Respiratory disorders Flashcards
- Passage of fluid or food, vomitus, drugs, other foreign material into trachea and lungs
- Which lung is more common?
- Cough usually will remove material if in upper tract
- Vocal cords and epiglottis normally prevent entry into lower tract
Aspiration
Effect on respiratory function depends on characteristic of the item aspirated
Solid objects, acidic secretions, etoh, lipids
Obstruction is common: either directly (object) or indirectly (inflammation)
Inflammation can inhibit gas exchange: increases risk of pneumonia
pathophysiology of aspiration
carrot or coin: may obstruct airflow and cause inflammation and swelling
Piece of steak (large object): occlude trachea, block airflow, can lose consciousness quickly
Hot dog: lodge in bronchus: collapse of area distal
Can have ball-valve effect: air in on inspiration, closes on expiration, air builds up
Pea or bean: may swell
Fatty or irritating solids: cause inflammation to area, may develop granuloma or fibrous tissue
Effects of aspirated solid
Acidic, etoh or oils: disperse into several bronchi and cause inflammation Narrow airways and increase secretions Can cause impairment of gas diffusion Other complications Respiratory distress syndrome Pulmonary abscess Solvents can be absorbed
Aspirated liquid
Young children Put objects in mouth Smooth round objects most dangerous Hot dogs, candy, carrots, coins, balloons, toxic fluids Depressed swallowing or gag reflex Post anesthesia, stroke Adults Eating and talking Alcohol intake
Etiology of aspiration
Cough, choke with marked dyspnea Stridor or hoarseness Wheezing Tachycardia, tachypnea Nasals flaring, chest retraction May reach for chest or neck
Signs and symptoms of aspiration
Prevent Cough it up Can use finger probe Heimlich maneuver Back blows Instrumentation may be needed Oxygen, supportive therapy, prophylactic antibiotics
Treatment for aspiration
Usually secondary
Usually occurs with CF or COPD
Childhood infections: aspiration
Bronchiectasis
Irreversible abnormal dilation or widening of of the medium-sized bronchi
Usually from recurrent inflammation and infections
Obstruction in airways or weakening of muscle and elastic fibers
Can be localized in one lobe or more diffuse
Fluid can collect and gets infected
Obstructionloss of ciliadifficult to remove fluid
Pathophysiology of Bronchiectasis
Chronic cough Copious amounts of purulent sputum Paroxysmal cough in morning Rhales and rhonchi can be heard Foul breath, dyspnea, hemoptysis Weight loss, anemia, fatigue
Signs and symptoms of Bronchiectasis
Antibioitics
Bronchodilators
Chest PT
Treat the primary condition
treatment of Bronchiectasis
Lung expansion is impaired
Reduced lung capacity
Some diseases demonstrated obstructive and restrictive signs
Restrictive lung disorders
Abnormality of chest wall
Restrictive Lung Disorders
Chronic long term exposure to irritating substances
Coal dust, silica, asbestos, fungal spores
Overload of small particles, difficult for cilia, mucus and nasal hairs to handle
Exposure over long time period, large number of particles, particles are very small
Aggravated by smoking
Pneumonconioses
Inflammation occurs Develop fibrous tissue Destroy connective tissue May have immune response (silica) Lose functional areas of lung Inspiration is difficult Tissue changes are irriversible
Pathophysiology of Pneumonconioses
Can cause pleural fibrosis
Increases risk of lung cancer (cigarette smokers)
Asbestos
Insidious onset
Develop dyspnea
Difficulty with inspiration
Cough is common…productive?
Signs and symptoms of Asbestos
Stop the exposure
Treat infections
Treatment of Asbestos
Pulmonary edema
Fluid collects in alveoli and intersitial area
Fluid decreases amount of oxygen diffusing into blood
Difficulty with lung expansion
Occurs when:
Inflammation is present
Plama protein levels are low (decrease plasma osmotic pressure)
Pulmonary hypertension
Vascular disorders
Left sided congestive heart failure
Hypoprotienemia (liver, kidney disease)
Inflammation in lungs (tumors, toxic gasses)
Blocked lymphatic drainage (tumors, fibrosis)
Etiology of vascular disorders
Mild pulmonary edema
More severe edema
Signs and symptoms of vascular disorder
Cough
Orthopnea
Rales
Mild pulmonary edema
Hemoptysis Frothy sputum Labored breathing Feels as if drowning Hypoxemia cyanosis
More severe edema
Treat the cause
Supportive care
Positive pressure mechanical ventilation
More at risk for pneumonia
Treatment for edema
Blood clot or mass that obstruct pulmonary artery or branch of it
Blocks flow of blood through the lung tissue
Usually caused by blood clots in leg veins
Lodges in lung as gets to smaller arteries
Leading cause of death in hospitals
600,000 people a year have PE, 60,000 die
Pulmonary Embolus
