Common Respiratory Disorders in Primary Care
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...& more SELF-TEST Respiratory system challenge Test your knowledge with this quick quiz. 1. Gas exchange takes place in the 8. Which continuous breath sounds are 14. Wheezes most commonly suggest a. pharynx. c. alveoli. relatively high pitched with a hissing a. secretions in large airways. b. larynx. d. trachea. or shrill quality? b. abnormal lung tissue. a. coarse crackles c. wheezes c. airless lung areas. 2. The area between the lungs is b. rhonchi d. fine crackles d. narrowed airways. known as the a. thoracic cage. c. pleura. 9. Normal breath sounds heard over 15. Which of the following indicates a b. mediastinum. d. hilum. most of both lungs are described as partial obstruction of the larynx or being trachea and demands immediate 3. Involuntary breathing is controlled by a. loud. c. very loud. attention? a. the pulmonary arterioles. b. intermediate. d. soft. a. rhonchi c. pleural rub b. the bronchioles. b. stridor d. mediastinal crunch c. the alveolar capillary network. 10. Bronchial breath sounds are d. neurons located in the medulla and normally heard 16. Which of the following would you pons. a. over most of both lungs. expect to find over the involved area b. between the scapulae. in a patient with lobar pneumonia? 4. The sternal angle is also known as c. over the manubrium. a. vesicular breath sounds the d. over the trachea in the neck. b. egophony a. suprasternal notch. c. scapula. c. decreased tactile fremitus b. xiphoid process. d. angle of Louis. 11. Which is correct about vesicular d. muffled and indistinct transmitted voice breath sounds? sounds 5. -
Acute (Serious) Bronchitis
Acute (serious) Bronchitis This is an infection of the air tubes that go down to your lungs. It often follows a cold or the flu. Most people do not need treatment for this. The infection normally goes away in 7-10 days. We make every effort to make sure the information is correct (right). However, we cannot be responsible for any actions as a result of using this information. Getting Acute Bronchitis How the lungs work Your lungs are like two large sponges filled with tubes. As you breathe in, you suck oxygen through your nose and mouth into a tube in your neck. Bacteria and viruses in the air can travel into your lungs. Normally, this does not cause a problem as your body kills the bacteria, or viruses. However, sometimes infection can get through. If you smoke or if you have had another illness, infections are more likely to get through. Acute Bronchitis Acute bronchitis is when the large airways (breathing tubes) to the lungs get inflamed (swollen and sore). The infection makes the airways swell and you get a build up of phlegm (thick mucus). Coughing is a way of getting the phlegm out of your airways. The cough can sometimes last for up to 3 weeks. Acute Bronchitis usually goes away on its own and does not need treatment. We make every effort to make sure the information is correct (right). However, we cannot be responsible for any actions as a result of using this information. Symptoms (feelings that show you may have the illness) Symptoms of Acute Bronchitis include: • A chesty cough • Coughing up mucus, which is usually yellow, or green • Breathlessness when doing more energetic activities • Wheeziness • Dry mouth • High temperature • Headache • Loss of appetite The cough usually lasts between 7-10 days. -
Octreotide Treatment of Idiopathic Pulmonary Fibrosis: a Proof-Of-Concept Study
drugs, while two patients underwent surgery in addition to Roncaccio 16, 21049, Tradate, Italy. E-mail: giovannibattista. chemotherapy. [email protected] As in other reference centres, the E. Morelli Hospital needs to transfer out all admitted cases to the hospitals referring them for Support Statement: This study was supported by the current specialised treatment, when culture conversion and clinical research funds of the participating institutions. For this stability have been achieved. Patients were transferred out after publication, the research leading to these results has received a median (IQR) hospital stay of 75.5 (51.5–127.5) days; 12 (100%) funding from the European Community’s Seventh Framework out of 12 and nine (75%) out of 12 achieved sputum-smear and Programme (FP7/2007-2013) under grant agreement FP7- culture conversion, after a median (IQR) time of 40.5 (24–64) and 223681. 