Respiratory Emergencies - Causes of Dyspnea part 1 Flashcards
Signs and symptoms of asthma
- Wheezing on inspiration/expiration
- Bronchospasm
Signs and symptoms of anaphylaxis
- Flushed skin or hives (urticaria)
- Generalized edema
- Hypotension
- Laryngeal edema with dyspnea
- Wheezing or stridor
Signs and symptoms of bronchiolitis
- Shortness of breath
- Wheezing
- Coughing
- Fever
- Dehydration
- Tachypnea
- Tachycardia
Signs and symptoms of bronchitis
- Chronic cough with sputum production
- Wheezing
- Cyanosis
- Tachypnea
Signs and symptoms of congestive heart failure
- Dependent (lower extremity) edema
- Crackles (pulmonary edema)
- Orthopnea
- Paroxysmal nocturnal dyspnea
Signs and symptoms of the common cold
- Cough
- Runny or stuffy nose
- Sore throat
Signs and symptoms of COVID-19
- Cough
- Fever
- Dyspnea
- Chest pain
- Anosmia (inability to smell)
Signs and symptoms of croup
- Fever
- Barking cough
- Stridor
- Mostly seen in pediatric patients
Signs and symptoms of diphtheria
- Difficulty breathing and swallowing
- Sore throat
- Thick, gray buildup in throat or nose
- Fever
Signs and symptoms of emphysema
- Barrel chest
- Pursed lip breathing
- Dyspnea on exertion
- Cyanosis
- Wheezing/decreased breath sounds
- Mostly seen in older patients
Signs and symptoms of epiglottitis
- Dyspnea
- High fever
- Stridor
- Drooling
- Difficulty swallowing
- Severe sore throat
- Tripod or sniffing position
- Mostly seen in pediatric patients
Signs and symptoms of influenza type A
- Cough
- Fever
- Sore throat
- Fatigue
Signs and symptoms of pertussis (whooping cough)
- Coughing spells
- Whooping sound
- Fever
Signs and symptoms of pneumonia
- Dyspnea
- Chills, fever
- Cough
- Green, red, or rust-colored sputum
- Localized wheezing or crackles
Signs and symptoms of pneumothorax
- Sudden chest pain with dyspnea
- Decreased breath sounds (affected side)
- Subcutaneous emphysema
Signs and symptoms of pulmonary embolus
- Dyspnea
- Occasionally will have a sharp chest pain
- Sudden onset
- Tachycardia
- Clear breath sounds initially
Signs and symptoms of tension pneumothorax
- Severe shortness of breath
- Diminished or absent breath sounds on one side
- Decreased/altered LOC
- Neck vein distention
- Tracheal deviation (late sign)
- Hypotension; signs of shock
Signs and symptoms of respiratory syncytial virus (RSV)
- Cough
- Wheezing
- Fever
- Dehydration
Signs and symptoms of tuberculosis (TB)
- Cough
- Fever
- Fatigue
- Productive/bloody sputum
An infectious disease in which a pseudomembrane forms, lining the pharynx; this lining can severely obstruct the passage of air into the larynx
Diphtheria
Severe shortness of breath, especially at night after several hours of reclining; the person is forced to sit up to breath
Paroxysmal nocturnal dyspnea
Severe dyspnea experienced when lying down and relieved by sitting up
Orthopnea
An acute or chronic inflammation of the lung that may damage lung tissue; usually associated with cough and production of sputum and, depending on its cause, sometimes fever
Bronchitis
Collapse of the alveolar air spaces of the lungs
Atelectasis
A patient with a disorder of the lungs likely has one of the following situations
- Gas exchange between the alveoli and pulmonary circulation is obstructed by fluid in the lung, infection, or collapsed alveoli
- The alveoli are damaged and cannot transport gases properly across their own walls
- The air passages are obstructed by muscle spasms, mucus, or weakened airway walls
- Blood flow to the lungs is obstructed by blood clots
- The pleural space is filled with air or excess fluid, so the lungs cannot properly expand
Besides shortness of breath, a patient with dyspnea may report ___
The sensation of chest tightness and air hunger
When a person reports a feeling of not getting enough air and has a strong need to breath
Air hunger
Chest tightness is described as ___
An uncomfortable feeling in the chest
When assessing a patient for complaints of dyspnea, ask about ___
Chest pain
When assessing a patient for complaints of chest pain, ask about ___
Dyspnea
In some patient’s breathing deeply causes pain because ___
It causes expansion of the chest wall
Infections that impair airflow through the airways are problems of ___
Respiration
