Respiratory System p1 Flashcards
(23 cards)
Signs of respiratory distress (8)
Pt assume posture to maximize airway size:
1. Flared nostrils
2. Open-mouth breathing, lips pulled back
3. Extended neck
4. Elbows away from body
5. Refusal to lay down
Others:
6. Noisy breathing
7. Muddy or dusky MM
8. Distress
- Dilated pupils, tachycardia, tachypnea, dyspnea
Evaluation of Respiratory Health
Common tests (6)
- RR/MM & effort
- Pulse O2
- Blood gas analysis
- Rads
- Culture
- Cytology
Evaluation of Respiratory Health
Less common tests (3)
- Bronchoscopy
- Ultrasound
- Biopsy
Types of oxygen therapy (7)
- Face mask
- Nasal catheter
- “Flow by”
- O2 tent
- O2 cage
- Endotracheal or tracheostomy tube
- Ventilator
Upper Airway Obstruction
1. Etiology
2. Causes (7)
- Anything in airway from larynx to bronchus
- Causes:
- Foreign object
- Tumor
- Swelling
- Trauma
- Anaphylaxis
- Laryngeal paralysis
- Collapsing trachea
- Brachycephalic syndrome
Upper Airway Obstruction
1. Signs (4)
2. Supportive care (2)
- Signs
- Noisy breathing in throat, coughing, gagging
- Extended head posture, slow deep breathing
- Hypersalivation
- Possible weakness, cyanosis - Care
- Keep Pt calm & resting
- Oxygen
Tracheostomy Care (5)
- Tube cleaning
- Inner cannula with chlorhex q2-6hrs - Dried exudate obstructing tube
- Monitor RR & effort
- Replace if needed - Nebulization near tracheostomy with saline to moisten airways.
- Sterile saline can be directly infused into trachea & immediately suctioned out (aseptically).
- Drugs can be given to patient to encourage fluid airway secretions (mucolytics).
Tracheostomy equipment/set up (6)
- Sx prep of ventral neck
- Dorsal recumbency
- Local or general anesthesia
- Small Sx pack
- Nylon sutures
- Tracheostomy tube
Indications for a tracheostomy (3)
- Emergency airway access
- Short term therapy
- Ventilation on awake animals
When suctioning airways, it must be… (4)
- Aseptic!
- Sterile catheter & gloves - Pre-oxygenate Pt 5min
- Atraumatic
- Rapid & efficient
- Pt cannot ventilate if you’re removing all the air from the airway!
Feline Asthma
1. Etiology
2. Signs (3)
3. Supportive care (3)
- Allergies or irritants cause severe airway inflammation & narrowing.
- Signs
- Acute labored breathing
- Chronic cough, possible wheeze
- Exercise intolerance - Care
- Emergency O2 & meds
- Minimal handling/stress!
- Chronic bronchodilators, antiB, air purifiers, corticosteroids
Inhaled Therapy: MDI
What is it?
Metered Dose Inhaler (MDI) medicines come in a pressurized canister. They need to be vigorously shaken for about 15 seconds immediately before dispensing “puffs” into the Valved Holding Chamber.
“Test spray” once into the air before use, or if unused for 1-3 weeks.
Pleural Effusion
1. Signs (4)
2. Diagnosis (2)
3. Supportive care (3)
- Signs
- Shallow, rapid breathing with exaggerated abdominal movements.
- Possible cough
- Fever
- Chest pain - Dx
- Imaging (rads, ultrasound)
- Thoracocentesis - Care
- Min stress, O2
- Remove pleural fluid ASAP
- Tx primary disease
Thoracocentesis
What is it? How to do it? (4)
- Place a needle into pleural space to remove air or fluid (Dx & therapeutic).
- Always a sterile procedure!
- First draw samples eval by cult & cytology.
- Vol of air or fluid collected on each side needs to be measured and carefully recorded.
Conditions Requiring Chest Drainage (3)
- Pneumothorax
- Hemothorax
- Pleural effusion
Pneumothorax
1. When does it occur?
2. How chest drainage helps:
- There is an opening on the surface of the lung or in the airways, in the chest wall, or both.
- Allows air to enter the pleural space between the pleurae, creating an actual space.
Hemothorax
1. What is it?
2. How chest drainage helps:
- Occurs after thoracic surgery and many traumatic injuries.
- Negative pressure between the pleurae is disrupted, and the lung will collapse to some degree, depending on the amount of blood.
- So chest tube time!!
Pleural effusion
1. What is it?
2. Treatment (3)
- Abnormal fluid accumulation in the pleural space.
- Tx
- Remove fluid & air as promptly as possible.
- Prevent drained air & fluid from returning to the pleural space.
- Restore negative pressure in the pleural space to re-expand the lung.
Pleural Effusion types (5)
- Transudate:
- CLEAR fluid that collects in the pleural space when there are fluid shifts in the body from conditions such as CHF, malnutrition, renal & liver failure. - Purulent
- Opaque, tan to yellow - Exudate:
- CLOUDY fluid with cells & proteins that collects when the pleurae are affected by malignancy or diseases such as TB and pneumonia. - Chylous
- Opaque, white to pink - Hemorrhagic
- Red to red-brown
Chest tube
1. Indications
2. How is air/fluid prevented from returning?
- Patient needs multiple of continuous evacuation of pleural space for air or fluid.
- It’s attached to a drainage device!
- Allows air & fluid to leave chest.
- One-way valve to prevent air & fluid from returning.
- Device is below Pt for gravity drainage.
How chest drainage system works:
1. Air drainage
2. Fluid
- Air
- Straw attached to chest tube from Pt is placed under 2cm of fluid (water seal).
- Air can push thru the straw but cannot be drawn back up. - Fluid
- First bottle collects drainage
- A second bottle is added and acts as the water seal.
Setting up suction heating: (3)
- Don’t boil spaghetti!
- Too much bubbling not clinically needed in majority of Pt.
- If too much, turn down vacuum source until bubbles go away, then slowly increase until they reappear, then stop!
Pneumonia
1. Diagnosis (2)
2. Supportive care (4)
- Dx
- rads
- Transtracheal wash (cytology & cult) - Care
- Tx primary disease
- Maintain hydration!
- Nebulize
- Coupage
