Week 3: Respiratory Conditions & Management Flashcards
Define hyperventilation
Fast and/or deep breathing
Define hypoventilation
Slow and/or shallow breathing
Define apnoea
Absent breathing/no breathing rate
Define heamoptysis
bleeding from respiratory tract below larynx
Define dyspnoea
Difficult or uncomfortable breathing
Define orthopnoea
Breathless when lying down, relieved by sitting or standing
Define PND
Paroxysmal nocturnal dyspnoea- a sensation of breathlessness that wakes the patient, often after 1-2 hours of sleep, usually relieved in the upright position
Define hypoxia
Hypoxia is the deficiency in the amount of oxygen reaching the tissues and cannot maintain adequate homeostasis
What are causes of hypoxia?
- poor oxygen delivery to tissues
- decreased alveolar PAO2
- diffusion impairment
- V/Q mismatch
- haemoglobin abnormalities
- poor cardiac output
What factors can influence respiration rate?
-Disease, exercise, shock, sleep, smoking, age, speech/singing, emotional displays, drugs
What are symptoms of asthma?
- audible expiratory wheeze
- increased work of breathing
- tachypnoea
- dyspnoea
- tachycardia
- reduced SpO2
- coughing
- chest tightness
What are possible asthma triggers?
infections, house dust mites, pollen and spores, animals, exercise, cold air, drugs, foods, pregnancy, emotion, deep inhalation
What causes asthma?
Bronchioconstriction
- chronic inflammation of bronchi makes them narrower
- excessive suptum
- hypersensitive airways
How would you manage asthma?
- oxygen therapy
- nebulised salbutamol
- prednisolone/hydrocorisone
What is the main stimulus to breathe for a patient with COPD?
Hypoxia
What does the term COPD cover?
- Chronic asthma
- Chronic bronchitis
- Emphysema
What is chronic bronchitis?
Inflammation and excessive mucus production in the bronchial tree
In which illness are the alveoli not seriously effected and diffusion of gases remain relatively normal?
Chronic bronchitis
What is emphysema?
Pathological changes in the lung, usually end of a process that has been progressing. Usually followed by chronic bronchitis
In which illness if there a permanent abnormal enlargement of the air spaces beyond the terminal bronchioles and destruction of the alveoli?
Emphysema
As emphysema decreases the surface for gas exchange, the resistance to pulmonary blood flow is what?
Increased
What are some of the symptoms of emphysema?
- reduced elasticity, trapping air making lungs become fibrous
- reduction in arterial PO2, increased RBC production
- expiration is a muscular act
- barrel shaped chest
What are some symptoms of the COPD worsening (acute exacerbation)?
- increased dyspnoea
- increased sputum
- increased cough
- increased wheeze
- reduced retention
- increased fatigue
- acute confusion
What are the signs and symptoms of a severe COPD episode?
- marked dyspnoea
- tachypnoea
- purse-lip breathing
- acute confusion
- use of accessory muscles
- new-onset cyanosis
- new-onset peripheral oedema
- marked reduction in activities of daily living
What are some causes of exacerbation of COPD?
- common cold
- flu
- COVID
- air pollutants
How would you manage COPD?
- early resp assessment inc SPO2 levels (aim for 88-92%)
- ask what normal SPO2 is
- nebulisation with salbutamol and assess response
comfortable patient position
What are bronchodilators?
Oxygen, salbutamol, ipratropium bromide
How many minutes should you limit oxygen drive nebulisation for?
6 minutes
What are time critical features of COPD?
- major ABCD problems
- extreme breathing difficulties
- cyanosis
- hypoxia unresponsive to oxygen
- exhaustion
What is a PE?
Pulmonary Embolism, a blood clot impairing blood supply to the lungs
What causes a PE?
Usually a deep vein thrombosis travelling from the leg to lungs
What are the symptoms of a PE?
- unexplained shortness of breath
- pleuritic chest pain
- sinus tachycardia
- reduced SPO2/ hypoxia
- haemoptysis
- signs of DVT
What are specific questions you should ask for a PE?
- recent surgery
- recent myocardial infection
- family Hx of DVT/PE
- pregnancy
- immobilisation
How do you manage a PE?
- oxygen therapy
- ECG 12 lead
- SPO2
- IV access
- wells score
- NEWS 2
- prepare to resuscitate
- pre alert
What does a wells score of more than 6 suggest for a PE?
That there will be a high probability of a PE
What does a wells score between 2-6 suggest about a PE?
A moderate probability of PE
What does a wells score of below 2 points suggest for a PE?
Low probability of a PE
What is pneumonia?
Inflammation in the lungs usually caused via infection, that develops over several days
What are the symptoms of pneumonia?
- confusion, resp distress and cyanosis, dyspnoea, pleuritic chest pain, malaise
- older patients may have a minimal cough and no fever but confusion and hypothermia
- a lower lobe infection can cause upper abdominal pain which can be referred to ask the shoulder
What are the causes of pneumonia?
Flu , hospitalised patients, cigarette smokers, excess alcohol, bronchiectasis, bronchia obstruction, immunosuppression, aspiration and IV drug use
How do you manage pneumonia?
- resp assessment inc SPO2
- oxygen therapy
- obs
- NEWS 2
- think sepsis!
What can respiratory infections cause?
- ventilatory impairment
- pneumonia
- tuberculosis
- acute bronchiolitis
- trachebrinchitis (croup)
- epiglottitis
