RESPIRATORY DISEASES

CHRONIC BRONCHITIS Chronic bronchitis - chronic inflammation and excessive production of mucous in the bronchi. Too much thick mucous in the bronchi is difficult to cough up. Therefore there is poor O 2 exchange within the lungs. For it to be considered chronic bronchitis, you have to have a productive cough that persists for at least 3 months of the yr, for at least 2 consecutive yrs.

CHRONIC BRONCHITIS SYMPTOMS Coughing (the first and most common symptom) Dyspnea -- even at rest RISK FACTORS smoking - almost always present Chronic infection Age Long term exposure to chemical fumes Tx Bronchodilators Antibitoics Oxygen therapy

CHRONIC BRONCHITIS

EMPHYSEMA Emphysema - a condition of the lungs characterized by abnormal, permanent enlargement of the alveoli. The disease is progressive. Alveoli lose elasticity, so they do not expand and shrink normally, therefore air gets trapped in the spaces and there is poor oxygen exchange. You will notice the "barrel chest" with some emphysema patients.

EMPHYSEMA

EMPHYSEMA

EMPHYSEMA SYMPTOMS Dyspnea Minimal coughing Wheezing Fatigue SOB RISK FACTORS Smoking Infection Age Pollution Dx CXR CT of chest Arterial blood gas Pulmonary function tests Tx Bronchodilators O 2 therapy Quit smoking

EMPHYSEMA

COPD Chronic Obstructive Pulmonary Disease (COPD) - is a disease state characterized by the presence of airflow obstruction caused by chronic bronchitis, emphysema or a combination of both. It is a progressive chronic lung disorder that obstructs the airways. More than 1/2 of COPD pt's die within 10 yrs of being dx At least 714,000 Canadians have been dx c COPD

COPD

COPD CAUSES/RISK FACTORS Smoking is the most common cause (90%) Second hand smoke Also caused by long term exposure to chemical fumes or dust Asthma Infections SYMPTOMS SOB ↑ mucous & coughing wheezing fatigue

COPD Dx Same as emphysema Tx *QUIT SMOKING* bronchodilators oxygen therapy increased fluid intake fast tx of RTI prevent exacerbations

PNEUMONIA P neumonia is an acute inflammation/infection of the lung tissue 200,000 to 300,000 Canadians develop pneumonia each yr. CAUSES Pneumonia can be caused by: Bacteria Virus Fungi Chemicals As the lungs become inflamed, pus, secretions and liquids build up in the alveoli, which weakens the distribution of oxygen to the blood. When your SpO 2 drops too severely, cells cease functioning normally and they can even die.

PNEUMONIA Risk Factors immobility smoking diabetes decrease consciousness leukemia alcoholism intubation air pollution aspiration

PNEUMONIA SIGNS & SYMPTOMS Pneumonia signs & symptoms come very quickly and include: shaking*fatigue fever*chest pain cyanosis*tachycardia chills productive cough (purulent sputum)

PNEUMONIA

PNEUMONIA Pneumonia can be “typical”: caused by streptococcus pneumoniae or “atypical”: caused by mycoplasm pneumoniae, legionella pneumophila or chlamydia pneumoniae Pneumonia can affect a whole lobe of the lung (lobal pneumonia) or the bronchioles and alveoli (bronchiole pneumonia) In hospital all new pneumonia admissions are put into isolation to rule out SARS Pneumonia is dx by a CXR and bloodwork

PNEUMONIA

PNEUMONIA Tx Antibiotics Proper diet (at least 1500 cal/day) Increased fluids (at least 3L/day) IV therapy may be used Oxygen therapy Bronchodilators Chest physio Sitting upright (fowler's & semi-fowlers position may help c breathing) There is a vaccine for pneumonia – for those >65 and special conditions

INFLUENZA

INFLUENZA Influenza: (flu) is a respiratory infection caused by a virus The flu causes significant morbidity and mortality rates. Flu season in Canada is November to May. Influenza is highly contagious. Influenza changes over time - which accounts for the ability to cause widespread disease. Influenza can lead to pneumonia

INFLUENZA CAUSES The flu is spread by droplet transmission. You can transmit the flu before you know you have it. SYMPTOMS Onset is usually sudden headache*fatigue*muscle aches chills*fever*runny nose cough*anorexia*sore throat Recovery is usually takes 1-2 weeks

INFLUENZA WHO IS AT RISK? 65 and older residents of LTC Children 2 and younger chronic diseases lung or heart disease immuno-suppressed caregivers *EVERYONE AT RISK SHOULD GET A FLU SHOT*

INFLUENZA Tx fluids meds to reduce symptoms rest antiviral drugs (They will shorten symptoms by about 1.5 days if given within 2 days of symptoms starting, and by 3 days if given within 12 hours of the start of symptoms).

ASTHMA To be done independently Pg 530 in textbook Definition Signs & Symptoms Causes Tx