Digital Respiratory System Disorders PDF

Respiratory System Disorders STUDY GUIDE FOR NURSING STUDENTS Get ahead with reliable respiratory system disorder information. FAMZ NURSING NOTES Respiratory System Respiratory System Disorders Asthma Chronic Obstructive Pulmonary Disease (COPD) Lung Cancer Pulmonary Hypertens...

Respiratory System Disorders STUDY GUIDE FOR NURSING STUDENTS Get ahead with reliable respiratory system disorder information. FAMZ NURSING NOTES Respiratory System Respiratory System Disorders Asthma Chronic Obstructive Pulmonary Disease (COPD) Lung Cancer Pulmonary Hypertension Pulmonary Fibrosis Pneumonia Auscultating Lung Sounds Mechanical Ventilation FAMZ NURSING NOTES The respiratory system is the organs and other parts of your body involved in breathing, when you exchange oxygen and carbon dioxide.The respiratory system is the network of organs and tissues that help you breathe. It includes your airways, lungs and blood vessels. The muscles that power your lungs are also part of the respiratory system. Diagram of the Human Respiratory System Parts of the Respiratory System Respiratory system includes your: Nose and nasal cavity Diaphragm Sinuses Lungs Mouth Bronchial tubes/bronchi Throat (pharynx) Bronchioles Voice box (larynx) Air sacs (alveoli) Windpipe (trachea) Capillaries Main functions of the respiratory system There are five functions of the respiratory system. Gas Exchange – oxygen and carbon dioxide. Breathing – movement of air. Sound Production. Olfactory Assistance – sense of smell. Protection – from dust and microbes entering body through mucus production, cilia, and coughing. What are the classification of respiration? There are two types of Respiration: Aerobic Respiration — Takes place in the presence of oxygen. Anaerobic Respiration –Takes place in the absence of oxygen. What are the factors affecting respiration? Rate of respiration depends on several factors such as temperature, oxygen, carbon dioxide, salts, water, hormones, light, inhibitors, age, injury/disease, etc. Increase in temperature increases the rate of respiration. Rate of respiration increases with increase in oxygen concentration.  “Respiratory disorders or diseases are diseases of lungs and human airways that affect human respiration.” A disorder is defined as a state of irregular functioning of the body. Respiratory system disorders or respiratory diseases are the medical terms used to study the various types of infections, allergies and other diseases related to the different organs, tissues and specialized cells of the human respiratory system. The respiratory system mainly consists of the upper respiratory tract, alveoli, bronchi, bronchioles, trachea, pleura, and pleural cavity. The common cold is an example of a mild respiratory disorder and other serious and life- threatening respiratory disorders include pneumonia, lung cancer and asthma, influenza, tuberculosis, etc. Factors Affecting Respiratory System Disorders There are several factors associated with respiratory system disorders. A few of these factors include: 1. Genetics 2. Allergies 3. Smoking 4. Air Pollution 5. Bacterial and viral infections. Factors Affecting Respiratory System Disorders Respiratory system disorders affect millions of people worldwide. There are three main types of respiratory diseases:Genetics 1. Airway Disease 2. Lung Tissue Disease 3. Lung Circulation Disease  Airway Disease Lung Circulation Disease It affects the bronchial tubes which This disorder occurs when the blood function by transporting oxygen vessels of the lungs are coagulated, and other gases in and out of the swollen or damaged. This affects the lungs. In airway disease, the ability of the lungs to receive oxygen passage for air is reduced, which is and release carbon dioxide. In associated either with narrowing extreme cases, this disorder may or blocking of bronchial tubes affect the functioning of the heart. Lung Tissue Disease Human lungs are covered by a thin tissue layer called the pleura. Due to certain viral or bacterial infections, the structure of the lung tissues is affected, which results in scarring or inflammation of the tissue that enables the lungs to expand normally and in turn, makes breathing difficult. Causes of Respiratory Disorders Respiratory diseases are caused due to exposure to pollutants, smoking, passively inhaling tobacco smoke, asbestos, radon, etc. Respiratory Diseases Asthma is a long-term disease of the lungs. It causes your airways to get inflamed and narrow, and it makes it hard to breathe. Severe asthma can cause trouble talking or being active. You might hear your doctor call it a chronic respiratory disease. Some people refer to asthma as "bronchial asthma." Asthma is a serious disease that affects about 25 million Americans and causes nearly 1.6 million emergency room visits every year. With treatment, you can live well. Without it, you might have to go to the ER often or stay at the hospital, which can affect your daily life Causes of Asthma No one really knows what causes asthma. What we do know is that asthma is a chronic inflammatory disease of the airways. The causes can vary from person to person. Still, one thing is consistent: When airways come into contact with a trigger, they become inflamed, narrow, and fill with mucus. How Asthma Attacks Happen? When you have an asthma attack, your airways narrow and it gets hard to breathe. This can result from spasms of the muscles around the airways, inflammation and swelling of the mucosal membrane that lines them, or high amounts of mucus inside them. You might have shortness of breath, wheeze or cough as your body tries to get rid of mucus. Why do you have asthma and your friend doesn't? No one knows for sure. Allergies play a role for many people, as do genetics. Asthma Triggers Some known triggers of asthma attacks include: Allergies Food and food additives Exercise Heartburn Smoking Sinusitis Medications Weather Smoke symptoms of an asthma attack Severe wheezing when breathing both in and out Coughing that won't stop Very rapid breathing Chest pain or pressure Tightened neck and chest muscles, called retractions Difficulty talking Feelings of anxiety or panic Pale, sweaty face Blue lips or fingernails Classification of asthma Mild intermittent asthma. Mild symptoms less than twice a week. Nighttime symptoms less than twice a month. Few asthma attacks.  