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Respiratory disorders For Nursing Students By- Ahmed Sodha

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Respiratory disorders For Nursing Students By- Ahmed Sodha

  1. 1. RESPIRATORY DISORDERS UNIT-3UNIT-3 BY- AHMED SODHA M.Sc.(N)-M.S.N.
  2. 2. PULMONARY FUNCTION TEST
  3. 3. PULMONARY FUNCTION TEST
  4. 4. PARANASAL SINUSES:- Air-filled cavities located within specific facial and skull bones are known as paranasal sinuses. Humans have four paired paranasal sinuses, frontal,paired paranasal sinuses, frontal, maxillary, sphenoid, and ethmoid, all extending from the respiratory area of the nasal cavity and named after the bones they are found in.
  5. 5. TYPES:-
  6. 6. P/P:-
  7. 7. DIAGNOSTIC EVALUATION:- • H.C. & P.E. • CT-SCAN & MRI • BLOOD STUDIES (CBC)
  8. 8. Management:- Antibiotics (broad spectrum antibiotics) Antiviral (acyclovir) Nasal decongestant Antihistamines Steam inhalation Surgical management:- Balloon sinuplasty Endoscopic sinus surgery
  9. 9. PHARYNGITISPHARYNGITISPHARYNGITISPHARYNGITIS DEFINITION:- PHARYNGITIS IS INFLAMMATION OF THE PHARYNX (TONSILS,PALATE,UVULA). CAUSES:- BACTERIAL INFECTION (STREPTOCOCCUS, H.INFLUENZA,BACTERIAL INFECTION (STREPTOCOCCUS, H.INFLUENZA, MORAXELLA) VIRAL INFECTION, EXPOSURE TO ALLERGIC SUBSTANCE TYPES :- ACUTE PHARYNGITIS CHRONIC PHARYNGITIS
  10. 10. C/M.:- FEVER, RED COLOURED PHARYNGEAL MEMBRANE SORE THROAT, MALAISE, DIFFICULTY IN SWALLOWING COUGH D/E.:- H.C. & P.E. BLOOD STUDIES CULTURE OF THE PHARYNGEAL MUCOSA
  11. 11. MANAGEMENT:- • ANTIBIOTICS (PENICILLIN, CLARITHROMYCIN AND AZITHROMYCIN) • ANTIVIRAL (ACYCLOVIR) • ANTIPYRETIC (PARACETAMOL) q SOFT & LIQUID DIET q HOT WATER GARGLINGq HOT WATER GARGLING q MOUTH CARE
  12. 12. EPISTAXIS:- EPISTAXIS IS THE COMMON OCCURRENCE OF BLEEDING FROM THE NOSE. IT S USUALLY NOTICED WHEN BLOOD DRAINS OUT THROUGH THE NOSTRILS.
  13. 13. CAUSES:- - TRAUMA - BLOW ON NOSE - IRRITATION - FOREIGN BODIES - HYPERTENSION- HYPERTENSION - RHINITIS - VIGRANT SNEEZING - HIGH ALTITUDE - EXTREME COLD OR HOT TEMPERATURE
  14. 14. TYPES:- 1) ANTERIOR EPISTAXIS- ITS BLEEDING OCCURE IN ANTERIOR PART. ITS COMMON TYPE. KISSELBACH’S PLEXUS (LITTLE’S AREA).
  15. 15. 2) POSTERIOR EPISTAXIS- ITS BLEEDING OCCURE IN POSTERIOR PART. WOODRUFF’S PLEXUS.
  16. 16. SIGNS & SYMPTOMS:- - NASAL BLEEDING (ANTERIOR EPISTAXIS) - PHARYNGEAL BLEEDING (POSTERIOR EPISTAXIS) - IRRITATION IN NOSE - DISCOMFORT - ITCHING DIAGNOSTIC EVALUATION:- - HISTORY COLLECTION - PHYSICAL EXAMINATION
  17. 17. COMPLICATIONS:- - SEPTALABSCESS - SINUSITIS
  18. 18. DEVIATED NASAL SEPTUM ITS COMMON PHYSICAL DISORDER OF THE NOSE CHARACTERISED BY DISPLACEMENT OF NOSE. THIS CONDITION DEVELOP WHEN THE THIN WALL (NASAL SEPTUM) INSIDE THE NOSE IS DISPLACED TO ANY ONE SIDE. THIS DEVIATED NASAL SEPTUM WILL MAKE ONE NASAL PASSAGE SMALLER.PASSAGE SMALLER. CAUSES:- -IMPACT TRAUMA - BLOW ON NOSE -CONGENITAL -TRAUMA OR INJURY
  19. 19. TYPES:- C- DEVIATION- S- DEVIATION- SYMPTOMS:- - BREATHING DIFFICULTY - NASAL CONGESTION - MSOTLY ASSYMPTOMATIC DIAGNOSTIC EVALUATION:- H.C & P.E.