70 (44–95) days, respectively. As of June 2011, one patient was cured, two had died and nine were still under treatment. Statement of Interest: None declared. Four (33.3%) cases reported adverse events, two being major (16.7%; neuropathy and low platelet count, needing temporary REFERENCES interruption of linezolid) and two minor (neuropathy and mild 1 Villar M, Sotgiu G, D’Ambrosio L, et al. Linezolid safety, anaemia). All adverse events were reversible. tolerability and efficacy to treat multidrug- and extensively drug-resistant tuberculosis. Eur Respir J 2011; 38: 730–733. In conclusion, despite the intrinsic difficulty of evaluating the 2 World Health Organization. Multidrug and extensively drug safety and tolerability of linezolid (administered within different resistant TB (M/XDR-TB): 2010 global report on surveillance and regimens including multiple anti-TB drugs guided by drug response. -
Auscultation 4
Post-Acute COVID-19 Exercise & Rehabilitation (PACER) Project Cardiovascular and Pulmonary Examination By: Morgan Johanson, PT, MSPT, Board Certified Cardiovascular and Pulmonary Specialist Disclaimer • This course is intended for educational purposes and does not replace mentorship or consultation with more experienced cardiopulmonary colleagues. • This content is current at time of dissemination, however, realize that evidence and science on COVID19 is revolving rapidly and information is subject to change. Introduction and Disclosures • Morgan Johanson has no conflicts of interest or financial gains to disclose for this continuing education course • Course faculty: Morgan Johanson, PT, MSPT, Board Certified Cardiovascular and Pulmonary Specialist – President of Good Heart Education, a continuing education company providing live and online Cardiovascular and Pulmonary Therapy and Rehabilitation training and mentoring services for Physical Therapist studying for the ABPTS Cardiovascular and Pulmonary Specialty (CCS) Examination. – Adjunct Faculty Member, University of Toledo, Ohio – Practicing at Grand Traverse Pavilions SNF in Traverse City, MI – Professional Development Chair, CVP Section of the APTA Disclosures • Any pictures contained in the course that are not owned by Morgan Johanson were obtained via Google internet search engine and are references on the corresponding slide. Morgan Johanson does not claim ownership or rights to this material, it is being used for education purposes only and will not be reprinted or copied (so -
Johns Hopkins School of Nursing BURPS List
1 Welcome to the School of Nursing at the Johns Hopkins University! As a faculty who coordinates one of your first semester courses I am making available to you some helpful and useful information. I have included it below for your reading pleasure! There are two documents: the “B.U.R.P.S.” list (Building and Understanding Roots, Prefixes and Suffixes) and Talk like a Nurse. This document lists many (not all) of the medical terms used in your first semester classes and I believe will ease your transition into a new way of speaking. THE B.U.R.P.S LIST Purpose: To become proficient in Building and Understanding Roots, Prefixes and Suffixes Rationale: Building and understanding medical terminology is simpler when the words are broken down into roots, prefixes and suffixes. Steps: Review the B.U.R.P.S. tables and try to determine the definitions of the examples Notice the overlap among the three groups of roots, prefixes and suffixes Make new words by changing one part of the word. For example, if an appendectomy is the removal of the appendix, then a nephrectomy is the removal of a kidney. Tachycardia is a fast heart rate and tachypnea is a fast respiration rate. Helpful Note: R/T means “related to” TALK LIKE A NURSE Purpose: To become familiar with acronyms commonly used by health care providers Rationale: Different professions have unique languages; medicine and nursing are no exceptions. The acronyms below are used in verbal and written communication in health care settings. Steps: Review the attached list of acronyms (then you can start to critique shows like “House” and “Gray’s Anatomy” for accuracy!) Notice that some acronyms have two different meanings; e.g., ROM stands for “range of motion” and “rupture of membranes” - be careful when using abbreviations Take the Self Assessment after reading the approved terms, found in Blackboard NOTE: All institutions have a list of accepted and “do not use” abbreviations. -
Bronchitis) 2013 Update
