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Chronic Restrictive Diseases - S/S - 6
- Dyspnea on exertion
- Persistent NON-PRODUCTIVE cough
- Hypoxemia, hypocapnea
- DEC vital capacity (Amount of air under volitional control)
- Difficulty expanding lungs --> DEC in lung V
- CXR changes
-
Restrictive lung disease - what is normal? - 2
- Expiratory flow
- FEV1 - NORMAL
-
Restrictive lung disease - DEC what? - 5
- Total lung capacity
- Vital capacity
- Functional residual capacity
- Residual V
- PaCO2
-
Restrictive Lung Disease - d/t abnormal lung parenchyma - 5
- Atelectasis
- Pneumonia
- Pulmonary fibrosis
- Pulmonary edema
- Acute respiratory distress syndrome
-
Restrictive Lung Disease - d/t abnormal pleura - 4
- Pleural effusion
- Pleural fibrosis
- Pneumothorax
- Hemothorax
-
DEC in chest wall is seen w/what dysfunctions? - 5
- Ankylosing spondylitis
- Arthritis
- Scoliosis
- Pectus excavatum
- Scleroderma - chest wall skin burns
-
Atelectasis - define; obstructive vs restrictive; confirmed how? breath sounds; chest excursion; percussion; + S/S (8)
- Collapsed or airless part of lung d/t loss of elasticity or airway blockage (infection)
- Confirmed by CXR - platelike streaks
- RESTRICTIVE
- DEC/Absent breath sounds
- DEC chest excursion
- Percussion - Dull or flat
- Dyspnea
- Cyanosis
- DEC BP
- Tachycardia
- Fever
-
Atelectasis Tx - what device? Why?
- (+) end-expiratory P
- Continuous (+) airway P
- Keep airways & alveoli open - as this disease is collapsed/airless lung
-
Acute Respiratory Distress Syndrome - define + d/t what?; obstructive vs restrictive; S/S (2); Tx
Alveolar collapse in premies resulting from lung inflammation d/t low levels of surfactant
- RESTRICTIVE
- Flaring nares
- Expiratory grunting
Tx - O2, surfactant admin, assisted ventilation
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SARS - define; obstructive vs restrictive; S/S (2); lab test INC/DEC (4)
An atypical respiratory illness caused by a coronovirus
RESTRICITVE
- Lab test - DEC WBC, platelets, & lymphocytes
- Lab test - INC liver function tests
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Rib fx - Frail chest - define; obstructive vs restrictive; S/S (4); Tx
2 or more fx in adjacent ribs d/t blunt trauma
RESTRICITVE
- Shallow breathing
- Crepitation during ventilation
- Inspiration pulled inward
- Expiration pushed outward
Tx: Splinting d/t pain
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Pneumothorax - define + confirmed how; obstructive vs restrictive; breath sounds; percussion; trachea?
- Air in pleural space - Confirmed by CXR
- RESTRICTIVE
- DEC/absent breath sounds
- Dry cough
- Tracheal deviation AWAY from injured side
- Percussion - Hyperresonant & tympanic
- Local or referred pain
-
ACUTE Pulmonary edema - S/S - 6 + Tx
- Extreme SOB w/profuse sweating
- Bubbly, wheezing or gasping sound during breathing
- Pink frothy sputum
- Cyanotic skin
- Rapid, IRREGULAR pulse
- Severe drop in BP
Tx - EMERGENCY - call 911
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Pulmonary emboli - w/ vs. w/o infarction - S/S (5); Tx
- W/Infarction:
- Chest pain
- Hemoptysis
- Pleural friction rub
- Fever
- (+) chest x-ray
- W/o infarction:
- Tachypnea
- Anxiety / Restlessness
- Rales (crackles)
- Wheezing
- DEC breath sounds
Tx - low dose heparin + analgesics
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Name 4 conditions w/COPD
- A - asthma
- B - bronchitis
- C - cystic fibrosis
- E - emphysema
-
COPD - General S/S (7); Stage III S/S (3)
- INC chest size - A-P diameter
- Dry or productive cough
- INC resistance to airflow
- Abnormal breath sounds
- Use of accessory breathing mms
- Often a history of smoking
- Stage III S/S:
- MM wasting
- Weight loss
- INC anteroposterior-to-lateral chest ratio = barrel chest
-
Asthma - define; obstructive vs restrictive; breath sounds; S/S (3)
Stimuli - allergens, exercise, cold
OBSTRUCTIVE
- Wheezing cough
- DEC breath sounds
- Dry or productive mucoid sputum w/plugs
- Chest wall symmetrically DEC
- Meds - prednisone, nebulizer or inhaler
- Bronchodilators administered PRIOR to exercise
-
Bronchitis - define; obstructive vs restrictive; breath sounds; S/S (2); Tx
- Chronic inflammation of tracheobronchial tree w/cough/sputum production
- @ least 3 months for 2 consecutive years
- OBSTRUCTIVE
- Wheezing or rhonchi breath sounds
- Productive mucoid or purulent sputum w/infection
- May have fever
Tx - Paced breathing; relationship to smoking
-
Bronchiectasis - define; obstructive vs restrictive; breath sounds; S/S (4 major +4 others)
- Progressive lung disease - permanent dilation of bronchi
- OBSTRUCTIVE
- Consistent productive cough
- Excessive sputum production
- Hemoptysis
- Crackles + DEC breath sounds
- Cyanosis
- Clubbing
- Hypoxemia
- Dyspnea
-
Cystic fibrosis (CF) - define; obstructive vs restrictive; breath sounds; Early signs (2); S/S (4); test; Tx
- Thickening of secretions of all exocrine glands, leading to obstruction
- OBSTRUCTIVE
- Excessive appetite & weight loss - early sign
- Infections
- Frequent, greasy stools
- Wheezing
- Productive mucoid or purulent sputum
- Test:
- (+) sweat electrolyte test - INC chloride
Tx: Percussion, vibration, shaking & postural drainage - many x/day in acute stage; Suction in severe cases
-
Emphysema - define; obstructive vs restrictive; breath sounds; S/S (5); Tx
- Permanent abnormal enlargement & destruction of air spaces distal to terminal bronchioles
- OBSTRUCTIVE
- INC lung compliance
- INC resonance
- DEC elastic recoil
- Barreled chest
- Use of accessory mms of ventilation
- DEC breath sounds w/or w/o wheezing
- Dyspnea
Tx: Pursed lip breathing during expiration
-
Obstructive lung disease - INC what? - 4
- Total lung capacity
- Functional residual capacity
- Residual V
- PaCO2
-
Obstructive lung disease - DEC what? - 4
- DEC in airflow
- Breath sounds
- Vital capacity
- FEV1 - Sharp DEC
-
Obstructive vs Restrictive - Flow rates (FEV1/FVC); Volumes
- Obstructive - Volumes essentially normal; Flow rates low
- Restrictive - Volumes DEC; Flow rates normal (Normal FEV1/FVC = 0.8 - 1.0)
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