BSN213 Pathophysiology Respiratory Function PDF

Hand Hygiene BSN213 Pathophysiology Respiratory Function Sem. 1 – Week 7 & 9 2023-2024 Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original c...

Hand Hygiene BSN213 Pathophysiology Respiratory Function Sem. 1 – Week 7 & 9 2023-2024 Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Outline Hand Hygiene ✓Pneumonia ✓Tuberculosis ✓Asthma ✓Chronic Obstructive Pulmonary Disease ✓Cystic Fibrosis ✓Pleural Effusion ✓Pneumothorax ✓Atelectasis ✓Acute Respiratory Failure Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Respiratory System Hand Hygiene Two divisions Air- conduction delivers air Includes the nose, mouth, trachea, bronchi, and bronchioles Gas exchange: swaps gases between air and blood Includes alveoli and capillaries https://youtu.be/wc2K1Olt4Q8 Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae The Respiratory System Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Gas Exchange Hand Hygiene Requires adequate ventilation and perfusion Ventilation/perfusion ratio (VQ ratio) Amount of air that reaches the alveoli per minute Amount of blood that reaches the alveoli per minute Normal ventilation = 4 L per minute Normal perfusion = 5 L per minute Dependent on alveolar and capillary surface area and thickness Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene The alveolar macrophages Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Gas exchange in the lungs https://youtu.be/WzrN6sJ1i_g Hand Hygiene Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Oxygen diffusion Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Lung Compliance Hand Hygiene Elasticity and recoil are vital. Surfactant: lipoprotein Has a detergent quality Reduces surface tension to prevent collapse of the alveolus Negative pressure system. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Breathing Hand Hygiene Largely involuntary Controlled by the medulla oblongata Chemoreceptors Stretch receptors Inspiration: inhaling Expiration: exhaling Diaphragm Intercostal muscles Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Pulmonary Function Test ❑Lung volumes Tidal volume: amount of air moved in and out with a normal breath (~500 mL) Minute respiratory volume: amount of air moved in and out in one minute (~6 L) Inspiratory reserve volume: maximum amount of air that can be inhaled over tidal volume (2–3 L) Expiratory reserve volume: maximum amount of air that can be exhaled over tidal volume (1–1.5 L) Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Pulmonary Function Test ❑Lung volumes Vital capacity: sum of the tidal volumes and the reserves. Residual volume: amount of air left in the lungs after forced expiration (1–1.5 L). Forced expiratory volume in one second is compared to the forced vital capacity (FVC) to diagnose pulmonary disease. FVC is the amount of air that can be forcibly exhaled from the lungs after taking the deepest breath possible, as measured by spirometry. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pulmonary Function Test Hand Hygiene Measuring air flow. (b) This graph shows several common measurements. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pulmonary Function Test (PFT) Hand Hygiene Measuring air flow. (a) This machine allows healthcare workers to determine tidal volume, inspiratory reserve volume, and other lung-capacity measurements to determine the health of an individual’s lung. material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © CHASSENET/BSIP/age Original fotostock © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Role in pH Balance Hand Hygiene Carbon dioxide is one of the body’s acids. Lungs alter the rate and depth of breathing to regulate pH. ✓Increased rate of breathing expels more carbon dioxide and raises pH. ✓Decreased rate of breathing retains more carbon dioxide and lowers pH. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Gas Transportation Hand Hygiene Carried by hemoglobin. Once at the site, hemoglobin must be able to release the gases. Affected by a variety of things such as pH and temperature. