N530 Respiratory problems Exam Study Set
cough - ANSWER -body's natural mechanism to protect itself by clearing the airways of
secretions and irritants
-acute: <3 wks
-subacute: 3-8 wks
-chronic: > 8wks
?s to ask during hx intake:
-onset: recent resp infection, exposure to inhaled substance (home, work, hobbies), new
med (aceI)
-timing: seasonal, night (dust mite), exercise (Asthma)
-quality: dry, productive
-positional (CHF, GERD)
-associated s/s: wheezing (asthma), fever, heartburn
differential dx:
•Infectious pulmonary diseases (e.g. PNA)
•Chronic pulmonary diseases (e.g. asthma, COPD)
•Aspiration
•GERD
•Lung cancer
•Cardiopulmonary conditions (e.g. CHF)
•Environmental exposures (e.g. secondhand smoke)
•Psychogenic factors
•Medications (ACE- inhibitor)
•Postnasal drip
•Cigarette smoking (most common cause of chronic cough)
dyspnea - ANSWER -difficulty breathing or inability to get sufficient air
,-usually d/t cardiac or pulm dz but can also be psychogenic (panic disorder)
?s to ask during hx intake:
-acute/chronic
-rest/exertion
-worsen when laying down, sudden SOB at night, LE swelling (CHF)
-CP (MI)
-wheezing (Asthma)
-sputum production (COPD)
-new sputum prod/change in color/consistency (resp infection)
-fatigue/pallor (anemia)
-anxiety (panic disorder)
differential dx:
-pulm: asthma, COPD, pulm HTN, CF
-cardiac: CHF, MI
-hematological: chronic anemia
-psychogenic: anxiety, panic
hemoptysis - ANSWER -expectoration of blood (bright red= fresh, dark red/black= old)
-coughing up blood/sputum that's blood tinged
-common cause: inflamm of lungs (bronchitis, PNA, TB, bronchiectasis)
massive hemoptysis management:
•Chest x-ray and CBC
•Keeping the airway open and preventing aspiration, endotracheal intubation may be
needed
•Transfusion of pRBCs to keep Hgb >7
•Referral to specialist for immediate treatment with surgery or bronchoscopy
nonemergency hemoptysis management:
•Chest x-ray and CBC
, •Sputum culture and sensitivities (for PNA or abscess)
•Sputum tested for acid fast bacilli (for TB)
•ABx for tx of infectious causes
•Smoking cessation education for chronic cough/hemoptysis due to cigarette smoking
respiratory tract infection location - ANSWER upper: nose, pharynx, larynx
lower: lower airways (Trachea, bronchi, bronchioles) and lungs
-most common cause: virus
upper respiratory infections - ANSWER frequency:
-children: 3-8 URI/yr (most frequently affects pts <5)
-adults: 2-4 URI/yr
-65+: <1 URI/yr
common viral URI (incubation period: 1-4days):
-rhinovirus
-coronvirus
-adenovirus
-respiratory syncytial virus (RSV) and parainfluenza virus cause URIs more often in
infants and young toddlers
bacterial:
•Streptococcus pneumoniae
•Haemophilus influenzae
•Moraxella catarrhalis
•Staphylococcus aureus
common cold - ANSWER -most frequent resp infection
-virual
•Fingers are the most common source of spread, so hand washing is key to preventing
transmission.
•Most common portal of entry are the nasal mucosa and conjunctivae of the eyes.
s/s:
cough - ANSWER -body's natural mechanism to protect itself by clearing the airways of
secretions and irritants
-acute: <3 wks
-subacute: 3-8 wks
-chronic: > 8wks
?s to ask during hx intake:
-onset: recent resp infection, exposure to inhaled substance (home, work, hobbies), new
med (aceI)
-timing: seasonal, night (dust mite), exercise (Asthma)
-quality: dry, productive
-positional (CHF, GERD)
-associated s/s: wheezing (asthma), fever, heartburn
differential dx:
•Infectious pulmonary diseases (e.g. PNA)
•Chronic pulmonary diseases (e.g. asthma, COPD)
•Aspiration
•GERD
•Lung cancer
•Cardiopulmonary conditions (e.g. CHF)
•Environmental exposures (e.g. secondhand smoke)
•Psychogenic factors
•Medications (ACE- inhibitor)
•Postnasal drip
•Cigarette smoking (most common cause of chronic cough)
dyspnea - ANSWER -difficulty breathing or inability to get sufficient air
,-usually d/t cardiac or pulm dz but can also be psychogenic (panic disorder)
?s to ask during hx intake:
-acute/chronic
-rest/exertion
-worsen when laying down, sudden SOB at night, LE swelling (CHF)
-CP (MI)
-wheezing (Asthma)
-sputum production (COPD)
-new sputum prod/change in color/consistency (resp infection)
-fatigue/pallor (anemia)
-anxiety (panic disorder)
differential dx:
-pulm: asthma, COPD, pulm HTN, CF
-cardiac: CHF, MI
-hematological: chronic anemia
-psychogenic: anxiety, panic
hemoptysis - ANSWER -expectoration of blood (bright red= fresh, dark red/black= old)
-coughing up blood/sputum that's blood tinged
-common cause: inflamm of lungs (bronchitis, PNA, TB, bronchiectasis)
massive hemoptysis management:
•Chest x-ray and CBC
•Keeping the airway open and preventing aspiration, endotracheal intubation may be
needed
•Transfusion of pRBCs to keep Hgb >7
•Referral to specialist for immediate treatment with surgery or bronchoscopy
nonemergency hemoptysis management:
•Chest x-ray and CBC
, •Sputum culture and sensitivities (for PNA or abscess)
•Sputum tested for acid fast bacilli (for TB)
•ABx for tx of infectious causes
•Smoking cessation education for chronic cough/hemoptysis due to cigarette smoking
respiratory tract infection location - ANSWER upper: nose, pharynx, larynx
lower: lower airways (Trachea, bronchi, bronchioles) and lungs
-most common cause: virus
upper respiratory infections - ANSWER frequency:
-children: 3-8 URI/yr (most frequently affects pts <5)
-adults: 2-4 URI/yr
-65+: <1 URI/yr
common viral URI (incubation period: 1-4days):
-rhinovirus
-coronvirus
-adenovirus
-respiratory syncytial virus (RSV) and parainfluenza virus cause URIs more often in
infants and young toddlers
bacterial:
•Streptococcus pneumoniae
•Haemophilus influenzae
•Moraxella catarrhalis
•Staphylococcus aureus
common cold - ANSWER -most frequent resp infection
-virual
•Fingers are the most common source of spread, so hand washing is key to preventing
transmission.
•Most common portal of entry are the nasal mucosa and conjunctivae of the eyes.
s/s:
