Respiratory Exam

Physiological changes of the respiratory system in the aging adult

Physiological changes in the respiratory system occur with aging and may mimic the presence of airway obstruction. For example, dyspnea is common in other chronic conditions, which may lead to asthma being overlooked.

obstructive sleep apnea clinical manifestation of COPD

dyspnea, chronic cough, and sputum production.

Risk Factors of COPD

-cigarette smoking, environmental factors, female, asthma

Pulmonary edema Clinical Manifestations

excessive shortness of breath, tachypneic, hypoxic, in distress, confusion, agitation, excessive sweating, cyanosis of the lips, and cold extremities. Hypertension is often present along with jugular venous distension (JVD);

Tension Pneumothorax, consequences of tracheal deviation

tension Pneumothorax- Tachycardia

Hypotension

Severe dyspnea

Distended jugular veins

Tracheal shift

Unilateral absent breath sounds

Rapid progression to cardiac arrest tracheal deviation- Coughing

Wheezing

Difficulty breathing

Changes in pulse, oxygen, or blood pressure

Pain in the chest.

Fluid appearance after thoracentesis, what might the appearance indicate?

Clear to yellowish: Typical pleural fluid color.

Green, brown, or bloody red: May indicate infection or bleeding.

Cloudy: High protein levels or contamination with white blood cells or microorganisms.

Pulmonary embolism client education

encourage client to do leg exercises, promote smoking cessation, encourage healthy diet and physical activity

Clinical manifestation findings associated with acute asthma exacerbation

wheezing, coughing, chest tightness, and dyspnea

Abnormal clinical findings associated with a chest tube

hemorrhage, tension pneumothorax, hypoxia

Care of a client with a chest tube (nursing interventions)

placing call light within reach, lowering client's bed to lowest position, placing needed items within reach

pneumothorax clinical manifestations

severe, pleuritic chest pain that radiates to the shoulder, and shortness of breath

chest percussion for patients who have pneumonia important assessment data

helps assess pulmonary function, location and diaphragmatic excursion

Reading ABGs

pH: 7.35-7.45 (acid-alkalosis)

PaO2: 35-45 (alkalosis-acid)

HCO3: 22-26 (acid-alkalosis)

anatomy of how oxygen molecules enter the lungs and exchange oxygen into blood stream

enter through nose or mouth then pass through the pharynx travel down the trachea and enter the bronchi and then move to the bronchioles and go to the alveoli

COPD education

- smoking cessation

- avoid environmental or occupational irritants

- avoid people with URIs, children, crowds***

- influenza and pneumococcal vaccines

-O2 therapy

- respiratory and physical therapy

COPD worsening symptoms of disease process

weight loss, barrel chest

Client education on benefits of utilizing a CPAP

assists in the increase of oxygen, decreases the work of breathing, and decreases cardiac workload as it increases intrathoracic pressure. CPAP is used to prevent airway collapse.

Pharmalogical treatment for pulmonary edema

Furosemide is the most common medication used. For a client being managed with diuresis, daily weights, strict input and output monitoring, and continuous pulse oximetry are followed

Asthma pathophysiology

Inflammation, edema, and excess mucus production lead to bronchospasm

expected hypercapnia lab values

pCO2 > 50mmHg, pH <7.35

clinical manifestations of an elderly client with pneumonia

increased confusion, falling, and loss of appetite