Medical Surgical Nursing Module 15

RESPIRATORY DISORDERS
WILFREDO D. QUIJENCIO JR. MD RN RM MAN

OXYGENATION (Respiratory)
PRINCIPLES in OXYGENATION
➢ To maintain oxygenation, the body requires a

constant supply of O2 and CO2.
➢ Oxygenation may be impaired when airways are

affected by airway obstruction.
➢ Oxygenation may be impaired when the

respiratory system is affected by disease,
resulting in damage to lung function.
➢ Oxygen therapy is necessary to restore

oxygenation when oxygenation is impaired.
RESPIRATORY 3
DISORDERS (WDQ)
RESPIRATORY 4
DISORDERS (WDQ)
RESPIRATION
•process that enables the exchange of O2 and CO2
Anatomy of the
Respiratoty System
1. Upper Airway
nose → oropharynx
2. Lower Airway
larynx → alveolus
RESPIRATORY 5
DISORDERS (WDQ)
PROCESSES INVOLVED IN RESPIRATION
❑ VENTILATION or BREATHING
✓ inspiration and expiration
✓ movement of air in and out of the lungs
❑ DIFFUSION or GAS EXCHANGE

✓ movement of gases between air [alveoli]
and blood in the pulmonary capillaries
❑ PERFUSION or CIRCULATION or BLOODFLOW

✓ transport of O2 and CO2 in the blood &
body fluids to the cells
RESPIRATORY 6
DISORDERS (WDQ)
REGULATION OF RESPIRATION
Respiratory Centers
❑ Medulla
✓ primary respiratory center
✓ Spontaneous rhythmic pattern
✓ affects both rate & depth
❑ Cerebral cortex
✓ voluntary breathing
❑ Pons
✓ involuntary breathing
❑ Hering Breuer reflexes
✓ stretch receptors in the lungs
RESPIRATORY 7
DISORDERS (WDQ)
REGULATION OF RESPIRATION
Humoral Regulation (Chemical)
❑ Central chemoreceptors
✓ directly (+) by  H+ in the CSF
✓  PCO2 → rapid  H+ in the CSF
✓ located at the medulla oblongata
❑ Peripheral chemoreceptors
✓ located at the carotid body & at the
aortic arch
✓ aortic arch → brain [via vagus nerve]
✓ carotid body → brain [via
glossopharyngel
nerve]
✓ primarily respond quickly to a  PO2 [<50
RESPIRATORY mm HG] 8
DISORDERS (WDQ)
FACTORS INFLUENCING RESPIRATION
❑ BP changes:  BP =  RR
❑ Body temperature changes:  temp =  RR
❑ Drugs: depressants  RR
❑ Age: decreases with age
✓ Neonate [35-60/min]
✓ Infant [44/min]
✓ Child 5 yrs [20-25/min]
✓ Adolescent 10-14yrs [17-22/min]
15yrs [20/min]
✓ Adult [16-20/min]
✓ older adult [12-16/min]
RESPIRATORY 9
DISORDERS (WDQ)
NURSING ASSESSMENT
1. Respiration [breathing patterns]

❑ Eupnea
❑ Tachypnea
❑ Bradypnea
❑ Dyspnea
❑ Apnea
❑ Orthopnea
❑ Biot’s
❑ Cheyne Stokes
❑ Kussmaul
❑ Paroxysmal nocturnal dyspnea
RESPIRATORY 10
DISORDERS (WDQ)
NURSING ASSESSMENT
2. Cough and secretions

❑ Cough
✓ Protective mechanism used to keep
tracheobronchial tree free of secretions
✓ Common symptom of respiratory disease
✓ Hacking, croupy, rattling, whooping,
barking
❑ Sputum
✓ Substance ejected from the lungs by
coughing or clearing the throat
✓ May be thick, viscous, tenacious or
gelatinous, frothy, mucoid, mucopurulent,
bloody
RESPIRATORY 11
DISORDERS (WDQ)
NURSING ASSESSMENT
3. Breath/Lung sounds
❑ Bronchial, Bronchovesicular, vesicular [normal]
❑ Adventitious [abnormal]
✓ Crackles/rales – discrete, discontinuous
inspiratory sounds; vibrations of fluid w/in
✓ Rhonchi – coarse sounds; indicate partial
obstruction of the airway
✓ Wheezes –continuous musical sounds from
narrowed small air passages
✓ Stridor/stertuous – noisy respiration
✓ Friction rub – grating sound
✓  breath sounds – poorly ventilated lungs
✓ Absence of BS – non-expanding
RESPIRATORY 12
DISORDERS (WDQ)
NURSING ASSESSMENT
4. Degree of chest pain and origin