Care Process Model DECEMBER 2013 DIAGNOSIS AND MANAGEMENT OF Acute Cough (Bronchitis) 2013 update This care process model (CPM) is produced by Intermountain Healthcare’s Lower Respiratory Tract Infection Team, a workgroup of the Primary Care Clinical Program. The CPM provides best-practice recommendations for differential IN THIS UPDATE? diagnosis and management of acute cough and bronchitis. WHAT’S NEW Germ Watch is available at • New data showing an upward trend in unnecessary KEY POINTS intermountainphysician.org use of antibiotics for treatment of acute bronchitis — • Diagnosis of acute bronchitis should be made only after ruling reinforcing our need to do better! out other sources of cough — including pneumonia, asthma, influenza, pertussis, • Updated information on sinusitis, and acute exacerbations of chronic bronchitis (AECB). 1 The algorithm on pages 2 and 3 influenza, and pertussis testing and treatment, guides that evaluation and diagnostic process. Local infection surveillance programs such as with links to more information. Germ Watch can provide up-to-date information about communicable diseases that routinely • Summary of evidence base for symptom affect our communities. relief of acute cough (see ACUTE BRONCHITIS • If acute bronchitis is the diagnosis, antibiotics are TREATMENT RECOMMENDATIONS box inside). Unnecessary Antibiotic Use NOT the answer! Despite ongoing evidence that antibiotics • New and revised provider and patient NOT are needed for acute bronchitis, latest data show that their % of adults with acute bronchitis who received an antibiotic education materials to support physicians in prescription within 3 days of office visit (based on SelectHealth data) use is actually increasing. SelectHealth rates rose from 70% in differential diagnosis and evidence-based treatment 2008 to nearly 75% in 2010 (see graph at right), which mirrors 76 74.87% of acute cough (bronchitis) and related illnesses. -
Bronchitis, Acute Chest Cold/ Bronchiolitis
SCHOOL HEALTH/ CHILDCARE PROVIDER BRONCHITIS, ACUTE CHEST COLD/ BRONCHIOLITIS Bronchitis and bronchiolitis are respiratory conditions that tend to occur more often in the fall and winter months. When infants and young children experience common respiratory viruses and are exposed to secondhand tobacco smoke, they are at risk of developing bronchiolitis, bronchitis, pneumonia, and middle ear infections. CAUSE Many different viruses, such as respiratory syncytial virus (RSV), parainfluenza, influenza, and adenoviruses; Mycoplasma pneumoniae; and some bacteria. Most of these organisms can cause other illnesses and not all persons exposed to the same organism will develop bronchitis or bronchiolitis. SYMPTOMS Usually starts with a runny nose, fever, and a dry, harsh cough that becomes looser as the illness progresses. Older children may cough up green or yellow sputum. Sore throat can occur in some cases. It may take 1 to 2 weeks for the cough to stop. SPREAD Respiratory viruses and bacteria are spread when an infected person coughs or sneezes tiny droplets into the air, and another person breathes them in. Also can be spread by touching the secretions from the nose and mouth of an infected person or by touching hands, tissues, or other items soiled with these secretions and then touching one’s eyes, nose, or mouth. INCUBATION Depends upon the organism that is causing illness. CONTAGIOUS Until shortly before symptoms begin and for the duration of acute symptoms. PERIOD EXCLUSION Childcare and School: Until fever is gone without the aid of fever reducing medication and the child is well enough to participate in routine activities. DIAGNOSIS Recommend parents/guardians call their health care provider if their child has a high fever, persistent sore throat, or persistent cough. -
Gas Exchange and Respiratory Function
LWBK330-4183G-c21_p484-516.qxd 23/07/2009 02:09 PM Page 484 Aptara Gas Exchange and 5 Respiratory Function Applying Concepts From NANDA, NIC, • Case Study and NOC A Patient With Impaired Cough Reflex Mrs. Lewis, age 77 years, is admitted to the hospital for left lower lobe pneumonia. Her vital signs are: Temp 100.6°F; HR 90 and regular; B/P: 142/74; Resp. 28. She has a weak cough, diminished breath sounds over the lower left lung field, and coarse rhonchi over the midtracheal area. She can expectorate some sputum, which is thick and grayish green. She has a history of stroke. Secondary to the stroke she has impaired gag and cough reflexes and mild weakness of her left side. She is allowed food and fluids because she can swallow safely if she uses the chin-tuck maneuver. Visit thePoint to view a