Respiratory Tract Conditions
Chapter 22
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Lungs
• Occupy majority of thoracic
cavity
• Primary bronchial tubes
• Alveoli
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Upper Respiratory Tract Infections
• Often caused by viruses
• No participation in physical activity
– Fever (≥100.5°F)
– Severe malaise
– Myalgias
– Weakness
– Shortness of breath
– Dehydrated
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Common Cold
• Contagious
– Person–person contact
– Airborne droplets
• Key—prevention!!!!
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Common Cold (cont.)
• S&S (begin 1–2 days after exposure and last 1–2 weeks)
–
Rhinorrhea
–
Sneezing
–
Nonproductive cough
–
Eye irritation
–
Malaise
–
Sore throat
–
Low-grade fever/chills
• Management
–
No cure—viral; OTCs can alleviate symptoms
–
Rest; fluids
–
Vitamin C; zinc gluconate
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Sinusitis
• Inflammation of the paranasal sinus
• Bacterial, viral, allergy, or environmental factors
• Often triggered by obstruction of passageway between
the sinuses
• S&S
– Congestion
– Facial pain (behind cheeks and eyes, above teeth)
– Purulent discharge possible
– Coughing
– Swelling of eyes
– Fever and chills
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Sinusitis (cont.)
• Bacterial infection—drainage will be dark; other causes—
clear
• Management
– Physician referral
– Control infection, reduce mucosal edema, and allow
for nasal discharge
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Pharyngitis
• Viral, bacterial, or fungal infection of the pharynx, leading to a
“sore throat”
• S&S
– Throat—dark red
– Tonsils swollen and red (possible pus present)
– Swallowing—painful
– Ear pain (due to swallowing)
– Rhinorrhea
– Lymphangitis
– Headache
– Cough
– Low-grade fever
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Pharyngitis (cont.)
• Management
– Physician referral—must rule out “strep”; requires
antibiotic
– Otherwise, treat symptoms—rest, fluids, warm saline
gargles, lozenges, and analgesics
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Laryngitis
• Tissues below level of epiglottis are swollen and inflamed
• S&S
– Weak, hoarse, gravely voice
– Sore throat
– Fever
– Cough (usually dry and nonproductive)
– Difficulty swallowing
• Management
– Self-limiting
– Decrease talking!
– Treat symptoms
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Tonsillitis
• Lymph glands located at back of throat
• Help protect the pharynx by filtering disease-producing
bacteria
• S&S
– Inflamed and enlarged tonsils
– Fever
– Painful swallowing
– Sore throat
– Slight voice change
• Acute cases: treated with antibiotics
• Chronic: surgical removal
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Allergic Rhinitis (Hay Fever)
• Seasonal allergic rhinitis
– Involves a specific period of symptoms in
successive years
– Caused by airborne pollens or fungus spores
associated with that season
• Perennial allergic rhinitis
– Occurs year-round if continually exposed to
allergens
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Allergic Rhinitis (Hay Fever) (cont.)
• S&S
– Postnasal drainage leads to chronic sore throat and
bronchial infection
• Take a complete history
• Management
– Limiting exposure to allergen
– Suppressive medication to alleviate symptoms
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Bronchitis
• Inflammation of mucosal lining of tracheobronchial tree
• Acute
– Commonly seen in physically active individuals
– Involves bronchial swelling, mucus secretion, and
increased resistance to expiration
– S&S
• Coughing
• Wheezing
• Large amounts of purulent mucus
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Bronchitis (cont.)
• Chronic bronchitis
– Can progress to serious illness
– S&S
• Marked cyanosis
• Edema
• Large production of sputum
• Abnormally high levels of CO2 and low levels of O2
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Bronchitis (cont.)
• Management
– Viral—no specific therapy available
– Bacterial—treated more effectively with macrolides
– Chronic—medical supervision to control symptoms
and prevent systemic failure
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Bronchial Asthma
• Caused by:
– Constriction of
smooth bronchial
muscles
– Increased bronchial
secretions
– Mucosal swelling
• Leads to inadequate
airflow during respiration
(especially expiration)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Bronchial Asthma (cont.)
• S&S
– Wheezing
– Rapid fatigue
– Acute attack
– Thick yellow/green sputum
– Anxiety
– Sweating
– Rapid heart rate
– Cyanosis, ↓ LOC in severe cases
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Bronchial Asthma (cont.)
• Management
– Seek medical help if no medications have been
prescribed
– Administer prescribed medications
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Exercise-Induced Bronchospasm
• Various factors can contribute to severity; ↑ risk with
allergies, sinus disease, hyperventilation
• Key—amount of ventilation and temperature of inspired
air
–
↑ ventilations in cold, dry, air → ↑ EIB risk
–
↑ strenuous exercise → ↑ ventilations
• Use of peak flowmeter
– Normal: up to a 10% ↓ in FEV1 after exercise
– Mild EIB: ↓ 10%–20%
– Moderate to severe EIB: ↓ 20%–40%
– Severe EIB: >40%
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Exercise-Induced Bronchospasm (cont.)
• S&S
– Chest pain and tightness
– Regular dry cough
– SOB after or during exercise
– Symptoms appear after 8–10 minutes of activity and
may worsen after activity stops
– Refractory period
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Exercise-Induced Bronchospasm (cont.)
• Management
– Prescribed medications
– Use of inhaler
– Proper warm-up and cool-down
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Influenza
• Viral bronchitis caused by Haemophilus influenzae type A, B,
or C
• Often epidemics—immunization available
• S&S
–
↑ temperature
– Chills
– Malaise
– Headache
– General muscle aches
– Hacking cough
– Inflamed mucous membranes
– Rapid onset within 24–48 hours of exposure
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Influenza (cont.)
• Management
– Rest and fluids
– Cough medications and analgesics for pain and fever
– Referral—fever does not reduce within 24 hours or
fever >103°F
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Pneumonia
• Inflammation and infection of lungs
• Caused by bacteria, viruses, mycoplasmas, and other
infectious agents
• S&S (can vary with type of organism causing infection)
– Bacterial pneumonia
• Often follows URI
• Symptoms appear suddenly
• Shaking, chills, a high fever, sweating
• Chest pain (pleurisy)
• Cough that produces thick, rust-colored, greenish or
yellow phlegm
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins
Pneumonia (cont.)
– Viral pneumonia
• Starts with a dry (nonproductive) cough, headache,
fever, muscle, and fatigue
• Progression—may become breathless and develop
cough that produces phlegm
• Risk of developing a secondary bacterial pneumonia
as well
• Management
– Bacterial pneumonia—antibiotics
– Viral—rest and fluids; antibiotics are not effective
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins