Lecture Notes                                      13                                        Respiratory System           ...
Copyright © 2011 by F.A. Davis Company. All rightsreserved. This product is protected by copyright. No part of it may be r...
Good timber does not grow with ease.The stronger the wind, the stronger the                trees.                      —Wi...
Common Signs and Symptoms ofRespiratory System Diseases andDisorders• Pain anywhere in the  respiratory  tract, especially...
Common Signs and Symptoms ofRespiratory System Diseases andDisorders • Breathing   irregularities   •   Dyspnea   •   Whee...
Allergic Rhinitis• Description  • Inflammation of the    nasal membranes due to    an allergic reaction to    air particle...
Sinusitis• Description  • Inflammation of the    paranasal sinuses  • Acute caused by common    cold  • Chronic follows   ...
Pharyngitis• Description • Inflammation of the   throat • May be acute or chronic • Most common throat   disorder   • Chil...
Pharyngitis• Etiology • Bacteria (Streptococcus   pyogenes) or viral (influenza   or common cold) infectious   agents • Se...
Pharyngitis• Signs and symptoms • Sore throat • Difficulty swallowing • Malaise • Fever • Headache • Coryza (common cold) ...
Pharyngitis• Diagnostic procedures • Physical exam reveals   red, swollen mucous   membranes   • Pustular pharyngeal     u...
Pharyngitis• Treatment • Antibiotics, if   bacterial • Warm saline gargles • Analgesics • Antipyretics • Rest • Adequate f...
Pharyngitis  Complementarytherapy   • Aromatherapy with     inhalation of     lavender, thyme, eucalyptus     , sandalwood...
Pharyngitis• Prognosis • Generally good • Complications can occur   with untreated strep• Prevention • Avoid such irritati...
Laryngitis• Description • Inflammation of the   laryngeal mucosa and the   vocal cords causing   hoarseness in voice • May...
Infectious Mononucleosis• Description • Acute infectious disease   characterized by sore   throat, fever, and   swollen ce...
Infectious Mononucleosis• Etiology • Caused by Epstein-Barr   virus (EBV) • Shed in saliva; spreads   through oral-pharyng...
Infectious Mononucleosis• Signs and symptoms • Initially vague symptoms   of   malaise, anorexia, and   chills • After 3 t...
Infectious Mononucleosis• Diagnostic procedures • History and physical   exam • Blood test showing   increased   leukocyte...
Infectious Mononucleosis• Treatment • Supportive treatment • Bed rest during acute   phase • Analgesics • Warm saline garg...
Infectious Mononucleosis  Complementarytherapy   • Bed rest   • Drink filtered water   • Organic diet containing no     gr...
Infectious Mononucleosis• Prognosis • Excellent, but takes   several weeks or months • EBV remains in a dormant   state fo...
Infectious Mononucleosis• The Epstein-Barr  virus causes  an  infection of the  1. B lymphocytes  2. pharynx  3. T lymphoc...
Pneumonia• Description • Acute inflammation of   respiratory   bronchioles, alveolar   ducts, sacs, and alveoli of   lungs...
Pneumonia• Etiology • Bacteria   (pneumococcus), viruses   (influenza) two main   types with bacterial   more serious • Fu...
Pneumonia• Signs and symptoms • Coughing, sputum   production • Pleuritic chest pain • Shaking chills, fever • Rales, dysp...
Pneumonia• Diagnostic procedures • History and physical   exam • Chest x-ray • Sputum smears and blood   cultures         ...
Pneumonia• Treatment • Varies with etiology • Antibiotics if bacteria • Humidified oxygen   therapy • Mechanical ventilati...
Pneumonia• Treatment (cont.)  • High-calorie diet  • Increased fluid intake  • Rest  • Analgesics  • Postural drainage    ...
Pneumonia  Complementarytherapy   • Supplements to strengthen     immune system   Client communication   • Describe seriou...
Pneumonia• Prognosis • Varies with etiology • If secondary to another   disease, or if elderly   person has influenza-type...
Chronic ObstructivePulmonary Disease• Description • Functional diagnosis   given to any   pathological process   that decr...
Chronic ObstructivePulmonary Disease• Description (cont.) • Chronic pulmonary emphysema:   permanent enlargement of air   ...
Chronic ObstructivePulmonary Disease• Etiology • Diseases that may lead   to COPD include chronic   asthma, bronchiectasis...
Chronic ObstructivePulmonary Disease• Signs and symptoms • Insidious; no symptoms until   lung is damaged • Chronic cough,...
Chronic ObstructivePulmonary Disease• Diagnostic procedures • History and physical   examination • Chest x-ray • Pulmonary...
