week 5 module 14 respiratory abnml Flashcards
HPI cough
onset nature: dry or moist sputum production sputum characteristics pattern severity associated s/s efforts to treat postural influence quality
sputum characteristics of bacterial infection
yellow green rust clear transparent purulent blood streaked sticky
sputum characteristics of viral infection
blood streaked (not- common)
sputum characteristics of chronic infectious disease
particularly abundant in the early morning
slight, intermittent blood streaking
occasional large amounts of blood
sputum characteristics cancer
slight
persistent
intermittent blood streaking
sputum characteristics infarction
blood clotted
large amounts of blood
sputum characteristics TB
occasional large amounts of blood
chest pain
onset and duration
- trauma, coughing, lower resp infection, recent surgery, hx thrombosis, prolonged immobilization
Associated symptoms
efforts to treat: heat, splinting, meds
chest pain does not originate in heart when
constant ache that lasts all day
does not radiate
made worse by pressing on chest wall
fleeting, needle-like jab that last a few seconds
situated in shoulders or between the shoulder blades
asthma patho
small airway obstruction due to inflammtation within the airways
- triggered by allergens anxiety, cold, exercise, URI, cigarette smoke
- > mucosal edema, inc. secretions, bronchoconstriction with inc. airway resistance
asthma subjective
episodes of paroxysmal dyspnea
chest pain and tightness
may last for minutes, hours or days
may be asymptomatic between episodes
asthma objective data
tachypnea and paroxysmal coughing with wheezing on expiration and inspiration prolonged expiration labored breathing fatigue anxious with inc. airway resistance hypoxemia dec. peak expiratory flow rate
atelectasis patho
incomplete expansion of the lung at birth or the collapse of the lung
- caused by compression from outside or resorption of gas from the alveoli in the presence of airway obstruction
atelectasis subjective
freq. seen in the postoperative setting
atelectasis objective
auscultation dampened or muted in the involved area
XR: consolidation assoc. with postobstructive pneumonia
bronchitis patho
inflammation of the large airways
-> inc. mucus secretions
bronchitis subjective
acute: fever and chest pain possible
chronic bronchitis: cough may be productive
bronchitis objective
hacking nonproductive cough
- minimal auscultation findings with no resp distress
wheezing or dampened auscultation when worsened
pleurisy patho
inflammatory process involving the visceral and parietal pleura
pleurisy subjective
sudden onset with chest pain when taking a breath
rubbing of the pleural surfaces can be felt by pt
pain referred to ipsilateral shoulder
pleurisy objective
resp. are rapid and shallow with diminished breath sounds
pleural friction rub auscultated
fever possible
pleural effusion patho
excessive nonpurulent fluid in the pleural space
pleural effusion subjective
cough with progressive dyspnea
pleuritic chest pain w/ inflammatory effusion
pleural effusion objective
auscultation and percussion vary with the amount of fluid present and position of patient
dullness and decreased tactile fremitus
- hyperresonant in area above.
mobile fluid with gravitate to dependent position
breath sounds muted in affected area
empyema patho
purulent exudative fluid collected in the pleural space
- non-free flowing
empyema subjective
often febrile and tachypneic cough and chest pain pt appears ill progressive dyspnea cough may produce blood or sputum
empyema objective
breath sounds are distant or absent in affected area
percussion is dull
vocal fremitus is absent
lung abscess patho
well-defined, circumscribed, inflammatory, and purulent mass that can develop central necrosis
- aspiration of food or infected material
lung abscess subjective
malaise
fever
SOB
lung abscess objective
percussion is dull
breath sounds distant or absent over affected area
pleural friction rub may be present
cough my produce purulent, foul-smelling sputum
pneumonia patho
inflammatory response of the bronchioles and alveoli to an infective agent
pneumonia subjective
bacterial infections can be rapid onset of - cough, pleuritic chest pain, dyspnea mycobacterial, fungal, atypical - onset of symptoms more insidious sputum production chills, fever, rigors N/V
pneumonia objective
febrile tachypnea tachycardia crackles and rhonchi diminished breath sounds egophony, bronchophony, and whispered pectorioguy dull to percussion inc. fremitus over area of consolidation
influenza patho
viral infection of the lung
-> leaves pt more susceptible to secondary bacterial infection
Entire respiratory tract may be overwhelmed by interstitial inflammation and necrosis
influenza subjective
cough fever malaise HA ST common cold
influenza objective
crackles
wheezes
rhonchi
tachypnea
tuberculosis patho
chronic infectious disease most often begins in the lung but may have widespread manifestations
- inhaled from infected person
TB subjuective
latent period
- asymptomatic, some regional lymph nodes involved
Active:
- fever, cough, wt. loss, night sweats
Hx of travel to region with endemic TB or close contact with infected person
TB objective
latent: no findings
active:
- consolidation and/or pleural effusion may develop with corresponding findings
- cough with blood streaked sputum
pneumothorax patho
presence of air or gas in the pleural cavity
- may result from trauma or occur spontaneously
pneumothorax subjective
minimal collections of air may be without s/s
larger: dyspnea and chest pain
pneumothorax objective
breath sounds over pneumothorax are distant
mediastinal shift with tracheal deviation can be seen
unexplained but persistent tachycardia may be a clue to minimal pneumothorax
hemothorax patho
presence of blood in the pleural cavity
- may be the result of trauma or invasive medical procedures
hemothorax subjective
dyspnea
lightheadedness
decreased pulmonay function
hemothorax objective
breath sounds distant or absent
percussion dull
fremitus and decreased
tachycardia and hypotension with large blood loss
lung cancer patho
bronchogenic carcinoma, malignant tumor
- tobacco smoke
- asbestos
- ionizing radiation
- inhaled carcinogenic agents
lung cancer subjective
may cause cough, wheezing, hemoptysis
peripheral tumors w/out obstruction may be asymptomatic
lung cancer objective
airway obstruction: postobstructive pneumonia can develop
malignant pleural effusion may develop
pulmonary embolism patho
embolic occlusion of pulmonary arteries risks: - older than 40 - hx venous thromboembolism - surgery with anesthesia longer than 30 min - heart disease - CA - fx of pelvis or leg bones - obesity - acquired or genetic thrombophilia
pulmonary embolism subjective
pleuritic chest pain with or without dyspnea
pulmonary embolism objective
possible low grade fever or isolated tachycardia hypoxia dull to percussion decreased fremitus if there is effusion pleural friction rub possible
epiglottitis patho
acute, life-threatening infection involving the epiglottis and surrounding tissues
- Hib
- strep
epiglottitis subjective
begins suddenly and progresses rapidly without cough
painful sore throat
difficulty swallowing
muffled voice
epiglottitis objective
pt sits straight up with neck extended and head forward anxious and ill appearing unable to swallow -> drooling no cough high fever beefy red epiglottis
