CHAPTER 16



Chapter 16 Pulmonary Examinations and Procedures

Diseases and Disorders of the Respiratory System

|Disease |Description |Symptoms |Treatment |

|Asthma |Chronic disease that affects the bronchiole tubes. |Wheezing |Avoidance of triggers |

| |Usually brought on by triggers such as exertion, cold air, and |Shortness of breath |Inhalers such as Albuterol, corticosteroids and |

| |allergens. |Cough |mast-cell stabilizing drugs |

| | | |Oxygen therapy |

|Bronchitis |Bronchitis is a respiratory disease in which the mucous |Low grade fever |Rest |

| |membranes of the bronchial passages become inflamed. |Cough with clear yellow or green mucus |Drink plenty of fluids to help thin out |

| |It may be acute (sudden onset) or chronic (long term throughout|Fatigue |secretions. |

| |one’s life). |Tightness in the chest with deep inspiration |Good nutrition |

| | |or cough |Bronchodilators |

| | |Wheezing |Anti-inflammatories |

| | |Shortness of breath |Smoking cessation |

| | | |Antibiotics (if indicated) |

|Chronic Obstructive Pulmonary|A slow progressive disease of the lungs that causes loss of the|Chronic cough |Exercise |

|Disease (COPD) |lung’s ability to function. |Chronic mucus |Breath training |

| |Conditions included in COPD include emphysema, chronic |Recurrent acute bronchitis |Nutritional guidance |

| |bronchitis and chronic obstructive bronchitis. |Shortness of breath that progressively |Oxygen therapy |

| | |worsens |Inhaled medications |

|Cystic Fibrosis (CF) |Cystic fibrosis is an inherited condition which affects organs |Failure to thrive in infants |Management of symptoms are |

| |in the body, particularly the lungs and digestive system. |Poor appetite |highly individualized |

| |The affected structures become clogged with mucus, making it |Poor energy level |Aerosol therapy |

| |difficult to breathe and digest food. |Low birth weight |Mucolytic agents |

| | |Salty taste to the skin |Postural drainage |

| | |Excessive coughing due to thickened mucus |Bronchodilators |

| | |Wheezing | |

|Lung Cancer |Cancer that attacks lung tissue. |Persistent cough |Lung surgery |

| |The major forms of lungs cancer are non-small cell lung cancer |Hoarseness |Radiation |

| |(NSCLC) and small cell lung cancer (SCLC). |Loss appetite and weight loss |Chemotherapy |

| | |Blood tinged sputum | |

| | |Shortness of breath | |

| | |If metastasized: bone pain, jaundice, and | |

| | |lymph node masses | |

|Pneumonia |Inflammation or infection of the lungs, causing the alveoli to |Cough with orange or green sputum (some blood|Determined by type of pneumonia. |

| |fill with pus or liquid, which makes it difficult to breathe. |may also be noted) |Erythromycin and cephalosporins are often used for|

| |Causes may be bacterial, viral, or fungal. |Fever |bacterial infections |

| | |Chills (may be severe) |Antifungals, if related to a fungal infection |

| | |Shallow breathing |Cough Syrups |

| | |Tachycardia |Oxygen |

| | |Fatigue | |

| | |Shortness of breath | |

| | |Chest pain | |

|Pulmonary Embolism (PE) |A blood clot in the lung. It usually comes from smaller vessels|Chest pain and pain upon inspiration |Thrombolytics (to help dissolve blood clots) |

| |in the arms, legs, pelvis, or heart. |Shortness of breath |Surgical removal of the embolism |

| |Patients with venous stasis, women on birth control or higher |Rapid respirations |Anticoagulation therapy to help prevent future |

| |amounts of estrogen, and post-surgery patients are most prone |Tachycardia |blood clots. |

| |to form a pulmonary embolism. |Hemoptysis (Spitting up blood) | |

| |Symptoms usually have a sudden onset. |Syncope (Fainting) | |

|Pulmonary Hypertension |A condition in which pulmonary circulation becomes abnormally |Dyspnea or Difficulty breathing |Most treatment is related to the underlying cause |

| |elevated. |Chest pain |of pulmonary hypertension and may include oxygen, |

| |Usually caused by constriction or tightening of the blood |Fainting |diuretics, anticoagulants, and calcium channel |

| |vessels that supply blood to the lungs. | |blockers. |

| | | |Revatio (newer medication for pulmonary arterial |

| | | |hypertension, reduces pressure in the pulmonary |

| | | |arteries) |

|Severe Acute Respiratory |A viral respiratory illness caused by a coronavirus. |Fever |Fluids |

|Syndrome (SARS) | |Chills |Vitamins |

| | |Cough |Antitussive (agents that help to stop coughing) |

| | |Body aches |Expectorant agents (agents that help to bring up |

| | |Headache |mucus) |

| | |Fatigue | |

|Sinusitis |Inflammation of the sinuses which may include: |Pain and pressure in the forehead, bridge of |Decongestants (agents that break up congestion) |

| |Frontal sinuses (over the eyes in the brow area) |the nose, or cheekbones |Antihistamines (agents that help to dry up |

| |Maxillary sinuses (inside each cheekbone) |Nasal and sinus congestion |sinuses) |

| |Ethmoid sinuses (just behind the bridge of the nose and between|Fever |Antibiotics |

| |the eyes) |Fatigue | |

| |Sphenoid sinuses (behind the ethmoids in the upper region of | | |

| |the nose and behind the eyes) | | |

|Upper Respiratory Infection |The upper respiratory tract encompasses the higher structures |Fever may or may not be present |Symptomatic treatment |

|(URI) |of the respiratory tract including the nose, nasal cavity, |Stuffy nose |If bacterial in nature, an antibiotic may be |

| |larynx, trachea and some sinuses. |Sneezing |prescribed |

| |URI infections may include the common cold, laryngitis |Sore throat |Decongestants and antihistamine therapy |

| |(inflammation of the voice box), pharyngitis (sore throat), |Drainage from nose | |

| |sinusitis (inflammation of the sinuses, tonsillitis |Sputum which may vary in color and | |

| |(inflammation of the tonsils, and croup (in children). |consistency | |

| |URI’s may be bacterial or viral in nature. |Altered breath sounds | |

Drugs for pulmonary hypertension

Sildenafil citrate is a drug manufactured by Pfizer and is packaged under two separate names. Revatio (sildenafil citrate) is marketed for patients with pulmonary arterial hypertension, and Viagra (sildenafil citrate) is marketed for patients with erectile dysfunction disorder (EDD). Sildenafil citrate primarily acts on the arterial walls of smooth muscle in both the lungs and penis. It doesn’t appear to induce vasodilation in other parts of the body. In patients with pulmonary hypertension, it relaxes the arterial walls of the pulmonary vessels, leading to decreased pulmonary arterial resistance and pressure. In EDD, sildenafil leads to smooth muscle relaxation which promotes vasodilation in the corpus cavernosum of the penis. This results in an increase in the flow of blood which, upon sexual stimulation, promotes an erection.

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