Restrictive disorders Flashcards
Restrictive Disorders
Differing etiologies result in difficulty expanding the lungs and reduction in lung volume; anything that affects elasticity or compliance of the lung
Acute restrictive disorders
Atelectasis AKA: numothorax normally unilateral: collapse of segments or lobes of lungs; can be caused by compression of lung tissue or obstructed airway with subsequent absorption of trapped air which collapses lung tissue distal to obstruction; common after thoracic or abdominal surgery because of general anesthetic, narcotics and pain that leads to shallow breathing pattern- Thus, the pt will need chest PT for positioning ,deep breathing, removing secretions to improve gas exchange, relieving pain.
Pt may exhibit: ( Acute restrictive disorders)
- Decreased chest movement
- absent breath sounds over involved area
- Mediastinal ( part of the chest b/w sternum, spinal column, and lungs ) & tracheal shift ( shift of mediastinum towards higher negative pressure compared to opp. side.)
- tachypnea: rapid breathing
- cyanosis: bluish color of skin due to lack of O2 in blood
ARDS
Acute or Adult Respiratory Distress
Increased permeability of the alveolar capillary membrane and sever hypoxemia (low blood O2) ; occurs as a result of a variety of insults ( sepsis, aspiration, pneumonia, trauma, fat embolism ( embolism caused by physical trauma i.e. long bone fx, soft tissue trauma, or burns), drug overdose, inhalation of toxic chemicals, shock, pancreatities, cardiopulmonary bypass, high inspired levels of O2 resulting in O2 toxicity, etc )
- The pt will need chest PT for positioning and removing secretions to improve gas exchange
Pt may exhibit (ARDS)
- Respiratory distress
- Severe hypoxia: that doesnt respond to high O2 concentrations
- Decreased lung compliance- too stiff to ventilate
Pulmonary edema
Accumulation of fluid in the extravascular space, which can initially occur in the interstitial ( interstitial tissue spaces) and then progress to the alveolar spaces: chest PT is NOT INDICATED
Pneumonia
Acute inflammation of lung parenchyma (abnormal tissue growth of structure) which fills alveoli with exudates ( fluid filled with cellular debris from blood vessels that deposit it in tissue) and leads to consolidation (alteration of lung tissue to a solid state) - chest PT possibly for obtaining sputum samples; deep breathing and positioning to improve gas exchange; supported cough to relieve pain, coughing, huffing, etc to remove secretions.
Other Restrictive disorders
Pleural effusion Interstitial lung disease neuromuscular and skeletal disorders obesity S/P abdominal or thoracic surgery CNS depression- -These pt must breath at an increased rate
Pleural effusion
Accumulation of fluid in pleural cavity that compresses lungs- chest PT RARELY INDICATED because the pt cannot expand lungs under pressure from fluid; however, mobilization of pt helps prevent undue atelectasis, and deep breathing & positioning may be used to optimize gas exchange.
Interstitial lung disease
group of 130 disorders often associated with immune disturbances- chest PT RARELY INDICATED EXCEPT for maintaining functional activities within limits of dyspnea, desaturation and fatugue
Neuromuscular and skeletal disorders
- Kyphoscoliosis ( backward and lateral curvature of spinal column
- anlylosing spondylities: inflammatory disease that causes vertebral s;ine to fuse
- Rib fx
- other trauma
Obesity
Ascites( abnormal accumulation of fluid in the abdomen)- limit diaphragm movement.
S/P abdominal or thoracic Surgery
Pain limits respiratory movements and coughing
CNS depression
Respiration depressed
Other disorders
-Abscess
-Pulmonary TB
Pulmonary embolism
