Respiratory System Common Procedures and Conditions

What is asthma?

A disease in which triggers can cause a spasm in the bronchial tree.

What asthma triggers are listed in the module?

Dust, infection, pollutants in the air, certain drugs, allergens, workplace agents, air pollution, obesity, and exercise.

What is allergic asthma?

Asthma in which inhaling an allergen initiates the attack; it is common in children.

What is occupational asthma?

Asthma triggered by workplace agents such as plastics, metals, wood, or grains.

What happens to the bronchioles during an asthma attack?

They become swollen and fill with excessive mucus, decreasing airflow to the lungs.

What symptoms and lung findings occur during an asthma attack?

Cough, chest tightness, shortness of breath, wheezing, and prolonged expiration.

How is spirometry used in asthma assessment?

To measure forced expiratory volume in 1 second and forced vital capacity before and after bronchodilator treatment.

What are bronchodilators?

Inhaled medications that dilate the bronchioles to improve airflow.

What are inhaled corticosteroids used for in asthma?

They are inhaled daily to control inflammation in the airway.

What is pneumonia?

A bacterial infection of the lungs.

What is community-acquired pneumonia?

Pneumonia that occurs outside of the hospital.

What are hospital-acquired and ventilator-acquired pneumonia?

Nosocomial infections that occur within the hospital.

What does nosocomial mean?

Relating to a hospital.

What bacterial species does the module identify as the most common cause of community-acquired pneumonia?

S pneumoniae.

What symptoms can occur with pneumonia?

Fever, cough, shortness of breath, sweating, chills, chest pain, myalgias, headache, or abdominal pain.

What physical findings can occur with pneumonia?

Fever, tachypnea, tachycardia, decreased O2 saturation, decreased breath sounds over the infection, and respiratory crackles.

What are respiratory crackles?

Short, sharp, or rough breath sounds caused by excessive fluid in the lungs.

How is pneumonia diagnosed and treated according to the module?

Diagnosis with a chest x-ray showing cloudy consolidation; treatment with antibiotics.

What is thoracentesis?

A procedure in which a needle is inserted into the pleural space and fluid is removed.

Why may thoracentesis be performed in severe pneumonia?

To allow the lungs to expand further and to allow bacterial culture and sensitivity testing of pleural fluid.

What does COPD stand for?

Chronic obstructive pulmonary disease.

What is COPD?

A common, preventable lung disease in which airflow is limited in the airway and alveoli because of damage largely from cigarette smoke exposure.

What symptoms are listed for COPD?

Excessive cough, sputum production, and shortness of breath.

What two types of COPD are listed?

Emphysema and bronchitis.

What is emphysema?

A condition in which the walls of the alveoli become distended and damaged.

What is dead space ventilation in emphysema?

Air is trapped in damaged alveoli and is unable to leave the lungs.

What is bronchitis in the COPD section?

Inflammation of the bronchioles causing chronic cough with excess sputum production.

What findings are associated with bronchitis in COPD?

Exacerbations of dyspnea, cyanosis, peripheral edema, rhonchi, and wheezing.

What treatments for COPD are listed?

Smoking cessation, supplemental oxygen, bronchodilators, and for severe COPD with chronic respiratory failure, lung transplant.

What is supplemental oxygen?

Oxygen provided through a tube or cannula inserted into the nose.

What is a pneumothorax?

A condition in which air collects in the pleural space.

What is a spontaneous pneumothorax?

Air collects in the pleural space without underlying lung disease or trauma.

What is a secondary pneumothorax?

A pneumothorax in a patient with underlying lung disease.

What is a traumatic pneumothorax?

A pneumothorax caused by trauma.

What is an iatrogenic pneumothorax?

A pneumothorax resulting as an adverse outcome from a procedure such as bronchoscopy, thoracentesis, lung biopsy, or central line placement.

What symptoms can occur with a pneumothorax?

Shortness of breath and chest pain on the side of the pneumothorax; mild cases may have minimal symptoms.

How is a small spontaneous pneumothorax treated?

Observation while the air is absorbed from the pleural space.

How can a large pneumothorax be treated?

With a chest tube that has a water seal and is attached to suction.

What is the purpose of the water seal on a chest tube?

To prevent air from returning to the lungs.

What does ARDS stand for?

Acute respiratory distress syndrome.

What is ARDS?

An emergent, life-threatening condition in which respiratory distress develops after an inciting event, with damage that impairs gas exchange and leads to hypoxemia and alveolar collapse.

What events associated with ARDS are listed?

Trauma, sepsis and shock, burns, CABG surgery, drugs and drug overdose, aspiration of stomach contents into the lungs, near drowning, and severe pneumonia.

When do severe ARDS symptoms typically progress after the inciting event?

Within 12–48 hours.

What findings can occur with ARDS?

Severe shortness of breath, labored breathing, tachypnea, crackles, and intercostal retractions.

What may a chest x-ray show in ARDS?

Patchy diffuse infiltrates throughout the lung or a complete white-out.

What is intubation?

Insertion of an endotracheal tube through the mouth into the bronchial tree.

What is a mechanical ventilator?

A machine that forces air into the lungs and assists the patient with breathing.

When may a tracheostomy be used in ARDS?

If the patient fails to improve and may require mechanical ventilation for a longer period.