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Respiratory Disorders Pathophysiology
Terms in this set (92)
Respiratory Disorders may result from
airway obstruction, alveloar damage, reduced lung expansion, or interference w/ pulmonary blood flow.
Respiratory and/or metabolic acidosis often accompany____
Condition in which the body's cells and tissues do not have enough oxygen, which affects cell metabolism, reducing cell function and leading to anaerobic metabolism and the development to metabolic acidosis.
Example of hypoxia:
A 4 year old has labored breathing. During your assessment you note a pulse rate of 70. These signs are indicative of:
these begin with a change in PCO2 and have the disturbance and the compensation moving in opposite direction change as the pH (aka pH goes up, normal value of others go down)
Results of Respiratory Disorders
decreased gas exchange, atelectasis, lobar collapse, secretion retention, pneumonia, respiratory failure
Examples of Respiratory Disorders
influenza, allergic rhinitis, acute rhinitis, bronchiolitis, bronchitis, sinusitis, pharyngitis, tonsilitis, laryngitis, otitis media, croup, RSV, pheumonia, asthma, COPD
UR Common Cold, (highly contagous) Inflammation of the nasal mucosa due to viral infection, allergies or (less commonly) chronic bacterial sinusitis, polyposis, deviated septum, tumor, foreign body, or medication, -rhinoviruse
Bacterial infection usually following rhinitis, cold, or an allergy that has obstructed/infected/inflammed the paranasal sinuses
Best/most common way to diagnose pneumonia
Influenza (Flu) Rx:
Anti-viral drugs: amantadine (Symmetrel, Endantadine), zanamivir (Relenza inhaler), or oseltamiver (Tamiflu); (Treatment is symptomatic, no cure, only treatment & prevention- vaccination, is supportive unless bacterial infection occurs; has to be treated by own immue system)
Example of pneumonia:
A patient comes into the clinic with dyspnea, tachycardia, tachyapnea, fatigue, SOB, fever, chills, chest pain, and is coughing up rust colored sputum. During percussion, the lung fields are dull and auscultation reveals crackles and bronchial breath sounds.
acute, viral respiratory infection (mainly in children btw 1 & 2yrs old) of the larynx, characterized by the inflamation of the larynx & subglottic area causing obstruction leading to hoarseness, a barking cough, & stridor
viral infection affecting both upper and lower respiratory tracts; 3 groups of the influenza virus--type A (most prevalent pathogen), type B, & type C; These viruses constantly mutate, preventing effective immune defense for prolonged periods so vaccination is recomended.
Pneumonia Clinical pic:
Impares oxygen diffusion when exudate fills the alveoli or interstitial tissue in lungs -> decreased O2, fever, cough, chills, dyspnea, tachyapnea, tachycardia for compensation, pleursity, & rusty-colored sputum (coughing up of)
Rhinitis: Clinical Picture
stuffy nose, swollen & red muscous membranes of the nose and pharynx with increased secretions, nasal congestion, coughing, couous watery discharge (rhinorrhea, sneezing, watery eyes)
Symptomatic, consisting of nasal decongestants (vasoconstrictors- reduce the edema & congestion of resp. passages ex: saline), acetamionphen- for fever & headaches
Common cold is spread through
respiratory droplets- either directly inhaled or are a spread by secrections (from hands or contaminated objects)
Upper Respiratory Infection
infectious disease either bacterial or viral of the upper respiratory tract involving the nose, throat, nasal passages, pharynx, and bronchi. (URI) (aka: common cold)
Bacterial infections are treated with____
An accumulation of fluid (high protein and WBC concentration), pus, or serum that has exuded out of a tissue, cavity or its capillaries due to injury or inflammation
As exudate accumulates from the ascending bacteria caused by nasal infection, the obstruction of nasal passageways causes pressure to build up inside the cavity, causing headache, sever pain & tenderness in the facial bones. What is the diagnosis?
Sinusitis Clinical Pic:
pressure build-up in sinus cavity = nasal congestion, facial bone pain & tenderness, headache, fever, sore throat.