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Oxyhemoglobin dissociation curve Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pneumonia https://youtu.be/3hTsve9jjsQ Hand Hygiene ❑Definition: Inflammation of the lung parenchyma ❑Causes: infectious agents, injurious agents or events, and pulmonary secretion stasis. ❑Viral Usually, mild Can lead to secondary bacterial pneumonia ❑Bacterial More common than viral Most often Streptococcus pneumoniae Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Classification of Pneumonia ❑Aspiration pneumonia Causes: impaired gag reflex, improper lower esophageal sphincter closure, inappropriate gastric tube placement. ❑Lobar pneumonia Confined to a single lobe. ❑Bronchopneumonia Most frequent type A patchy pneumonia throughout several lobes Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Classification of Pneumonia ❑Interstitial pneumonia or atypical Occurs in the areas between the alveoli Routinely caused by viruses or by uncommon bacteria ❑Nosocomial pneumonia Develops more than 48 hours after a hospital admission. ❑Community-acquired pneumonia Acquired outside the hospital or healthcare setting Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pneumonia Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Pneumonia Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Pneumonia Hand Hygiene ❑ Manifestations: productive or nonproductive cough, fatigue, pleuritic pain, dyspnea, fever, chills, crackles or rales, pleural rub, tachypnea, and mental status changes (especially in the elderly). ❑ Complications: septicemia, pulmonary edema, lung abscess, and acute respiratory distress syndrome. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Tuberculosis Hand Hygiene Infectious disease that primarily affects the lung parenchyma. Caused by the bacillus, Mycobacterium tuberculosis Fairly controlled until recently Resistant strains have developed in those immune compromised Most frequently occurs in the lungs, but can spread to other organs like meninges, kidneys, bones, and lymph nodes. Carried by airborne droplets. TB spreads from person to person (Contagious) Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Tuberculosis Hand Hygiene ❑ Primary infection When bacillus first enters the body. Macrophages engulf the microbe, causing a local inflammatory response. Some bacilli travel to the lymph nodes, activating the type IV hypersensitivity reaction. Granuloma or tubercle forms. Caseous necrosis and Ghon complexes develops. Bacilli can remain dormant for years. Usually, asymptomatic. Will test positive now. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Tuberculosis Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Hand Hygiene Tuberculosis ❑Secondary infection Reactivation of dormant bacilli Can spread to other organs Symptoms usually develop Ghon complexes ❑Manifestations: Low-grade fever, cough, night sweats, fatigue, and weight loss. The cough may be nonproductive, or mucopurulent sputum may be expectorated. Hemoptysis Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Hand Hygiene Chronic disorder that results in intermittent, reversible airway obstruction Characterized by acute airway inflammation, bronchoconstriction, bronchospasm, bronchiole edema, and mucus production A variety of triggers from infections to smoke Allergy is strongest predisposing factor. Extremely common Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Hand Hygiene ❑Types 1. Extrinsic asthma Increased IgE synthesis and airway inflammation, resulting in mast cell destruction and inflammatory mediator release. Mediator release causes bronchoconstriction, increased capillary permeability, and mucus production. Generally, presents in childhood or adolescence.. Triggers: allergens such as food, pollen, dust, and medications. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Hand Hygiene 2. Intrinsic asthma Not an allergic reaction Usually presents after age 35 years Triggers: upper respiratory infections, air pollution, emotional stress, smoke, exercise, and cold exposure 3. Nocturnal asthma Usually occurs between 3:00 and 7:00 a.m. May be related to circadian rhythms—at night, cortisol and epinephrine levels decrease, while histamine levels increase, leading to bronchoconstriction Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Hand Hygiene 4. Exercise-induced asthma Usually occurs 10–15 minutes after activity. Symptoms can linger for an hour. May be a compensatory mechanism to warm and moisten the airways. Followed by a refractory period that begins within 30 minutes and can last 90 minutes. 5. Occupational asthma Caused by a reaction to substances at work. Symptoms develop over time, worsening with each exposure and improving when away from work. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Hand Hygiene 6. Drug-induced asthma Frequently caused by aspirin—prevents the conversion of prostaglandins, which stimulate leukotriene release, a powerful bronchoconstrictor. Can be fatal. Reactions can be delayed up to 12 hours after drug ingestion. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Hand Hygiene. