Chapter 15: Altered Ventilation and Diffusion

Pneumonia

Infectious process: bacterial, viral
Spreads via respiratory droplet

Pneumonia Clinical Manifestations

-Sudden onset of fever
-Productive cough
-Tachypnea

Pneumonia Diagnosis

Chest X-ray

Pneumonia Treatment

-Antibiotics
-Maintain airway
-Prevention: hand hygiene

Emphysema

Inflammation and irreversible enlargement of the alveoli
-Loss of elastic recoil

Emphysema Etiology

Chronic smoking

Emphysema Clinical Manifestations

Barrel chest
Pursed lip breathing

Emphysema Treatment

Smoking cessation

Chronic Bronchitis

Inflammation and abundant mucus production in bronchioles
Smoking
-Bronchial thickening
-Destruction of cilia
-Mucous build up

Chronic Bronchitis Clinical Manifestations

-Hypoxemia and hypercapnia
-Cyanosis
-Persistent, productive cough

Chronic Bronchitis Diagnosis

Presentation of a persistent, productive cough over a period of 3 months or more within 2 consecutive years

Asthma

Chronic inflammatory disorder
-IgE mediated hypersensitivity reaction
-Bronchiole hyperresponsiveness, inflammation, bronchoconstriction, and excess mucous production

Asthma Clinical Manifestations

Wheezing, coughing, chest tightness, excessive sputum, and anxiety

Asthma Treatment

Control environmental triggers

Cystic Fibrosis

-Mutation of CF gene
-Electrolyte and water transport affecting certain epithelial cells
-Mucous plugging, inflammation, and infection in the lungs

Cystic Fibrosis Clinical Manifestations

-Infection
-Chronic cough

Cystic Fibrosis Diagnosis

Newborn screening and genetic testing

Cystic Fibrosis Treatment

Avoid/control respiratory infection

Acute Respiratory Distress Syndrome

-Severe acute inflammation and pulmonary edema
-Progression from lung injury to respiratory distress within 24-48 hours
-Infection

Acute Respiratory Distress Syndrome Clinical Manifestations

-Tachypnea
-Crackles

Acute Respiratory Distress Syndrome Diagnosis

Labs: ABGs, Cultures (Sepsis)

Acute Respiratory Distress Syndrome Treatment

Critical care