Chronic ObstructivePulmonary Disease• Treatment • Prevent complications and   further lung damage • Relieve symptoms • Bro...
Chronic ObstructivePulmonary Disease  Complementarytherapy   • Eat properly   • Limit salt, caffeine   Client communicatio...
Chronic ObstructivePulmonary Disease• Prognosis • Always guarded; cannot   be cured • Degree of disability   increases wit...
Chronic ObstructivePulmonary Disease• Chronic enlargement of  the air spaces beyond  the bronchioles due to  destruction o...
Bronchiectasis• Description • Permanent abnormal   dilation of bronchi • Usually   bilateral, involving   lower lobes of l...
Bronchiectasis• Etiology • Recurrent infections or   inflammation • Cystic fibrosis is cause   in half of cases • Risk fac...
Bronchiectasis• Signs and symptoms • Chronic cough • Expectorate large amounts of   purulent, foul-smelling   sputum, espe...
Bronchiectasis• Diagnostic procedures • Auscultation reveals   clicking, wheezing, bubb   ling, rattling sounds • Chest x-...
Bronchiectasis• Treatment • Aim is to control   infection and airway   obstruction • Antibiotics • Bronchodilators • Expec...
Bronchiectasis  Complementarytherapy   • Coughing exercises that     reduce bronchial secretions   Client communication   ...
Bronchiectasis• Prognosis • Good with treatment• Prevention • Avoid pulmonary   irritants, smoking • Influenza vaccine • T...
Asthma• Description • Recurrent attacks of   labored breathing;   wheezing   • Intrinsic: attacks without     evidence of ...
Asthma• Etiology • Uncertain • Familial history of   allergy • Common triggers include   URI, allergens, irritant   s, tob...
Asthma• Signs and symptoms • Pronounced   wheezing, dyspnea, tachy   pnea, chest tightness • Perspire profusely • Exhibit ...
Asthma• Diagnostic procedures • History and physical • Chest x-ray • Sputum analysis • Pulmonary function tests • Arterial...
Asthma• Treatment • Avoid “triggers” • Achieve adequate   oxygenation • Bronchodilation • Decrease airway   inflammation •...
Asthma  Complementarytherapy  • Neurobiofeedback  • Hydrotherapy  • Avoid known triggers  • Enhance immune system  Client ...
Asthma• Prognosis • Good with   proper, ongoing   treatment • Child may outgrow asthma• Prevention • Avoid   irritants, al...
Asthma• Asthma is recurrent  attacks of labored  breathing accompanied  by  1. obstruction  2. shortness of breath  3. hyp...
Pulmonary Tuberculosis• Description • Slowly developing bacterial   lung infection with   progressive necrosis of   lung t...
Pneumoconiosis• Description • Disease of the   respiratory tract • Caused by inhalation of   inorganic or organic   dust p...
Pneumothorax(Collapsed Lung)• Description • A collection of air or fluid   in the pleural cavity • Results in atelectasis;...
Pleurisy (Pleuritis)• Description  • Inflammation of the    visceral and parietal    pleural membranes that    surround th...
Pleurisy (Pleuritis)• Etiology  • Caused by infection of the    pleura by    bacteria, fungus, parasites, o    r viruses  ...
Pleurisy (Pleuritis)• Signs and symptoms • Sharp, stabbing pain   that can limit movement • Other symptoms include   cough...
Pleurisy (Pleuritis)• Diagnostic procedures  • Chest auscultation    reveals pleural friction    rub  • Chest x-ray  • CT ...
Pleurisy (Pleuritis)• Treatment  • Analgesics and anti-    inflammatory drugs  • Bed rest  • Thoracentesis                ...
Pleurisy (Pleuritis)   Complementary therapy    • Natural analgesics and      anti-inflammatory drugs    Client communicat...
Pleurisy (Pleuritis)• Prognosis  • Good, but pleural    effusion may develop• Prevention  • Early treatment of    respirat...
Pulmonary Embolism• Description • Mass of undissolved   matter in pulmonary   artery or branches • Complication of venous ...
Pulmonary Embolism• Etiology • Generally originates in   pelvic veins or deep lower-   extremity veins; travels   through ...
Pulmonary Embolism• Signs and symptoms • Size, location of   embolus determines • Dyspnea, tachypnea • Pulmonary hypertens...
Pulmonary Embolism• Signs and symptoms  (cont.) • Pleuritic pain • Tachycardia • Low-grade fever • Apprehension           ...
Pulmonary Embolism• Diagnostic procedures • History of predisposing   condition • ECG • Chest x-ray • Pulmonary angiogram ...
