Atelectasis – incomplete expansion of the lung; airway
obstruction
 Vasoconstriction and direction of blood way from
the heart => puts pressure on the heart (increased
cardiac workload)
 S/S: tachypnea (rapid breathing), tachycardia,
cyanosis (excessive concentration of deoxygenated
hemoglobin), hypoxemia, diminished/absent breath
sounds, diminished expansion of chest, intercostal
retractions (use of accessory muscles to breath)
Pneumothorax – collapse of lung
 S/S: increased respiratory rate, asymmetrical chest
movements during inspiration, diminished breath
sounds over painful chest area, “grating sounds”
during respiration
 Tension pneumothorax: trachea in the mediastinal
space shift toward the opposite side of the chest
Asthma – disorder of lung constriction; bronchospasm
 S/S: wheezing, breathlessness, dry cough, use of
accessory muscles
 Viruses may be a factor in children’s asthma
 Atopic asthma: IgE/ chemical mediators from mast
cells that have been sensitized
Pneumonia – can develop after influenza, rapid onset
 S/S: fine crackles, faint breath sounds, cough with
clear sputum
 Bacterial pneumonia: peptidoglycan cell wall,
endotoxins, replicates readily
Hypoxemia – hyperventilation, confusion
 S/S: hypoxemia, restless, agitation, incoordination,
reduced mental function with impaired judgement
Hypercapnia – too much CO2 in blood
 S/S: high bicarbonate, high erythropoietin, pressure
on kidney, high H+
 Alterations in carbon dioxide production
 Disturbance in the gas xc function of lungs
 Abnormalities in function of chest wall and
respiratory muscles
 Changes in neural control of respiration
COPD – obstruction of airway
 Productive cough with sputum, recurrent respiratory
infections, vulnerable to respiratory drive secondary
to O2 therapy
 Use anticholinergic (decrease involuntary
movement) and bronchodilator (open up airway)
 Risk of COPD: asthma and tobacco use
Emphysema - barrel chest; large amount of air trapped
at the end of breath; has no problem getting in O2; loss
of lung elasticity and enlargement of distal air spaces
 decreased elastic coil due to alveolar damage
 Increased anatomical dead space due to reduced
tidal volume
 Increased alveolar dead space due to incorrect
intrapleural pressure (overexpanded alveoli due to
air trapped)
 S/S: barrel chest; short and frequent breaths, exhale
through pursed lips; hyperresonance (decreased
breath sounds)
Chronic bronchitis – progressive obstructive lung
disorder in which airways are blocked by mucous or
inflammation; fluid retention associated with right heart
failure
 S/S: hypoxemia, peripheral edema, increased
mucous secretion, cyanosis , respiratory acidosis
Bronchiectasis – damages causing tubes to widen or
develop pouches
 S/S: purulent sputum, chest infections, anemia
 may result from cystic fibrosis or pneumonia
 mucous builds up and breeds bacteria, causing
frequent infections
Pleural effusion – watery leaky collection of fluid in the
lung cavity
 S/S: diminished heart sound, grating sound during
respiration
Cystic fibrosis (CF) – genetic disorder that affects cells
producing mucous, sweat, and digestive juices (pancreas)
 Impaired Cl- transport
 Increased Na+ absorption
 Decreased H2O content in mucociliary blanket =>
more viscid
 Thick, viscous secretions blocking lung passages
 Recurrent pulmonary infections
 Bronchiectasis and dilation
 To increase protein intake and pancreatic enzymes
to maintain maximum function while minimizing
secondary organ damage
Interstitial lung disease – stiff lung because scarring
tissues (fibrosis) => restriction of lung function
 Decreased tidal volume
 Increased respiratory rate
 Associated with amiodarone and radiation therapy
Pulmonary fibrosis – scarring of alveoli causing stiff lung
 S/S: short, shallow breaths due to decreased
elasticity of lungs
 noncompliant lungs => difficult to inflate => require
extra work to expand => more rapid breaths
Sarcoidosis – small patches of red and swollen tissues
affecting lung
 inflammatory process
 requiring corticosteroid to treat
Pulmonary emboli – impaired blood flow to regions of
the lung
 risk factors: post-surgery immobility, smoking, oral
contraceptives
 S/S: SOB, chest pain, dyspnea, increased respiratory
rate
 Ventilation without perfusion (air in and out but no
flow of blood to alveolar capillaries)
 Blockage of one of pulmonary arteries in lung
 DVT – blood clots from legs that travel to lungs
Pulmonary hypertension – continued increases in left
atrial pressure => medial hypertrophy and thickening of
the small pulmonary arteries => hypertension =>
elevation of pulmonary venous pressure
 S/S: SOB, decreased exercise tolerance, peripheral
edema, peripheral edema (swelling on feet)
Cor pulmonale – right heart failure
 Altered level of consciousness
 Jugular vein distension (venous congestion)
 Peripheral edema

Coup - most common obstruction in children; due to
parainfluenza -> to provide moist air to breath
 S/S: barking cough and inspiratory stridor
Epiglottis – medical emergency; sitting up with mouth
open and TRIPOD position (chin thrust forward)
 S/S: sore throat and fever
 Caused by H. Flu, pneumococci, group A strep
Rhinosinusitis - fever and facial pain, rhinorrhea
 Intranasal decongestants lead to rebound; use
limited to 305 days
Influenza – rapid onset of malaise
Respiratory Distress Disorder - grunting, nasal flaring (to
get in more air), chest retracting on inspiration; lack of
surfactant => blocks O2 intake
 Stiff lungs, difficult to inflate, impaired gas exchange,
hypoxemia despite high supplemental O2 therapy
Acute respiratory distress syndrome – fluid builds up in
alveoli
 Unable to breathds

 Acute lung injury/ acute RDS - rapid onset and
diffuse bilateral infiltrates

Pleuritis – infection causing coughs; sudden onset
 Unilateral chest pain associated with respiratory
movements
 Worsened by coughing or deep breathing
 If not smoking = most likely infection
BPD (Bronchopulmonary dysplasia) - hypoxemia, low
lung compliance, respiratory distress, stiff lung tissue
 Rapid and shallow breathing and chest tractions
 Fibrosis of airways, no elasticity, poor gas xc
 RDS develops in 24 hrs after birth, BPD develops
later
 Long-term ventilation support