Efnisyfirlit

• Contributors
• Previous edition contributors
• Preface
• 1 Anatomy and physiology
• Understanding respiratory anatomy and physiology
• Upper respiratory tract
• Nostrils and nasal passages
• Air passage
• Sinuses and nasopharynx
• Oropharynx and laryngopharynx
• Larynx
• Lower respiratory tract
• Conducting airways
• Secondary bronchi and the hilum
• Bronchi branches out
• Defense mechanisms
• Trapping foreign particles
• Acinus
• Diffusion
• Lungs and accessory structures
• Pleura and pleural cavities
• Serous fluid
• Thoracic cavity
• Mediastinum
• Thoracic cage
• Rib numbers
• Bordering on the costal angle
• Suprasternal notch
• Inspiration and expiration
• Accessory muscles
• External and internal respiration
• No room for expansion
• Resistance
• More work, less efficiency
• Other airflow alterations
• Trading places: O2 and CO2 exchange
• Ventilation–perfusion match
• Ventilation–perfusion mismatch
• Shunting
• Dead space
• The silent unit
• Spaces in between
• From the RBCs to the alveoli
• PaO2
• Acid–base balance
• Respiratory responses
• Acid–base imbalance
• Quick quiz
• Scoring
• Suggested references
• 2 Assessment
• Understanding respiratory assessment
• Obtaining a health history
• Asking about shortness of breath
• Asking about orthopnea
• Asking about cough
• Asking about sputum
• Asking about wheezing
• Asking about chest pain
• Check the broader health history
• Using a systematic approach
• Inspecting the chest
• Back, then front
• Assessing for symmetry
• Costal angle
• Breathing rate and pattern
• Paradoxical movement
• Muscle motion
• Inspecting related structures
• Skin color and nail beds
• Clubbing clues
• Palpating the chest
• Crepitus
• Palpating for tenderness
• Fremitus
• Measuring the symmetry
• Warning signs
• Percussing the chest
• Different sites, different sounds
• Ringing with resonance
• Problem sounds
• Movement of the diaphragm
• Auscultating the chest
• Preparing to auscultate
• Be firm
• What a change means
• Interpreting what you hear
• The next step
• Vocal fremitus
• Abnormal findings
• Chest abnormalities
• Abnormal respiratory patterns
• Abnormal breath sounds
• Quick quiz
• Scoring
• Suggested references
• 3 Diagnostic procedures
• Understanding respiratory diagnostic procedures
• Blood studies
• Arterial blood gas analysis
• Respiratory/metabolic systems
• Calling interference
• White blood cell count
• Interpreting elevated WBCs
• White blood cell differential
• The lowdown on eosinophils
• Sputum and pleural fluid studies
• Sputum analysis
• Normal flora
• Pathogenic organisms
• Obtaining the sputum culture
• Obtaining tracheal specimens
• Obtaining bronchial specimens
• Nasopharyngeal culture
• Nasopharyngeal flora
• Inspecting the nasopharynx
• Lab results
• Throat culture
• Possible pathogens
• Throat culture technique
• Delivery to the lab
• Endoscopic and imaging tests
• Bronchoscopy
• Complications
• Chest X-ray
• Fluoroscopy
• Diminished excursion
• Mediastinoscopy
• Magnetic resonance imaging
• Pulmonary angiography
• Thoracic computed tomography scan
• Thoracoscopy
• Ventilation–perfusion scan
• Technetium
• 133Xe gas
• Biopsies
• Lung biopsy
• Easy access
• What it all means
• Sedation
• Warning signals
• Pleural biopsy
• Specimen treatment
• After care
• Other diagnostic tests
• Pulmonary function tests
• Measuring volumes
• Calculating capacity
• Pulse oximetry
• Thoracentesis
• Interpreting the results
• Quick quiz
• Scoring
• Suggested references
• 4 Treatment
• Understanding respiratory treatments
• Drug therapy
• Respiratory drug classes
• Aerosol anti-infectives
• Aerosolized anti-infectives
• Pentamidine to prevent PCP
• Recommend ribavirin for RSV
• Treat with tobramycin
• Influenza and zanamivir
• Antitussives
• Part of the act
• Serious use
• Put to the test
• Beta2-adrenergic agonists
• Short-acting
• Long-acting
• Corticosteroids
• Reversing obstruction
• Systemic formulas
• Dosaging
• Inhaled steroids
• Decongestants
• Expectorants
• Leukotriene receptor antagonists
• Mechanism of action
• Mast cell stabilizers
• Mechanism of action
• Mucolytics
• Xanthines
• Mechanism of action
• Considerations
• Too much of a good thing
• Inhalation therapy
• Continuous positive airway pressure
• Indications
• Nasal CPAP
• Adverse effects
• Endotracheal intubation
• Drawbacks
• Oral tracheal intubation
• Contraindication
• Nasal intubation
• Difficult and damaging
• End-tidal carbon dioxide monitoring
• Lightening
• Evaluating the numbers
• Handheld oropharyngeal inhalers
• Compact, portable, and easy
• Powder form
• Flow triggered
• Spacers
• Turbo-inhalers
• The Diskus
• Incentive spirometry
• Mechanical ventilation
• Types of mechanical ventilation
• Programmed mechanical ventilation
• Synchronized intermittent mandatory ventilation
• Steps for caring for the ventilator patient
• Other steps
• Nebulizer therapy
• Types of nebulizers
• Oxygen therapy
• Fully equipped
• Compare and contrast
• Check those valves
