Chapter 16 - Respiratory
Anatomy and Physiology
Vocab
Acidosis
Breathing
Signs of Normal Breathing
- A normal rate (adult: 12 to 20 breaths/min; child: 15 to 30 breaths/min; infant: 30 to
60 breaths/min)
- A regular pattern of inhalation and exhalation
- Clear bilateral breath sounds
- Regular and equal chest rise (chest expansion) and fall
- Adequate depth (tidal volume)
- Unlabored; without adventitious (abnormal) breath sounds (wheezing, stridor
Signs of Inadequate Breathing
- The patient reports difficulty breathing or shortness of breath.
- The patient has an altered mental status associated with shallow or slow breathing.
- The adult patient appears anxious or restless; the pediatric patient appears sleepy or
listless.
- The respiratory rate is too fast or too slow (see Table 16-1).
- The breathing rhythm is irregular.
- The skin is pale, cool, clammy, or cyanotic.
- Adventitious breath sounds are heard
- Decreased or noisy breath sounds are heard on one or both sides of the chest.
- The patient cannot speak more than a few words between breaths. Ask the patient,
“How are you doing?” If the patient cannot speak at all, he or she most likely has a
respiratory emergency.
- You observe accessory muscle use, retractions, or labored breathing.
- The patient has unequal or inadequate chest expansion.
- The patient is coughing excessively.
- Tripod position, pursed lip breathing or nasal flaring.
Acute Pulmonary Edema
Info Heart muscle cant circulate blood properly, fluid builds up in
alveoli and in lung tissue
Signs and Symptoms If already dead, frothy pink sputum
Treatment
Other Notes
Asthma
Info Result of allergic reaction to inhaled substance, spasm of
bronchioles associated with excess mucus production
Signs and Symptoms Wheezing, dyspnea
Treatment 2 doses (4 puffs) of albuterol or epi if you already gave 2 doses
and nothing has helped
Other Notes Most prevalent in 5-17 years
Anaphylaxis
Info
Signs and Symptoms
Treatment Epi pen
Other Notes
Bronchiolitis
Info Illness caused by RSV infection, bronchioles become inflamed
and swell with mucus
Signs and Symptoms Shortness of breath, wheezing, coughing, fever, dehydration,
tachypnea, tachycardia,
Treatment Oxygen, frequently reassess, mainly supportive, suction thick
mucus if present, provide airway management,
Other Notes Usually effects male newborns and toddlers,
Congestive Heart Failure
Info
Signs and Symptoms Dependent edema, crackles, orthopnea, paroxysmal nocturnal
dyspnea
Treatment
Other Notes
COPD
Info Caused by chronic bronchial obstruction, slow process of dilation
and disruption of airways and alveoli, alveoli stay open and cant
squeeze
Either chronic bronchitis, pulmonary edema, or emphysema
Emphysema - chronic stretching of alveolar walls, loss of elastic
material
Chronic Bronchitis -
Signs and Symptoms Chronic Bronchitis -
Pulmonary Edema -
Emphysema - barrel chest, pursed lip breathing, dyspnea on
exertion, cyanosis, wheezing, decreased breath sounds
Treatment
Other Notes
Covid
Info
Signs and Symptoms High fever, cough, chest pain during inspiration, vomiting,
diarrhea, inability to smell
Croup
Info Inflammation and swelling of the pharynx, larynx, trachea
Usually secondary to an acute viral infection
Signs and Symptoms Starts with cold, cough, low grade fever of the span of a few
days, progresses to stridor, seal bark cough and fever
Treatment Humidified oxygen
Other Notes Often in pediatric patients between 6 months and 3 years in late
fall and winter
Diphtheria
Info
Signs and Symptoms Difficulty swallowing, sore throat, thick, gray buildup in throat or
nose, fever
Treatment
Other Notes
Epiglottitis
Info Inflammation of the epiglottis caused by bacterial infection
Signs and Symptoms Tripod position, drooling, dyspnea, high fever, stridor, difficulty
swallowing, sore throat, tripod position
Treatment Position comfortably, oxygen, don't let them cry, do not put
anything in their mouth,
Other Notes Mostly in pediatric patients
Influenza Type A
Info
Signs and Symptoms Fever, cough, sore throat, muscle aches, headache, fatigue,
possible fatigue, dehydration
Treatment
Other Notes
Pertussis / Whooping Cough
Info Airborne bacterial infection
Signs and Symptoms Feverish, “whoop” sounding cough
Treatment Dehydration, suction as needed
Other Notes Mostly affects children under 6
Pneumonia
Info Generally is an infection of the lungs
Bacterial or Viral
Signs and Symptoms Chunky, wet cough
Bacterial will come on quickly with high fever
Viral will come on gradually and will be less severe
Treatment Assess temp, airway support, oxygen
Other Notes Especially affects people who are chronically ill
Respiratory Syncytial Virus
Info Virus that causes infection in lungs and passages and can lead to
more serious problems
Signs and Symptoms Dehydration, cough, fever, wheezing
Treatment Humidified oxygen
Other Notes Highly contagious
Spontaneous Pneumothorax
Info Accumulation of air in the pleural space, occurs with lung
infections
Signs and Symptoms Crushing chest pain, sudden onset, decreased lung sounds in
affected side, subcutaneous edema
Treatment
Other Notes Occurs
Tension Pneumothorax
Info
Signs and Symptoms Severe shortness of breath, diminished/absent lung sounds on
affected side, decreased LOC, jugular venous distention, tracheal
deviation, hypotension, signs of shock
Treatment
Other Notes
Tuberculosis
Info Bacterial infection that affects the lungs
Signs and Symptoms Fever, cough, fatigue, night sweats, weight loss
Treatment Place mask on patient
Other Notes Strain can remain inactive for years
Wear gloves, eye protection and N-95
