Respiratory system diseases 1,2,3 Flashcards
orthopneoa
adopting posture to facilitate breathing
- neck extension
hyperpnoea
- increased resp effort (deeper) without dyspnoea
respiratory distress clinical signs
- tachypnoea/hyperpnoea
- orthopnoea
- visibly distressed/mouth breathing
- resp noises
- inspiratory (stertor/stridor) upper airway
- expiratory (wheezes, crackles on auscultation) lower airway
- cyanosis
- tachycardia, weak pulse
types of dyspnoea
- inspiratory- abnormal resp noises
- expiratory- abnormal auscultation
- mixed- parenchymal disease
oxygen administration options in conscious patients
- flow by
- face mask
- nasal prongs
- nasal catheter (longer term use)
- oxygen tent
- incubator
oxygen administration options in unconscious patients
- intubation
- tracheostmony
upper resp tract diseases (larynx, pharynx, trachea)
- BOAS
larynx- laryngeal paralysis (dog, lymphoma (cat)
pharynx- poly (cat), foreign body
trachea- tracheal collapse
Cinical signs of URT disease
- inspiratory dyspnoea
- nasal discharge
- sneezing/reverse sneezing
- stertor
nursing considerations for URT disease
- sedation
- oxygen
- keep cool
- avoid collars
- exercise
common causes for nasal disease
inflammatory: idiopathic
infectious
- bacterial
- virus
- fungal (aspergillus)
neoplastic
trauma
foreign body
dental disease
nursing care for nasal disease
- treat dyspnoea first
- stop any haemorrhage
- remove foreign object
- monitor fluid/food intake
- decongestant therapy
- isolate cats (possinly infectious)
investigations of nasal disease under GA
- full oral examination
- dental probing
- nasopharyngeal swab in cats
- imaging
- rhinoscopy
Aspergillosis cause
Aspergillus fumigatus
Aspergillosis clinical signs
- nasal discharge/bleeding
- sneezing
- pain
- nasal depigmentation
- predisposed in meso/dolichcephalic breeds
Diagnosing aspergilliosis using rhinoscopy
identification of fungal plaques
aspergilliosis treatment
- mechanical debridement endoscopically
- trephination into frontal sinus (drilling)
- topical antifungal
primary abnormalities in BOAS
- excessive soft tissues
- stenotic nares
- elongated/thick soft palate
- hypoplastic trachea
compensation in BOAS
harder inspiration
causing negative pressure in throat, neck, chest
causing laryngeal collapse and hiatal hernia
BOAS diagnosis
- physical exam
- fluoroscopy
- CT scan
BOAS nursing care
- owner education
- discourage breeding
- calm and stress free
- weight management
- avoid excessive heat
- harness instead of collar
cough: pathophysiology
- protective reflex to clear excess secretions/foreign material
- also associated with cong. heart fail.- enlarged left atrium puts pressure on airway
investigation of lower resp disease
- faecal analysis (lungworm)
- radiography/CT
- bronchoscopy
Bronchoscopy
- small tube down trachea
- collects broncho-alveolar lavage samples
Bronchoscopy equipment
- endoscope
- sterile saline
- collection pots
- mouth gag
- urinary catheter
- syringes
Bronchoscopy nursing considerations
- coupage required
- monitor until fully recovered
- easy access to emergency drugs/oxygen
- potential thoracocentesis
main lower airway diseases
- canine acute tracheobronchitis (kennel cough)
- canine chronic bronchitis
- feline lower airway disease (asthma)
canine tracheobronchitis
- can be caused by different viruses/bacteria
- most resolve after 14-21 days
- can progress to pneumonia
- highly contagious
viruses causing canine tracheobronchitis
- adenovirus 2
- parainfluenza virus
- herpes virus
bacteria causeing canine tracheobronchitis
bordetella bronchiseptica
canine chronic bronchitis
- chronic bronchial inflammation with over-secretion of mucus
- common in middle-aged and old dogs
