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Patient Care 2 > Disorders of the respiratory system > Flashcards

Disorders of the respiratory system Flashcards

1
Q

What groups can respiratory disorders be split into and what are they associated with?

A
  1. Upper respiratory tract = associated with inspiratory dyspnoea and an externally audible noise
  2. Lower respiratory tract = associated with expiratory dyspnoea and wheeze generally audible on thoracic auscultation
  3. Extrapulmonary disease
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2
Q

What are the components of the upper respiratory tract?

A
  • Nasal cavity
  • Pharynx
  • Larynx
  • Trachea
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3
Q

What are some clinical signs associated with nasal disease?

A
  • Sneezing
  • Snorting
  • Facial swelling
  • Facial rubbing
  • Dyspnoea
  • Nasal discharge
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4
Q

What could nasal discharge possible look like?

A
  • Serous
  • Mucoid
  • Mucopurulent (green)
  • Bloody
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5
Q

What are some possible causes for nasal disease?

A
  • Viral/bacterial/fungal
  • Allergies
  • Neoplasia
  • Ethmoid haematoma
  • FB
  • Polyp/cysts
  • Trauma
  • Coagulopathy
  • Dental disease
  • Sinusitis
  • Dacryocystitis (infection of the nasolacrimal sac)
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6
Q

What diagnostics can be done for a patient with suspected nasal disease?

A
  • History and clinical examination
  • Blood tests (haematology, biochemistry, clotting profile)
  • Imaging (X-rays/CT/MRI/Rhinoscopy/Endoscopy)
  • Bacteria and fungal culture
  • Nasal flush for cytology
  • Biopsy and histopathology
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7
Q

What treatment and nursing care can be done for a patient with nasal disease?

A

Dependent on cause

  • Barrier nurse and isolate (if infectious)
  • Monitor vitals and clinical signs including comfort
  • Cleaning/grooming including nasal orifices (apply vaseline)
  • Assist with feeding
  • Humidifier may be required
  • Medication under VS direction (ABs for bacterial infections and antifungals for fungal infections)
  • Assist with surgical procedure/removing FB
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8
Q

What are some common causes of laryngeal disease?

A
  • Persistant barking
  • Respiratory tract infections
  • Paralysis of arytenoid cartilage
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9
Q

What are some clinical signs of laryngeal disease?

A
  • Change in vocal ability
  • Coughing/gagging
  • Stridor (audible whistling noise) on inspiration
  • Exercise intolerance
  • Cyanosis
  • Hyperthermia
  • Dyspnoea (often with paradoxical abdominal movement)
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10
Q

What diagnostics can be done for a patient with suspected laryngeal disease?

A
  • History
  • Clinical examination
  • Endoscopy
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11
Q

What stabilisation and management his required for a patient with laryngeal disease?

A
  • O2 therapy
  • Sedation and rest (reduce stress and inspiratory effort)
  • Cooling
  • Tracheostomy (severe cases)
  • Hobday in mild cases
  • Tie-back in severe cases
  • Swap collar for harness
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12
Q

What is epiglottic entrapment?

A

Aryepiglottic folds become abnormal and envelopes the apex and lateral margins of the epiglottis

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13
Q

What clinical signs may be seen with epiglottic entrapment?

A
  • Stridor (audible whistling noise) on inspiration
  • Dyspnoea
  • Coughing
  • Cyanosis
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14
Q

What diagnostics can be done for a patient with suspected epiglottic entrapment?

A
  • History

- Endoscopy

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15
Q

What stabilisation and management is required for a patient with epiglottic entrapment?

A
  • Surgical correction
  • Systemic anti-inflammatories
  • ABs
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16
Q

What does the lower respiratory tract consist of?

A
  • Bronchi
  • Bronochioles
  • Alveoli
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17
Q

Orthopnoea

A

dyspnoea or shortness of breathing in lateral recumbency (usually improves in sternal recumbency)

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18
Q

What is acute respiratory disease?

A
  • Interruption or failure of normal respiratory function
  • Reduced O2 to the circulation
  • Increased CO2
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19
Q

What are some possible causes of acute respiratory disease?

A
  • Trauma (ruptured diaphragm and flail chest)
  • Pneomothorax/haemothorax/pyothorax/chylothorax (lymphatic fluid build up in thorax)
  • Neoplasia
  • Obstruction (FBV/tracheal collapse)
  • Infections
  • Pulmonary oedema
  • Pulmonary haemorrhage
  • Paraquat poisoning (plantkiller)
  • Gastric torsion
20
Q

What clinical signs are associated acute respiratory disease?

A
  • Tachypnoea/dyspnoea/orthopnoea
  • Mouth breeding
  • Cyanosis
  • Tachycardia
  • Collapse
21
Q

What treatment and nursing care can be done for a patient with acute respiratory disease?

A
  • Inform VS and set up O2
  • Keep patient calm and in quiet area
  • Minimal restraint
  • Replace collar with harness
  • Support in sternal if recumbent
  • Have crash box ready
  • Monitor closely
22
Q

What is flail chest?

A

Destabilisation of a portion of the ribs (often multiple)

23
Q

What clinical signs are associated with flail chest?

A
  • Tachypnoea/dyspnoea
  • Thoracic pain
  • Paradoxical inward displacement during inhalation and outward displacement during exhalation
  • Sub-cut emphysema
  • Hypoxaemia
24
Q

What diagnostics can be done for a patient with suspected flail chest?

A
  • Usually visually obvious

- Radiograph to confirm nature of the ribs

25
Q

What stabilisation and management is required for a patient with flail chest?