• Take a deep breath and cough
• Home oxygen
• Surgery
• Chest tube insertion
• Lung transplantation
• Criteria
• Contraindications
• Major complications
• Assessment
• Thoracotomy
• Pneumonectomy
• Lobectomy
• Segmental and wedge resections
• Tracheotomy
• Miscellaneous treatments
• Chest physiotherapy
• Extracorporeal membrane oxygenation
• Arterial catheters
• Venous catheter
• Oozing observations
• Mucus clearance device
• Prone positioning
• Diaphragmatic movement
• Size matters
• Eye care
• Safety
• Monitoring response
• Quick quiz
• Scoring
• Suggested references
• 5 Infection and inflammation
• Understanding respiratory infection and inflammation
• BOOP, idiopathic
• The history of BOOP
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Assessment and teaching
• Bronchiectasis
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Croup
• Incidence
• What causes it
• How it happens
• What to look for
• Acute spasmodic laryngitis
• What tests tell you
• How it’s treated
• Treating airway swelling
• What to do
• Nursing considerations
• Parent teaching
• Epiglottiditis
• What causes it
• How it happens
• What to look for
• Sit up, lean forward
• What tests tell you
• Airway management
• How it’s treated
• What to do
• Anticipation
• Laryngitis
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Pharyngitis
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• Hot versus cold
• What to do
• Humidification
• Pneumonia
• What’s your type?
• Community acquired
• Nosocomial
• Aspiration pneumonia
• Those at risk
• What causes it
• How it happens
• What to look for
• Sounds, sights, and sensations
• What tests tell you
• How it’s treated
• More oxygen, please
• Add-ons
• What to do
• Get comfortable
• Pregnancy precautions
• Respiratory syncytial virus
• Seasonal cause
• Complications
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Tonsillitis
• What causes it
• How it happens
• What to look for
• Blocked and constricted
• What tests tell you
• How it’s treated
• What to do
• Tuberculosis
• Typical TB
• What causes it
• Dormant disease
• Elderly risks
• Complications
• How it happens
• What to look for
• What tests tell you
• Sampling the skin
• How it’s treated
• First line of defense
• What to do
• Precautions
• Adverse effects
• Color concerns
• Quick quiz
• Scoring
• Suggested references
• 6 Obstructive disorders
• Understanding obstructive disorders
• Asthma
• Making things worse
• What causes it
• Outside and sensitive
• A look within
• Workplace triggers
• Genetic influences
• How it happens
• What to look for
• Typical symptoms
• Oxygen deprivation
• Chest contour
• Auscultation
• What tests tell you
• How it’s treated
• What to do
• Humidification
• Preventing complications
• Chronic bronchitis
• What causes it
• How it happens
• Cellular changes
• Inflammation and obstruction
• Secondary changes
• Altered hemoglobin
• What to look for
• C3—Cough, cyanosis, compensation
• Right-sided failure
• What tests tell you
• How it’s treated
• What to do
• Cystic fibrosis
• What causes it
• How it happens
• Symptom sources
• What to look for
• Telltale symptoms
• Meconium conundrum
• Common in kids
• Pancreatic prognosis
• What tests tell you
• Further diagnostic testing
• How it’s treated
• The alfa aerosol
• New approaches
• What to do
• Not small adults
• Emphysema
• What causes it
• How it happens
• Altered lung compliance
• Altered circulation
• Alveolar airway and collapse
• Air trapping
• Complications
• What to look for
• Inspect, palpate, percuss, auscultate
• What tests tell you
• How it’s treated
• What to do
• Sleep apnea
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• Bilevel positive airway pressure
• What to do
• Quick quiz
• Scoring
• Suggested references
• 7 Restrictive disorders
• Understanding restrictive disorders
• Acute respiratory distress syndrome
• What causes it
• How it happens
• Inflammation—it’s such a follower
• Decreased gas exchange
• Ventilation prevention
• Shunting
• Responses to fluid buildup
• Alkalosis
• What to look for
• What tests tell you
• How it’s treated
• More meds
• What to do
• Treatment
• Acute respiratory failure
• What causes it
• How it happens
• What to look for
• Respiratory compensation
• Cardiac response
• CNS response
• What tests tell you
• How it’s treated
• Oxygenate
• Intubate and ventilate
• Opening the airways
• What to do
• Maintain and administer
• Nutrition and safety
• Follow up care
• Asbestosis
• What causes it
• How it happens
• What to look for
• Inspect and auscultate
• What tests tell you
• How it’s treated
• Aerosol therapy
• Cor pulmonale
• What to do
• Atelectasis
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Bronchopulmonary dysplasia
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Idiopathic pulmonary fibrosis
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• RDS of the neonate
• What causes it
• How it happens
• Collapse, hypoxia, injury
• Decreases, increases, shunts
• What to look for
• It gets worse . . .
