Respiratory System Flashcards
Pathophysiology of COPD
COPD is a pulmonary disease that causes obstruction of airflow in the lungs.
inflammation of bronchioles become deformed, narrow
Excessive mucus production
Inability to fully exhale
COPD is irreversible
can be mild or severe
managed with lifestyle changes + medications
Causes of COPD
Environmental irritants, ie. smoking, poor air pollution.
Usually happens gradually, most notice signs and symptoms middle age
May have constant or chronic COPD
productive or non-productive cough
dyspnea
recurrent lung infections
Gas Exchange Related to COPD
Not enough oxygen getting in, retaining carbon dioxide
Experiencing respiratory acidosis
Red blood cells waiting to be deoxygenated but cannot due to low amounts of oxygen
The body compensates by producing more red blood cells but this causes the blood to become too thick
increases the pressure in the pulmonary artery = pulmonary hypertension
blood backs cup in right side of heart
Right side heart: pulmonary artery brings un-oxygenated blood to the lungs to become oxygenated
Blue Bloaters COPD
Chronic bronchitis = Blue bloaters
Cyanosis and edema due to hypoxia (blue Around the mouth), swelling
can lead to right sided HF
Bronchioles inflamed, damaged + produce mucous = Retain CO2 which leads to hyper inflammation of the lung and a flattened diaphragm
Pink Puffers COPD
Hyperventilation = Pink complexion = empyema
Alveoli sac loses elasticity due to inflammation
poor gas exchange
increased CO2 = low oxygen
Hyperinflation of the lungs
enlarged lungs
flattened diaphragm
use of accessory muscles
Barrel chest
Symptoms of COPD
Remember LUNG DAMAGE
Lack of energy
Unable to tolerate activity (SOB)
Nutrition poor (weight loos, emphysema)
Gas abnormal (PCO2 >45 + PO2 <90 - respiratory acidosis )
Dry productive cough
Accessory muscles for breathing/abnormal lung sounds
Anteroposterior diameter (barrel chest)
Gets in tripod position to breath
Extrememe dyspnea
Nursing Interventions COPD
High Fowlers
Assess lung sounds and sputum production
Teach pursed lip breathing + diaphoretic breathing
Adminster breathing tx such as inhalers
Oxygen as needed
Keep O2 88-92% due to low oxygen levels (too much oxygen could cause them to stop breathing or increase CO2 production)
How to diagnose COPD
Spirometer: how much volume the lungs can hold during inhalation, how fast air volume is exhaled
Low reading = restrict breathing and Increased Severity
Other tests: Chest Xray and ABGs
Complications COPD
(Rylee loves licking pachos penis)
Right sided HF
Lung infections
Lung Cancer
Pneumonia
Pneumothorax
Education COPD
Nutrition: High cal + protein
Small frequent meals
2-3L of Water
Avoid sick people + irritants
Stop smoking
Vaccinations up to date
Pathophysiology Asthma
Chronic lung disease that causes
narrowing and inflammation of the airways
no cure
Asthma is caused by triggers
The smooth muscle constricts
less airflow
Chest tightness
Dyspnea
Mucosa lining and goblet cells produce excess mucus leading to
coughing
decreased airflow
wheezing (heard on expiration)
Respiratory acid
Cause of Asthma
unknown
there are many triggers
environmental factors
respiratory infections
GERD
hormonal shifts
exercise induced
Substance indued
Early Signs and Symptoms of Asthma
Early: should have asthma action plan in place
Shortness of breath
Easily fatigued with physical activity
Frequent cough (night) + issues sleeping
Signs and symptoms similar to cold: sneezing, scratchy throat, tired, irritable, wheezing with activity
Active Signs and Symptoms of Asthma
Active: During asthma attack
Chest tightness
Wheezing
Coughing
Dyspnea
Increased respiratory rate
If not treated can progress to…
Cannot speak
Chest retractions
Cyanosis lips + Skin
Sweaty
Rescue inhalers do not work - medical treatment asap
Nursing Interventions Asthma
Presents with an attack…
Be sure to gather a baseline assessment
High fowlers
O2 95-99%
Keep pt clam
Bronchodilators
Assess lungs, Vital signs cyanosis, retractions, ease of speaking and peak flow meter reading
Peak Flow Meter
Shows how controlled asthma is/is it getting worse
Use with action plan + lets to know when they need their short acting bronchodilator + when its time too get medical help
Personal best = highest number over a period of time, number will be used to compare against other readings, should do this when asthma is under control
Less than 80% = follow action plan
Patient Education Asthma
Asthma Action plan
Know the Triggers + warning signs
Don’t quit exercising: Warm up 10-15 min before exercising, take short acting beta agonist before