Pulmonary Embolism• Treatment • Maintain adequate   cardiovascular and   pulmonary function while   clearing obstruction •...
Pulmonary Embolism  Complementarytherapy   • Use of compression     stockings   Client communication   • Instruct client t...
Pulmonary Embolism• Prognosis • Guarded if embolism   triggers pulmonary   infarction; can be   lethal• Prevention • Early...
Sleep Apnea• Description • An individual’s breathing   at night repeatedly   stops and starts • Accompanied by loud   snor...
Sleep Apnea• Description (cont.) • Three types   • Obstructive sleep apnea:     throat muscles relax   • Central sleep apn...
Sleep Apnea• Etiology • Throat muscles relax,   airways narrow, and   breathing temporarily stops • Brain causes individua...
Sleep Apnea• Signs and symptoms • Loud snoring;   hypersomnia • Observed periods of   breathing cessation   during sleep •...
Sleep Apnea• Diagnostic procedures • History and physical   exam • Nocturnal   polysomnography (sleep   study) • Oximetry ...
Sleep Apnea• Treatment • Continuous positive   airway machine (CPAP) • Dental appliance worn at   night • Uvulopalatophary...
Sleep Apnea  Complementarytherapy   • Weight loss   Client communication   • Remind clients about     losing weight, avoid...
Sleep Apnea• Prognosis • Complicated because not   all treatments are   successful and many   clients stop trying• Prevent...
Lung Cancer• Description • Various malignant neoplasms • Appears in   trachea, bronchi, air sacs   of lungs • Leading caus...
Lung Cancer• Etiology • 87% caused directly or   indirectly by smoking • Radon gas: second   leading cause • Long-term exp...
Lung Cancer• Signs and symptoms • Early stage, no   symptoms • Smoker’s cough • Hoarseness • Weight loss                  ...
Lung Cancer• Signs and symptoms  (cont.) • Wheezing • Chest pain • Dyspnea • Hemoptysis                       85
Lung Cancer• Diagnostic procedures • Chest x-ray • Sputum cytology • Fiberoptic bronchoscopy • Tissue biopsy              ...
Lung Cancer• Diagnostic procedures  (cont.) • Helical low-dose CT scan   can detect small tumors • Blood tests • CT scan a...
Lung Cancer• Treatment • Combination of   surgery, radiation, chem   otherapy • Photodynamic therapy for   small tumors   ...
Lung Cancer  Complementarytherapy   • Acupuncture and massage   • Hypnosis, yoga, and     meditation   Client communicatio...
Lung Cancer• Prognosis • Despite diagnostic   advances, overall   survival rate has   changed little during   last 30 year...
Sudden Infant DeathSyndrome• Description • Unexpected and   unexplained death of an   apparently healthy   infant usually ...
Sudden Infant DeathSyndrome• Etiology • Unknown • Possibilities include   mechanical suffocation,   prolonged apnea, lack ...
Sudden Infant DeathSyndrome• Signs and symptoms • None • Infant does not cry out   or struggle • When found may be   cyano...
Sudden Infant DeathSyndrome• Diagnostic procedures • Diagnosis of SIDS is   exclusionary • An autopsy rules out   other ca...
Sudden Infant DeathSyndrome• Treatment • None • Emotional support for   parents                           95
Sudden Infant DeathSyndrome  Complementarytherapy   • None   Client communication   • Referral for grief     counseling   ...
Sudden Infant DeathSyndrome• Prognosis • It is believed that   children are no longer   at risk past age 1• Prevention • H...
Sudden Infant DeathSyndrome• Children are at the  most risk for SIDS at  age  1. 1 year  2. 10 to 12 weeks  3. 12 to 15 we...
Acute Tonsillitis• Description  • Inflammation of a    tonsil, usually the    palatine tonsils  • May be acute or chronic ...
Acute Tonsillitis• Etiology  • Most frequently caused    by Streptococcus    pyogenes or   Staphylococcus aureus  • Common...
Acute Tonsillitis• Signs and symptoms  • Sudden onset of chills  • High-grade fever  • Mild to severe sore    throat  • Ma...
Acute Tonsillitis• Signs and symptoms  (cont.)  • Headache  • Dysphagia  • Tonsillar hypertrophy    and abscess           ...
Acute Tonsillitis• Diagnostic procedures  • Physical examination  • Throat culture to detect    bacteria  • Blood test may...
Acute Tonsillitis• Treatment  • Antibiotics  • Saline gargle  • Analgesics  • Antipyretics  • Tonsillectomy               ...
Acute Tonsillitis   Complementary therapy    • Fluid diet with diluted      juices and warm broths    Client communication...
