RSPT 1101 – Introduction to Respiratory Care
Cardiopulmonary Symptoms
Reference & Reading: Wilkins Chapter 3
Cough
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One of the most common symptoms associated with lung disease
Powerful protective mechanism for the lung and airways
Caused by mechanical, chemical, inflammatory, or thermal stimulation of the
cough receptors
 Made up of three phases
1. Inspiratory phase
2. Compression phase
3. Expiratory phase
 Causes and Clinical Presentation
 Acute cough
 Chronic cough
Cough also associated with pulmonary problems
Descriptions
 The type of cough present should be documented using commonly accepted
adjectives.
a. Productive
b. Effective
c. Weak
d. Dry
e. Chronic productive
 Quality, time & setting of cough
a. barking
b. brassy - harsh, dry
c. hoarse
d. wheezy - bronchial
e. chronic productive – bronchopulmonary disease
f. hacking
Sputum Production
 Sputum
 Phlegm
Causes and Descriptions – Table 3-3
 Caused by inflammation of the mucus secreting glands that line the airways
 Inflammation
 Sputum described
 Thick but clear sputum.
 Pink frothy sputum
 Thick, purulent (pus-containing) sputum is consistent with infection.
o Yellow-green
o Foul odor
Hemoptysis
Causes
 Persistent strong coughing
 Acute infection
 Bronchogenic carcinoma
 Cardiovascular disease
 Trauma
 Anticoagulant therapy
Descriptions
 Streaky hemoptysis
 Massive hemoptysis
Hemoptysis versus Hematemesis
 Blood from the lung
 Blood from the stomach
Shortness of Breath (Dyspnea)
Dyspnea is a common symptom of patients with lung or cardiac problems.
Subjectiveness of Dyspnea
 Dyspnea is a subjective complaint
 The degree of dyspnea may not correlate
 Dyspnea should always be investigated
Dyspnea Scoring System
 A variety of scoring systems have developed to help quantify dyspnea at a
single point in time to help track changes with treatment.
 The Modified Borg Scale
 Many other tools are also available.
Causes, Types, and Clinical Presentation of Dyspnea
 Dyspnea occurrence
 The adjectives patients use to describe their dyspnea may correlate with the
underlying pathology.
 Acute dyspnea
 Chronic dyspnea is almost always progressive.
Descriptions
 Paroxysmal nocturnal dyspnea (PND) is often seen in CHF patients.
 Orthopnea
 Trepopnea
 Platypnea
Chest Pain
 Chest pain
 Angina
Pulmonary Causes of Chest Pain
 Pleural inflammation
 Pneumonia, Pulmonary infarction
 Pleuritic pain
 Chest wall pain
Descriptions
 Chest pain from heart disease is often described as aching, squeezing,
pressing, or viselike.
 Patients with pleuritic chest pain. The pain increases with deep breathing.
Dizziness and Fainting (Syncope)
 Syncope
 Patients with lung disease who cough very forcefully may experience syncope.
Descriptions
 Vasovagal syncompe
 Orthostatic hypotension
 Cough syncope
Swelling of the Ankles (Dependent Edema)
 Patients with chronic hypoxemia often develop right heart failure.
 Dependent Edema – RHF leads to reduced venous return and increased
hydrostatic pressure in the peripheral venous blood vessels especially in the
dependent tissues (e.g., ankles).
 Ankle edema
Description
 Pitting edema
Fever, Chills, and Night Sweats
Descriptions
 Sustained fever
 Remittent fever
 Intermittent fever
 Fever is a concern because it may signal infection and it increases oxygen
consumption.
Fever with Pulmonary Disorders
 Pneumonia
 Lung abscess
 Tuberculosis
 Empyema
 Acute bacterial infections
Headache, Altered Mental Status, and Personality Changes
 Lung disease can lead to headache
 Sudden changes in personality
 RTs must be sensitive to personality changes because they may be indicative of
acute lung problems in the patient with chronic lung disease.
Snoring
Incidence and Causes
 Snoring occurs in about 5% to 10% of children and 10% to 30% of adults.
 Causes of snoring
 Causes of Obstructive Sleep Apnea
o Obesity
o Enlarged tonsils
o Large tongue
o Short thick neck
o Nasal obstruction
 Alcohol and sleeping medications can also make snoring worse.
Clinical Presentation
 Patients with obstructive sleep apnea always snore during sleep.
 OSA patients will complain
o excessive daytime sleepiness
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o
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poor concentration skills
bedwetting, impotence
high blood pressure