Inadequate oxygen delivery to the tissues is a problem of ___
Oxygenation
Caused by inflammation and swelling of the pharynx, larynx, and trachea
Croup
Croup is often secondary to ___
An acute viral infection of the respiratory tract
Croup is typically seen in ___
Children between 6 months and 3 years
Peak seasonal outbreaks of croup occur in ___
Late fall and during the winter
Croup starts with ___
A cold, cough, and a low-grade fever that develops over a few days
The hallmark signs of croup are ___, which signal ___
- Stridor and a seal-bark cough
- A narrowing of the air passages of the trachea
Croup is rarely seen in adults because ___
Their breathing passages are larger and can accommodate the inflammation and mucus production without producing symptoms
Croup often responds well to the ___
Administration of humidified oxygen
___ are not indicated for croup and can worsen a patient’s symptoms
Bronchodilators
A life-threatening inflammatory disease of the epiglottis
Epiglottitis
Most common cause of epiglottitis
Bacterial infection
Epiglottitis was most commonly seen in ___ prior the the development of ___
- Infants and children
- a childhood vaccine against Haemophilus influenzae
In preschool and school-age children especially, the epiglottis can swell ___ with epiglottitis
2 to 3 times its normal size
Children with epiglottitis look ___
Ill, report a very sore throat, and have a high fever. Often found in the tripod position and drooling. Stridor is a late sign
How to treat children with suspected epiglottitis
Treat gently and try not to do anything that will cause the to cry. Keep them in the position of comfort, and give them high-flow oxygen. Do not put anything in the mouth, this could trigger a complete airway obstruction
You should be concerned if your adult patient presents with stridor or any other sign of airway obstruction without an ___
Obvious mechanical cause
For an adult with acute epiglottitis you should focus patient management on ___
Maintaining a patent airway and provide prompt transport to the ED
Common cause of illness in young children, causing an infection in the lungs and breathing passages, and can lead to other serious illnesses such as bronchiolitis and pneumonia, as well as serious heart and lung problems in premature infants and children who have depressed immune systems
Respiratory syncytial virus
RSV
Respiratory syncytial virus
RSV is spread by ___
Droplets when the patient coughs or sneezes. Can also survive on surfaces including hands and clothing
When assessing a child with suspected RSV, look for ___
Signs of dehydration
Infants with RSV often refuse ___
Liquids
How to treat RSV
Treat airway and breathing problems as appropriate. Humidified oxygen is helpful if available
A respiratory illness that often occurs due to RSV infection and results in severe inflammation of the bronchioles
Bronchiolitis
Bronchiolitis occurs most frequently in ___, during ___
- Newborns and toddlers, especially boys
- Spring and winter
During bronchiolitis the bronchioles become ___
Inflamed, swell, and fill with mucus
How to treat bronchiolitis
Mainly supportive. Provide appropriate oxygen therapy and allow the patient to remain in a position of comfort. Suctioning thick mucus from the nostrils if present. Reassess frequently for signs of worsening respiratory distress. Be prepared to provide airway management and positive-pressure ventilation if needed
General term that refers to an infection of the lungs
Pneumonia
Pneumonia is often a ___ infection
Secondary
Factors that predispose patients to pneumonia
- Institutional residence
- Recent hospitalization
- Chronic diseases processes
- Immune system compromise
- History of COPD
Interventions such as ___ can increase the risk of developing pneumonia
Intubation or tracheostomy
Children with pneumonia often present with ___
Unusually rapid or labored breathing or breathing characterized by grunting or wheezing sounds
White pneumonia cases where it is severe and the oxygen exchange at the alveoli is significantly impaired, the ___
Lips and fingernails may be blue or gray
If the pneumonia is in the lower part of the lungs, there may be ___
Fever, abdominal pain, and vomiting rather than dyspnea
Bacterial pneumonia results in ___
