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Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
Respiratory distress
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Respiratory distress

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  • A patient with a nosebleed at night could wake up with hemoptysis in the morningSometimes difficult to determine origin. Those with a history of slcoholism or cirrhosis may cause nausea and vomiting. This could be introduced into the lungs(aspiration) and cause the symptom of hemoptysis. Conversely, when there is bronchopulmonary bleeding at night, the patient could swallow the blood and vomit in the morning.
  • For that level of exertion neuromuscular disease Hypoxemia, exercise
  • If you have ever seen Mom flare her nostrils when she gets mad… this is for a different kind of distress.
  • The Parietal Pleura is the serous membrane that lines the inner chest wall. This and the chest wall are filled with pain fibers unlike the inner tissue of the lungs. Those existing conditions may not hurt, such as tumors, however the inflammation may cause a tearing or sharp pain.
  • Obstruction of blood flow to the heart, reducing oxygen transport to the rest of the body Hypovolemia, or low volume, causes a decrease in available blood or Hemoglobin . Hypocapnia, few and shallow breaths, can be caused by sedation or OD
  • When those fluids start to back up, it can cause right heart failure, fluid can overload the lungs causing respiratory distress.
  • The contents of the stomach can be an irritant on the lungs and cause exacerbation of asthma or other lung conditions
  • Most common in children, cough may indicate asthmatic bronchitis Pneumothorax is the presence of air within the pleural space. This space is the ling of the lung and the lining of the chest wall. This normally has no air. This can happen during mechanical ventilation and trauma such as in the following video
  • Transcript

    • 1. Respiratory DistressSigns & SymptomsABGs
    • 2. Identification LOOK at the patient
    • 3. Identification Early Assessment Adequate Time of Implementation Avoidance of Advanced or Invasive Procedures
    • 4. Cardiopulmonary Symptoms Cough Sputum Production Hemoptysis Dyspnea Chest Pain Dizziness/Fainting Swelling of the Ankles Fever, Chills, Nights Sweats Headache, AMS, Personality changes GERD
    • 5. Coughing Acute - allergies, Bronchitis Chronic - COPD, Asthma, TB Recurrent - Asthma, Allergies Dry - PE, Inhale irritants Dry then Productive - Pneumonia, asthma, smoking Chronic Productive - Chronic Bronchitis, Pneumonia Inadequate - Muscle weakness, Sedation, Emphysema
    • 6. Coughing Paroxysmal - Aspiration, Asthma Barking - Croup, Epiglottitis Brassy/Hoarse - Laryngitis, Inspiratory Stridor Bronchitis - Obstruction, Croup, Wheezy Epiglottitis - Asthma, Bronchitis, Bronchospasm Morning - Smoking, Chronic Bronchitis
    • 7. Coughing Afternoon or - Exposure to Evening irritants Associated with Position Change - Bronchiectasis, Left Associated with Heart Failure, Eating or Drinking GERD - Aspiration, Neromuscular Diseases
    • 8. Sputum Production Cause ◦ Mucus Glands (Most often) Characteristics ◦ Color (clear, green, yellow, blood tinged) ◦ Consistency (thin, thick, viscous, tenacious, frothy) ◦ Odor ◦ Quantity ◦ Time of day
    • 9. Hemoptysis Coughing up blood streaked or bloody sputum Hemoptysis is not Hematemesis
    • 10. Dyspnea Shortness of Breath (SOB) Respiratory and cardinal symptom of Cardiac Hematologic, metabolic, chemical, neurologic, psycogenic, mechanical
    • 11. Dyspnea Work of Breathing (WOB) abnormally high Ventilatory capacity is reduced Drive to breath is elevated
    • 12. Signs of Difficulty Breathing Tripod ◦ Support arms on a stationary object Accessory Muscles ◦ Intercostal Muscles ◦ Supraclavicular ◦ Subscapular
    • 13. Signs of Difficulty Breathing Nasal Flaring
    • 14. Signs of Difficulty Breathing Cyanosis ◦ Central ◦ Acrocyanosis
    • 15. Chest Pain (Angina) Cardinal Symptom of Heart Disease Variation ◦ Classic symptoms: Left sided arm, jaw, shoulder, back pain or pressure ◦ Center of the chest ◦ Radiating to Back and Legs ◦ Nausea ◦ Vomiting ◦ Dizziness
    • 16. Chest Pain: Pulmonary Causes Pleuritis ◦ Tachypnea, splinting affected side ◦ Sharp, stabbing Pulmonary Embolus/Infarction ◦ Stabbing, Sudden, Increased by Inspiration ◦ Dyspnea, Tachypnea, Blood-tinged Sputum
    • 17. Chest Pain: Pulmonary Causes Pneumothorax ◦ Sharp, Tearing, Sudden, Localized ◦ Dyspnea, Tachypnea ◦ Tension Pneumothorax  Mediastinal shift, Jugular Distention Pulmonary Hypertension ◦ Similar to Angina, also caused by stress ◦ Dyspnea, Tachypnea, anxiety, jugular distention
    • 18. Syncope Dizziness and Fainting Reduced Blood Flow Reduced Supply of Oxygen
    • 19. Syncope Causes ◦ Obstruction of blood flow  Thrombosis  Embolism  Hypovolemia ◦ Prolonged bouts of coughing ◦ Hypoxia ◦ Hypocapnia
    • 20. Swelling of the Ankles Peripheral Edema ◦ Capillaries of the lungs narrow ◦ Pressures Build ◦ Fluid moves to other tissues
    • 21. Fevers, Chills, Night Sweats Pulmonary Origins ◦ Infection most likely  Abscess  TB  Pneumonia ◦ Chills ◦ Night Sweats
    • 22. Headache and AlteredMental Status Inadequate Oxygen ◦ If hypercapnia continues  Alertness  Drowsiness  Disorientation  Stupor  Coma
    • 23. GERD Gastroesophageal Reflux Disease Abnormal Reflux of Gastric Contents into the Esophagus. Can cause or worsen symptoms of asthma
    • 24. Causes Asthma ◦ Wheezing, Prolonged Expiration Pneumothorax ◦ Acute, Sharp Pleuritic pain, Decreased or absent breath sounds ◦ Tracheal shift ◦ Tension Pneumothorax  Life Threatening/Minutes
    • 25. Tension Pneumothorax
    • 26. Tension Pneumothorax Diminished breath sounds Tachycardia, Hypertension Immediate Decompression of the Chest ◦ 18 gauge needle ◦ Over second rib on the anterior aspect of chest ◦ Rush of air through the needle ◦ Remain in place until more conventional chest tube is inserted ◦ Patient should become more stable quickly
    • 27. Causes Foreign Body Aspiration  Stridor, Wheeze, Retractions Pulmonary Emboli  Chest Pain, Arrhythmias, Tachypnea, Wheezing Pulmonary Edema  Dyspnea on exertion, Crackles at bases of lungs
    • 28. Remember One of the most important things… LOOK at your patient
    • 29. References Wilkins, Robert L.; Stoller, James K.; Kacmarek, Robert M. 2009. Fundamental’s of Respiratory Care. Ninth Ed. Mosby Elsevier

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