Respiratory Conditions Flashcards
What is happening during an asthma attack?
spasms in the bronchi due to irritation. They contract causing a sudden worsening of symptoms
Signs and symptoms of asthma
shortness of breath, chest tightness, coughing attacks, wheeze during expiration,
Asthma: History taking questions
How often do they struggle with their asthma symptoms
is it normally well controlled
do they have a respiratory nurse
any recent admissions
how often do they use their inhaler
Treatment of mild to moderate asthma
encourage use of inhaler if oxygen sats are normal
2 puffs every 2 minutes for up to 10 puffs
if this does not help then use nebulised salbutamol
Treatment of acute-severe asthma
5mg of nebulised salbutamol with 6-8L/min oxygen
Ipratropium Bromide 500mcg nebulised
Hydrocortisone 100mg IV
Prednislone 40mg oral
Magnesium sulphate 2g IV over 20 mins
Adrenaline 1:1000 500mcg IM
Asthma: Life threatening signals
altered consciousness
extreme difficulty with breathing
exhaustion
cyanosis
silent chest
poor resp effort
oxygen sats less than 92%
Hypotension
arrythmia
PEF less than 33%
How does salbutamol work?
smooth muscle relaxant
bronchodilation
What is chronic bronchitis
clinically defined as a persistent cough with sputum production
What is emphysema?
permanent enlargement of the air spaces below terminal bronchioles as a result of destruction of alveoli walls
Treatment for COPD
oxygen, salbutamol, and ipratropium bromide
limit nebulisation to 6 minutes in patients who retain carbon dioxide
Signs and symptoms of COPD
increased dyspnoea
increased sputum production
increased chronic cough
increased wheeze
breathlessness
fatigue
confusion
frequent winter bronchitis
COPD severe episode symptoms
tachypnoea
pursed lip breathing
new onset cyanosis
new onset peripheral oedema
exhaustion
confusion
use of accessory muscles
Pneumonia overview
infection of terminal bronchioles and alveoli
lobar: localised to one lobe of the lung
Bronchopneumonia: widespread infection
Symptoms: fever, cough, pleuritic chest pain, muscle and joint pain, pyrexia, tachypnoea, tachycardia, crackles
Treatment: antibiotics, rest and fluids
What is an embolus
a blood bourne substance that is transported from one part of circulation to another, lodging in a blood vessel that is too small for it to pass through.
Signs and symptoms of a pulmonary embolism
pleuritic chest pain, tachypnoea, tachycardia, oxygen sats less then 92%, cough, haemoptysis, syncope
Moderate risks for developing a pulmonary embolism
chronic heart or respiratory failure
Chemo
Hormone replacement therapy
cancer
oral contraceptives
paralytic strokes
post partum
thrombophilia
Low risks of developing a pulmonary embolism
best red
increased age
obesity
pregnancy
varicose veins
What are cheyne stroke respirations?
a breathing disorder characterised by irregular cyclical episodes of apnoea and hyperventilation
Pneumothorax overview
types
symptoms
treatment
abnormal collection of air within the pleural spaces which can lead to lung collapse
spontaneous: rupture of small sacs in the lung
Tension: progressive build up of air in the pleural space often due to a laceration
Open: external chest wound causing a tension pneumothorax
Symptoms: pleuritic chest pain, resp distress, tachypnoea, tachycardia, falling oxygen sats, agitation, decreased breath sounds and hyperresonance
Treatment:
oxygen
open chest wound: chest seal and needle thoracentesis
Breathing in children:
abnormal breathing sounds
positioning
recession
management
breath holding
snoring. muffled or hoarse speech, stridor, grunting or wheezing
excessive muscle use
use of chest muscles, laboured breathing, head bobbing, nasal flaring
high flow oxygen via non re breath mask, reassess RR, assess level of consciousness
stopping breathing for up to a minute. can become blue, floppy and stiff.
