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Altered Ventilation and Diffusion (INFECTIOUS (Pneumonia (manifestations…

- - - - microorganisms: bacteria, viruses, fungi
    - - RBCS, WBCS, Fibrin accumulation in lungs
      - dehydration, metabolic acidosis
      - poor oxygen diffusion
      - hypoxia, fever, chills, cough, tachypnea, tachycardia, pleuritic pain, sputum production
    - - typical
        
        pneumococcal bacteria attach to epithelium receptors- infect type 2 alveolar cells
      - atypical
        
        immune-mediated mechanism
    - - antibiotics
      - oxygen therapy
      - IV fluids, fever management
      - chest physiotherapy
- - - - cause
        
        smoking
        
        genetic inheritance of alpha antitrypsin
      - manifestations
        
        air trapping: decrease in O2 uptake and CO2 release
        
        chronic hypoxemia, hypercapnia, chronic cough, dyspnea, wheezing, barrel chest
      - mechanism
        
        early
        
        inflammation in small airways distal to respiratory bronchioles; proteolytic and antiproteolytic enzyme competition
        
        late
        
        loss of elastic recoil of alveoli, inner lining of arteries and arterioles of respiratory tract thickens, irreversible enlargement of air spaces
      - treament
        
        smoking cessation
        
        drug therapy: to increase AA, bronchodilators, steroid anti-inflammatory, mucolytic agents
        
        supplemental O2, lung transplant
    - - mechanism
        
        changes in bronchioles in response to chronic inflammation, hyperplasia, destruction of cilia, squamous cell metaplasia, or bronchial wall thickening
        
        narrowing airway lumen, occluding lumen with mucous
      - cause
        
        smoking
        
        environmental pollutants
      - manifestations
        
        similar to emphysema
        
        chronic productive cough with excessive mucous for 3 months or more in 2 consecutive years
      - treatment
        
        supplemental O2
        
        drug therapy as emphysema
        
        smoking cessation
    - - mechanism
        
        chronic inflammatory disorder results in intermittent/persistent airway obstruction via bronchial hyper responsiveness, inflammation, bronchoconstriction, excess mucous production
      - cause
        
        unknown; potential frequent exposures to environmental allergens
      - treatment
        
        controlling environmental triggers
        
        monitoring lung function
        
        pharmacologic therapy to reverse inflammation, bronchoconstriction, and mucous secretion
      - manifestations
        
        immune response triggers cascade of events including bronchospasm, mucous plugs, edema, exudate accumulation, and cell debris accumulation
        
        over time: airway remodeling (smooth muscle hyperplasia, narrowing of airways, destruction of epithelium)
        
        airway hyperactivity, wheezing, breathlessness, chest tightness, excessive sputum, cough
- - - - disrupted production of surfactant, damage to type 2 alveolar cells, atelactasis
      - O2 and CO2 diffusion issues, hyaline membrane formation, ventilation and diffusion impairment
      - poor lung expansion, hypoxemia, hypercapnia, acidosis, tachypnea, dyspnea, retractions, crackles
    - - injury: from inhalation of smoke, lung infections, aspiration of gastric fluids, lung trauma, anaphylaxis, lack of blood flow, etc
    - - supportive, O2 supplementation, mechanical ventilation
    - - inflammatory response triggered from injury
      - chemical mediators promote collection of inflammatory cells, fluids, and proteins that leak into lung tissues and cause edema
- - - - autosomal recessive genetic transmission
    - - clearing airways of mucous
      - controlling infections
      - bronchodialators, reducing inflamation
    - - air trapping, hyperinflation, access formation, lung tissue consolidation, persistent pneumonia, lung tissue fibrosis, cyst formation
      - tenacious secretions, chronic cough, mucoid sputum, tachypnea, wheezing/crackles, chest pain, hemopytosis, barrel chest, nasal polyps, finger clubbing
    - - impaired electrolyte transportation across epithelial cells on mucosal surfaces (water, chloride conduction)
      - mucous plugging, inflammation, infection in lungs as a result of abnormally thick respiratory tract secretions