Respiratory Conditions

Question 1

What is happening during an asthma attack?

Answer 1

spasms in the bronchi due to irritation. They contract causing a sudden worsening of symptoms

Question 2

Signs and symptoms of asthma

Answer 2

shortness of breath, chest tightness, coughing attacks, wheeze during expiration,

Question 3

Asthma: History taking questions

Answer 3

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

Question 4

Treatment of mild to moderate asthma

Answer 4

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

Question 5

Treatment of acute-severe asthma

Answer 5

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

Question 6

Asthma: Life threatening signals

Answer 6

altered consciousness

extreme difficulty with breathing

exhaustion

cyanosis

silent chest

poor resp effort

oxygen sats less than 92%

Hypotension

arrythmia

PEF less than 33%

Question 7

How does salbutamol work?

Answer 7

smooth muscle relaxant

bronchodilation

Question 8

What is chronic bronchitis

Answer 8

clinically defined as a persistent cough with sputum production

Question 9

What is emphysema?

Answer 9

permanent enlargement of the air spaces below terminal bronchioles as a result of destruction of alveoli walls

Question 10

Treatment for COPD

Answer 10

oxygen, salbutamol, and ipratropium bromide

limit nebulisation to 6 minutes in patients who retain carbon dioxide

Question 11

Signs and symptoms of COPD

Answer 11

increased dyspnoea
increased sputum production
increased chronic cough
increased wheeze
breathlessness
fatigue
confusion
frequent winter bronchitis

Question 12

COPD severe episode symptoms

Answer 12

tachypnoea
pursed lip breathing
new onset cyanosis
new onset peripheral oedema
exhaustion
confusion
use of accessory muscles

Question 13

Pneumonia overview

Answer 13

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

Question 14

What is an embolus

Answer 14

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.

Question 15

Signs and symptoms of a pulmonary embolism

Answer 15

pleuritic chest pain, tachypnoea, tachycardia, oxygen sats less then 92%, cough, haemoptysis, syncope

Question 16

Moderate risks for developing a pulmonary embolism

Answer 16

chronic heart or respiratory failure

Chemo

Hormone replacement therapy

cancer

oral contraceptives

paralytic strokes

post partum

thrombophilia

Question 17

Low risks of developing a pulmonary embolism

Answer 17

best red

increased age

obesity

pregnancy

varicose veins

Question 18

What are cheyne stroke respirations?

Answer 18

a breathing disorder characterised by irregular cyclical episodes of apnoea and hyperventilation

Question 19

Pneumothorax overview

types
symptoms
treatment

Answer 19

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

Question 20

Breathing in children:
abnormal breathing sounds
positioning
recession
management
breath holding

Answer 20

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.