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Emphysema (Signs/Symptoms - Exclusive (prolonged exhalation, thin, barrel…
Emphysema
Signs/Symptoms - Exclusive
prolonged exhalation
thin, barrel chest appearance - caused by loss of lung elasticity + air trapped in lungs
diminished breath sounds
difficulty breathing w little exertion
coughing w little sputum
pursed lipped breathing
tachycardia
diaphoresis
may be on home O2
Pathophysiology
alveolar walls are destroyed
reduces surface area in contact w pulmonary capillaries
disruption in gas exchange
patient becomes progressively hypoxic + begins to retain CO2
greatly increased airway resistance
breathing is difficult
exhaling becomes active process
purses lips while exhaling to create his own "PEEP"
"PEEP": positive end-expiration pressure
creates back pressure in distal bronchioles, keeping them more open
requires less force + energy to move the air through the more open bronchioles
lung tissue looses elasticity
alveoli become distended w/ trapped air
Signs/Symptoms - General
anxious, alert, oriented
wheezing + rhonchi (auscultation)
dyspneic
tachypnea
use of accessory muscles
tripod position
SpO2 of 94%+ unless in respiratory distress
Treatment - Supportive
position in head-up position of comfort
O2 of SpO2 of at least 94%
watch for signs of decompensation during transport
decreased mental status
decreased respiratory rate w decreased SpO2
CPAP if pt doesn't improve w simple O2 administration
Facts
permanent disease process distal to the terminal bronchioles
seen most often in ppl 60-70y.o.
more common in men than women
causes
primary - smoking
second + well-recognized - genetically triggered decrease in protein called Alpha1 antitrypsin
AKA genetic emphysema
can occur in ppl 40-50 y.o.
continuous exposure to environmental toxins put person at risk of developing emphysema