Breath through nose, wear scarf on cold windy days
Don’t exercise when sick
Pathophysiology Pneumonia
Lower respiratory infection
inflammation of the alveoli sacs (alveoli sacs are responsible for gas exchange)
Alveoli sacs become inflamed, full of fluid, WBCs, RBCs and bacteria which makes them unable to open and close properly
Build up of CO2 = low oxygen = Hypoxemia = Respiratory acidosis
Risk Factors Pneumonia (could lead tot death if you have…)
Prior infection (influenza, cold)
Weak immune system (young/old or HIV)
Immobile: Stroke, decreased neurological status, aspiration risks
Lung problems: COPD, smoker
Post op: abdominal + chest surgery (hospital acquired pneumonia)
Types of Pneumonia
Community acquired: Most occurring, pt got germs outside healthcare setting
Hospital acquired: Pt on technical ventilation is at major risk
hard to treat, most serious, bacteria tends to be very strong and resistant to antibiotics, pt developed 48-72 hours after admission
Diagnosis Pneumonia
Auscultation of lungs
Coarse crackles, bronchi or brachial breath sounds
Chest X-ray + sputum culture (to identify germ)
Education Pneumonia
Incentive spirometer usage every 1-2 hours
Stay hydrated 2-3L per day = thin secretions
If they have a fever/dehydration they will loose 300-400ml/day watch for HF
Immobile = turn pt + keep HOB 30%
Stop smoking
Keep vaccinations up to date
Signs and Symptoms Pneumonia
P N E U M O N I A
Productive cough
Pleuritic pain (chest pain when coughing or breathing)
Neurological changes (elderly/fatigue, increased respiratory rate)
Elevated labs: PCO2 > 45 + Increased WBCs
Unusual breath sounds
Mild to high fever
Nausea + vomiting
Need for oxygen
Increased HR + RR
Aching all over + activity intolerance with SOB
Nursing Interventions Pneumonia
Assess Lung sounds, Vitals, Color of skin
Collect sputum
Monitor ABG results
Chest xray
Breathing treatments
Chest percussion
Suction as needed
Pulmonary Edema Pathophysiology
Fluid in the lungs
risk factors: anything that can cause fluid overload eg. kidney failure, HF
Medical Emergency:
results in SOB
prevents the body from being able to get adequate amounts of oxygen
Signs and Symptoms Pulmonary Edema
(happy people don’t try pot just cocaine careful of over dose)
Hypoxemia
Dyspnea
Tachypnea
Pink frothy secretions
Orthopnea
Diaphoresis
Cyanosis
Peripheral edema
JVD
Crackles on auscultation
Diagnosis (Tests) Pulmonary Edema
Chest X-ray
ABGs
Treatment Pulmonary Edema
Oxygen
Diuretics
Medication to strengthen heart muscles/relieve pressure on the heart
Cause of Pulmonary Edema
CHF
the left ventricle struggles to pump blood which causes fluid to leak from the vessels and begin to accumulate in the lungs
Refractory Hypoxemia
The patient will maintain a low blood oxygen level even though they are receiving high amounts of oxygen
Acute Respiratory Distress Syndrome
Type of respiratory failure
occurs when the capillary membrane that surrounds the alveoli sac becomes damaged which causes fluid to leak into the sac
Results in impaired gas exchange
Not enough oxygen to the body and organs
fast onset
occurs in people who are already sick
high mortality rate
Indirectly: Sepsis, burns, blood transfusion, drug overdose, inflammation off pancreas
Direct: Pneumonia, aspiration, inhaling toxic substance, drowning, embolism
Pleural Effusion Pathophysiology
Collection of fluid in the pleural space (outside the lungs)
restriction of lung expansion
The pleural are thin membranes that line the lungs and the inside of the chest cavity
Causes of Pleural Effusion
Very common
Excess fluid may either be protein poor (transudative) or protein rich (educative) these categories help determine the cause of the pleural effusion
Common causes of Transudative plural effusion
Protein poor
Heart Failure
Pulmonary Embolism
Cirrhosis
Post open heart surgery
Common causes off exudative plural effusion
Protein Rich
Pneumonia
Cancer
Pulmonary embolism
Kidney Disease
Inflammatory disease
Signs and Symptoms Pleural Effusion
(Al, Cries, over, Dead, Dogs)
Some patients are asymptomatic
Chest pain
Dry, non productive cough
Dyspnea
Orhopnea: inability to breath easily, unless the person iim sitting up straight out standing
Diagnosis of Plural effusion
Chest Xray
CT scan of chest.
Ultrasound of chest
Thoracentasis - sample of fluid
Pleural fluid analysis
Treatment of Pleural Effusion
Based on underlying condition
Diuretics + other heart failure meds are used
If causing respiratory symptoms - thoracentesis or chest tubes may be used for drainage