Respiratory Eupnea : normal, quiet breathing - PowerPoint Presentation

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Respiratory

Slide2

Eupnea

: normal, quiet breathing

 Apnea: cessation of breathing

Dyspnea

: Difficulty breathing

Bradypnea

: abnormally decreased rate of breathing

Hyperpnea

/

Tachypnea

: abnormally increased rate of breathing

Cheyne

-Stokes: respirations gradually increase then cease entirely for a few seconds (often seen in dying patients)

Rales

: rattling, gurgling sounds heard with breathing (seen in Congestive Heart Failure)

Hyperventilation: depth and rate of breathing are increased

Hypoventilation: slow, shallow breathing

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Diseases/Disorders of the Respiratory System

Dyspnea

Hyperventilation

Epistaxis

URI (upper respiratory infection)

Laryngectomy

Pneumonia

Pleurisy

Epiglottitis

Pulmonary Embolism/infarction

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Diseases/Disorders of the Respiratory System

Atelectasis

Pneumothorax

Tuberculosis

Influenza

Asthma

COPD (Chronic Obstructive Pulmonary Disease)

ARDS (Adult respiratory Distress Syndrome)

IRDS (infant Respiratory Distress

Syndrome) (SIDS)

Occupational Lung Disorders

Lung Cancer

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Dyspnea

Causes: airway obstruction, hypoxia, pulmonary edema, lung diseases, heart conditions, allergic reactions,

pneumothorax

, poisoning (CO)

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Respiratory Distress

 

Pt begins to increase rate and depth of respirations

Followed by SOB (

dyspnea

)

Hypoxia may follow because of decreased O2

Pt begins gasping for air, has blurred vision, is cyanotic

Increased blood CO2 stimulates medulla to increase respirations, but with time the medulla is depressed and breathing rate slows

If untreated, apnea occurs

If onset is slow,

Cheyne

-Stokes develops

 Then respiratory arrest to unconsciousness

Pupils dilate and pt goes into cardiac arrest

Pt has suffocated = asphyxia

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Hyperventilation: Breathing Too Rapidly and Too Deeply

S & S

a.

Carpopedal

spasms (tingling, cramping of upper extremities)  

b. Chest pain, anxiety

c.

Perioral

numbness, but not cyanotic

CO2 level is too low so treat by having pt. breathe into a paper bag

If breathing is shallow, it’s not hyperventilation

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Epistaxis: Nosebleed

Blood vessels close to surface, so bleeding looks profuse

  Treatment: pinch nostrils, lean forward, ice to neck

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URI: Upper Respiratory Infection, Usually Viral

Sinusitis

Laryngitis

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Laryngectomy: Usually From Cancer of Larynx

Airway must be rerouted by stoma formed by tracheotomy (

tracheostomy

is permanent)

 

Must use electronic voice box

CPR - bag to stoma

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Pneumonia: Lung Infection - Viral, Bacterial, Fungal

S & S: fever, cough, chills, headache,

myalgia

, rash,

dyspnea

Tx

:

antivirals

, antibiotics,

antifungals

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Pleurisy

Inflammation of pleura surrounding lung

 

Fluid can be removed by

thoracentesis

( procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest)

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Epiglottitis

Usually in small children

Signs: drooling, tripod position

3.

Tx

: transport ASAP, do NOT try to look in the mouth as this can cause the throat to close off completely and may cause breathing to stop altogether

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Pulmonary Embolism/Infarction

A moving clot into the vessels of the lungs

Lung tissue gets deprived of O2

At risk: recent post-operatives, immobile pts, those on birth control pills, trauma, blood clots in the legs, heart valve replacement pts

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Atelectasis

Imperfect Expansion = Collapsed Lung

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Pneumothorax

Air in thoracic cavity, lungs collapse

Trauma - lungs punctured by ribs or other sharp object

Spontaneous - weakened area of lung ruptures and releases air into thoracic cavity; more common in young, thin males; also occurs after surgery; Ca

 Tension - collapsed lung gets pushed against heart and great vessels and other lung -

TRUE EMERGENCY!

 S & S:

dyspnea

, sharp pain prior to onset, weak rapid pulse, hypotension, uneven chest expansion (flail chest), neck vein distention, trachea will deviate to side opposite ruptured lung

 TX: high O2, transport ASAP

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Tuberculosis

Bacterial infection of lungs: Mycobacterium tuberculosis

 S & S: cough,

hemoptysis

, low grade fever

 

Tx

: long term antibiotic therapy;

lobectomy

of affected lung

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Asthma

Episodic spasms of muscles of bronchi cause constriction

 Interferes with expiration of air

 Mucus overproduces and is thick so air flow decreases on exhalation and air is trapped in lungs

 Pt must exhale forcefully, producing the characteristic wheezing sound on expiration

 S & S: no chest pain usually, pt is tense/anxious/frightened, wheezing on expiration, increased pulse rate 120+, normal rhythm, neck veins distended, cyanosis, coughing

 

Tx

: reassure

and

calm

pt, check medications inhalant, position upright, O2, transport

 Prolonged attack = status

asthmaticus

-

Can be fatal!

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Chronic bronchitis

Bronchiole lining inflamed

 Excess mucus produced but cilia are scarred/paralyzed

 Inhaled irritants

 S & S: persistent cough, SOB, tightness in chest, dizziness, periodic cyanosis, “blue bloaters”

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Emphysema

Chronic, alveoli lose elasticity and air is trapped in the alveoli, alveoli rupture then fuse into large irregular spaces

 Excess mucus produced

 Poor gas exchange

 S & S:

dyspnea

on exertion, chronic cough, rapid pulse, irregular, B/P normal, wheezing, breathe with pursed lips, develop barrel-chest appearance due to trapped air, “pink puffers”

 CO2 narcosis: medulla becomes insensitive to increased CO2 levels over time and only peripheral receptors respond

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Bronchiectasis

Bronchi and bronchioles widen so blood is not O2 rich therefore pt is

dyspneic

, cyanotic, with foul greenish sputum

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Cystic fibrosis

Pancreatic enzyme deficiency causes increased mucus glands, increased viscosity of mucus, more secretions and infections, scarring of membranes

 Inherited

 

Tx

: monitor VS,

orthopnic

position, loosen restrictive clothing, keep pt warm but not overheated, decrease stress, O2 (chronic: postural drainage)

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