❑ Lung parenchyma
✓ Dull, constant ache, poorly localized
❑ Pleura
✓ Sharp, abrupt, increased with respiration or
with cough or sneeze
❑ Chest wall
✓ Localized, constant & increased w/
movement
5. Cyanosis
❑ Peripheral – extremities/nailbeds; 2  CO
❑ Central – lips, tongue, face; 2  O2 in blood
❑ Differential – upper or lower half of body;
RESPIRATORY cardiac diseases 13
DISORDERS (WDQ)
NURSING ASSESSMENT
6. Airway patency
7. Bronchospasm
8. Level of consciousness
9. Vital signs for temp, RR, pulse & skin color changes
10. Observe for hemoptysis and hypoxia
11. Other systemic complications
12. Oxygen concentration [pulse oximetry]
13. Conditions associated with respiratory failure
RESPIRATORY 14
DISORDERS (WDQ)
DIAGNOSTIC PROCEDURES
Radiologic Studies
❑ Chest x-ray
❑ Lung scintigraphy: measures concentration of -
rays from lung after intake of isotope
❑ Perfusion studies: outline pulmonary vascular
structures after intake of radioactive isotopes IV
✓ Pulmonary embolism & blood flow
abnormalities
❑ Bronchography
✓ An opaque substance is inserted into trachea,
& x-ray of TB tree and lungs is taken
✓ Client is NPO to prevent dangers of aspiration
and regurgitation
RESPIRATORY 15
DISORDERS (WDQ)
Bronchoscopy
❑ Visualization of the interior of the TB tree w/ a tube-

like lighted scope
❑ Diagnostic: collection of secretion & specimen
❑ Therapeutic tool to remove foreign materials
❑ Procedure and Nursing care:
✓ Place client supine w/ hyperextended neck
✓ PostOP: check pt’s ability to control secretions
✓ Observe for potential complications of
laryngospasm, laryngeal edema, anesthesia
complications, subcutaneous emphysema
✓ Inform pt. to expect hoarseness & sore throat
RESPIRATORY 16
DISORDERS (WDQ)
Biopsy
❑ Lung Tissue
✓ May be done by needle
✓ During bronchoscopy
✓ Open lung
❑ Lymph node
✓ Scalene or mediastinal
✓ To assess metastasis of lung Ca
❑ Nursing care:
✓ Observe for hemothorax and/or pneumothorax
RESPIRATORY 17
DISORDERS (WDQ)
Thoracentesis
❑ A needle puncture through the chest wall

❑ Aspiration of fluid or air from the pleural sac
❑ Diagnostic and therapeutic
❑ Nursing care & intervention:
✓ Secure consent
✓ Position: upright leaning on over bed table
✓ Remain still, avoid coughing during insertion
✓ Postprocedure: turn on unaffected side
✓ Bed rest, monitor
RESPIRATORY 18
DISORDERS (WDQ)
RESPIRATORY 19
DISORDERS (WDQ)
Pulmonary Function Studies
❑ Vital capacity – max volume of air that can be

exhaled after a maximum inhalation
✓ Reduced in COPD
❑ Tidal volume – inhaled + exhaled air [N breathing]
❑ Inspiratory reserve – max inhaled air after N exp
❑ Expiratory reserve – max exhaled air after N insp
❑ Functional residual capacity – remained volume of
air in the lungs after expiration
❑ Residual volume – remained volume of air in the
lungs after forceful expiration
RESPIRATORY 20
DISORDERS (WDQ)
Arterial Blood Gas Studies
❑ To assess ventilation by measuring :

✓ Oxygen (PO2) [95%]
✓ Carbon dioxide (PCO2) [35-45 mmHg]
✓ Arterial pH [7.35-7.45]
✓ O2 saturation [93-98%]
✓ Bicarbonate (HCO3-) [24-30 mmHg]
❑ Determine state of acid-base balance
❑ Common site for blood ext’n: radial artery
❑ 10ml pre-heparinized syringe to prevent clotting
❑ Container w/ ice to prevent hemolysis
RESPIRATORY 21
DISORDERS (WDQ)
Sputum Examination
❑ Gross appearance
❑ C&S
❑ AFB staining
❑ Cytologic exam
✓ Early morning sputum specimen
✓ Rinse mouth w/ plain water
✓ Use sterile container
✓ Specimen for C&S is collected before the 1st
dose of antibiotic
✓ For AFB staining –3 consecutive mornings
RESPIRATORY 22
DISORDERS (WDQ)
Skin Test
❑ Mantoux test
✓ PPD [Purified Protein Derivative]
✓ Intradermal
✓ Read 48-72 hrs after injection
✓ (+) test – induration of 10mm or more
✓ For HIV – 5mm (+) test
✓ Means exposure to Mycobacterium tubercle;
but does not signify active disease
RESPIRATORY 23
DISORDERS (WDQ)
CHRONIC CHRONIC
INFECTIOUS TRAUMA
OBSTRUCTIVE RESTRICTIVE
• PTB • Asthma • Pleural • Open Wound