Mild persistent asthma. Symptoms three to six times a week. Nighttime symptoms three to four times a month. Asthma attacks might affect activities. Moderate persistent asthma. Daily asthma symptoms. Nighttime attacks five or more times a month. Symptoms may affect activities. Severe persistent asthma. Ongoing symptoms both day and night. You have to limit your activities. Your asthma may be getting worse if: You have symptoms more often and they interfere more with your daily life. You have a hard time breathing. You can measure this with a device called a peak flow meter. You need to use a quick-relief inhaler more often. Types of Asthma There are several: Adult-onset asthma. Asthma can start at any age, but it's more common in people younger than 40. Status asthmaticus. These long-lasting asthma attacks don’t go away when you use bronchodilators. They’re a medical emergency that needs treatment right away. Asthma in children. Symptoms can vary from episode to episode in the same child. Watch for problems like: Coughing often, especially during play, at night, or while laughing. This may be the only symptom. Less energy or pausing to catch their breath while they play Fast or shallow breathing Saying their chest hurts or feels tight A whistling sound when they breathe in or out Seesaw motions in their chest because of trouble breathing Shortness of breath  Exercise-induced bronchoconstriction. You might hear this called exercise-induced asthma. It happens during physical activity, when you breathe in air that’s drier than what’s in your body, and your airways narrow. It can affect people who don’t have asthma, too. You’ll notice symptoms within a few minutes after you start to exercise, and they might last 10 to 15 minutes after you stop. Allergic asthma. Things that trigger allergies, like dust, pollen and pet dander, can also cause asthma attacks. Nonallergic asthma. This type flares in extreme weather. It could be the heat of summer or the cold of winter. It could also show up when you’re stressed or have a cold. Occupational asthma. This usually affects people who work around chemical fumes, dust, or other irritating things in the air. Eosinophilic asthma. This severe form is marked by high levels of white blood cells called eosinophils. It usually affects adults between 35 and 50 years old. Nocturnal asthma. Your asthma symptoms get worse at night. Aspirin-induced asthma. You have asthma symptoms when you take aspirin, along with a runny nose, sneezing, sinus pressure, and a cough. Cough-variant asthma. Unlike with other types, the only symptom of this kind of asthma is a long-term cough. Chronic obstructive pulmonary disease (COPD) is a long-term (chronic) condition. COPD is described according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) system using four stages. The goals of the GOLD system are to increase awareness of COPD and lower the morbidity (illness from a disease) and mortality rate (death from a disease). COPD is a major cause of illness and death throughout the U.S. as well as across the globe. In fact, according to a report by the World Health Organization (WHO), COPD is the fourth leading cause of death in the world. The GOLD system was started in 1997 by several major organizations that focus on health, including WHO. The Four GOLD Stages of COPD The GOLD system aims to classify the severity of the disease based on symptoms and lung function, as well as the prevalence of flare-ups. The stages of COPD include: Stage I: Early Stage II: Moderate Stage III: Severe Stage IV: Very severe ach stage can involve various symptoms and requires different diagnostic parameters. Usually, a different treatment plan will be initiated as a person's COPD progresses from one stage to the next. Some symptoms and treatment modalities overlap from one stage to another, but the symptoms continue to worsen with the progression of the disease, from stage I to stage IV. Stage I: Early Stage COPD During the early stages of COPD an abnormal inflammatory response is present in the lungs, there is an obstruction of normal airflow through the lung's airways, and there's an abnormal pulmonary (lung) and systemic (throughout the entire body) immune response to long-term noxious particle exposure (usually from cigarette smoke). Stage II: Moderate Stage COPD During the second stage of COPD, the condition begins to impact life on a day to day basis, adversely affecting a person’s activity level and overall health.  