Severe symptoms more quickly, including high fevers which put the child at risk for febrile seizures
Other signs and symptoms of pneumonia
- Dry skin
- Decreased skin turgor
- Exertion dyspnea
- Productive cough
- Chest discomfort or pain that varies with inspiration and expiration
- Headache
- Nausea
- Vomiting
- Musculoskeletal pain
- Weight loss
- Confusion
- May be febrile, tachycardia, or even hypotensive
- May have diminished breath sounds along with the presence of wheezing, crackles, or rhonchi
- Pulse oximetry reading may be low
- Possible fever
Treatment of pneumonia
Airway support and supplemental oxygen
Pertussis is spread by ___
Droplet infection
A patient with pertussis will be ___
Feverish and exhibit a whoop sound on inspiration after a coughing attack
Symptoms of pertussis are similar to ___, but ___
- Colds
- Coughing spells can last for more than 1 minute, during which the child may turn red or purple
Infants and younger children with pertussis should be treated in a hospital because they are ___
At greater risk for complications such as pneumonia
An animal respiratory disease that has mutated to infect humans
Influenza type A
All strains of influenza type A ares spread by ___
Direct contact with nasal secretions and aerosolized droplets from coughing and sneezing by infected people
Influenza type A viruses cause ___
Fever, cough, sore throat, muscle aches, headache, and fatigue and may lead to pneumonia or dehydration
COVID-19 is a respiratory disease caused by the ___
Virus SARS-CoV-2
COVID-19 is transmitted by ___
Aerosol droplets, through airborne particles generated by sneezing or coughing, and by direct contact
COVID-19 can survive on surfaces for ___
Several days
Inability to smell
Anosmia
TB spreads by ___
Cough
TB most commonly affects the ___, but can also be found in ___
- Lungs
- Any organ in the body, especially the kidneys, spine, and lining of the brain and spinal cord (meninges)
TB can remain dormant for ___
Years
Patients with active TB involving the lungs will report ___
Fever, coughing, fatigue, night sweats, and weight loss
If the lung infection from TB becomes severe, the patient will experience ___
Shortness of breath, coughing, productive sputum, bloody sputum, and chest pain
PPE for treating a patient with suspected active TB
Gloves, eye protection, N-95 respirator plus a mask on the patient
Cause of an acute pulmonary edema
Left side of the heart cannot remove blood from the lung as fast as the right side delivers it
Result of an acute pulmonary edema
Fluid builds up within the alveoli and in the lung tissue between the alveoli and the pulmonary capillaries
___ often trigger this flash pulmonary edema
High BP and low cardiac output
Pulmonary edema is usually the result of ___
Congestive heart failure
Patient risk factors for congestive heart failure
Hypertension and a history of coronary artery disease and/or atrial fibrillation
A condition in which the atria no longer contract, but instead quiver
Atrial fibrillation
The patient with pulmonary edema usually experiences ___
Dyspnea with rapid, shallow respirations. In the most severe cases, you will see frothy pink sputum at the nose and mouth
Chronic congestive heart failure can have an acute onset occur when ___
The patient stops taking medication, eats food that is too salty, or has a stressful illness, a new heart attack, or an abnormal heart rhythm
What can trigger a pulmonary edema other than heart disease?
- Poisoning from inhaling large amounts of smoke or toxic chemical fumes
- Traumatic injuries to the chest
- Exposure to high altitudes
Pulmonary edema from reasons other than heart disease, fluid will ___
Collect in the alveoli and lung tissue in response to damage to the tissues of the lung or the bronchi
Signs and symptoms of congestive heart failure
- Difficulty breathing with exertion
- Sudden attack of respiratory distress that wakes them at night when they ae in a reclining position
- Coughing
- Feeling suffocated
- Cold sweats
- Tachycardia
Primary assessment findings for pulmonary edema
Cool, diaphoretic, cyanotic skin. Adventitious breath sounds such as crackles or wheezing. Tachycardia pulse. Hypertension early, followed by deterioration to hypotension as a late finding