• Pneumonia • Emphysema Effusion • Pneumothorax
• Legionnaire’s • Chronic • Pneumothorax • Hemothorax
Bronchitis • Cancer • Rib Fracture
RESPIRATORY 24
DISORDERS (WDQ)
RESPIRATORY 25
DISORDERS
RESPIRATORY DISORDERS (Upper Airway)

Epistaxis
❑ Causes
✓ Trauma/irritation
✓ Infection
✓ Tumors
✓ Systemic dse [HPN, blood dyscrasias]
✓ Systemic treatment [chemotherapy,
anticoagulant]
RESPIRATORY 26
DISORDERS

Epistaxis
❑ Nursing Intervention
✓ Sit up, lean forward, head tipped downward
✓ Pressure over the soft tissues of the nose for at
least 5 mins
✓ Cold compress/ice pack
✓ Nasal pack w/ neosenephrine (3-5days)
✓ Liquid diet, then soft diet
✓ Avoid oral-temperature taking
✓ Do not blow nose for 2 days after removal of
nasal pack
✓ Notify physician if epistaxis is recurrent
RESPIRATORY 27
DISORDERS

Sinusitis
➢ Infection of the paranasal sinuses
❑ Causes
✓ Viral
✓ Bacterial
❑ Signs and symptoms
✓ Pain [Maxillary – cheek, upper teeth; Frontal –
above eyebrows; Ethmoid – in & around the
eyes; Sphenoid – behind eye, occiput, top of
the head]
✓ Fever and malaise
✓ Stuffy nose
✓ Purulent or discolored nasal discharge
RESPIRATORY ✓ Headache 28
DISORDERS
Sinusitis
❑ Nursing Management
✓ Positioning
✓ Analgesics, antipyretics
✓ Antimicrobials
✓ Nasal decongestants [Sudafed, Dimetapp]
✓ Irrigation of maxillary sinuses w/ warm NSS
✓ Caldwell-Luc Surgery [Radical Antrum Surgery]
▪ Do not chew on affected side
▪ Caution w/ oral care to prevent trauma,
infxn
▪ Do not wear dentures for 10 days
▪ No blowing of nose for 2 wks
RESPIRATORY ▪ Avoid sneezing for 2 wks after surgery 29
DISORDERS
Tonsillitis

✓ Sore throat
✓ Dysphagia
✓ Otalgia (ear pain)
✓ Generalized malaise
✓ Cervical lymphadenopathy
✓ Fever
✓ Foul breath
RESPIRATORY 30
DISORDERS
Tonsillitis
✓ Rest and  fluid intake
✓ Warm saline throat irrigation
✓ Ice collar to relieve discomfort
✓ Analgesics and antipyretics
✓ Antibiotics
✓ Surgery – Tonsillectomy
▪ PreOP Care:
• Check for loose tooth
• Assess for URTI [postOP bleeding]
• Check PT
RESPIRATORY 31
DISORDERS

Tonsillitis
✓ Surgery – Tonsillectomy
▪ PostOP Care:
• Position on side until fully awaken, then
mid-fowlers
• Oral airway until swallowing reflex (+)
• Monitor for hemorrhage [frequent
swallowing, bright red vomitus,  PR]
• Comfort [ice collar, Acetaminophen]
• Foods & fluids [cold fluids, bland
foods]
• Patient teaching
RESPIRATORY 32
DISORDERS

Laryngeal Cancer
❑ Predisposing Factors
✓ Over use of voice [teachers, singers]
✓ Family predisposition to cancer
✓ Persistent hoarseness associated with otalgia
& dysphagia
✓ Lump on throat
✓ Pain in the adam’s apple that radiates to the
ear
✓ Dyspnea, enlarged cervical nodes and
cough
RESPIRATORY 33
DISORDERS

Laryngeal Cancer
❑ Management
✓ Subtotal laryngectomy – retains voice
✓ Total – absolute loss of voice
✓ Tracheostomy – temporary or permanent
▪ PostOP Care:
• Establish patent airway
• Head of bead elevated 45
• Assist patient on communicating –
provide writing materials, etc
• Practice swallowing
• Cover tracheostomy w/ porous
material
• Avoid powder, spray, aerosol near
RESPIRATORY trachea 34
DISORDERS
CHRONIC CHRONIC
INFECTIOUS TRAUMA
OBSTRUCTIVE RESTRICTIVE
• PTB • Asthma • Pleural • Open Wound

