Respiratory

Respiratory Conditions

• Early signs of cerebral hypoxia: Restlessness and irritability.
• Respiratory assessment: Visualizing and assessing breath sounds. If lungs sound clear but the patient is blue, they're not getting enough oxygen.
• Asthma: Difficulty breathing due to narrowed, swollen airways and mucus production. Symptoms: shortness of breath (SOB), wheezing, coughing, hypoxemia, respiratory acidosis. Interventions: bronchodilators, steroids, hydration, oxygen, nebulizer. Avoid morphine and NSAIDs.
• COPD (Chronic Obstructive Pulmonary Disease): Characterized by bronchospasm and shortness of breath.
  • Bronchitis: Inflammation of the bronchioles, increased mucus, often described as "blue bloaters" with barrel chests.
  • Emphysema: Destruction of alveoli, often described as "pink puffers". Normal SpO2 for COPD is typically 88-92% and maintaining it above 92% isn't always beneficial .Interventions for COPD include: pursed-lip breathing, high fowlers, leaning forward, adequate hydration, and mechanical soft foods, to help retain energy.
• Empyema: Pus in the pleural cavity, often associated with pneumonia. Interventions may include elevation of the head of bed (HOB), antibiotics, chest tube or thoracentesis (drainage).
• Acute Respiratory Distress Syndrome (ARDS): Fluid buildup in alveoli, impairing oxygen exchange. First sign of increased respiration. followed by dyspnea, retractions, and cyanosis. Hypoxemia is typically not responsive to supplemental oxygen alone due to fluid blockage. Interventions: mechanical ventilation with PEEP (positive end-expiratory pressure).
• Pulmonary Embolism (PE): Blood clot lodged in a pulmonary artery. Symptoms: chest pain, dyspnea, tachypnea, blood-tinged sputum; body compensates by hyperventilating, leading to respiratory alkalosis. Management: elevate HOB, administer oxygen, thrombolytic therapy, and encourage ambulation to prevent venous stasis.

Pneumonia

• Pneumonia: Infection affecting lung lobes. Alveoli fill with fluid, reducing gas exchange.
• V/Q mismatch: Imbalance between ventilation (airflow) and perfusion (blood flow) in the lungs, impairing oxygenation.
• Pneumothorax: Presence of air in the pleural space, leading to lung collapse. Types: open (air freely circulates), closed (air not increasing), tension (air trapped, compressing lung). Symptoms include: sharp chest pain, shortness of breath, cyanosis, tachycardia, tachypnea, hypotension. Interventions: 3-way dressing, oxygen, chest tube, potential surgery.
• Nasopharyngeal airway: Tube used to keep the upper airway open. Avoid use in persons with potential head trauma (e.g., skull fracture) due to possible malpositioning.

Other Conditions

• Pleural effusion: Fluid buildup between the lungs and chest wall. Causes: pleuritic pain, dyspnea, dry cough, orthopnea. Interventions: high Fowler's position, monitoring of breath sounds, encouraging deep breathing and coughing, thoracentesis if needed.
• Pleurisy: Inflammation of the pleura, causing stabbing chest pain, worse with breathing.
• Tuberculosis (TB): Infectious disease. Diagnostic tests: PPD test, chest x-ray, sputum culture. Preventive measures: airborne precautions, treatment typically lasting 6 months or longer, medications like Rifapentine (Prifin).