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Respiratory Emergencies: Principle function = RESPIRATION at alveoli,…
Respiratory Emergencies:
Principle function = RESPIRATION at alveoli
Asthma
Wheezing on inspiration/expiration
Brochospasm
acute spasm of bronchioles w/ excessive mucus production and swelling of mucous lining of respiratory passage
Age: highest in 5-17 years
wheezing *
severe: exhaling is tiring and cyanosis
acute asthma attack: allergic response to food or allergen
between attacks may not breathe normally
severe emotional stress, exervise, and respiratory infections
Anaphylaxis
flushed skin/Uticaria
Generalized Edema
Decreased BP
Laryngeal edema w/ dyspnea
Wheezing/Stridor
signs of shock
Broncholitis
dyspnea
wheezing, crackles, or rhonchi
coughing
fever
dehydration
Tachypnea
Tachycardia
often occurs due to RSV - results in severe bronchioles
frequent in newborns and toddlers, commonly boys
common in winter/spring
typically at increased risk for developing childhood asthma.
supportive treatment
-bacterial pneumonia: severe symptoms more quickly w/ high fever (children have higher risk for seizures)
-viral pneumonia: more gradually and less severe
pulse ox may be low
Bronchitis
Chronic cough (w/ sputum production)
Wheezing
Cyanosis
Cyanosis
Tachypnea
CHF
Pulmonary Edema
Crackles (pulmonary edema)
Orthopnea
Paroxysmal nocturnal dyspnea
cold sweats
Common cold
cough
runny/stuffy nose
sore throat
Croup
fever
barking cough *
stridor
mostly seen in pediatric patients
caused: inflammation of larynx, pharynx, and trachea, secondary to acute viral infection of upper respiratory tract
age: 6mo-3years
Easily transmittable w/ children
starts w/ cold, cough, and low grade fever that develops over 2 days
responds well to humidified O2, bronchodilators not for couple may worsen symptoms
Diphtheria
difficulty breathing and swallowing
sore throat
thick, gray build up in throat/nose
fever
Emphysema
barrel chest
pursed lip breathing
dyspnea on exertion
cyanosis
wheezing/decreased breath sounds
Epiglottitis
dyspnea
high fever
stridor: late sign
drooling*
difficulty swallowing
severe sore throat
tripod or sniffing position
common cause: bacterial infection
vaccine has decreased incidence of epiglottitis
sudden onset, look ill, report very sore throat, high fever.
will often be found in tripod position and drooling.*
highflown O2, position of comfort, put nothing in mouth
influenza type A (flu)
cough
fever
sore throat
fatigue
animal respiratory disease that mutated to humans
H1N1 = pandemic
muscle aches/headaches
pertussis (whooping cough)
coughing spells: may last more than a min.
"whooping" sound*
fever
age: children under 6, highly contagious
-under 6 mo. can be life threatening
vomit or not have appetite,
look for dehydration
adults - not common but can cause severe upper respiratory infection leading to pneumonia in geriatric or immunocompromised
geriatric patients can have cracked ribs from coughing
Pneumonia
dyspnea
chills, fever
cough
green, red, or rust-colored sputum
localized wheezing or crackles
significant cause of morbidity worldwide
infection in lungs, collects in normal lung tissue, impairing gas exchange
secondary infection from upper respiratory infection
intubation and tracheostomy can increase risk
predisposition:
-residence homes
-recent hospitalization
-chronic disease processes
-immune system compromise
-COPD
lower lung pneumonia:
-fever
-abdominal pain
vomiting
Pneumothorax
pleuritic chest pain w/ dyspnea
decreased breath sounds (affected side)
subcutaneous emphysema
partial or complete accumulation of air in pleural space
caused by trauma or medical conditions
tall thin men are at higher risk when performing strenuous activities.
-Hypotension
-jugular vein distention
-cyanosis
Pulmonary embolus
-sharp chest pain
-dyspnea
-tachycardia
-tachypnea
-varying degrees of hypoxia
-cyanosis
-acute chest pain
-hemoptysis (coughing up blood)
clear breath sounds initially
blood clot formed in vein that breaks off and moves through venous system
embolus: anything in circulatory system that moves from point of origin to distant cite and lodges, obstructing blood flow in area
patients with LE immobilization at higher risk, pregnancy, active cancer
tension pneumothorax
severe shortness of breath
decreased/altered level of consciousness
neck vein distention
tracheal deviation (late sign)
hypotension; signs of shock (late sign)
respiratory syncytial virus (RSV)
cough
wheezing
fever
dehydration*
common in young children. infection in lungs and breathing passages, which can leader to more serious problems like bronchiolitis and pneumonia
high contagious
infants w/ RSV often refuse liquid
Tuberculosis (TB)
-fever
-cough
-fatigue
-night sweats
-bloody sputum
-weight loss
-chest pain
bacterial infection - dangerous b/c
many strains are resistant to antibiotics
infects lungs but can be
found in other organs
remain dormant for years
-higher transmission
-prison
-nursing home
-homeless shelters
-IV drug users
-countries w/ high levels
wear gloves, eye protection, and N-95
Causes for dyspnea:
-pulmonary edema
-hay fever
-pleural effusion
-obstruction of the airway
-hyperventilation syndrome
-environmental/industrial exposure
-CO poisoning
-Drug overdose
Acute Pulmonary Edema
heart is injured that it cannot circulate blood properly, left side cannot remove blood as fast as right side brings in, therefore causing a fund buildup in alveoli and in the lung tissue between alveoli and pulmonary capillaries. Edema interferes w/ gas exchange and does not leave enough room for lungs to take a slow deep breath.
typically a result of CHF, but can also be a result of chest trauma, poisoning from smoke/toxins, high altitudes
high BP and low CO often trigger flash pulmonary edema
patients are sick and frightened (literally drowning in fluid)
dyspnea, rapid, shallow respirations,
severe: frothy pink sputum from nose/mouth
cool, diaphertic, cyanotic skin, crackles/wheezing, tachycardia, HTN early but later Hypotension
COPD
slow process of dilation and disruption of airways an alveoli caused by chronic bronchial obstruction
3rd leading cause of death in US
umbrella term: emphysema & chronic bronchitis
-emphysema: loss of elastic material in lungs that occur when alveolar spaces chronically stretch due to inflamed airways and obstruction of airflow in lungs. Walls eventually fall apart leaving large holes in lung that resemble air pockets
-chronic bronchitis: Protective cells and mechanisms that remove foreign particles are destroyed weakening airways
caused by: direct lung and airway damage from infection or inhalation of smoke/toxin. typically caused by smoking
Chronically produce sputum, chronic cough, difficulty expelling air from lungs, long expiration phases, and wheezing. Also crackles, rhonchi, and wheezes, or diminished lung sounds
COPD vs. CHF
Pulmonary edema (CHF): wet lung sounds (rhonchi, crackles): quicker development of symptoms
COPD: dry lung sounds (wheezes): bronchial constrictions, present w/ shortness of breath, slow onset
treat patient not lung sounds
Meds: O2, bronchodilators, and corticosteroids
Hay Fever
coldlike symptoms:
-runny nose
-sneezing
-congestion
-sinus pressure
caused by allergic response
atopic
Pleural Effusion
collection of fluid outside of lung on one/both side of chest
compresses lung(s) and causes dyspnea:
-although can build up for weeks patients typically report dyspnea onset suddenly
hear decreased lung sounds over region of chest wall where fluid has moved lung away from chest wall, typically feel better upright.
plea