Stage III: Severe COPD A person with stage III COPD will begin to experience symptoms that are more severe; these include: An intensified level of cough and shortness of breath Frequent flare-ups Respiratory infections (recurrent colds, bronchitis, or pneumonia) Headaches (particularly in the morning) Rapid breathing Lips or nail beds that turn blue Swelling in the legs, ankles or feet Difficulty with deep breathing Decrease in level of mental alertness/mental confusion Trouble sleeping Stage IV: Very Severe COPD Over time, the irreversible damage to the lungs, caused by COPD, spreads to areas where oxygen is exchanged; this results in emphysema.6 In the later stages of COPD, the lungs have stopped being able to provide the body with an adequate supply of oxygen. This, in turn, impacts other organs, such as the heart and the pulmonary artery. The heart must work harder to pump the blood, which can result in heart disease. Water retention can occur as the heart becomes weaker and fluid may pool, causing swelling in the lower extremities (the feet, legs and ankles). Lung cancer is a disease caused by uncontrolled cell division in lungs. Cells divide and make more copies of themselves as a part of their normal function. But sometimes, they get changes (mutations) that cause them to keep making more of themselves when they shouldn’t. Damaged cells dividing uncontrollably create masses, or tumors, of tissue that eventually keep organs from working properly. Lung cancer is the name for cancers that start in lungs — usually in the airways (bronchi or bronchioles) or small air sacs (alveoli). Cancers that start in other places and move to lungs are usually named for where they start Normal structure and function of the lungs  Lungs are 2 sponge-like organs in chest. The right lung has 3 sections, called lobes. The left lung has 2 lobes. The left lung is smaller because the heart takes up more room on that side of the body. When a person breathe in, air enters through the mouth or nose and goes into lungs through the trachea (windpipe). The trachea divides into tubes called bronchi, which enter the lungs and divide into smaller bronchi. These divide to form smaller branches called bronchioles. At the end of the bronchioles are tiny air sacs known as alveoli. The alveoli absorb oxygen into blood from the inhaled air and remove carbon dioxide from the blood when exhale. Taking in oxygen and getting rid of carbon dioxide are lungs’ main functions. Lung cancers typically start in the cells lining the bronchi and parts of the lung such as the bronchioles or alveoli. A thin lining layer called the pleura surrounds the lungs. The pleura protects your lungs and helps them slide back and forth against the chest wall as they expand and contract during breathing. Below the lungs, a thin, dome-shaped muscle called the diaphragm separates the chest from the abdomen. When you breathe, the diaphragm moves up and down, forcing air in and out of the lungs. symptoms of lung cancer A cough that doesn’t go away or gets worse over time. Trouble breathing or shortness of breath (dyspnea). Chest pain or discomfort. Wheezing. Coughing up blood (hemoptysis). Hoarseness. Loss of appetite. Unexplained weight loss. Unexplained fatigue (tiredness). Shoulder pain. Swelling in the face, neck, arms or upper chest (superior vena cava syndrome). Small pupil and drooping eyelid in one eye with little or no sweating on that side of your face (Horner’s syndrome).  symptoms of lung cancer Non-small cell lung cancer Small cell lung cancer (SCLC) Non-small cell lung cancer (NSCLC) Small cell lung cancer (SCLC) grows is the most common type of lung more quickly and is harder to treat cancer. It accounts for over 80% of than NSCLC. It’s often found as a lung cancer cases. Common types relatively small lung tumor that’s include adenocarcinoma and already spread to other parts of squamous cell carcinoma. your body. Specific types of SCLC Adenosquamous carcinoma and include small cell carcinoma (also sarcomatoid carcinoma are two less called oat cell carcinoma) and common types of NSCLC. combined small cell carcinoma. Other types of cancer in the lungs Other types of cancer can start in or around your lungs, including lymphomas (cancer in your lymph nodes), sarcomas (cancer in your bones or soft tissue) and pleural mesothelioma (cancer in the lining of your lungs). These are treated differently and usually aren’t referred to as lung cancer. Lung cancer staging Each stage has several combinations of size and spread that can fall into that category. For instance, the primary tumor in a Stage III cancer could be smaller than in a Stage II cancer, but other factors put it at a more advanced stage. The general staging for lung cancer is: Stage 0 (in-situ): Cancer is in the top lining of the lung or bronchus. It hasn’t spread to other parts of the lung or outside of the lung. Stage I: Cancer hasn’t spread outside the lung. Stage II: Cancer is larger than Stage I, has spread to lymph nodes inside the lung, or there’s more than one tumor in the same lobe of the lung. Stage III: Cancer is larger than Stage II, has spread to nearby lymph nodes or structures or there’s more than one tumor in a different lobe of the same lung. Stage IV: Cancer has spread to the other lung, the fluid around the lung, the fluid around the heart or distant organs.  