RESPIRATORY AND CARDIOVASCULAR DISORDERS OVERVIEW
Respiratory Disorders
Lung Cancer (Lung CA)
Causes/Risk Factors: Smoking is the leading cause, followed by exposure to chemicals,
a high-fat low-fiber diet, age, genetics, environmental factors, and pre-existing lung
lesions.
Assessment: Early signs include a chronic cough, chest pain, hemoptysis (coughing up
blood), dyspnea (difficulty breathing), increased tactile fremitus, dull sounds on
percussion, and recurring infections or pleural effusion.
Diagnosis: Techniques include bronchoscopy, biopsy, imaging methods like CT, MRI,
PET scans, and sputum cytology to identify cancerous cells.
Management: Surgical options include pneumonectomy, lobectomy, segmentectomy,
and wedge resection, often followed by chest tube placement. Additional treatments may
involve radiation and chemotherapy.
Pleural Effusion
Causes/Risk Factors: Often iatrogenic, resulting from other medical conditions such as
infections or tumors.
Assessment: Symptoms include dyspnea, cough, diminished or absent breath sounds, flat
or dull sounds on percussion, decreased tactile fremitus, and tracheal deviation towards
the unaffected side.
Diagnosis: Procedures include thoracentesis, pleural fluid analysis, pleural biopsy, and
chest x-ray to visualize fluid accumulation.
Management: Patients are often placed in a semi-Fowler's position; treatments may
include thoracentesis, pleurodesis, pleurectomy, chest tube insertion, or pleuroperitoneal
shunt.
,Pulmonary Embolism (PE)
Causes/Risk Factors: Commonly caused by blood clots (DVT), trauma (fat embolism),
heart disease (e.g., atrial fibrillation), and infections.
Assessment: Symptoms include sudden onset of dyspnea, chest pain, tachycardia, low
oxygen saturation, and hemoptysis.
Diagnosis: Diagnostic methods include pulmonary angiography, chest CT, V/Q scan, and
D-dimer assay to assess clot presence.
Management: Focuses on prevention of blood clots, oxygen therapy, pain management
with morphine, anticoagulants (heparin, warfarin), and thrombolytics (alteplase,
streptokinase, urokinase).
Tuberculosis (TB)
Causes: Primarily caused by Mycobacterium tuberculosis, a highly infectious bacterium.
Risk Factors: Close contact with infected individuals, weakened immune systems,
substance abuse, poor nutrition, crowded living conditions, and age (very young and
elderly).
Assessment: Symptoms include persistent cough, night sweats, fever, weight loss, and
blood-tinged sputum, with lung sounds often revealing wheezing or crackles.
Diagnosis: Confirmed through skin tests (Mantoux), chest x-rays, and the Quantiferon
blood test, which is considered the gold standard.
Management: Involves medical management with antibiotics (isoniazid, rifampin,
pyrazinamide, ethambutol) and nursing management including the use of N95 respirators
and placement in negative pressure rooms.
Laryngeal Cancer
Causes/Risk Factors: Major contributors include tobacco and alcohol use, genetics, age,
vitamin deficiencies, and weakened immune systems.
, Assessment: Symptoms include hoarseness, cough, sore throat, pain with hot liquids,
dysphagia, dyspnea, and foul breath due to ulceration.
Diagnosis: Techniques include laryngoscopy (both indirect and direct), fine needle
aspiration (FNA) biopsy, CT/MRI, PET scans, and barium swallow tests.
Management: Treatment may involve laryngectomy (subtotal or total), radiation therapy
with skin care for irritation, and chemotherapy with antiemetics prior to treatment.
Cardiovascular Positioning and Oxygen Management
Semi-Fowler's Position
The Semi-Fowler's position involves the patient sitting at a 30-45 degree angle, which
can help improve respiratory function and reduce cardiac workload.
This position is often used in patients experiencing respiratory distress or heart failure to
facilitate easier breathing.
It is beneficial for patients with myocardial infarction (MI) as it can help alleviate anxiety
and promote comfort.
Nursing interventions include ensuring the patient is supported with pillows and
monitoring vital signs regularly.
This position can also aid in venous return and reduce the risk of orthostatic hypotension.
Oxygen Therapy
Oxygen therapy is critical in managing patients with cardiovascular issues, particularly
those with myocardial infarction or heart failure.
Administering oxygen can help increase the oxygen supply to myocardial tissues,
reducing ischemic damage.
Typical flow rates range from 2-4 L/min via nasal cannula, but may vary based on patient
needs and clinical guidelines.
