Dysnpea - ANSWER - breathing discomfort with an attempt to increase respiratory
effort
- Three Severe Signs of Dyspnea:
1. Flaring of nostrils
2. Use of accessory muscles
3. Retraction of intercostal spaces
Orthopnea - ANSWER - SOB that occurs when laying flat
Paroxysmal Nocturnal Dyspnea - ANSWER - severe SOB and coughing at night
Kassmaul's Respirations (Hyperpnea) - ANSWER - increased respirations with large
tidal volume and no expiratory pause (associated with respiratory acidosis)
Cheyne-Stoke's Respirations - ANSWER - periods of deep/faster breathing
(hyperventilation) followed by a gradual stop (apnea)
Labored Breathing - ANSWER - increased work of breathing
- Occurs with obstructed airways
- Stridor or wheezing
,Restricted Breathing - ANSWER - prevent lung from fully expanding with air due to
stiffen lungs/chest wall
- Tachypnea and small tidal volumes
What is the goal of ventilation? - ANSWER - - Maintain an optimal pH through
release of CO2
- Hypoventilation à hypercapnia à acidosis
- Hyperventilation à hypocapnia à alkalosis
Hypoxemia - ANSWER - decreased oxygen of arterial blood presenting as central
cyanosis
· Hypoventilation from lack of neurological stimulation (drug overdose)
· Respiratory diseases (COPD)
· Pulmonary edema & fibrosis
Hypoxia - ANSWER - decreased oxygen in cells of tissues presenting as peripheral
cyanosis
Respiratory Failure - ANSWER - inadequate gas exchange resulting in low O2/pH and
high CO2
- Causes can be direct or indirect injury
Restrictive Disorders - ANSWER - decreased lung compliance requiring more effort
to expand lungs during inspiration resulting of V/Q mismatch - hypoxemia
,Aspiration - ANSWER - food or fluid in the right lower lobe of the lungs
- Clinical Manifestations:
· Sudden onset of choking
· Coughing with/without vomiting
· Dyspnea
· Wheezing
Bronchiectasis - ANSWER - persistent abnormal dilation of the bronchi associated
with bronchial inflammation
- Chronic inflammation causes destruction of bronchial walls & permanent dilation
- Airway damage leads to bronchospasms & increased purulent mucous
- Hemoptysis, clubbing of fingers and cor pulmonale occurs
Bronchiolitis - ANSWER - diffuse inflammatory obstruction of bronchioles
- Common in children
- Linked to a viral infection of upper/lower airways (adults)
- S/S = increased respirations, use of accessory muscles, fever, dry non-productive
cough
- Can lead to a hyper-inflated chest and hypoxemia
Atelectasis - ANSWER - collapse of lung tissue (alveoli) which affects gas exchange
- S/S = dyspnea, cough, fever, leukocytosis
- Compression - external pressure on lungs from tumors, fluid, air or abdominal
distention
- Absorption - removal of air from obstructed/hypoventilation alveoli or from
inhalation of anesthetics/concentrated oxygen
- Surfactant Impairment - decreased production or inactivation of surfactant à lung
collapse
, Pulmonary Fibrosis - ANSWER - excessive amount of fibrous or connective tissue in
the lung
- May be due to inhalation of toxic gases or dusts & autoimmune disorders
- More common in men (over 60 years)
Idiopathic Pulmonary Fibrosis - ANSWER - fibrotic process results in chronic
inflammation & alveolar epithelialization
- Loss of lung compliance à lung stiffens up
- Decreased diffusion across alveolocapillary membrane à hypoxemia with
hyperventilation & hypercapnia
Pulmonary Edema - ANSWER - abnormal accumulation of fluid in the alveoli
- Cause:
· Left-sided heart failure
· Capillary injury à increased capillary permeability
· Obstruction of lymphatic system
- Clinical Manifestations:
· Dyspnea
· Hypoxemia
· Inspiratory crackles
· If severe = frothy pink sputum, hypoventilation, hypercapnia
Acute Respiratory Distress Syndorme (ARDS) - ANSWER - fluid leaks into the lungs
resulting in difficulty/impossible breathing (MEDICAL EMERGENCY)
- Result in severe hypoxemia and decreased lung compliance in both lungs
- Clinical Manifestations:
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