• . . . And complicated
• What tests tell you
• How it’s treated
• What to do
• Prescribing PEEP
• Sarcoidosis
• What causes it
• How it happens
• What to look for
• Inspection of the eye and skin
• Palpate and auscultate
• What tests tell you
• Diagnostic support group
• How it’s treated
• What to do
• Silicosis
• What causes it
• How it happens
• Alveolar macrophages
• What to look for
• What tests tell you
• How it’s treated
• Fluid intake
• What to do
• Quick quiz
• Scoring
• Suggested references
• 8 Vascular lung disorders
• Understanding vascular lung disorders
• Cor pulmonale
• What causes it
• Common causes
• How it happens
• In the red
• Obstruction and constriction
• Compensatory mechanism
• What to look for
• Progressive symptoms
• What tests tell you
• How it’s treated
• What to do
• Pulmonary edema
• What causes it
• How it happens
• Hydrostatic force
• Result of capillary injury
• What to look for
• Inspection
• Palpation
• What’s more
• What tests tell you
• How it’s treated
• Ventilate, dilate, and mobilize
• Positive inotropic agents
• Arrhythmias
• Morphine effect
• What to do
• Pulmonary embolism
• What causes it
• How it happens
• Collapse, atelectasis, death
• Rare but serious
• What to look for
• Less common signs
• What tests tell you
• How it’s treated
• Shock
• Septic emboli
• Indications for surgery
• What to do
• Pulmonary hypertension
• What causes it
• Secondary causes
• How it happens
• Alveolar hypoventilation
• Valves, ventricles, and vascular obstruction
• Primary cardiac disease
• What to look for
• Look, touch, and listen
• What tests tell you
• How it’s treated
• Drug choices
• What to do
• Quick quiz
• Scoring
• Suggested references
• 9 Traumatic injuries
• Understanding traumatic injuries
• Blunt chest injury
• What causes it
• How it happens
• What to look for
• Rib fractures
• Common flail chest symptoms
• What tests tell you
• How it’s treated
• What to do
• Pneumothorax
• Semi-Fowler’s position
• Treating hemothorax
• Colloids for contusions
• Cardiac consideration
• Tension and rupture
• Penetrating chest injury
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• Hemorrhage, shock, hypotension
• What to do
• Pneumothorax
• What causes it
• How it happens
• What to look for
• Every breath hurts
• Further findings
• Did we mention the tension?
• What tests tell you
• How it’s treated
• With trauma
• With less lung collapse
• With more lung collapse
• With tension
• What to do
• Inhalation injury
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Quick quiz
• Scoring
• Suggested references
• 10 Neoplastic disorders
• Understanding neoplastic disorders
• Laryngeal cancer
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Pre-operative laryngectomy care
• Partial laryngectomy post-operative care
• Total laryngectomy post-operative care
• Lung cancer
• What causes it
• How it happens
• What to look for
• Other affected systems
• Metastatic S&S
• What tests tell you
• More tests
• How it’s treated
• What to do
• Preop
• Postop
• All together now
• High-risk teaching
• Quick quiz
• Scoring
• Suggested references
• 11 Respiratory emergencies
• Understanding respiratory emergencies
• Airway obstruction
• What causes it
• It’s anatomic
• How it happens
• How low can you go?
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Anaphylaxis
• What causes it
• How it happens
• Exposure
• In the system
• What tests tell you
• How it’s treated
• What to do
• After Care
• Preventing future attacks
• Asphyxia
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Bronchospasm
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• Asthma chronicles
• ’Tis the season
• What to do
• Wheezing
• Submersion injury
• What causes it
• Types of submersion injuries
• How it happens
• Effects of saltwater aspiration
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Respiratory arrest
• What causes it
• How it happens
• Secondary respiration arrest
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Respiratory depression
• What causes it
• How it happens
• What to look for
• What tests tell you
• How it’s treated
• What to do
• Listen and look
• Sudden unexplained infant death/sudden infant death syndrome
• Positive decline
• Increased incidence
• That time of year?
• What causes it
• How it happens
• Start from the beginning
• Other signs
• What to do
• Go to the info
• Brief resolved unexplained events in infants—formerly known as apparent life-threatening event
• Exams and Tests
• Treatment
• Outlook (Prognosis)
• Quick quiz
• Scoring
• Suggested references
• Appendices and index
• Glossary
• Quick-reference guide to laboratory tests
• Index