muscle spasm, oedema and blockage by inflammatory cells.
what can cause asthma
infections, cold air or inhaled irritants, poor childhood living conditions, smoking, premature birth, childhood diseases.
acute severe asthma symptoms
resp rate >25, pulse >110, peak flow 33-50% of predicted best value, unable to complete sentences in one breath.
life threatening asthma symptoms
exhaustion, confused, coma, silent chest, cyanosis, feeble resp effort, bradycardia, hypotension, peak flow <33%, SPO2 <92%.
asthma treatment
open airway, use inhaler, salbutamol in O2, and iprotropium, adrenaline, steroids.
impared perfusion of the alveoli
pneumonia, pleurisy, PE (pulmonary embolism), TB, industrial lung diseases.
What should you always ask an asthmatic when treating them?
have they ever been in ICU or ventilated?
pneumonia is…
acute inflamation of the lungs caused by a virus or bacteria.
what commonly causes pneumonia?
follows cold, particularly elderly or those with chronic bronchitis.
signs and symptoms of pneumonia
tachypnoea and shallow, cough up sputum which may be blood stained. deep breaths and coughing will cause distressing chest pain, pyrexia, flushed face.
pneumonia management
open airway, administer O2, monitor vital signs.
pleurisy is…
Inflammation of the pleura, often occurs with pneumonia. has a characteristic rubbing sound on auscultation, treated like pneumonia.
Pulmonary embolism is…
a blood clot that blocks part of the pulmonary artery which deprives part of a lung of its blood supply. may cause infarction (death of area of lung).
causes of PE
Deep vein thrombosis, elderly, atrial fibrillation, recent operation, long distance travel, childbirth, contraceptive pill.
signs and symptoms of PE
Dyspnoea, tachycardia, pleuritic pain, apprehension, cough, tachypnoea, haemoptysis (coughing blood), leg pain- clinical DVT.
PE management
open airway, entinox, O2, prepare for CPR.
TB is…
chronic lung infection that may persist for several years. patient may not have particular symptoms.
signs and symptoms of TB
Fever, weight loss, cough- often with haemoptysis.
hyperventilation syndrome
rate of breathing exceeds metabolic demand. It is higher than what is required to maintain normal CO2 levels.
causes of hyperventilation syndrome
PE, diabetic ketoacidosis, asthma, hypovolemia (lack of blood), emotion stress or anxiety.
signs and symptoms of hyperventilation
acute anxiety, tetany, carpopedal spasm, numbness and tingling of mouth and lips, aching of chest, feeling lightheaded.
management of hyperventilation
open airway, O2 if cyanosed, maintain calm approach, coach respiration and encourage talking, DO NOT USE a paper bag or anything else for the patient to breath into.
Name the 4 industrial lung disease
Pneumoconiosis, silicosis, asbestosis, byssinosis.
tension pneumothorax
air enters pleural cavity through open chest wound but tissue acts as one way flap so pleural cavity increases, decreasing lung capacity.
signs and symptoms of tension pneumothorax
dyspnoea, panic, cyanosis, haemoptysis, pain at site, tachycardia, tachypnoea, asymmetry of chest.
signs and symptoms of tension pneumothorax
extreme respiratory distress, severe pain, incrased cyanosis, diminished breth sounds (on affected side), hyperresonance (on affected side), possible evidnce of subcutaneous emphysema, tracheal deviation (late sign).
management of tension pneumothorax
100% O2, needle decompression.
When should you take peak flow?
Before and after treatment.
What factors impact peak flow in a healthy person?
Height and sex
How many readings of peak flow should be taken each time?
three
Which reading is taken out of the peak flow readings?
The best.
What should be done between each peak flow reading?
Allow for rest.
What does salbutamol do?
Relaxes muscle in the medium and small airways, moistens airway.
What type of drug is salbutamol?
Selective beta2 adrenoceptor
Nebules of salbutamol contain what dosage?
2.5mg/2.5ml and 5mg/2.5ml
When is salbutamol nebulising used?
acute asthma where normal inhaler has failed. Exacerbated COPD. Allergy/anaphylaxis and smoke inhalation. Basically any lower respiratory issue.
Cautions of using salbutamol
hypertension, angina, overactive thyroid, late pregnancy, Severe hypotension in beta blocker users, COPD patients should only have 6minutes/6litres.
Side effects of salbutamol
tremor, tachycardia, palpitations, headache, feeling of tension, peripheral vasodilation, muscle cramps, rash.
what do you give first for asthma and COPD- salbutamol or ipratropium?
salbutamol then 1 dose of ipratropium then salbutamol repeatedly.
adult salbutamol dose
5mg every 5minutes
what type of drug is ipratropium bromide
antimuscarinic brocodilator
what effect does ipratropium have
short term relief in children with acute severe/ life threatening asthma of adults with COPD.
what dosage of ipratropium nebules are there?
250mcg/1ml and 500mcg/2ml.
What are the contra-indications of ipratropium in emergency situation?
None.
Cautions for ipratropium.
Glaucoma- protect eyes from mist. Pregnancy and breast feeding. Prostatic hyperplasia. COPD 6litres/6minutes.
Side effects of ipratropium.
nausea and vomiting, dry mouth, achycardia/arrhythmia, paroxysmal tightness of the chest, allergic reaction.
Adult dose of ipratropium
500mcg/2ml (no repeat dose – max dose of 500 mcg).
What type of drug is adrenaline?
Sympathomimetic that stimulates both alpha and beta adrenergic receptors.
What is adrenaline 1:1000 used for?
Reverses allergic manifestations of acute anaphylaxis, Relieves bronchospasms in acute-severe asthma.
When is adrenaline given in asthma?
Life threatening when with failing ventilation and continued deterioration despite nebuliser therapy.
Adrenaline cautions
Severe hypertension may occur in patients on beta-blockers, do not administer IV adrenaline in cases of anaphylaxis.
Adrenaline dosage for adults
500 mcg every 5 minutes intramuscular. No max dose.
What does hydrocortisone do?
Reduces inflammation and suppresses the immune response.
What is in hydrocortisone?
An ampoule containing 100mg of hydrocortisone sodium succinate for reconstitution with up to 2mls of water.
When is hydrocortisone used?
Severe or life-threatening asthma, anaphylaxis, adrenal crisis.
Contraindications for hydrocortisone.
Allergies (patients may be allergic to the sodium component).
Cautions in hydrocortisone.
None, although avoid IM injections if the patient requires thrombolysis.
Side effects of hydrocortisone.
May cause burning or itching in the groin if administered too quickly.
Hydrocortisone dosage for asthma.
Slow IV injection over 2 minutes (IM if IV is not possible). 100 mg in 2ml for IV (adult)/ 100 mg in 1 ml for IM (adult).