How to confirm sinusitis diagnosis:
radiograph or transillumination
a course of antibiotics to eradicate infection, analgesics & decongestants
A swab showing many eosinophil may indicate
alleviates symptoms but does not influence course of disease, Treatment for viral respiratory tract infections
Treatment for viral respiratory tract infections
Croup symtomatic treatment:
endotracheal intubation to keep airway open, ventalitor or humidifier (relieves obstruction) & antibiotics if bacterial
Epiglottitis is caused by
the bacteria HiB (Haemophilus influenzae type B)
an upper respiratory bacterial infection that causes the epiglottis to swell obstructing the airway; rapid onset mostly affecting children 3-7 yrs old; caused by the bacteria HiB (Haemophilus influenzae type B)
sudden los of voice, hoarseness, pain, edema, drooling, narrowing of airway, dysphagia, fever, stridor, and assumes tripod positon (sitting) w/ mouth open, struggling to breath
tracheostomy (1st line of defense), intubation, ventalator, antibiotics, and oxygen treatment
What is aTracheostomy and when is it used as a first line of defense?
a surgical operation that creates an opening into the trachea with a tube inserted to provide a passage for air; Epiglottitis
What is intubation and which respiratory disorders call for its use?
Insertion of a tube into the trachea; Croup, Epiglottitis
A harsh, high-pitched inspiratory sound simular to crowing; indicates an upper airway obstruction of the trachea or laryngx; Caused by a viral infection- either Croup or Epiglottitis
Pneumonia risk factors:
smoking, chronic disease especially those affecting the lungs, liver, & kidneys, alcoholism, immunosuppressant drugs (chemotherapy), immune deficiency, and following any aspiration or inflammation in the lung (cilia is reduced)
Influenza (Flu) S&S:
sudden onset fever, muscle aches, fatigue, also includes S&S of the common cold
Complications & at Risk: Influenza
The elderly, infants & people w/ chronic diseases such as lung disease
Most comlications and deaths during flu epidemics result from....
pneumonia (respiratory failure)
Classifications of pneumonia (primary or secondary) based on...
causitive agent (virus), anatomical location of infection (lobar), pathophysiolic changes (alveoli inflammation to necrosis of bronchial epithelium), or epidemiologic data (hospital-aquired)
Types of pneumonia
Lobar, Bronchopneumonia, Legionnaire's, Myoplasma (PAP),
Inflammation of the pleural membrane
Rusty-colored sputum is a sign of...
streptococcus pneumoniae (pneumonia) & pulomonary TB
3 stages of Lobar pneumonia
type of pneumonia caused by multiple bacteria affecting the bronchioles & alveoli of both lungs; characterized by scattered patchy consolidation centered around bronchioles; S&S mild fever, congestion causes productive cough w/ yellow-green sputum, & dyspnea
depends on the classification of pneumonia (bacterial (antibiotics), viral (antivirals), acetematophen.. etc), oxygen, antibiotics, intubation, & ventilator
Pulmonary Tuberculosis S&S:
love-grade fever, night sweats, dry cough, SOB, swollen lymph nodes, anorexia, weight loss, hemoptysis, cavity
Obstructive Lung Diseases
COPD, asthma, emphysema, chronic bronchitis, bronchiectasis
Bacteria: Mycobacterium bovi
Bacterial infections are treated with
a middle respiratory viral infection, occuring mainly in the first 24 months of their lives characterized by a barking cough
presence of what on a swab test proves positive for being allergic?
a viral infection, caused by an allergic reaction, produces these S&S watery eyes, sneezing, coughing & loss of taste and smell
this bacterial nasas infection ascends from the nose & obstructs the paranasal sinuses, which causes a pressure build-up leading to bone-tenderness and headache
mucoid discharge expelled from one's respiratory tract that have significant abn,ormal characteristics depending on the causative factor and it's severity ranging from thick & sticky, cloudy to clear yellowish-green to a rusty red & pus-filled to blood tinged
Hemoptysis is blood-tinged, bright red, frothy sputum that is associated with
very large amounts of sputum (aka purulent bc it contains pus), has a foul odor and is an indicator of what?
sputum in patients with asthma or cystic fibrosis is
thick and sticky
when indicating a bacterial infection, sputum will be
yellowishs-green, cloudy, and thick
the most important indication that one can draw from sputum is
the presence or absence of TB
______ or whistling sounds often indicate obstruction of small airways
often associated with obstruction of the airways are
labored breathing, prolonged inspiration or expiration time
plural inflammation may be caused by
what highly contagious viral infection is spread through respiratory droplets, which either are directly inhaled or are spread by secretions on hands, or contaminated objects such as facial tissue and has a symptomatic treatment that includes nasal spray, decongestants, acetaminophen, antihistamines, and humidifiers?
the common cold (rhinitis)
prevents against secondary bacterial infection that can occur in a patient with a viral infection
diagnosis of which common secondary bacterial infection is best determined by radiography and trans-illumination and what is the best treatment for it?
