Week 3: Respiratory Conditions & Management
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Define hyperventilation
Fast and/or deep breathing
Define hypoventilation
Slow and/or shallow breathing
Define apnoea
Absent breathing/no breathing rate
Define heamoptysis
bleeding from respiratory tract below larynx
Define dyspnoea
Difficult or uncomfortable breathing
Define orthopnoea
Breathless when lying down, relieved by sitting or standing
Define PND
Paroxysmal nocturnal dyspnoea- a sensation of breathlessness that wakes the patient, often after 1-2 hours of sleep, usually relieved in the upright position
Define hypoxia
Hypoxia is the deficiency in the amount of oxygen reaching the tissues and cannot maintain adequate homeostasis
What are causes of hypoxia?
• poor oxygen delivery to tissues • decreased alveolar PAO2 • diffusion impairment • V/Q mismatch • haemoglobin abnormalities • poor cardiac output
What factors can influence respiration rate?
-Disease, exercise, shock, sleep, smoking, age, speech/singing, emotional displays, drugs
What are symptoms of asthma?
• audible expiratory wheeze • increased work of breathing • tachypnoea • dyspnoea • tachycardia • reduced SpO2 • coughing • chest tightness
What are possible asthma triggers?
infections, house dust mites, pollen and spores, animals, exercise, cold air, drugs, foods, pregnancy, emotion, deep inhalation
What causes asthma?
Bronchioconstriction - chronic inflammation of bronchi makes them narrower - excessive suptum - hypersensitive airways
How would you manage asthma?
• oxygen therapy • nebulised salbutamol • prednisolone/hydrocorisone
What is the main stimulus to breathe for a patient with COPD?
Hypoxia
What does the term COPD cover?
• Chronic asthma • Chronic bronchitis • Emphysema
What is chronic bronchitis?
Inflammation and excessive mucus production in the bronchial tree
In which illness are the alveoli not seriously effected and diffusion of gases remain relatively normal?
Chronic bronchitis
What is emphysema?
Pathological changes in the lung, usually end of a process that has been progressing. Usually followed by chronic bronchitis
In which illness if there a permanent abnormal enlargement of the air spaces beyond the terminal bronchioles and destruction of the alveoli?
Emphysema
As emphysema decreases the surface for gas exchange, the resistance to pulmonary blood flow is what?
Increased
What are some of the symptoms of emphysema?
• reduced elasticity, trapping air making lungs become fibrous • reduction in arterial PO2, increased RBC production • expiration is a muscular act • barrel shaped chest
What are some symptoms of the COPD worsening (acute exacerbation)?
• increased dyspnoea • increased sputum • increased cough • increased wheeze • reduced retention • increased fatigue • acute confusion
What are the signs and symptoms of a severe COPD episode?
• marked dyspnoea • tachypnoea • purse-lip breathing • acute confusion • use of accessory muscles • new-onset cyanosis • new-onset peripheral oedema • marked reduction in activities of daily living