Respiratory Lecture: Restrictive respiratory disorders, a Flashcards
Restrictive lung
disorders
A restrictive lung disorder occurs where the ability of the chest wall and diaphragm to move with respiration are restricted or impaired
Restrictive lung
disorders types
extrapulmonary, where the lung tissue is normal or intrapulmonary, where the lung tissue or pleura cause the constriction
Extrapulmonary
cns
neuromuscular
chest walll
cns
•Head injury, CNS lesion (tumour,
stroke)
•Opioid and barbiturate use
neuromuscular
Neuromuscular system • Spinal cord injury •Guillian-Bare syndrome • Myasthenia gravis • Muscular dystrophy
chest wall
Chest wall trauma (flail chest)
•Obesity –hypoventilation syndrome
• Kyphoscoliosis
Intrapulmonary
Pleural disorders
Parenchymal disorders
Pleural disorders
• Pleural effusion
• Pleurisy
• Pneumothorax (already discussed
with trauma)
Parenchymal disorder
• Atelectasis • Pneumonia (already discussed with infections) • Interstitial lung disease • Acute respiratory distress syndrome (ARDS)
Pleural effusion
Pleural effusion is an abnormal collection of fluid in the pleural space. It is an indication of underlying problem/disease process
Chest X-Ray
Signs and symptoms = dyspnea, cough and occasional sharp, non-radiating chest pain that is worse on inhalation Management = treat underlying cause, drain collection (UWSD), pleurodesis
Atelectasis
Collapsed, airless alveoli.
Mucus blocks bronchioles and the air beyond the
blockage is absorbed leaving an airless alveoli.
Atelectasis affect and lead
Can affect a lung segment, lobe or entire lung (on
occasion)
Can lead to pneumonia when bacteria grow in stagnant
mucus
Most common cause;
Atelectasis
Obstruction of the small airways with secretions
(common in bedridden patients, elderly, patients who
have had major abdominal or thoracic surgery and
those who smoke)
Nursing diagnosis include
Atelectasis
•Ineffective airway clearance related to
ineffective cough, pain, obstruction
•Impaired gas exchange related to
hypoventilation
Atelectasis
Nursing action;
✓Encourage deep breathing and coughing exercises ✓Incentive spirometer can assist ✓Adequate analgesia ✓Teach patient how to splint incisions when coughing
Interstitial lung disease
Diverse group of lung diseases (more than 200 types)
that are characterised by inflammation and or fibrosis
of the pulmonary interstitium
Interstitial lung disease type
They are chronic and progressive
Treatment is aimed at reducing exposure to causative
agent (where known) and treating the underlying
disease process. Often the cause is unknown as in IPF.
Prognosis is poor
Interstitial lung disease therapy
Supportive therapies, pharmacological therapies, lung
transplantation if suitable candidate
