respiratory diseases Flashcards
Asthma can be chronic or acute what is the difference?
chronic - is persistent, symptoms can be mild moderate or severe but you will have them all of the time.
acute - is intermittent, symptoms are not always there and you will feel normal between flareups.
Causes of asthma extrinsic and intrinsic ?
extrinsic = allergies
animals, dust, pollen, foods, pollution, respiratory infections, smoking/vaping
intrinsic = non-atopic (not allergies)
weather
stress/upset - anxiety
exercise
female hormones - oestrogen has a link to respiratory problems, a lot of adrenaline being released
factors that increase your risk of developing asthma?
Being female at birth
Black people are more affected
smoking, even 2nd hand smoke
working in an environment with irritants
respiratory infections
genetically predisposed
What are the signs/symptoms of a mild/moderate asthma attack?
wheezing and coughing, PT is still able to speak in full sentences, Symptoms are worsening.
Peak flow >50-70%
HR >125 over 5s, >140 under5s
RR >30 over 5s, >40 under 5s
What are the signs/symptoms of acute asthma attack?
wheeze and cough, inability to complete sentence in one breathe,
peak flow 50-33% best
HR >110 over 5s, >140 under 5s
RR >25 over 5s 40> under 5s
What are the signs/symptoms of life threatening asthma?
Silent chest (will hear some air entry but significantly reduced,
altered consciousness
exhaustion
arrhythmia
hypotension
cyanosis
poor respiratory effort
peak flow <33% at best
SpO2 <92%
What are the signs/symptoms of near fatal asthma?
requires mechanical ventilation
(in hosp - will show raised PaCO2, body can’t get rid of CO2 we can’t test for this)
Asthma management (assume not time critical but will still be very urgent)?
- remove any potential triggers
- encourage use of own inhaler if they have one
- calm breathing coaching as they will be very panicked
- O2 following guidelines (94-98/ their normal) can cause vasoconstriction
- Salbutamol nebuliser (5mg for an adult)
- Ipratropium bromide (similar to brown inhaler)
- Hydrocortisone or prednisolone (steroids, reduce inflammation)
- Adrenaline (is just to buy time to get to ED makes heart problem things worse, last resort kinda)
- Seretide - longterm steroid
- spacer with salbutamol for children or new ppl gives them more time to breathe in and get full dose
- be vigilant for signs of tension pneumothorax
- NaCl maybe if event leading to dehydration
What is COPD?
Chronic obstructive pulmonary disease
an umbrella term for diseases such as emphysema and chronic bronchitis.
it is where airflow is limited and not fully reversible.
What are the modifiable/non-modifiable risks for COPD?
Hereditary disposition
respiratory viral infection
smoking 85-90% of COPD patients were smokers
air pollution
occupational exposure
COPD patients in respiratory failure, what are the 2 types?
T1 - low O2 levels in blood, could be asthma and could have normal CO2 in comparison (will kill the pt quicker as giving more O2 will worsen the CO2 levels)
T2- raised CO2 in blood (will be worrying for pt with COPD)
What are the differences between Emphysema, chronic bronchitis,
emphysema - the lungs have lost elasticity, can result in barrel chest
chronic bronchitis - hypersecretion of mucus, due to continuous irritation the walls are thickened and inflamed, and their ability to remove the mucus is lost. they will commonly get infections.
What are the SPO2 levels expected from COPD pts ?
98-94% unless known otherwise
where it may be 92-89% and they will know its lower
COPD pts may retain CO2, or could have difficulty removing O2?
The bodys insufficiency to move O2 and CO2 in and out of the lungs can lead to hypoxia and hypercapnia, where the body becomes acidotic which can damage the kidney and brain etc. which is why you have to be careful giving COPD patients O2 as it can make one problem better (SPO2 levels) and one worse (acidosis)
signs and symptoms of emphysema and chronic bronchitis?
- breathlessness (worse on exertion)
- chronic recurrent cough, rapid onset
- regular sputum productions (change in colour)
- frequent lower respiratory tract infections
- wheeze and or crackles on auscultation
- weight loss (of muscle mass)
- waking breathless during the night
- ankle swelling (consider r-sided HF)
- cyanosis
- raised jugular vein
- cachexia (muscle wastage, due to the alveoli damage)
- hyperinflation of chest (barrel chest!)
- extra use of accessory muscles