concept map that illustrates the relationships that exist between the nursing diagnoses, interventions, and outcomes for the patient’s clinical problems. LWBK330-4183G-c21_p484-516.qxd 23/07/2009 02:09 PM Page 485 Aptara Nursing Classifications and Languages NANDA NIC NOC NURSING DIAGNOSES NURSING INTERVENTIONS NURSING OUTCOMES INEFFECTIVE AIRWAY CLEARANCE— RESPIRATORY MONITORING— Return to functional baseline sta- Inability to clear secretions or ob- Collection and analysis of patient tus, stabilization of, or structions from the respiratory data to ensure airway patency improvement in: tract to maintain a clear airway and adequate gas exchange RESPIRATORY STATUS: AIRWAY PATENCY—Extent to which the tracheobronchial passages remain open IMPAIRED GAS -
Chest Auscultation: Presence/Absence and Equality of Normal/Abnormal and Adventitious Breath Sounds and Heart Sounds A
Northwest Community EMS System Continuing Education: January 2012 RESPIRATORY ASSESSMENT Independent Study Materials Connie J. Mattera, M.S., R.N., EMT-P COGNITIVE OBJECTIVES Upon completion of the class, independent study materials and post-test question bank, each participant will independently do the following with a degree of accuracy that meets or exceeds the standards established for their scope of practice: 1. Integrate complex knowledge of pulmonary anatomy, physiology, & pathophysiology to sequence the steps of an organized physical exam using four maneuvers of assessment (inspection, palpation, percussion, and auscultation) and appropriate technique for patients of all ages. (National EMS Education Standards) 2. Integrate assessment findings in pts who present w/ respiratory distress to form an accurate field impression. This includes developing a list of differential diagnoses using higher order thinking and critical reasoning. (National EMS Education Standards) 3. Describe the signs and symptoms of compromised ventilations/inadequate gas exchange. 4. Recognize the three immediate life-threatening thoracic injuries that must be detected and resuscitated during the “B” portion of the primary assessment. 5. Explain the difference between pulse oximetry and capnography monitoring and the type of information that can be obtained from each of them. 6. Compare and contrast those patients who need supplemental oxygen and those that would be harmed by hyperoxia, giving an explanation of the risks associated with each. 7. Select the correct oxygen delivery device and liter flow to support ventilations and oxygenation in a patient with ventilatory distress, impaired gas exchange or ineffective breathing patterns including those patients who benefit from CPAP. 8. Explain the components to obtain when assessing a patient history using SAMPLE and OPQRST. -
Community-Acquired Pneumonia in Adults: Diagnostic Reliability of Physical Examination Techniques and Their Teaching in Academia
James Madison University JMU Scholarly Commons Physician Assistant Capstones The Graduate School Fall 12-14-2018 Community-acquired pneumonia in adults: Diagnostic reliability of physical examination techniques and their teaching in academia Amber Tordoff James Madison University Lauren A. Williams James Madison University Follow this and additional works at: https://commons.lib.jmu.edu/pacapstones Part of the Bacteria Commons, Bacterial Infections and Mycoses Commons, Diagnosis Commons, Investigative Techniques Commons, Medical Pathology Commons, Respiratory Tract Diseases Commons, Virus Diseases Commons, and the Viruses Commons Recommended Citation Tordoff AL, Williams LA. Community-Acquired Pneumonia in Adults: Diagnostic Reliability of Physical Examination Techniques and their Teaching in Academia. JMU Scholarly Commons Physician Assistant Capstones. https://commons.lib.jmu.edu/pacapstones/44/. Published December 12, 2018. This Presentation is brought to you for free and open access by the The Graduate School at JMU Scholarly Commons. It has been accepted for inclusion in Physician Assistant Capstones by an authorized administrator of JMU Scholarly Commons. For more information, please contact [email protected]. Community-Acquired Pneumonia in Adults: Diagnostic Reliability of Physical Examination Techniques and their Teaching in Academia Amber Tordoff, PA-S and Lauren Williams, PA-S, James Madison University, Harrisonburg, Virginia _____________________________________________________________________________________ ABSTRACT Background: -
Antibiotic Prescribing for Acute Bronchitis: How Low Can We Go?