Overview Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart. In one form of pulmonary hypertension, called pulmonary arterial hypertension (PAH), blood vessels in the lungs are narrowed, blocked or destroyed. The damage slows blood flow through the lungs, and blood pressure in the lung arteries rises. The heart must work harder to pump blood through the lungs. The extra effort eventually causes the heart muscle to become weak and fail. In some people, pulmonary hypertension slowly gets worse and can be life- threatening. Although there's no cure for some types of pulmonary hypertension, treatment can help reduce symptoms and improve quality of life. Symptoms Pulmonary hypertension signs and symptoms include: Blue lips and skin (cyanosis) Chest pressure or pain Dizziness or fainting spells (syncope) Fast pulse or pounding heartbeat (palpitations) Fatigue Shortness of breath (dyspnea), initially while exercising and eventually while at rest Swelling (edema) in the ankles, legs and eventually the belly area (abdomen)  Causes Group 1: Pulmonary arterial hypertension (PAH) Causes include: Unknown cause (idiopathic pulmonary arterial hypertension) Changes in a gene passed down through families (heritable pulmonary arterial hypertension) Use of certain drugs or illegal substances Heart problems present at birth (congenital heart disease) Other conditions such as HIV infection, chronic liver disease (cirrhosis) and connective tissue disorders (scleroderma, lupus, others) Group 2: Pulmonary hypertension caused by left-sided heart disease Causes include: Left-sided heart valve disease such as mitral valve or aortic valve disease Failure of the lower left heart chamber (left ventricle) Group 3: Pulmonary hypertension caused by lung disease Causes include: Chronic obstructive pulmonary disease (COPD) Scarring of the tissue between the lung's air sacs (pulmonary fibrosis) Obstructive sleep apnea Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension Group 4: Pulmonary hypertension caused by chronic blood clots Causes include: Chronic blood clots in the lungs (pulmonary emboli) Other clotting disorders  Group 5: Pulmonary hypertension triggered by other health conditions Causes include: Blood disorders, including polycythemia vera and essential thrombocythemia Inflammatory disorders such as sarcoidosis and vasculitis Metabolic disorders, including glycogen storage disease Kidney disease Tumors pressing against pulmonary arteries Risk factors Pulmonary hypertension is more often diagnosed in people ages 30 to 60. Growing older can increase the risk of developing Group 1 pulmonary hypertension, called pulmonary arterial hypertension (PAH). However, PAH from an unknown cause (idiopathic PAH) is more common in younger adults. Other things that can raise the risk of pulmonary hypertension include: A family history of the condition Being overweight Blood-clotting disorders or a family history of blood clots in the lungs Exposure to asbestos Congenital heart disease Living at a high altitude Use of certain drugs, including some weight-loss medicines and illegal drugs such as cocaine or methamphetamine Use of selective serotonin reuptake inhibitors (SSRIs), used to treat depression and anxiety Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, you become progressively more short of breath. The scarring associated with pulmonary fibrosis can be caused by a multitude of factors. But in most cases, doctors can't pinpoint what's causing the problem. When a cause can't be found, the condition is termed idiopathic pulmonary fibrosis. The lung damage caused by pulmonary fibrosis can't be repaired, but medications and therapies can sometimes help ease symptoms and improve quality of life. For some people, a lung transplant might be appropriate. What are alveoli? Alveoli are tiny, delicate air sacs in your lungs. They help get oxygen into the bloodstream when you inhale. In pulmonary fibrosis, the thin walls of these air sacs start to scar and thicken. When that happens, it’s harder for the air sacs to do their job and get oxygen to the rest of the body.  Symptoms Signs and symptoms of pulmonary fibrosis may include: Shortness of breath (dyspnea) A dry cough Fatigue Unexplained weight loss Aching muscles and joints Widening and rounding of the tips of the fingers or toes (clubbing) Causes Pulmonary fibrosis scars and thickens the tissue around and between the air sacs (alveoli) in your lungs. This makes it more difficult for oxygen to pass into your bloodstream. The damage can be caused by many different factors — including long-term exposure to certain toxins, certain medical conditions, radiation therapy and some medications. Occupational and environmental factors Long-term exposure to a number of toxins and pollutants can damage your lungs. These include: Silica dust Asbestos fibers Hard metal dust Coal dust Grain dust Bird and animal droppings Radiation treatments Some people who receive radiation therapy for lung or breast cancer show signs of lung damage months or sometimes years after the initial treatment. The severity of the damage may depend on: How much of the lung was exposed to radiation The total amount of radiation administered Whether chemotherapy also was used The presence of underlying lung disease Are pulmonary fibrosis and COPD the same? No, pulmonary fibrosis and chronic obstructive pulmonary disease (COPD) are not the same. However, they are similar in some ways. Pulmonary fibrosis and COPD are both lung diseases that get worse over time. Both conditions can make breathing difficult. But these conditions affect your lungs differently: Pulmonary fibrosis Providers classify pulmonary fibrosis as an interstitial lung disease. The interstitial tissues are cells that make up the space between blood vessels and other structures inside the lungs. Pulmonary fibrosis damages these cells. It is a rare disease. COPD COPD is a more common type of lung disease. Diseases like emphysema and chronic bronchitis are types of COPD. In COPD, lung tissue is damaged, alveoli are destroyed and airways can get irritated and inflamed (swollen). What is idiopathic pulmonary fibrosis? Idiopathic is a term providers use when they can’t determine what caused a condition. Idiopathic pulmonary fibrosis is the most common type of interstitial lung disease. How common is pulmonary fibrosis? Medical experts have a hard time pinpointing exactly how many people have pulmonary fibrosis. According to one study, idiopathic pulmonary fibrosis affects at least 200,000 people in the U.S. Can pulmonary fibrosis be hereditary? Medical experts do believe people can inherit this disease through genes that run in families. However, inheriting pulmonary fibrosis is very rare. Researchers still have much to learn about how (and which) genes may cause pulmonary fibrosis.  