  20. 20. TREATMENT:- - NASAL DECONGESTANT - ANTIHISTAMINES - NASAL SPRAYS SURGICAL MANGEMNT:- SEPTOPLASTY
  21. 21. TONSILLITIS:- ITS DEFINED AS INFECTION & INFLAMMATION OF THE TONSILS. ETIOLOGY:- -BACTERIAL INFECTION (MOSTLY STREPTOCOCCUS) -VIRAL INFECTION C/M.:- -RED SWOLLEN TONSILS-RED SWOLLEN TONSILS -FEVER - HEADACHE -MALAISE -DYSPHAGIA -SORE THROAT
  22. 22. D/E:- - H.C. & P.E. - BLOOD TEST - THROAT CULTURE MANAGEMENT:- - ANTIBIOTICS (ERYTHROMYCIN, CLARITHROMYCIN) - ANTIPYRETICS (PARACETAMOL)- ANTIPYRETICS (PARACETAMOL) - ANTIVIRAL (ACYCLOVIR) - ANALGESICS (ACETAMINOPHEN) - HOT WATER GARGLING SURGICAL MANAGEMENT - TONSILECTOMY
  23. 23. PERITONSILLAR ABSCESS (QUINSY) / PTA ITS DEFINED AS A COLLECTION OF PUS OR PURULENT EXUDATE BETWEEN THE TONSILAR CAPSULE & THE SURROUNDING TISSUES. ITS COMPLICATION OF TONSILLITIS. CAUSES:-CAUSES:- BACTERIAL INFECTION (STREPTOCOCCUS MOSTLY) VIRAL INFECTION
  24. 24. PATHOPHYSIOLOGY:- DUE TO ETIOLOGY INFLAMMATION OF TONSILAR CAPSULE INCREASES INFLAMMATION DEVELOPMENT OF PUS
  25. 25. C/M.:- →SORE THROAT →SWELLING OF THE SOFT PALATE →ENLARGEMENT OF NECK LYMPH GLANDS →DYSPHAGIA →FEVER →NECK MUSCLE PAIN→NECK MUSCLE PAIN →TRISMUS (INABILITY/DIFFICULTY IN OPENING MOUTH) →HOT POTATO / MUFFED VOICE →(SOUNDS LIKE TALKING WITH HOT FOOD IN THEIR MOUTH)
  26. 26. D/E :- H.C. & P.E. BLOOD TEST CT-SCAN MANAGEMENT:- - ANTIBIOTICS (PENICILLIN, CLINDAMYCIN)- ANTIBIOTICS (PENICILLIN, CLINDAMYCIN) - ANTIVIRAL - ANTIPYRETICS - CORTICOSTEROIDS (PREDNISOLONE) - ENDOTRACHEAL INTUBATION (IF NEEDED)
  27. 27. SURGICAL MANAGEMENT:- -NEEDLE ASPIRATION (SLOWLY PUTTING A NEEDLE INTO THE ABSCESS WITHDRAWING THE PUS ONTO A SYRINGE) -INCISION & DRAINAGE -TONSILLECTOMY
  28. 28. ASTHMA
  29. 29. CAUSES & RISK FACTORS:- - SMOKING CIGARETTES - AIR POLLUTANTS - ALPHA 1 ANTITRYPSIN DEFICIENCY - FAMILY HISTORY - SECONDARY TO FREQUENT UPPER RESPIRATORY TRACT INFECTIONTRACT INFECTION
  30. 30. EMPHYSEMA:- ITS DISEASE IN WHICH DAMAGE OCCURS TO AIR SACS(ALVEOLI). EMPHYSEMA AFFECTS THE WALLS OF THE MILLIONS OF TINY AIR SACS WHICH BECOME INFLAMMED & LOOSE ELASTICITY.
