Chapter 16 Pulmonary Examinations and Procedures
Diseases and Disorders of the Respiratory System
Disease
Description
Symptoms
Treatment
Asthma
Chronic disease that affects the bronchiole
tubes.
- Wheezing
- Avoidance of triggers
- Shortness of breath
Usually brought on by triggers such as
exertion, cold air, and allergens.
- Cough
- Inhalers such as
Albuterol, corticosteroids
and mast-cell stabilizing
drugs
- Oxygen therapy
Bronchitis
Bronchitis is a respiratory disease in
which the mucous membranes of the
bronchial passages become inflamed.
It may be acute (sudden onset) or chronic
(long term throughout one’s life).
- Low grade fever
- Rest
- Cough with clear
yellow or green
mucus
- Drink plenty of fluids to
help thin out secretions.
- Fatigue
- Bronchodilators
- Tightness in the chest
with deep inspiration
or cough
- Anti-inflammatories
- Wheezing
- Antibiotics (if indicated)
- Good nutrition
- Smoking cessation
- Shortness of breath
Chronic
Obstructive
Pulmonary
Disease (COPD)
A slow progressive disease of the lungs
that causes loss of the lung’s ability to
function.
Conditions included in COPD include
emphysema, chronic bronchitis and
chronic obstructive bronchitis.
- Chronic cough
- Exercise
- Chronic mucus
- Breath training
- Recurrent acute
bronchitis
- Nutritional guidance
- Shortness of breath
that progressively
- Inhaled medications
- Oxygen therapy
Disease
Description
Symptoms
Treatment
worsens
Cystic Fibrosis
(CF)
Cystic fibrosis is an inherited condition
which affects organs in the body,
particularly the lungs and digestive
system.
The affected structures become clogged
with mucus, making it difficult to breathe
and digest food.
- Failure to thrive in
infants
- Management of
symptoms are
- Poor appetite
- highly individualized
- Poor energy level
- Aerosol therapy
- Low birth weight
- Mucolytic agents
- Salty taste to the skin
- Postural drainage
- Excessive coughing
due to thickened
mucus
- Bronchodilators
- Wheezing
Lung Cancer
Cancer that attacks lung tissue.
- Persistent cough
- Lung surgery
The major forms of lungs cancer are nonsmall cell lung cancer (NSCLC) and small
cell lung cancer (SCLC).
- Hoarseness
- Radiation
- Loss appetite and
weight loss
- Chemotherapy
- Blood tinged sputum
- Shortness of breath
- If metastasized: bone
pain, jaundice, and
lymph node masses
Pneumonia
Inflammation or infection of the lungs,
causing the alveoli to fill with pus or
liquid, which makes it difficult to breathe.
Causes may be bacterial, viral, or fungal.
- Cough with orange or
green sputum (some
blood may also be
noted)
- Fever
- Determined by type of
pneumonia.
- Erythromycin and
cephalosporins are often
used for bacterial
Disease
Description
Symptoms
- Chills (may be
severe)
Treatment
infections
- Shallow breathing
- Antifungals, if related to
a fungal infection
- Tachycardia
- Cough Syrups
- Fatigue
- Oxygen
- Shortness of breath
- Chest pain
Pulmonary
Embolism (PE)
Pulmonary
Hypertension
A blood clot in the lung. It usually comes
from smaller vessels in the arms, legs,
pelvis, or heart.
- Chest pain and pain
upon inspiration
- Thrombolytics (to help
dissolve blood clots)
- Shortness of breath
Patients with venous stasis, women on
birth control or higher amounts of
estrogen, and post-surgery patients are
most prone to form a pulmonary
embolism.
- Rapid respirations
- Surgical removal of the
embolism
Symptoms usually have a sudden onset.
- Syncope (Fainting)
A condition in which pulmonary
circulation becomes abnormally elevated.
- Dyspnea or Difficulty
breathing
Usually caused by constriction or
tightening of the blood vessels that supply
blood to the lungs.
- Chest pain
- Tachycardia
- Hemoptysis (Spitting
up blood)
- Fainting
- Anticoagulation therapy
to help prevent future
blood clots.
- Most treatment is related
to the underlying cause
of pulmonary
hypertension and may
include oxygen, diuretics,
anticoagulants, and
calcium channel
blockers.
- Revatio (newer
medication for
pulmonary arterial
Disease
Description
Symptoms
Treatment
hypertension, reduces
pressure in the
pulmonary arteries)
Severe Acute
Respiratory
Syndrome
(SARS)
A viral respiratory illness caused by a
coronavirus.
- Fever
- Fluids
- Chills
- Vitamins
- Cough
- Antitussive (agents that
help to stop coughing)
- Body aches
- Headache
- Fatigue
Sinusitis
- Frontal sinuses (over the eyes in the
brow area)
- Pain and pressure in
the forehead, bridge
of the nose, or
cheekbones
- Maxillary sinuses (inside each
cheekbone)
- Nasal and sinus
congestion
- Ethmoid sinuses (just behind the
bridge of the nose and between the
eyes)
- Fever
Inflammation of the sinuses which may
include:
- Expectorant agents
(agents that help to bring
up mucus)
- Decongestants (agents
that break up congestion)
- Antihistamines (agents
that help to dry up
sinuses)
- Antibiotics
- Fatigue
- Sphenoid sinuses (behind the ethmoids
in the upper region of the nose and
behind the eyes)
Upper
Respiratory
Infection (URI)
The upper respiratory tract encompasses
the higher structures of the respiratory
tract including the nose, nasal cavity,
larynx, trachea and some sinuses.
URI infections may include the common
- Fever may or may not
be present
- Stuffy nose
- Sneezing
- Symptomatic treatment
- If bacterial in nature, an
antibiotic may be
prescribed
- Decongestants and
Disease
Description
cold, laryngitis (inflammation of the voice
box), pharyngitis (sore throat), sinusitis
(inflammation of the sinuses, tonsillitis
(inflammation of the tonsils, and croup (in
children).
URI’s may be bacterial or viral in nature.
Symptoms
- Sore throat
Treatment
antihistamine therapy
- Drainage from nose
- Sputum which may
vary in color and
consistency
- Altered breath sounds
Drugs for pulmonary hypertension
Sildenafil citrate is a drug manufactured by Pfizer and is packaged under two separate names. Revatio (sildenafil citrate) is marketed
for patients with pulmonary arterial hypertension, and Viagra (sildenafil citrate) is marketed for patients with erectile dysfunction
disorder (EDD). Sildenafil citrate primarily acts on the arterial walls of smooth muscle in both the lungs and penis. It doesn’t appear to
induce vasodilation in other parts of the body. In patients with pulmonary hypertension, it relaxes the arterial walls of the pulmonary
vessels, leading to decreased pulmonary arterial resistance and pressure. In EDD, sildenafil leads to smooth muscle relaxation which
promotes vasodilation in the corpus cavernosum of the penis. This results in an increase in the flow of blood which, upon sexual
stimulation, promotes an erection.