Risk factors Factors that make you more susceptible to pulmonary fibrosis include: Age. Although pulmonary fibrosis has been diagnosed in children and infants, the disorder is much more likely to affect middle-aged and older adults. Sex. Idiopathic pulmonary fibrosis is more likely to affect men than women. Smoking. Far more smokers and former smokers develop pulmonary fibrosis than do people who have never smoked. Pulmonary fibrosis can occur in patients with emphysema. Certain occupations. You have an increased risk of developing pulmonary fibrosis if you work in mining, farming or construction or if you're exposed to pollutants known to damage your lungs. Cancer treatments. Having radiation treatments to your chest or using certain chemotherapy drugs can increase your risk of pulmonary fibrosis. Genetic factors. Some types of pulmonary fibrosis run in families, and genetic factors may be a component. Pulmonary Fibrosis Illustration  Overview Pneumonia is a medical condition characterized by inflammation of the lungs caused by a bacterial, viral, fungal, or parasitic infection. It occurs when the air sacs in the lungs, called alveoli, become filled with pus, mucus, and other fluids, making it difficult to breathe. Pneumonia can affect people of all ages, but it is more common in infants, young children, the elderly, and those with weakened immune systems. The symptoms of pneumonia may include coughing, fever, chills, chest pain, rapid breathing, shortness of breath, fatigue, sweating, and headache. Here are more detailed explanations for each of the points mentioned  Symptoms Pneumonia symptoms can vary depending on the type and severity of the infection. In general, symptoms may include: Cough, which may produce phlegm or mucus that is yellow, green, or bloody Chest pain or discomfort, particularly when breathing deeply or coughing Shortness of breath, which may worsen with physical activity Rapid heartbeat or breathing Fever, sweating, and chills Fatigue, weakness, or malaise Loss of appetite Confusion or delirium in older adults  Causes Pneumonia can be caused by a variety of infectious agents, including bacteria, viruses, fungi, and parasites. The most common causes of pneumonia are: Bacteria: Streptococcus pneumoniae is the most common bacterial cause of pneumonia. Other bacteria that can cause pneumonia include Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae. Viruses: Viral pneumonia is usually caused by influenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses (including the virus that causes COVID-19). Fungi: Fungal pneumonia is less common than bacterial or viral pneumonia and is typically seen in people with weakened immune systems. The most common fungal causes of pneumonia include Pneumocystis jirovecii, Aspergillus, and Histoplasma. Parasites: Parasitic pneumonia is rare and usually seen in people with weakened immune systems. The most common parasite that can cause pneumonia is the protozoan parasite called Pneumocystis jirovecii. Aspiration: Aspiration pneumonia occurs when foreign matter, such as food, drink, or vomit, is inhaled into the lungs. This can happen in people who have difficulty swallowing or who are under general anesthesia. Chemical irritants: Inhalation of chemical irritants, such as chlorine gas or ammonia, can cause chemical pneumonia. This type of pneumonia is more common in people who work with chemicals or in industrial settings. Radiation therapy: Radiation therapy to the chest area can cause inflammation and damage to the lungs, leading to radiation-induced pneumonia.  Types There are several different types of pneumonia, each with their own specific causes, symptoms, and treatment approaches. Here are some of the most common types of pneumonia: Community-acquired pneumonia (CAP) This is the most common type of pneumonia and is acquired outside of healthcare facilities. It can be caused by a variety of infectious agents, including bacteria, viruses, and fungi. Hospital-acquired pneumonia (HAP) This is the most common type of pneumonia and is acquired outside of healthcare facilities. It can be caused by a variety of infectious agents, including bacteria, viruses, and fungi. Ventilator-associated pneumonia (VAP) This is a type of HAP that occurs in people who are on mechanical ventilation. The risk of developing VAP increases with the duration of mechanical ventilation.  Aspiration pneumonia This type of pneumonia develops when foreign matter, such as food, drink, or vomit, is inhaled into the lungs. It is more common in people with swallowing difficulties, alcohol or drug abuse, or neurological disorders. Atypical pneumonia This is a type of pneumonia that is caused by atypical bacteria, such as Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella pneumophila. It typically presents with milder symptoms than other types of pneumonia. Fungal pneumonia This is a type of pneumonia caused by fungal infections, such as Pneumocystis jirovecii, Aspergillus, or Histoplasma. It is more common in people with weakened immune systems. Viral pneumonia This is a type of pneumonia caused by viral infections, such as influenza, respiratory syncytial virus (RSV), or COVID-19.  Diagnosis The diagnosis of pneumonia typically involves a combination of medical history, physical examination, and diagnostic tests. Here are some common methods used to diagnose pneumonia: Medical history: The doctor will ask about your symptoms, medical history, and any underlying conditions that may increase your risk of developing pneumonia. Physical examination: The doctor will examine your lungs, listen to your breathing sounds, and check for any signs of infection, such as fever, cough, and rapid breathing. Chest X-ray: A chest X-ray can help to confirm the diagnosis of pneumonia by showing areas of inflammation and consolidation in the lungs. Blood tests: Blood tests can help to identify the underlying cause of the pneumonia, such as bacterial or viral infection. Blood tests can also measure the severity of the infection by looking at markers of inflammation and immune response. Sputum culture: A sputum culture involves collecting a sample of phlegm from your lungs and testing it for bacteria or fungi. Polymerase chain reaction (PCR) test: PCR is a molecular technique that can identify the genetic material of bacteria or viruses in a sample of sputum or blood. Bronchoscopy: This is a procedure where a flexible tube with a camera on the end is inserted into the lungs to collect a sample of lung tissue or fluid for testing.  Preventions Preventing pneumonia involves taking measures to reduce the risk of infection and maintaining a healthy immune system. Here are some ways to prevent pneumonia: Get vaccinated: Vaccines are available to protect against several types of bacteria and viruses that can cause pneumonia, including Streptococcus pneumoniae, Haemophilus influenzae, and influenza viruses. Talk to your doctor about the recommended vaccines for your age and health status. Practice good hygiene: Wash your hands frequently with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face. Avoid close contact with people who are sick and cover your mouth and nose when coughing or sneezing. Quit smoking: Smoking damages the lungs and weakens the immune system, increasing the risk of developing pneumonia. Quitting smoking can help to reduce the risk of pneumonia and improve overall health. Manage underlying conditions: Chronic conditions, such as diabetes, heart disease, and lung disease, can increase the risk of developing pneumonia. Managing these conditions through proper treatment and self-care can help to reduce the risk of infection. Practice healthy habits: Eating a balanced diet, getting enough sleep, and staying physically active can help to boost the immune system and reduce the risk of infection. Practice proper food and water safety: Avoid eating undercooked meat or eggs, and drink only safe water. Avoid swimming in contaminated water or coming into contact with animals or animal waste. Auscultation of the lung is an important part of the respiratory examination and is helpful in diagnosing various respiratory disorders. Auscultation assesses airflow through the trachea-bronchial tree. It is important to distinguish normal respiratory sounds from abnormal ones for example crackles, wheezes, and pleural rub in order to make correct diagnosis. It is necessary to understand the underlying pathophysiology of various lung sounds generation for better understanding of disease processes. Bedside teaching should be strengthened in order to avoid erosion in this age old procedure in the era of technological explosion. Auscultation is the term for listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory system and respiratory system (heart sounds and breath sounds), as well as the gastrointestinal system (bowel sounds). It is an integral part of physical examination of a patient and is routinely used to provide strong evidence in including or excluding different pathological conditions that are manifested clinically in the patient. The stethoscope comprises a bell and a diaphragm. The bell is most effective at transmitting lower frequency sounds, while the diaphragm is most effective at transmitting higher frequency sounds. In other words, the bell is designed to hear low pitched sounds and the diaphragm is designed to hear high pitched sounds. They are connected via rubber tubing to the ear pieces. These should be worn facing forward as the ear canals run anteriorly. Optimal Environment To optimise the effectiveness of auscultation the surroundings should be: Quiet - the ambient noise might interfere the heart and lung sounds. Warm -so that the patient feels comfortable while;the upper part of the body is being exposed. Also, it is to avoid shivering that may add the noise. Appropriate lighting - to allow good coordination between visual and auscultatory findings. Lung Auscultation Points and Sounds Learn lung auscultation points and normal breath sounds vs abnormal breath sounds. This article will highlight everything you need to know about assessing a patient’s lung sounds. As a nursing student or nurse, it is important you know how to correctly assess a patient during a head-to-toe assessment. Listening to lung sounds are a vital part of this assessment. The Basics about Lung Auscultation Anterior Lung Auscultation Points Posterior Lung Auscultation Points Normal Lung Sounds Auscultate Lung