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.
Usually brought on by triggers such as exertion, cold air, and allergens. / Wheezing
Shortness of breath
Cough / Avoidance of triggers
Inhalers such as Albuterol, corticosteroids and mast-cell stabilizing drugs
Oxygen therapy
Bronchitis / Bronchitis is a respiratory disease in which the mucous membranes of the bronchial passages become inflamed.
It may be acute (sudden onset) or chronic (long term throughout one’s life). / Low grade fever
Cough with clear yellow or green mucus
Fatigue
Tightness in the chest with deep inspiration or cough
Wheezing
Shortness of breath / Rest
Drink plenty of fluids to help thin out secretions.
Good nutrition
Bronchodilators
Anti-inflammatories
Smoking cessation
Antibiotics (if indicated)
Chronic Obstructive Pulmonary Disease (COPD) / A slow progressive disease of the lungs that causes loss of the lung’s ability to function.
Conditions included in COPD include emphysema, chronic bronchitis and chronic obstructive bronchitis. / Chronic cough
Chronic mucus
Recurrent acute bronchitis
Shortness of breath that progressively worsens / Exercise
Breath training
Nutritional guidance
Oxygen therapy
Inhaled medications
Cystic Fibrosis (CF) / Cystic fibrosis is an inherited condition which affects organs in the body, particularly the lungs and digestive system.
The affected structures become clogged with mucus, making it difficult to breathe and digest food. / Failure to thrive in infants
Poor appetite
Poor energy level
Low birth weight
Salty taste to the skin
Excessive coughing due to thickened mucus
Wheezing / Management of symptoms are
highly individualized
Aerosol therapy
Mucolytic agents
Postural drainage
Bronchodilators
Lung Cancer / Cancer that attacks lung tissue.
The major forms of lungs cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). / Persistent cough
Hoarseness
Loss appetite and weight loss
Blood tinged sputum
Shortness of breath
If metastasized: bone pain, jaundice, and lymph node masses / Lung surgery
Radiation
Chemotherapy
Pneumonia / Inflammation or infection of the lungs, causing the alveoli to fill with pus or liquid, which makes it difficult to breathe.
Causes may be bacterial, viral, or fungal. / Cough with orange or green sputum (some blood may also be noted)
Fever
Chills (may be severe)
Shallow breathing
Tachycardia
Fatigue
Shortness of breath
Chest pain / Determined by type of pneumonia.
Erythromycin and cephalosporins are often used for bacterial infections
Antifungals, if related to a fungal infection
Cough Syrups
Oxygen
Pulmonary Embolism (PE) / A blood clot in the lung. It usually comes from smaller vessels in the arms, legs, pelvis, or heart.
Patients with venous stasis, women on birth control or higher amounts of estrogen, and post-surgery patients are most prone to form a pulmonary embolism.
Symptoms usually have a sudden onset. / Chest pain and pain upon inspiration
Shortness of breath
Rapid respirations
Tachycardia
Hemoptysis (Spitting up blood)
Syncope (Fainting) / Thrombolytics (to help dissolve blood clots)
Surgical removal of the embolism
Anticoagulation therapy to help prevent future blood clots.
Pulmonary Hypertension / A condition in which pulmonary circulation becomes abnormally elevated.
Usually caused by constriction or tightening of the blood vessels that supply blood to the lungs. / Dyspnea or Difficulty breathing
Chest pain
Fainting / Most treatment is related to the underlying cause of pulmonary hypertension and may include oxygen, diuretics, anticoagulants, and calcium channel blockers.
Revatio (newer medication for pulmonary arterial hypertension, reduces pressure in the pulmonary arteries)
Severe Acute Respiratory Syndrome (SARS) / A viral respiratory illness caused by a coronavirus. / Fever
Chills
Cough
Body aches
Headache
Fatigue / Fluids
Vitamins
Antitussive (agents that help to stop coughing)
Expectorant agents (agents that help to bring up mucus)
Sinusitis / Inflammation of the sinuses which may include:
Frontal sinuses (over the eyes in the brow area)
Maxillary sinuses (inside each cheekbone)
Ethmoid sinuses (just behind the bridge of the nose and between the eyes)
Sphenoid sinuses (behind the ethmoids in the upper region of the nose and behind the eyes) / Pain and pressure in the forehead, bridge of the nose, or cheekbones
Nasal and sinus congestion
Fever
Fatigue / Decongestants (agents that break up congestion)
Antihistamines (agents that help to dry up sinuses)
Antibiotics
Upper Respiratory Infection (URI) / The upper respiratory tract encompasses the higher structures of the respiratory tract including the nose, nasal cavity, larynx, trachea and some sinuses.
URI infections may include the common cold, laryngitis (inflammation of the voice box), pharyngitis (sore throat), sinusitis (inflammation of the sinuses, tonsillitis (inflammation of the tonsils, and croup (in children).
URI’s may be bacterial or viral in nature. / Fever may or may not be present
Stuffy nose
Sneezing
Sore throat
Drainage from nose
Sputum which may vary in color and consistency
Altered breath sounds / Symptomatic treatment
If bacterial in nature, an antibiotic may be prescribed
Decongestants and antihistamine therapy
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.