Acute Tonsillitis• Prognosis  • Usually good, but    complications of otitis    media, mastoiditis, and    sinusitis• Prev...
Thrush• Description • Yeast infection of the   mucus membrane lining   the mouth and tongue • Commonly seen in infants   a...
Croup• Description • Acute, severe   inflammation and   obstruction of the upper   respiratory tract • Occurs most frequen...
CreditsPublisher: Margaret BiblisAcquisitions Editor: Andy McPheeDevelopmental Editors: Yvonne Gillam, Julie MundenBackgro...
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Session 12: Ch 13 PowerPoint Presentation

  1. 1. Lecture Notes 13 Respiratory System Diseases and DisordersClassroom Activity to AccompanyDiseases of the Human BodyFifth EditionCarol D. Tamparo Marcia A. Lewis
  2. 2. Copyright © 2011 by F.A. Davis Company. All rightsreserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means— electronic, mechanical, photocopying, recording, orotherwise—without written permission from the publisher.
  3. 3. Good timber does not grow with ease.The stronger the wind, the stronger the trees. —Willard Marriott 3
  4. 4. Common Signs and Symptoms ofRespiratory System Diseases andDisorders• Pain anywhere in the respiratory tract, especially sore throat• Cough • Productive or nonproductive • Chronic or acute• Hemoptysis, hematemesis 4
  5. 5. Common Signs and Symptoms ofRespiratory System Diseases andDisorders • Breathing irregularities • Dyspnea • Wheezing • Tachypnea • Rales • Fever • Malaise • Headache • Cyanosis 5
  6. 6. Allergic Rhinitis• Description • Inflammation of the nasal membranes due to an allergic reaction to air particles causing sneezing and rhinorrhea • Acute or chronic • Very common; affects about 20% of the 6 population
  7. 7. Sinusitis• Description • Inflammation of the paranasal sinuses • Acute caused by common cold • Chronic follows bacterial or viral infection • Allergic due to allergic rhinitis • Hyperplastic combination 7 of purulent acute and
  8. 8. Pharyngitis• Description • Inflammation of the throat • May be acute or chronic • Most common throat disorder • Children often have five incidents per year • Adults often have two incidents per year 8
  9. 9. Pharyngitis• Etiology • Bacteria (Streptococcus pyogenes) or viral (influenza or common cold) infectious agents • Secondary to measles, chickenpox • Trauma to mucosa from heat, sharp objects, chemical irritants • Chronic usually due to 9 persistent cough or allergies
  10. 10. Pharyngitis• Signs and symptoms • Sore throat • Difficulty swallowing • Malaise • Fever • Headache • Coryza (common cold) • Rhinorrhea 10
  11. 11. Pharyngitis• Diagnostic procedures • Physical exam reveals red, swollen mucous membranes • Pustular pharyngeal ulcerations visible • Throat culture to identify infecting organism 11
  12. 12. Pharyngitis• Treatment • Antibiotics, if bacterial • Warm saline gargles • Analgesics • Antipyretics • Rest • Adequate fluid intake 12
  13. 13. Pharyngitis Complementarytherapy • Aromatherapy with inhalation of lavender, thyme, eucalyptus , sandalwood • Gargle with warm water, ¼ tsp turmeric powder, pinch of salt • Herbal teas Client communication • If strep is found, treat to13 prevent rheumatic fever or
  14. 14. Pharyngitis• Prognosis • Generally good • Complications can occur with untreated strep• Prevention • Avoid such irritating substances as cigarette smoke, known allergens 14
  15. 15. Laryngitis• Description • Inflammation of the laryngeal mucosa and the vocal cords causing hoarseness in voice • May be acute or chronic; viral or bacterial 15
  16. 16. Infectious Mononucleosis• Description • Acute infectious disease characterized by sore throat, fever, and swollen cervical lymph glands • Primarily affects adolescents and young adults 16
  17. 17. Infectious Mononucleosis• Etiology • Caused by Epstein-Barr virus (EBV) • Shed in saliva; spreads through oral-pharyngeal route • EBV infects the B lymphocytes • Person contagious before 17 symptoms develop until
  18. 18. Infectious Mononucleosis• Signs and symptoms • Initially vague symptoms of malaise, anorexia, and chills • After 3 to 5 days, fever, sore throat, and swollen lymph nodes in throat 18 and neck occur
  19. 19. Infectious Mononucleosis• Diagnostic procedures • History and physical exam • Blood test showing increased leukocytes, lymphocytes, monocytes, and antibodies to EBV 19