Respiratory Disorders
Lung Cancer (Lung CA)
Causes/Risk Factors: Smoking is the leading cause, followed by exposure to chemicals,
a high-fat low-fiber diet, age, genetics, environmental factors, and pre-existing lung
lesions.
Assessment: Early signs include a chronic cough, chest pain, hemoptysis (coughing up
blood), dyspnea (difficulty breathing), increased tactile fremitus, dull sounds on
percussion, and recurring infections or pleural effusion.
Diagnosis: Techniques include bronchoscopy, biopsy, imaging methods like CT, MRI,
PET scans, and sputum cytology to identify cancerous cells.
Management: Surgical options include pneumonectomy, lobectomy, segmentectomy,
and wedge resection, often followed by chest tube placement. Additional treatments may
involve radiation and chemotherapy.
Pleural Effusion
Causes/Risk Factors: Often iatrogenic, resulting from other medical conditions such as
infections or tumors.
Assessment: Symptoms include dyspnea, cough, diminished or absent breath sounds, flat
or dull sounds on percussion, decreased tactile fremitus, and tracheal deviation towards
the unaffected side.
Diagnosis: Procedures include thoracentesis, pleural fluid analysis, pleural biopsy, and
chest x-ray to visualize fluid accumulation.
Management: Patients are often placed in a semi-Fowler's position; treatments may
include thoracentesis, pleurodesis, pleurectomy, chest tube insertion, or pleuroperitoneal
shunt.
,Pulmonary Embolism (PE)
Causes/Risk Factors: Commonly caused by blood clots (DVT), trauma (fat embolism),
heart disease (e.g., atrial fibrillation), and infections.
Assessment: Symptoms include sudden onset of dyspnea, chest pain, tachycardia, low
oxygen saturation, and hemoptysis.
Diagnosis: Diagnostic methods include pulmonary angiography, chest CT, V/Q scan, and
D-dimer assay to assess clot presence.
Management: Focuses on prevention of blood clots, oxygen therapy, pain management
with morphine, anticoagulants (heparin, warfarin), and thrombolytics (alteplase,
streptokinase, urokinase).
Tuberculosis (TB)
Causes: Primarily caused by Mycobacterium tuberculosis, a highly infectious bacterium.
Risk Factors: Close contact with infected individuals, weakened immune systems,
substance abuse, poor nutrition, crowded living conditions, and age (very young and
elderly).
Assessment: Symptoms include persistent cough, night sweats, fever, weight loss, and
blood-tinged sputum, with lung sounds often revealing wheezing or crackles.
Diagnosis: Confirmed through skin tests (Mantoux), chest x-rays, and the Quantiferon
blood test, which is considered the gold standard.
Management: Involves medical management with antibiotics (isoniazid, rifampin,
pyrazinamide, ethambutol) and nursing management including the use of N95 respirators
and placement in negative pressure rooms.
Laryngeal Cancer
Causes/Risk Factors: Major contributors include tobacco and alcohol use, genetics, age,
vitamin deficiencies, and weakened immune systems.
, Assessment: Symptoms include hoarseness, cough, sore throat, pain with hot liquids,
dysphagia, dyspnea, and foul breath due to ulceration.
Diagnosis: Techniques include laryngoscopy (both indirect and direct), fine needle
aspiration (FNA) biopsy, CT/MRI, PET scans, and barium swallow tests.
Management: Treatment may involve laryngectomy (subtotal or total), radiation therapy
with skin care for irritation, and chemotherapy with antiemetics prior to treatment.
Cardiovascular Positioning and Oxygen Management
Semi-Fowler's Position
The Semi-Fowler's position involves the patient sitting at a 30-45 degree angle, which
can help improve respiratory function and reduce cardiac workload.
This position is often used in patients experiencing respiratory distress or heart failure to
facilitate easier breathing.
It is beneficial for patients with myocardial infarction (MI) as it can help alleviate anxiety
and promote comfort.
Nursing interventions include ensuring the patient is supported with pillows and
monitoring vital signs regularly.
This position can also aid in venous return and reduce the risk of orthostatic hypotension.
Oxygen Therapy
Oxygen therapy is critical in managing patients with cardiovascular issues, particularly
those with myocardial infarction or heart failure.
Administering oxygen can help increase the oxygen supply to myocardial tissues,
reducing ischemic damage.
Typical flow rates range from 2-4 L/min via nasal cannula, but may vary based on patient
needs and clinical guidelines.