Sounds The Basics of Lung Auscultation: Listen to both the anterior and posterior sides of the chest Start at the top and work your way to the bottom of the chest while comparing sides (watch the video for the technique) When listening note the following: A full inspiration and expiration cycle The inspiration and expiration sound’s pitch, quality, duration, and if it is normal sounding Ask yourself is there anything “weird” heard along with the inspiration and expiration. For example, are you hearing crackles or wheezes? Have the patient sitting up with arms resting on lap. When listening to the posterior side of the chest the arms need to definitely be in the lap so the scapulae are separated. Use the diaphragm of the stethoscope to auscultate at various locations (see images below) Have patient breathe in and out through mouth slowly while listening. Allow the patient to set the pace to prevent hyperventilating , especially patients with breathing disorders like COPD. Anterior Lung Auscultation Points The apex of the lung which is right above the clavicle Then move to the 2nd intercostal space to assess the right and left upper lobes.  Posterior Lung Auscultation Points Start right above the scapulae to listen to the apex of the lungs. Then find C7 (which is the vertebral prominence) and go to T3…in between the shoulder blades and spine. This will assess the right and left upper lobes. Normal Lung Sounds Vesicular - are usually quiet, mostly inspiratory, with a distinctive pause before a quieter expiratory phase. They are soft and low pitched with a rustling quality during inspiration and are even softer during expiration. These are the most commonly auscultated breath sounds, normally heard over the most of the lung surface. They have an inspiration/expiratory ratio of 3 to 1 or I:E of 3:1.  perform auscultation Lungs Auscultation is performed by placing a stethoscope, or a medical instrument used for listening to the internal sounds of the body, flat on the body at different locations that correspond to different organs in the body. Auscultation is usually performed in a quiet, warm, private environment. While the individual takes a deep breath, the healthcare professional will listen to the heart, lung, and bowel sounds on both the anterior and posterior (i.e., the front and back, respectively) sides of the chest as well as the anterior side of the abdomen. A stethoscope has two sides, a bell and a diaphragm. The diaphragm of the stethoscope is the larger flat side and is typically used to hear normal high pitched sounds that can occur in the heart, lungs, and abdomen as well as abnormal sounds that can occur (e.g., splitting of s2 in the heart, crackles in the lungs, or hypoactive sounds in the bowels). On the other hand, the bell of the stethoscope is the cone shaped side of the stethoscope and is usually used to hear low pitched sounds, like that of heart murmurs, which are extra heart sounds that can occur with heart failure, as well as the sound of turbulent blood flowing, also known as a bruit. Important facts to know about auscultation Lungs Auscultation refers to the technique performed by a variety of healthcare professionals (e.g., medical doctors and registered nurses) during a physical examination in order to listen to the internal sounds of the body, such as the heart sounds, lung sounds, and bowel sounds. Auscultation is performed by placing a stethoscope, or a medical instrument used for listening to the internal sounds of the body, flat on the body at different locations that correspond to different organs in the body. The diaphragm of the stethoscope is the larger flat side and is typically used to hear normal high pitched sounds, and the bell of the stethoscope is the cone shaped side of the stethoscope, which is usually used to hear low pitched sounds. The 5 points of auscultation of the heart center around the heart valves and include the aortic, pulmonic, tricuspid, and mitral valve as well as an area called Erb’s point. The auscultation points of the lungs coincide with the type of breath sounds heard and include the area around the trachea, the area between the 1st and 2nd intercostal space on both the anterior and posterior sides of the chest, and bilaterally over the entire lung fields. The healthcare provider auscultating will listen for a full cycle of inspiration and expiration at each site using a stepladder pattern, listening for both normal and abnormal breath sounds. The auscultation points of the lungs Normal breath sounds include bronchial, bronchovesicular, and vesicular lung sounds. Bronchial breath sounds are loud, high pitched sounds that are heard best over the trachea on the anterior portion of the chest and below the back of the neck on the posterior side of the chest. These sounds occur as air moves through the trachea. Bronchovesicular breath sounds are medium pitched sounds. They are heard best over the 1st and 2nd intercostal space beside the sternum on the anterior side of the chest and between the shoulder blades on the posterior chest. These sounds are produced when air moves through the large airways of the lungs. Mechanical ventilation is a form of life support. A mechanicalventilator is a machine that takes over the work of breathingwhen a person is not able to breathe enough on their own. The mechanical ventilator is also called a ventilator, respirator, or breathing machine. There are many reasons why patient may need a ventilator, but low oxygen levels or severe shortness of breath from an infection such as pneumonia are the most common reason Mechanical ventilation is a form of life support. A mechanical ventilator is a machine that takes over the work of breathing when a person is not able to breathe enough on their own. The mechanical ventilator is also called a ventilator, respirator, or breathing machine. Mechanical ventilation is a form of life support that helps you breathe (ventilate) when you can’t breathe on your own. This can be during surgery or when you’re very sick. While mechanical ventilation doesn’t directly treat illnesses, it can stabilize you while other treatments and medications help your body recover.  