  20. 20. Infectious Mononucleosis• Treatment • Supportive treatment • Bed rest during acute phase • Analgesics • Warm saline gargles 20
  21. 21. Infectious Mononucleosis Complementarytherapy • Bed rest • Drink filtered water • Organic diet containing no growth hormone or antibiotics Client communication • Stress reduction of 21 activities until infection
  22. 22. Infectious Mononucleosis• Prognosis • Excellent, but takes several weeks or months • EBV remains in a dormant state for life• Prevention • Avoid oral-pharyngeal contact with known EBV infected persons 22
  23. 23. Infectious Mononucleosis• The Epstein-Barr virus causes an infection of the 1. B lymphocytes 2. pharynx 3. T lymphocytes 4. lymph nodes 23
  24. 24. Pneumonia• Description • Acute inflammation of respiratory bronchioles, alveolar ducts, sacs, and alveoli of lungs • Uni- or bilateral; affecting all or portion of lung • Lobar: affects more than one lobe • Bronchopneumonia: bacterial form 24 • Interstitial pneumonia: scars
  25. 25. Pneumonia• Etiology • Bacteria (pneumococcus), viruses (influenza) two main types with bacterial more serious • Fungi, protozoa, rickett siae • Secondary to systemic 25 diseases
  26. 26. Pneumonia• Signs and symptoms • Coughing, sputum production • Pleuritic chest pain • Shaking chills, fever • Rales, dyspnea • Cyanosis • Generalized weakness 26
  27. 27. Pneumonia• Diagnostic procedures • History and physical exam • Chest x-ray • Sputum smears and blood cultures 27
  28. 28. Pneumonia• Treatment • Varies with etiology • Antibiotics if bacteria • Humidified oxygen therapy • Mechanical ventilation 28
  29. 29. Pneumonia• Treatment (cont.) • High-calorie diet • Increased fluid intake • Rest • Analgesics • Postural drainage 29
  30. 30. Pneumonia Complementarytherapy • Supplements to strengthen immune system Client communication • Describe seriousness of illness • Encourage vaccination • Teach deep 30 breathing, postural
  31. 31. Pneumonia• Prognosis • Varies with etiology • If secondary to another disease, or if elderly person has influenza-type pneumonia, prognosis poor • Complications include lung abscess or bacteremia• Prevention • High-risk persons should receive pneumococcal vaccine 31
  32. 32. Chronic ObstructivePulmonary Disease• Description • Functional diagnosis given to any pathological process that decreases the ability of lungs and bronchi to perform ventilation • Pulmonary emphysema • Chronic bronchitis 32
  33. 33. Chronic ObstructivePulmonary Disease• Description (cont.) • Chronic pulmonary emphysema: permanent enlargement of air spaces beyond terminal bronchioles resulting from destruction of alveolar walls; lungs lose elasticity • Chronic bronchitis: inflammation of bronchial mucous membranes with hypertrophy, hyperplasia; 33 productive cough
  34. 34. Chronic ObstructivePulmonary Disease• Etiology • Diseases that may lead to COPD include chronic asthma, bronchiectasis, silicosis, pulmonary tuberculosis • Predisposing factors are smoking, exposure to polluted air, respiratory infections, allergies, b34 reathing textile dust
  35. 35. Chronic ObstructivePulmonary Disease• Signs and symptoms • Insidious; no symptoms until lung is damaged • Chronic cough, chest tightness, increased mucus production • Dyspnea • Barrel chest in pulmonary emphysema • “Blue bloater” – chronic bronchitis 35
  36. 36. Chronic ObstructivePulmonary Disease• Diagnostic procedures • History and physical examination • Chest x-ray • Pulmonary function tests • Arterial blood gases • Sputum analysis; CT scan 36
  37. 37. Chronic ObstructivePulmonary Disease• Treatment • Prevent complications and further lung damage • Relieve symptoms • Bronchodilators, inhaled corticosteroid medications • Oxygen therapy • Diuretics • Surgery to remove wedges of damaged lung 37
  38. 38. Chronic ObstructivePulmonary Disease Complementarytherapy • Eat properly • Limit salt, caffeine Client communication • Avoid smoking, cigarette smoke, dust, air pollution, work-related fumes 38 • Avoid excessive
  39. 39. Chronic ObstructivePulmonary Disease• Prognosis • Always guarded; cannot be cured • Degree of disability increases with time • High mortality from complications• Prevention • Do not smoke • Periodic exams to 39 evaluate
  40. 40. Chronic ObstructivePulmonary Disease• Chronic enlargement of the air spaces beyond the bronchioles due to destruction of the alveolar walls is 1. asthma 2. atelectasis 3. emphysema 4. bronchiectasis 40
