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
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