J Am Board Fam Pract: first published as 10.3122/15572625-13-6-462 on 1 November 2000. Downloaded from Antibiotic Prescribing for Acute Bronchitis: How Low Can We Go? By the time I graduated from medical school in of that wise philosopher Pogo, "We have seen the 1975, I had learned that most respiratory tract enemy, and he is us." infections in otherwise healthy children and adults No doubt, we can do better. Several investiga were caused by viruses, such as parainfiuenza, in tors have described successful methods of reducing fluenza, adenovirus, and respiratory syncytial virus. antibiotic use for respiratory tract infections. This learning was reinforced during my family Gonzales et al2 found that combined patient and practice residency training in Charleston, Se. I was clinician education was effective in reducing anti taught that the challenge of primary care practice is biotic use for acute bronchitis from 74% to 48% in to distinguish the many patients with benign, self a health maintenance organization setting. Using a limited respiratory tract infections from those pa quality improvement approach and a computer tients who are more seriously ill with bacterial based patient record in an academic family practice pneumonia and who need an antibiotic to recover setting, Ornstein and colleagues3 reduced antibi more quickly and more certainly. Anned with this otic prescribing for acute bronchitis from 60% to scientific knowledge, I marched valiantly into prac less than 30%. tice, determined to base my prescribing on good These and other initiatives show that it is pos science. It was only in rural practice that I clearly sible to reduce use of antibiotics for acute respira recall regularly confronting syndromes called tory tract infections, but how low can we go? The 4 "acute bronchitis" and "sinusitis," for which pa report by Hueston et al in this issue of the JABFP suggests that, for patients with the diagnosis of tients seemed to expect an antibiotic and for which acute bronchitis, the answer might not be 0%. -
ACOI Board Review Course Bronchitis, Pneumonia and TB
ACOI Board Review Course Bronchitis, Pneumonia and TB MarkAlain Déry, DO, MPH, FACOI Chief Innovation Officer Medical Director of HIV and Hepatitis Services Access Health Louisiana; FQHC Medical Director AIDS Educational Training Center (AETC) Medical Director Southern Center for Health Equities Executive Director; 102.3FM WHIV-LP Human Rights and Social Justice Radio [email protected] Disclosures Objectives At the conclusion of this section, participants; Will recognize the common clinical features of community acquired pneumonia include cough, fever, pleuritic chest pain, dyspnea, and sputum production. Will comprehend that most initial treatment regimens for community-acquired pneumonia are empiric and that a local epidemiology, travel history, and other epidemiologic and clinical clues should be considered when selecting an empiric regimen. At the end of the presentation the attendee will recognize that pulmonary complications of TB include hemoptysis, pneumothorax, bronchiectasis, extensive pulmonary destruction (including pulmonary gangrene), malignancy, venous thromboembolism, and chronic pulmonary aspergillosis. Dr. Derys’ Rule’s for the Boards MEMORIZE; Topics that save lives. Topics that prevent morbidity and mortality. Bronchitis, Pneumonia and TB; Acute Bronchitis- Pathogens Acute Bronchitis PATHOGENS; Viruses: most common • Rhinovirus • Parainfluenza virus • Coronavirus • Respiratory syncytial virus (RSV) • Influenza: the only realistically treatable virus • Common non-infectious offenders: allergens, smoke/smoking, toxic