  31. 31. • Centriacinar Emphysema: Involves primarily the respiratory bronchiole (proximal and central part of the acinus is expanded) • The distal acinus or alveoli are unchanged. • Occurs more commonly in the upper lobes. • Most common type. • Seen in cigarette smokers
  32. 32. • Panacinar Emphysema: Involves entire respiratory acinus, from respiratory bronchiole to alveoli is expanded. • Occurs more commonly in the lower lobes, especially basal segments, and anterior margins of the lungs. • It is the type seen in alpha 1 - antitrypsin deficiency
  33. 33. • Distal acinar (Paraseptal emphysema):The distal respiratory acinus, including alveolar duct and alveoli, is expanded. • Occurs primarily adjacent to the pleura and connective tissue septa, especially in the upper lobes.
  34. 34. • The walls of acinus are destroyed when there is an imbalance between proteases and anti-proteases in the lung. • Protease is an enzyme like elastase, which can digest connective tissue elements. Proteases are found throughout the body, especially in neutrophils and macrophages. • To counterbalance the destructive effects of proteases, nature provides inhibitors such as alpha-proteases, nature provides inhibitors such as alpha- antitrypsin. • Smoking increases the level of lung proteases while impairing the action of anti-proteases. Patients with panacinar emphysema may lack alpha-antitrypsin.
  35. 35. P/P:- DUE TO ETIOLOGY INCREASES THE LEVEL OF LUNG PROTEASES IMPAIRING THE FUNCTION OF ALPHA-1 ANTI- TRYPSIN DESTRUCTION OF ELASTIC TISSUE OF ALVEOLARDESTRUCTION OF ELASTIC TISSUE OF ALVEOLAR WALL LOOSENING OF ELASTICITY NATURE OF ALVEOLI
  36. 36. CHRONIC BRONCHITIS
  37. 37. CLINICAL MANIFESTATIONS
  38. 38. - ANTITUSSIVE (CODEINE, BENZONATATE) - MUCOLYTIC (AMBROXOL)
  39. 39. PLEURAL EFFUSION
  40. 40. A PLEURAL EFFUSION IS EXCESS FLUID THAT ACCUMULATES IN THE PLEURAL CAVITY. [PLEURAL CAVITY- THE FLUID-FILLED SPACE THAT SURROUNDS THE LUNGS.] TYPES :- 1. TRANSUDATIVE P.E. WHEN FLUID LEAKS FROMBLOOD VESSELS INTO THEWHEN FLUID LEAKS FROMBLOOD VESSELS INTO THE PLEURAL SPACE. 2. EXUDATIVE P.E. CAUSED BY INFLAMMATION OF PLEURAL SPACE BY LUNG DISEASE.
  41. 41. CAUSES:- -CCF -LIVER FAILURE - PERITONEAL DIALYSIS - PNEUMONIA - LUNG ABSCESS - TB - CHRONIC BRONCHITIS
  42. 42. P/P:- DUE TO ETIOLOGY STIMULATION OF MAST CELLS IN THE LUNGS RELEASE OF HISTAMINES INCREASED VASCULAR PERMEABILITY INCREASED BLOOD FLOW INCREASED HYDROSTATIC PRESSURE FLUID SHIFT TO PLEURAL SPACE TRANSUDATIVE PLEURAL EFFUSION
  43. 43. C/M:- - CHEST PAIN - COUGHING - BREATHING DIFFICULTY - SHORTNESS OF BREATH - CHEST HEAVINESS - FEVER - ORTHOPNEA (PERSON MUST SIT OR STAND TO BREATH COMFORTABLY)BREATH COMFORTABLY) D/E :- - H.C. & P.E. - CHEST X-RAY - CT SCAN - THORACENTHESIS
  44. 44. MANAGEMENT:- AIMS OF TREATMENTS ARE - REMOVE THE FLUID - PREVENT FURTHER FLUID BUILD UP - TREATING UNDERLYING CAUSES THORACENTHESIS ANTIBIOTICS CATHETER INSERTION / DRAINAGE TUBE

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