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Pathophysiology Hand Hygiene Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Stages of an Asthma Attack Hand Hygiene ❑Stage one Related to bronchospasms, and usually signaled by coughing. Peaks within 15 to 30 minutes. Inflammatory mediators responsible include leukotrienes, histamine, and some interleukins. ❑Stage two Peaks within 6 hours of symptom onset. Result of airway edema and mucus production. The alveolar hyperinflation causes air trapping. Bronchospasm, smooth muscle contraction, inflammation, and mucus production combine to narrow the airways. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Asthma Hand Hygiene ❑Manifestations: Wheezing Shortness of breath/ Dyspnea Chest tightness Cough Tachypnea Anxiety ❑Status asthmaticus Life-threatening, prolonged asthma attack that does not respond to usual treatment. Can lead to respiratory alkalosis and respiratory failure quickly. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Chronic Obstructive Pulmonary Disease Hand Hygiene Debilitating chronic disorders characterized by irreversible, progressive tissue degeneration and airway obstruction. Severe hypoxia and hypercapnia can lead to respiratory failure. Oxygen begins to drive breathing. Can also lead to cor pulmonale. ❑Two main conditions: ✓Chronic bronchitis ✓Emphysema Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Chronic Obstructive Pulmonary Disease Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Chronic Obstructive Pulmonary Disease Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Chronic Bronchitis Hand Hygiene The presence of cough and sputum production for at least 3 months in each of 2 consecutive years. “Blue bloaters” Characterized by inflammation of the bronchi, a productive cough, and excessive mucus production. ❑ Complications: frequent respiratory infections and respiratory failure Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Chronic Bronchitis Hand Hygiene ❑Manifestations: hypoventilation, hypoxemia, cyanosis, hypercapnia, polycythemia, clubbing of fingers, dyspnea at rest, wheezing, edema, weight gain, malaise, chest pain, and fever. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Emphysema Hand Hygiene Destruction of the alveolar walls leads to large, permanently inflated alveoli. “Pink puffers.” Alpha1-antitrypsin deficiency(genetically linked) necessary for lung remodeling. Loss of elastic recoil and hyperinflation of the alveoli, leading to air trapping. ❑Causes: genetic predisposition and smoking. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Emphysema Hand Hygiene Manifestations: Dyspnea upon exertion, diminished breath sounds, wheezing, chest tightness, tachypnea, hypoxia, hypercapnia, increased anterior–posterior thoracic diameter (from 1:2 to 1:1), activity intolerance, anorexia, and malaise. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Emphysema Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Emphysema Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae COPD - Pathophysiology Hand Hygiene Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Cystic Fibrosis Hand Hygiene Life-threatening condition resulting in severe lung damage and nutrition deficits Affects cells that produce mucus, sweat, saliva, and digestive secretions Secretions become thick and tenacious. Caused by mutation on seventh chromosome, leading to abnormality in protein involved in chloride cellular transport Autosomal recessive Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Cystic fibrosis Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Cystic Fibrosis Hand Hygiene ❑Complications: atelectasis, recurrent infections, corpulmonale, respiratory failure, malabsorption, malnutrition, electrolyte imbalances, and infertility. ❑Manifestations: meconium ileus, salty skin, steatorrhea, fat-soluble vitamin deficiency, chronic cough, hypoxia, fatigue, activity intolerance, audible rhonchi, and delayed growth and development. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pleural Effusion Hand Hygiene Excess fluid in the pleural cavity. Fluid may include exudates, transudates, blood, and pus. Can impair breathing. May also see pleurisy—inflammation of the pleural membranes. ❑Manifestations: dyspnea, chest pain, tachypnea, tracheal deviation, absent lung sounds and dullness over the affected area, tachycardia, and pleural friction rub. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pleural Effusion Pleural effusion is a buildup of fluid in the lining of the lungs Hand Hygiene X-ray of pleural effusion 54 Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pleural Effusion - Pathophysiology Hand Hygiene Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Pneumothorax Hand Hygiene Condition in which the air enters the space between the chest wall and the lung (pleural space or pleural cavity). Can cause lung to collapse. ❑Risk factors: smoking, tall stature, and history of lung disease or previous pneumothorax Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Types of Pneumothorax Hand Hygiene ❑Spontaneous pneumothorax Air enters from an opening in the internal airways Primary spontaneous pneumothorax Occurs when a small air blister (bleb) on the top of the lung ruptures. Blebs are caused by a weakness in the lung tissue. Usually, mild. Secondary spontaneous pneumothorax Develops in people with preexisting lung disease Can be more severe and even life threatening Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Types of Pneumothorax Hand Hygiene ❑Traumatic pneumothorax Result of a blunt or penetrating injury to the chest. ❑Tension pneumothorax Most serious type Occurs when the pressure in the pleural space is greater than the atmospheric pressure due to trapped air in the pleural space or entering air from a positive-pressure mechanical ventilator. Can cause the affected lung to collapse completely and shift the heart. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Types of Pneumothorax Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Pneumothorax Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Pneumothorax Hand Hygiene ❑Manifestations: Sudden chest pain & Chest tightness Dyspnea & Tachypnea Decreased breath sounds over the affected area Asymmetrical chest movement Trachea and mediastinum deviation Tachycardia & hypotension Pallor Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae Hand Hygiene Atelectasis Atelectasis is collapse or incomplete expansion of the lung or part of the lung. May be acute or chronic OR Microatelectasis (which is not detectable on chest x-ray) Macroatelectasis with loss of segmental, lobar, or overall lung volume. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Smeltzer et al. (2010) 62 fchs.ac.ae Hand Hygiene Atelectasis ❑ Possible causes are: Prolonged supine positioning/ Immobilized patients Increased abdominal pressure Altered breathing patterns Retained/ excess secretions & pain Alterations in small airway function Reduced lung volumes due to musculoskeletal or neurologic disorders Restrictive defects and specific surgical procedures (e.g., upper abdominal, thoracic, or open-heart surgery) Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Smeltzer et al. (2010) 63 fchs.ac.ae Atelectasis Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Hand Hygiene fchs.ac.ae Atelectasis Hand Hygiene X-ray of atelectasis (a) Normal lung. (b) Lung with atelectasis. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Courtesy of Leonard V. Crowley, MD, Century College. fchs.ac.ae Atelectasis Hand Hygiene Clinical Manifestations Is insidious. Signs and symptoms: increasing dyspnea, cough, and sputum production. In acute atelectasis involving a large amount of lung tissue (lobar atelectasis), marked respiratory distress may be observed. ▪ Other symptoms: tachycardia, tachypnea, pleural pain, and central cyanosis, difficulty breathing in the supine position & anxiety. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Smeltzer et al. (2010) 66 fchs.ac.ae Hand Hygiene Atelectasis Assessment and Diagnostic Findings: When clinically significant atelectasis develops, it is generally characterized by increased work of breathing and hypoxemia. Decreased breath sounds and crackles are heard over the affected area. ▪ A chest x-ray may suggest a diagnosis of atelectasis before clinical symptoms appear; - the x-ray may reveal patchy infiltrates or consolidated areas. Prevention: increasing mobility, coughing, and deep breathing; effective pain management; and incisional splinting. Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org Smeltzer et al. (2010) 67 fchs.ac.ae Acute Respiratory Failure Hand Hygiene Life-threatening inability of the lungs to maintain adequate oxygenation Result of many respiratory conditions Types of respiratory Failure: ✓Hypoxemic respiratory failure (O2 Level less than 50 mm Hg) ✓Hypercapnic respiratory failure (Co2 Level more than 50 mm Hg) Manifestations: Shallow respirations Headache, Tachycardia, dysrhythmias, lethargy, and confusion. Complications: heart failure and death Original material supplied by Health Protection Scotland. Responsibility for the editing and use of these materials lies with the individual and not Health Protection Scotland or Healthcare A2Z. © 2006, original content developed by Healthcare A2Z, www.healthcareA2Z.org fchs.ac.ae