Respiratory disease pathophysiology Flashcards
Name the structures in upper respiratory tract
nasal passages, sinuses, nasopharynx, pharynx, larynx, tonsils, glottis
name the structures in lower respiratory tract
lower trachea, right and left bronchus, bronchial tree, lungs, pleural membranes, alveolar ducts, alveoli, mediastinum
order of conducting passages
Upper respiratory: nasal cavity –> pharynx –> larynx
Lower respiratory: trachea –> primary bronchi –> lungs
what is allergic rhinitis
an inflammatory disorder
clinical manifestations of allergic rhinitis
sneezing, rhinorrhea, pruritus, nasal congestion, and watery itchy eyes
what is allergic rhinitis triggered by
allergens that bind to IgE antibodies on mast cells - release inflammatory mediators
dust mites, mold
what is histamine
causes the majority of the symptoms associated with allergic reactions
- can be drug-induced, food, contacts
- hives or urticaria can develop
what are histamines
stored in the mast cells (skin and soft tissue) and the basophils (blood)
what can histamines cause when activated
hives and itching of skin
dilation of blood vessels resulting in erythema and hypotension
bronchoconstriction - shortness of air
effect sleep/wake cycles
increase the secretion of acid in the stomach
upper respiratory tract infection
viral self-limiting rhinitis sinusitis laryngitis laryngotracheobronchitis (croup) acute bronchitis influenza
what is rhinitis
the common cold
respiratory droplet
s/s of rhinitis
low-grade fever headache fatigue nasal congestion rhinorrhea cough
what is sinusitis
may be secondary infection
anything in the nose can increase risk
what is rhinovirus
early fall, spring, and summer
lives up to 3 hrs outside body
-on skin surface and on objects (doorknobs)
how does rhinovirus spread
droplet
contaminated objects
s/s of sinusitis
pain above or below eyes
cloudy, green, or yellow discharge
congestion
throat irritation
how to treat sinusitis
hard to treat with antibiotics
7 or more days
decongestants
epiglottitis clinical diagnosis
inspiratory stridor and retractions rapid onset of fever pain difficulty swallowing drooling (absence of barking cough differentiates from croup)
what is the steeple sign indicative of
epiglottal swelling
what drugs do you use to treat URIs
antihistamines
sympathomimetics
antitussives
expectorants
MOA of antihistamines
block histamine release from receptors
what are the indications for antihistamines
allergies, cold and flu symptoms
what does an antihistamine treat
edema, inflammation, itch, rash, red/watery eyes, runny nose, sneezing
what is a first generation antihistamine
diphenhydramine (Benadryl)
side effects of diphenhydramine
sedation, dry mouth, dizziness, low BP
what drugs are sympathomimetics (decongestant)
phenylephrine and pseudoephedrine
MOA of phenylephrine and pseudoephedrine
mimics the action of SNS, activates alpha 1-adrenergic receptors and causes vasoconstriction of blood vessels causing nasal turbinates to shrink and open nasal passage
indications of phenylephrine and pseudoephedrine
reduce nasal congestion, allergic rhinitis, sinusitis, common cold
SE of phenylephrine and pseudoephedrine
SE related to CNS –> agitation, insomnia, anxiety, tachycardia, heart palpitations
Nursing considerations for pseudoephedrine
potential for abuse
one of the active ingredients in meth
limits on how much a patient can get
patient education for sympathomimetics
do not use for more than 4 days –> rebound nasal congestion occurs if drug is abruptly stopped after prolonged use
-tapering off recommended
what drugs are antitussive
dextromethorphan, codeine, benzonatate
indication for antitussive
cough suppressant
MOA of antitussive (dextromethorphan, codeine, benzonatate)
directly suppresses the cough reflex in the brain
SE of dextromethorphan, codeine, benzonatate (Antitussive)
CNS depressant
- DO NOT take with other CNS depressants
- potential for abuse
what drug is an expectorant
guaifenesin (Mucinex)
MOA of guaifenesin
reduction in surface tension of secretion helping thin the mucus making it easier to expectorate
SE of guaifenesin
few, mild GI distress
nursing considerations for guaifenesin
be careful in patients with chronic cough/asthma
encourage fluid to help thin secretions as well