  41. 41. Bronchiectasis• Description • Permanent abnormal dilation of bronchi • Usually bilateral, involving lower lobes of lung 41
  42. 42. Bronchiectasis• Etiology • Recurrent infections or inflammation • Cystic fibrosis is cause in half of cases • Risk factors • Tuberculosis (TB) • Bronchial obstruction • Recurrent lung infections 42
  43. 43. Bronchiectasis• Signs and symptoms • Chronic cough • Expectorate large amounts of purulent, foul-smelling sputum, especially first thing in morning • Hemoptysis • Cyanosis and paleness • Fatigue • Shortness of breath and 43 wheezing
  44. 44. Bronchiectasis• Diagnostic procedures • Auscultation reveals clicking, wheezing, bubb ling, rattling sounds • Chest x-ray, CT scan • CBC • Tuberculin skin test CBC = complete blood count. 44
  45. 45. Bronchiectasis• Treatment • Aim is to control infection and airway obstruction • Antibiotics • Bronchodilators • Expectorants • Postural drainage 45
  46. 46. Bronchiectasis Complementarytherapy • Coughing exercises that reduce bronchial secretions Client communication • Remind clients to return to primary care provider if chest pain or shortness of breath worsens 46
  47. 47. Bronchiectasis• Prognosis • Good with treatment• Prevention • Avoid pulmonary irritants, smoking • Influenza vaccine • Treat lung infections promptly 47
  48. 48. Asthma• Description • Recurrent attacks of labored breathing; wheezing • Intrinsic: attacks without evidence of allergic response; begins in adulthood • Extrinsic: bronchospasm result of allergic response 48 to environmental irritants;
  49. 49. Asthma• Etiology • Uncertain • Familial history of allergy • Common triggers include URI, allergens, irritant s, tobacco smoke, exercise or exertion, changes respiratory infection URI = upper in 49 temperature or
  50. 50. Asthma• Signs and symptoms • Pronounced wheezing, dyspnea, tachy pnea, chest tightness • Perspire profusely • Exhibit pallor • Difficulty speaking 50
  51. 51. Asthma• Diagnostic procedures • History and physical • Chest x-ray • Sputum analysis • Pulmonary function tests • Arterial blood gases • ECG • Skin tests for allergen detection ECG = electrocardiogram. 51
  52. 52. Asthma• Treatment • Avoid “triggers” • Achieve adequate oxygenation • Bronchodilation • Decrease airway inflammation • Use long-term preventative controller 52 drugs and quick-relief
  53. 53. Asthma Complementarytherapy • Neurobiofeedback • Hydrotherapy • Avoid known triggers • Enhance immune system Client communication • Identify triggers and asthma-proof home • Stress importance of 53 medication regimen
  54. 54. Asthma• Prognosis • Good with proper, ongoing treatment • Child may outgrow asthma• Prevention • Avoid irritants, allergens 54
  55. 55. Asthma• Asthma is recurrent attacks of labored breathing accompanied by 1. obstruction 2. shortness of breath 3. hypoxia 4. wheezing 55
  56. 56. Pulmonary Tuberculosis• Description • Slowly developing bacterial lung infection with progressive necrosis of lung tissue • Starts with phagocytosis then growths of inflamed granular-appearing tissue (granulomas) form and calcify • Calcification lesions 56 appear on x-ray
  57. 57. Pneumoconiosis• Description • Disease of the respiratory tract • Caused by inhalation of inorganic or organic dust particles or chemicals over prolonged period • Silicosis, asbestosis, b erylliosis, anthracosis 57
  58. 58. Pneumothorax(Collapsed Lung)• Description • A collection of air or fluid in the pleural cavity • Results in atelectasis; complete or partial collapse of one or both lungs • Can be spontaneous or traumatic • Caused by rupture of bleb along lung’s surface 58
  59. 59. Pleurisy (Pleuritis)• Description • Inflammation of the visceral and parietal pleural membranes that surround the lungs • May be primary or secondary • Associated with pleural effusion 59
  60. 60. Pleurisy (Pleuritis)• Etiology • Caused by infection of the pleura by bacteria, fungus, parasites, o r viruses • Can be caused by inhaled toxins or chemicals • Often secondary to pneumonia, heart failure, pulmonary= systemic lupus SLE erythmatosus. infection, neoplasm, SLE, pulm 60 onary embolism, and chest
  61. 61. Pleurisy (Pleuritis)• Signs and symptoms • Sharp, stabbing pain that can limit movement • Other symptoms include coughing, fever and chills, and chest pain that is greater during inspiration • Dyspnea 61