Mechanical ventilation and intubation Intubation and mechanical ventilation often happen together, but they’re not the same. When a provider intubates, they put a tube down your throat into your airway (trachea). Then, a provider will connect the tube in your throat to a ventilator. Sometimes a face mask connects you to the ventilator and you don’t have to be intubated. Types of mechanical ventilation Modern mechanical ventilators use positive pressure to push air into your lungs. Positive pressure ventilation can be invasive or noninvasive. Invasive mechanical ventilation: This means you have a tube in your airway connected to a ventilator. This tube can go through your mouth (intubation) or neck (tracheostomy). Noninvasive ventilation: This uses a face mask connected to a ventilator. Straps hold the mask to your head to hold it tight. The ventilator pushes air into your lungs. Forms of noninvasive ventilation include devices you might use at home, like CPAP or BiLevel positive airway pressure (often known under the trade name BiPAP®). Mechanical ventilators used Providers use mechanical ventilators to support your breathing when you can’t breathe on your own. Mechanical ventilation: Can give you oxygen. Helps remove carbon dioxide so it doesn’t build up. Prevents parts of your lungs from collapsing from lack of pressure. Who needs to have mechanical ventilation You might need mechanical respiration: During surgery. General anesthesia can make it difficult to breathe well enough on your own. If you have certain lung conditions or infections. In a medical emergency that blocks your airway or impairs your breathing. If you have certain brain injuries or conditions. Your brain might not communicate well enough with the rest of your body, including your lungs, to allow you to breathe properly. If you have any conditions that cause your blood to have too much carbon dioxide (hypercapnia) or not enough oxygen (hypoxemia). To prevent you from accidentally getting fluids into your lungs (aspiration). Specific conditions that might require you to have mechanical ventilation include: Acute respiratory distress syndrome (ARDS). Pneumonia. COVID-19 and other respiratory illnesses. Chronic obstructive pulmonary disease (COPD). Stroke. Traumatic brain injury. Coma. Anaphylaxis. How long can you be kept on a ventilator The length of time you need mechanical ventilation depends on the reason. It could be hours, days, weeks, or — rarely — months or years. Ideally, you’ll only stay on a ventilator for as little time as possible. Your providers will test your ability to breathe unassisted daily or more often. In general, if you need to be on a ventilator for a long time (2 weeks or so), a provider will switch you from an endotracheal tube to a tube in your neck (tracheostomy).  Risks of mechanical ventilation Providers take steps to avoid complications of mechanical ventilation. However, there can still be some risks, including: Bacterial infections. The tube in your airways can bring bacteria into your lungs, causing infections like ventilator-associated pneumonia (VAP). This is treated with antibiotics. Lung damage. The pressure from the ventilator can damage your lungs. Collapsed lung. If part of your lung is weak, it might develop a hole, causing your lung to collapse (pneumothorax). Heart and blood flow changes. Being on a ventilator can affect how your heart works. If your heart doesn’t work as well, it can decrease your blood pressure or raise your heart rate. These changes can also mean less oxygen gets to your blood (decreased perfusion), even though plenty is getting into your lungs. Sometimes, people aren’t able to come off a ventilator. If you need to be on a ventilator for a long time, a provider will remove the tube from your mouth. They’ll insert a tube through a small cut (incision) in your neck. Prolonging the dying process. If someone is unlikely to recover from their condition, putting them on mechanical ventilation may prevent the dying process. This can cause unnecessary suffering. Your provider will guide you in making decisions about mechanical ventilation in this case. Recover from mechanical ventilation How long it takes to recover from mechanical ventilation depends on why you needed it and how long you were on it. Your provider can tell you what to expect and how to take care of yourself while you recover. Mechanical ventilation can save your life in an emergency or if you get very sick and can’t breathe on your own. It’s not meant to treat conditions, but it can give your body the time it needs to get better. In cases of very serious or worsening illness, some people may not be able to breathe on their own again. Regardless of your health, make sure your provider and your family know your wishes for your medical care. Having discussions about your goals and setting up advanced directives and healthcare power of attorney is an important step. This can help your loved ones if they need to make decisions on your behalf.