1 / 36

Respiratory Patho

Respiratory Patho. Chronic Obstructive Pulmonary Disease. Also called COLD-- chronic obstructive lung disease Emphysema Chronic bronchitis Asthma. Emphysema. What is it? Destruction of alveolar walls-- below the bronchioles Decreases surface area Decreases area available for exchange

johana
Download Presentation

Respiratory Patho

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Respiratory Patho

  2. Chronic Obstructive Pulmonary Disease • Also called COLD-- chronic obstructive lung disease • Emphysema • Chronic bronchitis • Asthma

  3. Emphysema • What is it? • Destruction of alveolar walls-- below the bronchioles • Decreases surface area • Decreases area available for exchange • Increase resistance to pulmonary blood flow

  4. Emphysema cont... • Can lead to pulmonary hypertension • Cor pulmonale = right heart failure • Lungs can not recoil and air is trapped • Residual lung capacity increases • PO2 decreases over time • Increased RBC • Polycythemia-- high hematocrit

  5. Emphysema cont... • PCO2 increased • Hypoxic drive • Causes • Complications of disease • Pneumonia • URI • Dysrhythmias cancer

  6. Emphysema cont... • Home drugs • Bronchodilators • Steroids • Later-- oxygen

  7. Emphysema cont.. • Assessment • Weight loss-- thin • Dyspnea esp on exertion • Cough only in AM • Barrel chest • Tachypnea

  8. Emphysema cont.. • Pink puffers • Enlarged accessory muscles • Clubbing of fingers • Pursed lips-- prolonged expiration-- active now • Wheezing or rhonchi may or may not be present

  9. Chronic bronchitis • Increase in the number of mucous cells • Large amount of sputum • Diffusion normal • Hypercarbia due to deceased alveolar ventilation

  10. Chronic bronchitis • Assessment • Overweight • Blue bloaters • Rhonchi • RHF-- JVD, pedal edema

  11. Management of COPD • Goal??? • Treat hypoxia • Reverse bronchoconstriction • Reassure patient-- EMONTIONAL support • Oxygen using patient distress to determine amount • Monitor for cardiac dysrhythmias

  12. Management of COPD • IV 5% D/W or NS KVO • Nebulizer • Albuterol, Proventil Ventolin • isoethharine, Bronksol • metrproterenol, Alupent • Sympathomimetic, Beta agonist B2 selective

  13. Management of COPD • Bronchodilation • Uses-- COPD, Pul edema, asthma, severe allergic reactions • Contraindications-- tachycardia • Monitor B/P, pulse, ECG • Side effects-- tachycardia, palpitations, anxiety,headache, dizzy

  14. Asthma • Asthma patients do die • Increasing deaths over 45 years old • Higher death rate in Afro-Americians • definition • Chronic disease due to air flow obstruction • Small airways consrtict

  15. Asthma • Causes of acute excerbations • allergens • cold air • irritants-- smoke, pollen • medications

  16. Asthma • Phase one • Release of histamine • Bronchoconstriction and bronchial edema • Usually will respond to Beta agonist • Phase two • WBC invade bronchioles • Cause edema and swelling of bronchioles

  17. Asthma • Phase 2 will not respond well to Beta agonists • May need steroids • Assessment • Dyspnea and wheezing • Cough • Hyperressonance

  18. Asthma • Assessment cont. • Tachypnea • Use of accessory muscles • Speech dyspnea • History-- what did pt take • beta agonist?, steroids, anticholinergics, bronchodilators?

  19. Asthma • History of admissions to hospital for asthma • Hx of intubations? • Management • Corect hypoxia, reverse bronchospasm • Treat inflammatory process

  20. Asthma treatment • Emotional support • Primary and secondary survey • Oxygen • EKG and pulse ox • Beta agonist-- nebulizer • Epinephrine SQ 0.3-0.5 mg or cc 1:1000 solution Peds 0.01 mg.kg up to 0.3mg

  21. Asthma treatment • Aminophyllin-- Xanthine bronchodilator (not a beta agonist) • Solu Medrol--- steroid

  22. Status Asthmaticus • Severe, prolonged asthma attack which can not be broken by usual treatment • Wheezing may be absent-- silent chest • Severe acidosis • May have to intubate

  23. Pneumonia • More prevalent in??? • Elderly • HIV positive • Peds • Infection in the lungs • Bacterial, viral, fungal

  24. Pneumonia • Assessment • “looks sick” • fever and chills • tachypnea, tachycardia • general weakness-- malaise • Productive cough-- yellow, blood-tinged • Chest pain-- upper abd pain

  25. Pneumonia • Rhoncho, wheezing, rales • percussion??? • Management • Emotional support • Primary and secondary survey • O2, EKG, Pulse ox, IV-- may be dehyrated • Position, when would nebulizer be used?

  26. Toxic inhalation • May cause inflammation and constriction or laryngospasm or edema of larynx • superheated air • toxic products • chemicals • inhaled steam

  27. Toxic inhalation • Scene safety • If hoarseness, brassy cough or stridor-- possible laryngeal edema-- be careful • May need to intubate • Humidified O2, IV, EKG, Pulse ox • Be careful about nebulized drugs

  28. Carbon monoxide • Odorless, tasteless gas • binds with hemoglobin 200 faster than oxygen • receptor sites do not transport oxygen • cellular hypoxia • history-- how long and where

  29. Carbon monoxide • Signs and symptoms • headache and irritability • confusion or agitation • vomiting, chest pain, LOC, seizures • Cyanotic, cherry red is late sign

  30. Carbon monoxide • Management • Remove from site • Airway, high oxygen • treat for respiratory depression or shock • Hyperbaric

  31. Pulmonary embolus • Blood, air, foreign body that lodges in pulmonary artery • Many are diagnosed on autopsy • S and S • Sudden unexplained SOB • Chest pain may or may not be present • Shock symptoms

  32. Pulmonary embolus • Who is at risk • long term immoblization • BCP • Hx of thrombophlebitis • Delivery • long bone fx

  33. Pulmonary embolus • Management • Transport ASAP • High O2, position • Emotional support • IV, pulse ox, EKG, 12 lead • May need to tube

  34. Hyperventilation syndrome • Anxiety or situational problem • consider other medical problems • do not minimize • loss of CO2 cause Respiratory Alkalosis • rapid and shallow respirations • nervous, dizzy, chest pain

  35. Hyperventilation syndrome • Numbness and tingling-- mouth, hands, feet • carpopedal spasms • Treatment • EMOTIONAL SUPPORT • slow respirations

  36. Central nervous system dysfunction • Head trauma, stroke, brain tumor, drugs • dysfunctional of spinal cord, nerves, respiratory muscles • spinal cord trauma, polio, myasthenia gravis, Lou Geriigh’s disease, MS, MD

More Related