Review

Where do pulmonary problem occur? - all is due to

Astthma - bronchi and brionchiols - bronchoconstriction and inflammation and mucus

COPD/Emphysema - small airways adn alveloi

What happens in the pleurial space

visceral pleural - lungsparietal plureal - chest cavity

pneumothorax - hyerpresonase breat sounds

pleural effuis - tactile fremitus

empyema - antibiotics, drainage

recognizing respiratory distress

ABCs- airway, breathing, circulation

diminisished breath sounds, increased WOB, asymmetrical chest expantion, cyanosis, tachypnea, AMS (worsening), dyspnea, restlessness

pneumonia - fever, cough, sputum, localized crackles, signs of infection, tachpnea, decreased oxygen

pulmonary edema - bilateral crackles, orthopnea, dypnea, periferal edema, weight gain - think fluid overload

atelecticisi - recent surgery, imparied mobility

Wheezing - lower airways

difficult airflow due to narrowing of airway

pneumothorax - absent breath sounds on one side

stridor -

ABCs - oxygenation, ventilation, acid base balance

chest xray - pneomothorax, pneumonia, pleural effision, atelectisis

pnumothrawx with hyperventialation - PaCO2 low

COPD acidosis

PAC02 - ventalation

PAO2 - oxygentation

insentive spirometry - 3 seconds deeply base of the lungs

pneumonia - cultures, antipitoics

Hosptial acqi=red pneunomis - after 48 hours hospital admission when infection was not present on admission - CRP

Pneumonia Vaccines - 2 vaccines - consider age, risk factors, vaccination history, timing

Severe antiboticreactions

TB - gradual, persitant cough, nigthsweats, lowgrade fever,

Nasal canual - 1-6 liter

simple face mask 0 start at 35 % - 5 -10 liters

3 sided tape for

sub Q emphysema - air trapped undereath the skin