Unit 3 - Respiratory Diseases pt 1 - intro Flashcards
2 broad categories of chronic pulmonary diseases
- obstructive
2. restrictive
hypoxemia
reduced O2 content in the blood due to resp. alterations/disease.
hypoxia
lack of O2 availability to the body’s tissues. may be due to hypoxemia or other non respiratory causes
hypercapnia
increased CO2 content in the blood due to respiratory alterations/disease.
pulmonary edema
fluid accumulation in the lung tissue. May be due to pulmonary disease, heart failure, and other systemic conditions.
altered breathing patterns
- apneustic
- biots
- chyene-stokes
- hyper/hypoventilation
- kussmauls
- stridor
- wheezing
eupnea
normal, unlabored breathing
hyperventilation
increased alveolar ventilation, relative to metabolic demands (examples – “anxiety”, “panic attack”). Typically due to increased frequency of breaths, rather than increased depth of breathing. May result in a drop in PaCO2 (“hypocapnia”).
hypoventilation
decreased ventilation, relative to metabolic demands. Shallow and/or infrequent breaths. May result in a rise in PaCO2 (“hypercapnia”). Examples – pneumonia, CPOD, drugs, neuromuscular disorders.
apneustic
gasping inspiration followed by short or absent expiration. “Sleep Apnea”.
biot’s
abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea
cheyne-stokes
Repeated cycles of deep breathing followed by shallow breaths or cessation of breathing. Often seen with severe CHF.
Kassmaul’s and characteristic of
abnormally deep and rapid respirations
*characteristic of diabetic coma
stridor
high pitched sound created by an obstruction to airflow, especially an obstruction at the level of the trachea or larynx. (“upper airway obstruction”)
wheezing
high pitched sounds created as air passes through narrowed tracheobronchial airways.
*asthma
deeper
dry cough
Hypersensitive airways
Congestion
Tumor
Meds? – ACE inhibitors
productive cough (3 kinds)
Purulent (pus) sputum indicates infection
Non-purulent sputum indicates non-specific irritation
Hemoptysis (coughing up blood) - “possible” pathologic condition
dyspnea (what it is, hallmark feature of…., occurs…)
- **Hallmark feature of pulmonary disease
- shortness of breath
- Occurs secondary to inadequate ventilation and (lack of O2 in the circulating blood)
- Occurs mainly with diffuse, rather than localized disease
orthopnea
dyspnea when lying down, secondary to fluid shifts and decreased efficiency of the respiratory muscles
chest pain
Usually sub-sternal, or over the involved lung field
May mimic angina, including radiation to the neck or UE
Pleural irritation (“pleurisy”)may result in sharp pain that is reduced by lying on the affected side, thus limiting movement (“autosplinting”)
Digital clubbing
A loss of the normal angle between the nail and nail-bed on the fingers and toes.
- caused by a chronic perfusion deficit secondary to pulmonary disease.
- May also occur with certain cardiac, liver, and GI disorders
Cyanosis
bluish coloring of the skin and mucous membranes
occurs secondary to reduced O2 saturation or hemoglobin
pulmonary changes with aging
- dec respiratory muscle strength and endurance
- dec in # of elastic fibers in the lung tissue
- dec in overall lung function (FVC, FEV1)
- inc chest-wall stiffness
- inc work of breathing (WOB)
- inc susceptibility to respiratory infections
- inc complications during anesthesia
OT/PT implications with aging pulmonary changes
Expect reduced exercise capacities in older adults
Be aware of signs/symptoms of pulmonary disease, including abnormal breathing patterns
Monitor vitals at rest and during activity, including pulse oximetry if available
Educate on importance of regular aerobic exercise to reduce the age-related changes in cardiorespiratory function
infectious and inflammatory diseases
Pneumonia Pneumocystis Carinii Lung Abscess Pneumonitis Acute Bronchitis Pulmonary Tuberculosis
pneumonia
acute lung tissue inflammation
“restrictive” pulmonary disease
s/s pneumonia
chills / fever elevated WBCs respiratory distress sputum changes cloudy areas on chest x-ray
pneumonia etiology
Virus:
*50% of All Types of pneumonia
A common complication of Influenza A, B, C
Adenoviruses (“common cause of upper respiratory infections”)
Bacterial: Diplococcus pneumonia (pneumococcal) > 50% of bacterial cases Klebsiella pneumonia (“Friedlander’s”) – alcoholism and poor nutrition seem to predispose to this type of pneumonia
Hypostasis (“lying in bed”)
Aspiration - passes and goes into lungs
Fungus
lobar pneumonia (how long, what it produces, causes)
- Self-limiting, last 10 days
- Involves 1 entire lobe
- Produces an intra alveolar exudate (“thick protein and cellular rich fluid”)
common causes: Pneumococcus and Klebsiella
Consolidation of the Affected Lobe
Healthy Adults
bronchopneumonia
Significant pleural effusion may result in atelectasis (“collapsed lung”)
Diffuse patchy consolidation pattern
Usually Bilateral
Occludes Small Airways
Longer Recovery; Permanent Damage
Elderly and Infants
May result in Pleurisy, Staph, and Strep
Pneumocystis Carinii Pneumonia
- people who are immunosuppressed
- progressive, often fatal
ex) people with HIV, chemotherapy, organ transplant, Malnourishment
lung abscess - def, risk factor and tx
- Accumulation of exudate in the lung
- Often a complication of a bacterial pneumonia
***risk factor: Aspiration associated alcoholism
Treatment = antibiotics and nutritional support
pneumonitis and causes
Def- acute inflammation of lung tissue
Causes: Usually caused by infections Other causes: Systemic Lupus Erythematosus (SLE) Air-born irritants Aspiration of gastric fluids Obstructive form related to lung cancer Interstitial pneumonitis related to AIDS
acute bronchitis - cause, s/s, tx
Inflammation of bronchi and trachea
Self –limiting (usually 1-3 weeks)
Causes:
Viral infections
Exposure to chemical irritants, fumes, smoke
Symptoms:
Fever, cough, sore throat, laryngitis, chest pain, wheezing
Treatment:
Rest, humidity, hydration, good nutrition
tuberculosis (TB)
highly contagious bacterial infection that can be spread via inhalation of droplets from another person
Once exposed, an individual may not actually manifest the disease for months or even years later. The TB may lie “dormant”.
Once active, the TB can lead to granuloma (“collection of immune cells”) formation in the lungs with resulting lung damage.
Early tx is critical to avoid permanent damage
risk factors TB
Weakened immune system (HIV) Poor nutrition Crowded and unsanitary living conditions Homelessness Alcoholism Healthcare worker Migrant worker
s/s TB
Cough (sometimes producing phlegm) Coughing up blood Excessive sweating, especially at night Fatigue Fever Unintentional weight loss Other symptoms that may occur with this disease: Breathing difficulty Chest pain Wheezing
PT/OT implications for TB
“Negative pressure” isolation when in hospital.
Airborne infection signs should be posted on doors and doors should be kept closed.
Patients must wear mask when leaving room.
Healthcare workers/visitors should wear mask when entering room.
Gloves must be worn if handling infectious material.
Tx TB
Consists of a combination of 4 different medications (isoniazid, rifampicin, pyrazinamide, and ethambutol) that when used together are very effective in curing TB. Treatment may last from 6-9 months.
Left untreated, TB is associated with a high mortality rate.