  62. 62. Pleurisy (Pleuritis)• Diagnostic procedures • Chest auscultation reveals pleural friction rub • Chest x-ray • CT scan or ultrasound 62
  63. 63. Pleurisy (Pleuritis)• Treatment • Analgesics and anti- inflammatory drugs • Bed rest • Thoracentesis 63
  64. 64. Pleurisy (Pleuritis) Complementary therapy • Natural analgesics and anti-inflammatory drugs Client communication • Stress need for bed rest • Apply pressure to the site of pain when coughing 64
  65. 65. Pleurisy (Pleuritis)• Prognosis • Good, but pleural effusion may develop• Prevention • Early treatment of respiratory infections 65
  66. 66. Pulmonary Embolism• Description • Mass of undissolved matter in pulmonary artery or branches • Complication of venous thrombosis 66
  67. 67. Pulmonary Embolism• Etiology • Generally originates in pelvic veins or deep lower- extremity veins; travels through circulatory system until it blocks pulmonary artery • At risk are those with body casts, CHF, varicose veins, polycythemia vera, thrombocytosis, neopla67 CHF = congestive heart failure. sms, postoperative clients;
  68. 68. Pulmonary Embolism• Signs and symptoms • Size, location of embolus determines • Dyspnea, tachypnea • Pulmonary hypertension • Substernal pain 68
  69. 69. Pulmonary Embolism• Signs and symptoms (cont.) • Pleuritic pain • Tachycardia • Low-grade fever • Apprehension 69
  70. 70. Pulmonary Embolism• Diagnostic procedures • History of predisposing condition • ECG • Chest x-ray • Pulmonary angiogram • MRI • CT scan • Auscultation 70
  71. 71. Pulmonary Embolism• Treatment • Maintain adequate cardiovascular and pulmonary function while clearing obstruction • Anticoagulants • Fibrinolytic therapy • Surgical management 71
  72. 72. Pulmonary Embolism Complementarytherapy • Use of compression stockings Client communication • Instruct client to not massage or cross legs 72
  73. 73. Pulmonary Embolism• Prognosis • Guarded if embolism triggers pulmonary infarction; can be lethal• Prevention • Early postoperative ambulation • Anticoagulant therapy if73 at risk
  74. 74. Sleep Apnea• Description • An individual’s breathing at night repeatedly stops and starts • Accompanied by loud snoring 74
  75. 75. Sleep Apnea• Description (cont.) • Three types • Obstructive sleep apnea: throat muscles relax • Central sleep apnea: brain does not send proper signals to the muscles that control breathing • Complex apnea: combination of both 75
  76. 76. Sleep Apnea• Etiology • Throat muscles relax, airways narrow, and breathing temporarily stops • Brain causes individual to awaken and take a breath • Repeated incidences causes oxygen level in blood to fall • Individuals feel sleep deprived and have difficulty76 functioning all day
  77. 77. Sleep Apnea• Signs and symptoms • Loud snoring; hypersomnia • Observed periods of breathing cessation during sleep • Morning headache • Dry mouth; sore throat • Insomnia 77
  78. 78. Sleep Apnea• Diagnostic procedures • History and physical exam • Nocturnal polysomnography (sleep study) • Oximetry to measure oxygen blood level • Portable 78 cardiorespiratory
  79. 79. Sleep Apnea• Treatment • Continuous positive airway machine (CPAP) • Dental appliance worn at night • Uvulopalatopharyngoplast y (UPPP) • Maxillomandibular advancement 79 • Tracheostomy
  80. 80. Sleep Apnea Complementarytherapy • Weight loss Client communication • Remind clients about losing weight, avoiding alcohol, sleeping on their side, and wearing80 their appliance
  81. 81. Sleep Apnea• Prognosis • Complicated because not all treatments are successful and many clients stop trying• Prevention • No prevention except weight loss, avoiding alcohol, sleeping on the side, and keeping nasal 81 passages open
  82. 82. Lung Cancer• Description • Various malignant neoplasms • Appears in trachea, bronchi, air sacs of lungs • Leading cause of cancer deaths in both sexes • Two major types • Non–small-cell (more common; slower growth, spread) • Small cell 82
  83. 83. Lung Cancer• Etiology • 87% caused directly or indirectly by smoking • Radon gas: second leading cause • Long-term exposure to asbestos, uranium, arsen ic, some petroleum products 83
  84. 84. Lung Cancer• Signs and symptoms • Early stage, no symptoms • Smoker’s cough • Hoarseness • Weight loss 84
  85. 85. Lung Cancer• Signs and symptoms (cont.) • Wheezing • Chest pain • Dyspnea • Hemoptysis 85
  86. 86. Lung Cancer• Diagnostic procedures • Chest x-ray • Sputum cytology • Fiberoptic bronchoscopy • Tissue biopsy 86
