1	Respiratory Lecture #2 Dr. Kathleen Ethridge Northeast Texas Community College
2	Management of Lower Airway and Pulmonary Vessel Disorders
3	Asthma In asthma, the airways overreact to a stimulus which causes bronchospasm, edematous swelling of mucous membranes, and copious production of thick mucus.
4	Peak Flowmeter Measures peak expiratory flow volume. Normal peak flow for adults range from 300 to 700 L/min Baseline values are needed for comparison
5	Critical Monitoring For client with asthma, notify the physician for symptoms after treatment: Anxiety Increased effort of respirations Continuous cough Respiratory distress nasal flaring accessory muscles pursed lip breathing cyanosis
6	Chronic Obstructive Pulmonary Disease
7	Chronic Obstructive Pulmonary Disease Chronic Bronchitis Emphysema
8	"Chronic Bronchitis" Chronic Bronchitis Age 40 to 50 year Stocky build with no history of weight loss Barrel chest cyanotic Emphysema Age 50 to 75 Cachectic appearance Tachypnea pink skin color
9	"Chronic Bronchitis" Chronic Bronchitis increased secretions edema bronchospasm thickened bronchial walls
10
11	COPD Treatment Prevention of infections Bronchodilators Low flow oxygen Corticosteroids Balance of activities Teach self-care
12	Acute Tracheobronchitis Acute inflammation of the mucous membranes with raw burning pain in anterior chest region Caused by inhalation of noxious gases or smoke overvigorous suctioning harsh coughing observe for cough-related syncope Treatment is focused on the cause
13	Croup Acute epiglottitis Acute laryngotracheobronchitis (LTB Acute spasmodic laryngitis Note: Do not examine child’s throat, as it may cause airway spasm (especially in epiglottitis)
14	Pulmonary Embolus Obstruction of a pulmonary artery caused by air, fat, or emboli Treatment bed rest oxygen, ventilator anticoagulants
15	Pulmonary Hypertension Mean Pulmonary Artery Pressure > 25 Poor Prognosis Symptoms dyspnea fatigue chest pain
16	Management of Clients with Parenchymal and Pleural Disorders
17	Atelectasis Definition Collapse of lung tissue Causes Develops when interference of lungs expanding pleural effusion; tumor, pneumothorax chest wall disorders airway obstruction insufficient pulmonary surfactant increased elastic recoil
18	Influenza Viral infection of respiratory tract Spread by droplet Sudden onset Causes fever, muscle aches and cough
19	Pneumonia Lobar pneumonia consolidation in one lobe of one lung Lobular or bronchopneumonia patchy consolidation throughtout lobes of one or both lungs
20	Community-acquired Pneumonia Treatment outpatient or inpatient obtain culture speciments appropriate antibiotics
21	Assessment of Pneumonia Pneumococcal pneumonia sudden onset, chill, fever, chest pain, cough Staphylococcal pneumonia sudden onset, fever, chills, pain, cough Influenzal pneumonia cough, green sputum Gram-negative sudden onset, high fever, chills, pain, dyspnea
22	Pneumonia Continued Anaerobic bacterial pneumonia low-grade fever, dyspnea, crackles, cyanosis Legionnaires’ disease fever, headache 48 hrs; then high fever, dyspnea Mycoplasma pneumonia slowly rising fever, headache, cough Viral pneumonia headache, myalgia followed by high fever, dyspnea, cough
23	Pneumonia Continued Fungal pneumonia usually asymptomatic resembles influenza Parasitic pneumonia immunocompromised client cough, dyspnea, chest pain, fever, crackles, night sweats
24	Lung Abscess Pus within the lung tissue Bad odor Sputum will have a foul taste
25	Tuberculosis Causes and Prevention Pathophysiology Treatment
26	Treatment of Tuberculosis Basic treatment 2 months of daily doses of isoniazid and rifampin plus 1 or 2 additional drugs followed with 4 months of isoniazid and refampin at least 2 medications are added to a failing TB treatment program
27	Medications for Tuberculosis First-Line Drugs Isoniazid (INH) Rifampin Rifapentine
28	Medications Continued Second-Line Drugs Capreomycin Ethionamide
29	Prevention of Transmission in Hospitals Early identification Promptly initiate multidrug therapy Isolation Particulate respirators
30	Surveillance for TB Transmissions Routine TB skin testing Surveillance of cases Therapeutic regiments based on clinical history and drug-resistance data
31	TB skin testing 0-4 mm induration is not significant 5mm or greater may be 10mm or greater is usually considered significant
32	Fungal Pulmonary Diseases Coccidioidomycosis Histoplasmosis
33	Cystic Fibrosis Definition dysfunction precipitated by an obstruction of the exocrine gland ducts, causing thick mucous secretions Symptoms Treatment
34	Interstitial Lung Disease Group of inflammatory lung diseases The alveolar wall becomes thick and fibrotic
35	Sarcoidosis Characterized by the formation of widespread granulomatous lesions Cause is unknown
36	The End