- can cause tracheal collapse, mitral valve disease, pulmonary hypertension
canine chronic bronchitis pathophysiology
- predisposed by kennel cough, allergens, parasites
- narrowing of lower airway
- inflammation/mucus obstruction
- bronchomalacia- weakened cartilage
- bronchiectasis- end-stage bronchial change
bronchomalacia
weakened cartilage
bronchiectasis
end-stage bronchial change
- bronchioles merged together
chronic bronchitis nursing considerations
- weight control
- avoidance of airway irritants (smoke, dust)
- owner support with medication
inhaled therapy
- for corticosteroids and bronchodilator
feline lower airway disease
- covers many airways dieases
- feline asthma, bronchitis
feline lower airway disease pathophysiology
predisposed by bacteria, virus, parasite, allergen
- obstruction of bronchus
FLUT emergency treatment
- oxygen
- stress free
- bronchodilators
- corticosteroids
- sedation
pulmonary parasite types
- intestinal worms
- lungworms
- heartworms
intestinal worms
- toxocara (roundworm) or ancylostoma (hookworm)
- migrate through lungs before adult reaches gut
- verminous pneumonia
lungworms
- lung is final destination
Heartworms
- cause respiratory signs
- angiostrongylus vasorum
angiostrongylus vasorum
- ‘french heartworm’
- infection through eating slugs, snails, frogs
- larvae migrate into alveoli which are coughed up and swallowed
- adult worms live in pulmonary artery
clinical signs of angiostrongylus vasorum
- resp disease
- severe pulmonary hypertension
- increased bleeding tendency
treatment of angiostrongylus vasorum
- fenbendazole or moxidectin
preventative - wormer againt angiostrongylus
bacterial pneumonia
- mixed flora
- ihaled bacteria/haematogenous
- acute/chronic
predisposing causes of bacterial pneumonia
- chronic bronchitis
- bronchiectasis
- immunosuppression
- foreign body
- aspiration
investigations of bacterial pneumonia
- haemotology- neutrophilia/neutropenia
- SpO2- hypoxia
- chest x-rays/CT
nursing care for bacterial pneumonia
- fluid therapy
- nebulization
- nutrition
- oxygen
Restrictive dyspnoea
Restricted lung expansion most commonly due to pleural space disease
Pathophysiology of pleural space disease
- negative intrathoracic pressure necessary to keep lungs inflated
- restrictive deficit-> positive thoracic pressure
- can lead to decreased CO, arrest
Causes of pleural space disease
- Pneumothorax
- haemothorax
- pyothorax
- chylothorax (lymph)
- congestive heart failure
Clinical signs of pleural space disease
- tachypnoea
- restrictive dyspnoea
- paradoxical breathing
- pleural effusion
- muffled lung sounds ventrally
- pneumothorax
- absent lung sounds dorsally, increased resonance during percussion
Pleural space disease diagnostics
- chest radiographs if stable
- thoracic ultrasound
- thoracocentesis
- fluid analysis
Nursing considerations for pleural space disease
- delay diagnostics until stable
- low stress, sedation
- monitor SpO2
- supplement oxygen
- prepare for thoracocentesis
Thoracocentesis
Aspiration of air or fluid from the pleural cavity by inserting a needle, catheter or drain via a caudal rib space
Prep for thoracocentesis
- Clip
- sterile equipment
- suitable needle
- 3 way tap + syringe
- measuring jug if effusion
- cranial aspect of rib (no nerves, vessels)
Fluid analysis of pleural effusion
Pure- Clear, poor protein
- hypoalbuminaemia
Modified- Yellow, blood tinged- protein rich
- heart failure, pericardial disease
Turbid fluid- exudate
- pyothorax
Trochar-type thoracic drain
- like a catheter
- sutured in place
Seldinger-type thoracic drain
- catheter placed over a wire
- only suitable for watery fluid and air (small)
Thoracic drain care
- aseptic
- measure and record vol of fluid