Beta-2 adrenergic receptors are used to...so they are properly named....
open bronchioles; bronchodialators
Collapse of a lung or portion of a lung. Most common cause is airway obstruction. Bronchiole becomes blocked with secretions & the alveoli distal to it collapse. Obstruction common after surgery and immobility. Can occur with compression of lung tissue (as in pleural effusion or pneumothorax) Insufficient surfactant results in increased recoil properties leading to this.
A patient taking which type of corticosteroids (anti-inflammatory and anti-allergenic inhaler) may experience the following adverse effects; edema, hyperglycemia, hypokalemia, muscle wasting, peptic ulcer, and hypertension?
Examples of Respiratory Disorder Diagnostic Tests
Chest X-ray, TB test, sputum culture (includes biopsy & cytological exam), bronchoscopy, arterial blood gas testing, radiography, oximeter saturation,spirometry-pulmonary function test, and exercises tolerance test
CO2 levels decrease because it's removed faster than it's produced because of hyperventilation
Excess levels of carbon dioxide in the bloodstream.
A decrease in the Oxygen Saturation of the Blood; can lead to Hypoxia
most common viral respiratory infections in children and pathologies all include inflammation of mucosa causing the obstruction of airways
Croup, Epiglottis, and Bronchiolitis
_________ is a risk following any aspiration or inflammation in the lung, when fluids pool or defense mechanisms such as cilia are reduced (ex: from smoking). It may develop as a primary acute infection in the lungs, or it may be secondary to another respiratory or systemic condition in which tissue resistance is reduced.
An accumulation of purulent exudates in a body cavity, especially the pleural space, as a result of bacterial infection, such as pleurisy or tuberculosis.
Asymptomatic, productive cough, hemoptysis, fever, night sweats
what methods are used when classifying pneumonia?
categories may be based on the causative agent, the anatomical location of the infection, pathophysiological changes, or epidemiologic data
Which type of pneumonia does not have a productive cough, is transmitted by aerosol, and is considered least contagious?
Which type of pneumonia has a productive cough with rusty sputum?
What are the stages in the pathogenesis of TB?
primary/Gohn's complex infection- & secondary/active reinfection
The development of TB begins with Inhalation of the pathogen ________, an infection primarily affecting the lungs but may invade other organs. It is also an acid-fast, aerobic, slow-growing, asymptomatic, but sneaky and invasive microbe. After lying dormant then attacking the body's defense system, it releases both an inflammatory response and a delayed hypersensitive reaction, which strategically target the individual's broken down resistance.
Stage 2 of TB invasion occurs when the microorganisms first enter the lungs. The _______ infection aka ____s _______, still contain some live bacilli, which is used to form a tubercle. In the tubercle's middle, _________ necrosis takes place and depending on the individual's health, a healthy person will have the now calcified tubercle detected- called primary or latent infection.
primary; Gohn's Complex; casesation
In those w/ low resistance, stage 3 or the secondary/______ stage of infection is about to take over since it cannot be controlled and progresses into the active infection, spreading through the lungs and other organs. __________ TB is a rapidly progressive and aggressive form. New organisms multiply, tissue destruction occurs, forming a large area of necrosis, where Cavitation begins.
This is an inherited (genetic) recessive disorder of the EXOCRINE glands. Causes secretions of thick mucus that blocks the respiratory and GI system. This clogs up the alveoli (poor oxygenation) and GI system (blocks production of pancreatic enzymes so cannot absorb nutrients). Diagnosed by positive sweat test. Child may have had meconium ileus (small bowel obstruction) as newborn. May be placed on prophylactic antibiotics.
Acute or chronic disease of the respiratory system in which inflammation narrows the airways from the lungs to the nose and mouth, causing difficulty in breathing. Signs and symptoms include wheezing, shortness of breath, chest tightness, and coughing.
Type I; wheezing on expiration after labored inspiration, tachycardia; hyperinflated chest, upright breathing posture, accessory muscle use; elevated serum IgE levels
Corticosteroids are used for what?
A type of COPD defined as hypersecretion of mucus sufficient to produce a productive cough on most days for 3 months during 2 consecutive years. Hypersecretion of mucus usually begins in the large airways and is not associated with airway obstruction. Later hypersecretion progresses to the smaller airways, where airway obstruction begins initially. This is called:
A pathological condition of the lungs marked by an abnormal increase in the size of the air spaces, resulting in labored breathing and an increased susceptibility to infection. It can be caused by irreversible expansion of the alveoli or by the destruction of alveolar walls.
A condition characterized by increased anterior-posterior chest diameter caused by increased functional residual capacity due to air trapping from small airway collapse. A barrel chest is frequently seen in patients with chronic obstructive diseases, such as chronic bronchitis and emphysema.
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