A
  • O2 support
  • Analgesia
  • Sensible positioning
  • Bandage chest to reduce movement of the segment
  • Surgery (only with penetrating wound)
26
Q

What is chronic pulmonary disease?

A

Associated with a narrowed bronchial lumen

27
Q

What are some possible causes chronic pulmonary disease?

A
  • Bronchial inflammation with oedema and hyperaemia of bronchial mucosa
  • Bronchospasm
  • Bronchomalacia
  • Mucous accumulation
  • Acute anaphylactic reaction (uncommon)
  • Infection
  • FB
  • Trauma
  • Collapsed lung
  • Tumour
28
Q

What specific diseases are related to chronic pulmonary disease?

A
  • Asthma
  • Chronic bronchitis
  • Pneumonia
  • Pulmonary haemorrhage
  • Pulmonary oedema (eg cardiac failure)
  • Lungworm
  • Neoplasia
29
Q

What clinical signs are associated with chronic pulmonary disease?

A
  • Coughing
  • Wheezing
  • Tachypnoea
  • Exercise intolerance
  • Lethargy
30
Q

What diagnostics can be done for a patient with suspected chronic pulmonary disease?

A
  • Thoracic X-rays (bronchial or bronchointerstitial pattern on X-rays, pulmonary hyperinflation and a flattened diaphragm)
  • Lower airway cytology (eosinophilic inflammation >17% eosinophils for feline asthma, neutrophilic inflammation evident for chronic bronchitis)
  • Heartworm test (ideally both antigen and antibody test)
  • Baermann faecal test
31
Q

What management and nursing care is required for a patient with chronic pulmonary disease?

A
  • Bronchodilators, corticosteroids, potential parasite control
  • O2 support
  • Rest/avoid stress
  • Monitor vitals
  • Medication under VS direction
32
Q

What clinical signs are associated with BOAS?

A
  • Stertor
  • Stridor
  • Exercise intolerance/collapse
  • Cyanosis
  • Syncope
  • Gastro-oesophageal reflux/vomiting/regurgitation
33
Q

What diagnostics can be done for a patient with suspected BOAS?

A
  • Observe clinical signs
  • Breed disposition
  • Examination of upper airway under GA
34
Q

What stabilisation and management is required for a patient with BOAS?

A
  • O2 support
  • Sedation to reduce stress and inspiratory effort
  • Cooling
  • Tracheostomy in severe cases
  • Surgical correction of anatomy in severe cases
35
Q

What is tracheal disease?

A
  • Cartilaginous rings are abnormal or degenerate

- Usually seen in small-breed dogs

36
Q

What clinical signs are associated with tracheal disease?

A
  • Cough like a goose-honk and dyspnoea with stress or excitement
  • Cyanosis
  • Collapse
37
Q

What diagnostics can be done for a patient with suspected tracheal disease?

A
  • Clinical history and exam
  • Clinical signs
  • Thoracic x-rays
  • Tracheal endoscope
  • Tracheal wash
38
Q

What treatment and nursing care can be done for a patient with tracheal disease?

A
  • O2 support
  • Intubation if emergency (risk further irritation)
  • Quiet environment
  • Long term weight management
  • Restrict exercise
  • Avoid dry, smokey and dusty atmospheres
  • Tracheal stent placed (specialist)
  • Swap collar for harness
39
Q

What is a tracheotomy?

A
  • Temporary or permanent procedure
  • Most often used as a life-saving procedure in an emergency situation to bypass an upper airway obstruction
  • Done under GA or sedation and local anaesthetic
  • Area below larynx on ventral midline neck is clipped and prepared
  • Incision made along midline and between the rings of the trachea
  • Tube inserted and secured in place
39
Q

What is a tracheotomy?

A
  • Temporary or permanent procedure
  • Most often used as a life-saving procedure in an emergency situation to bypass an upper airway obstruction
  • Done under GA or sedation and local anaesthetic
  • Area below larynx on ventral midline neck is clipped and prepared
  • Incision made along midline and between the rings of the trachea
  • Tube inserted and secured in place
40
Q

What is the reason for performing a bronchoalveolar lavage (BAL)?

A
  • Investigate coughing and suspected bronchial or alveolar disease
  • Obtain sample for cytology and bacteriology from lower airways
41
Q

What equipment is required for a bronco alveolar lavage (BAL)?

A
  • Bronchoalveolar lavage catheter or a soft urinary catheter
  • Syringes (5-30ml)
  • Warm sterile saline
  • Sample pots (EDTA for cytology and plain for culture)
  • Microscope slides for smears of any monoid material present
42
Q

How is a tracheal wash performed?

A
  • Using an endoscope
  • Long narrow sterile tube passed through the endoscope lumen
  • Sterile water flushed through into the trachea
  • Sucked back into the syringe
  • Sample sent for cytology and bacteriology
43
Q

What equipment is required for a thoracocentesis?

A
  • Sedation (if necessary)
  • Ultrasound
  • Clippers
  • Cotton wool/swabs and skin disinfectant
  • Local anaesthetic
  • Sterile gloves
  • Blade (number 15)
  • IV catheter (butterfly catheter for cats)
  • Extension set
  • 3-way tap
  • Syringe
  • Bowl
  • Sample pots (EDTA and plain for culture)
44
Q

What is required for a chest drain and how is it performed?

A
  • Use of a fenestrated drain and a trocar
  • Insertion can be carried out under GA or local
  • Skin incision made between 9th and 12th ribs and a subcutaneous tunnel made to the level off the 7th/8th intercostal space
  • Drain is pushed through the intercostal muscles
  • Once in place needs to be secured and sealed
  • Mechanical suction can be applied as necessary to drain the thorax

Patient Care 2 (13 decks)

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