  87. 87. Lung Cancer• Diagnostic procedures (cont.) • Helical low-dose CT scan can detect small tumors • Blood tests • CT scan and MRI 87
  88. 88. Lung Cancer• Treatment • Combination of surgery, radiation, chem otherapy • Photodynamic therapy for small tumors 88
  89. 89. Lung Cancer Complementarytherapy • Acupuncture and massage • Hypnosis, yoga, and meditation Client communication • Follow-up care essential • Regular check-ups • Refer to cancer support 89 systems
  90. 90. Lung Cancer• Prognosis • Despite diagnostic advances, overall survival rate has changed little during last 30 years• Prevention • Stop smoking • Avoid other irritants 90
  91. 91. Sudden Infant DeathSyndrome• Description • Unexpected and unexplained death of an apparently healthy infant usually ages 10 to 12 weeks • Death most often occurs while sleeping • Occurs more often in 91 males than females and
  92. 92. Sudden Infant DeathSyndrome• Etiology • Unknown • Possibilities include mechanical suffocation, prolonged apnea, lack of vitamin B complex, unknown virus, immunological abnormalities, defect in respiratory mucosa, or 92 abnormal larynx
  93. 93. Sudden Infant DeathSyndrome• Signs and symptoms • None • Infant does not cry out or struggle • When found may be cyanotic and have blood- tinged sputum 93
  94. 94. Sudden Infant DeathSyndrome• Diagnostic procedures • Diagnosis of SIDS is exclusionary • An autopsy rules out other causes of death 94
  95. 95. Sudden Infant DeathSyndrome• Treatment • None • Emotional support for parents 95
  96. 96. Sudden Infant DeathSyndrome Complementarytherapy • None Client communication • Referral for grief counseling • SIDS support systems • Teach parents to place 96 infants on their backs for
  97. 97. Sudden Infant DeathSyndrome• Prognosis • It is believed that children are no longer at risk past age 1• Prevention • Home monitoring devices • Placing infants on their backs to sleep 97
  98. 98. Sudden Infant DeathSyndrome• Children are at the most risk for SIDS at age 1. 1 year 2. 10 to 12 weeks 3. 12 to 15 weeks 4. under 2 months 98
  99. 99. Acute Tonsillitis• Description • Inflammation of a tonsil, usually the palatine tonsils • May be acute or chronic 99
  100. 100. Acute Tonsillitis• Etiology • Most frequently caused by Streptococcus pyogenes or Staphylococcus aureus • Common complication of pharyngitis 100
  101. 101. Acute Tonsillitis• Signs and symptoms • Sudden onset of chills • High-grade fever • Mild to severe sore throat • Malaise 101
  102. 102. Acute Tonsillitis• Signs and symptoms (cont.) • Headache • Dysphagia • Tonsillar hypertrophy and abscess 102
  103. 103. Acute Tonsillitis• Diagnostic procedures • Physical examination • Throat culture to detect bacteria • Blood test may reveal leukocytosis 103
  104. 104. Acute Tonsillitis• Treatment • Antibiotics • Saline gargle • Analgesics • Antipyretics • Tonsillectomy 104
  105. 105. Acute Tonsillitis Complementary therapy • Fluid diet with diluted juices and warm broths Client communication • Remind clients to take all antibiotics 105
  106. 106. Acute Tonsillitis• Prognosis • Usually good, but complications of otitis media, mastoiditis, and sinusitis• Prevention • None 106
  107. 107. Thrush• Description • Yeast infection of the mucus membrane lining the mouth and tongue • Commonly seen in infants and diabetics, in long- term antibiotic use, chemotherapy treatments, and those with HIV or AIDS 107
  108. 108. Croup• Description • Acute, severe inflammation and obstruction of the upper respiratory tract • Occurs most frequently between age 3 months and 3 years • Treated symptomatically 108
  109. 109. CreditsPublisher: Margaret BiblisAcquisitions Editor: Andy McPheeDevelopmental Editors: Yvonne Gillam, Julie MundenBackgrounds: Joseph John Clark, Jr.Production Manager: Sam RondinelliManager of Electronic Product Development: Kirk PedrickElectronic Publishing: Frank MusickThe publisher is not responsible for errors of omission or for consequences from application of information in thispresentation, and makes no warranty, expressed or implied, in regard to its content. Any practice described in this presentationshould be applied by the reader in accordance with professional standards of care used with regard to the uniquecircumstances that may apply in each situation. 109

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