Pharm N189 Study guide for respiratory System

 COPD
o Chronic airflow limitation (emphysema and chronic bronchitis)
o S/S
 Easily fatigued
 Frequent respiratory infections
 Use of accessory muscles to breathe
 Orthopenic
 Wheezing
 Pursed-lip breathing
 Chronic cough
 Barrel chest
 Dyspnea
 Prolonged expiratory time
 Digital clubbing
 COR pulmonale (late in disease)
 Thin in appearance
o Starts to restructure things on pulmonary and tissue level
 Distal cyanosis.
 Chest starts to restructure because of air trapping.
 Clubbing, sluggish cap refill.
 Assess cap refill on ear or bridge of nose
 Assessment
o Inspection: rate, rhythm, O2 sat, PT appearance, LOC & work of breathing.
o Auscultating:
 Crackles- COPD
 Wheezes- asthma
 pleural rubs
 stridor- upper airway obstruction
o hypoxia
o RALES- crackles, smaller airways, fluids in lungs (AVEOLI)
 In CHF and Pneumonia
o Rhonchi- larger airways, obstruction or fluid accumulation in the larger airways.
 COPD, Pneumonia.
o Wheezing- effects bronchi, construction, air trying to pass through the
bronchioles.
 Asthma, bronchitis.
o Stridor- Upper airway, over trachea, foreign airway obstruction.
 Assessment: EARLY signs Respiratory Distress
o Tripod position, accessory muscle use, wheezing, Tachypnea (>20BPM), little/no
change in SaO2, ALOC: mild/confusion & anxious.
 Assessment: LATE signs Respiratory distress
o Grunting, bradypneas (<12 BPM), inaudible breath sounds, cyanosis, Low SaO2
(70s), ALOC: worse/unresponsive.
 Bronchodialtors
o BETA 2 AGONIST- activates beta2 receptors resulting in bronchodilation.
 Albuterol