• Pneumonia • Emphysema Effusion • Pneumothorax
• Legionnaire’s • Chronic • Pneumothorax • Hemothorax
Bronchitis • Cancer • Rib Fracture
RESPIRATORY 35
DISORDERS
COPD – DO that obstruct the pathway of normal alveolar
ventilation either by spasm of the airways, mucus
secretions, or changes in the airway &/or alveoli
Emphysema vs Chronic Bronchitis
permanent overdistention of long-term inflammation of

alveoli w/ resulting destruction mucus memb. of bronchial tubes w/
of the alveolar walls recurrent cough & sputum prod’n for
3 mos or more in 2 consecutive yrs
“PINK PUFFER” “BLUE BLOATER”
RESPIRATORY 36
DISORDERS
RESPIRATORY DISORDERS (COPD)
Emphysema Chronic Bronchitis
Cigarette smoking, Heredity, Cig. smoking, RTI, Pollutants

Aging process
Inflammation
Disequilibrium between
Bradykinin, Histamine, PGs
ELASTASE & ANTIELASTASE
 Capillary permeability
Destruction of ELASTIC RECOIL
Fluid/Cellular Exudation
Overdistention of ALVEOLI
Edema of mucus membrane
Retention of CO2 Hypersecretion of mucus
Hypoxia, Respiratory Acidosis Persistent Cough

RESPIRATORY 37
DISORDERS
38
39
Emphysema Chronic Bronchitis
No cyanosis (Pink) Cyanosis (Blue)

Thin appearance Edematous
Exertional dyspnea Exertional dyspnea
Ineffective cough Recurrent cough w/
Barrel chest Sputum production
Purse lip breathing Digital clubbing
Prolonged expiration Respiratory rate
Use of accessory muscles Use of accessory muscles
R-sided Heart Failure R-sided Heart Failure

Pulmonary HPN Cor pulmonale
Spontaneous Pneumothorax
RESPIRATORY 42
DISORDERS
THE DIFFERENCE….

Collaborative Management
❑ Rest:  O2 demand of tissues
❑  fluid intake
❑ Good oral care. To remove sputum & prevent infxn
❑ Diet:  calorie,  CHON,  CHO
❑ O2 therapy 1-3LPM [2lpm safest]
❑ Breathing exercises [pursed-lip breathing]
❑ Avoid cigarette smoking, alcohol, pollutants
❑ CPT- percussion, vibration, postural drainage
❑ Bronchial hygiene measures [steam, aerosol,
medimist inhalation]
❑ Pharmacotherapy [Antitussives, Bronchodilators,
antihistamine, steroids, antimicrobials]
RESPIRATORY 45
DISORDERS
RESPIRATORY DISORDERS (BRONCHIECTASIS)

❑ An irreversible condition of bronchi with
destruction of muscular and elastic structure
of the bronchial wall
❑ A condition in which damage to the airways
causes them to widen and become flabby
and scarred
RESPIRATORY 46
DISORDERS

❑ SIGNS AND SYMPTOMS
✓ Chronic cough with purulent sputum
✓ Hemoptysis
✓ Exertional dyspnea
RESPIRATORY 47
DISORDERS

❑ DIAGNOSTICS
✓ Bronchoscopy
✓ CBC – possible increase in WBC
✓ CT scan – detects presence or absence of
bronchial dilation
RESPIRATORY 48
DISORDERS
RESPIRATORY 49
DISORDERS
RESPIRATORY 50
DISORDERS
RESPIRATORY DISORDERS (ASTHMA)
❑Chronic inflammatory disease of the airways

characterized by hyper-responsiveness, mucosal
edema and mucous production
❑Disorder of the bronchial airways characterized

by periods of reversible bronchospasm
❑Also known as the “reactive airway disease”
RESPIRATORY 51
DISORDERS

❑ TYPES OF ASTHMA
✓Immunologic asthma- occurs in childhood

✓Non-immunologic asthma- occurs in
adulthood and associated with recurrent
respiratory infections.
✓Mixed, combined immunologic and non-
immunologic
RESPIRATORY 52
DISORDERS

❑ CAUSE AND RISK FACTORS
✓Family history of asthma

✓Allergens: dust, pollens
✓Secondary smoke inhalation
✓Air pollution
✓Stress
RESPIRATORY 53
DISORDERS
RESPIRATORY 54
DISORDERS
❑ Signs & Symptoms:

✓ Tends to sit up
✓ Restlessness/anxiety
✓ Dyspnea, tachypnea, tachycardia
✓ Flaring of alae nasi, retractions
✓ Cough, tightness or pressure on chest
✓ Cold clammy skin
✓ Diaphoresis
✓ Wheezing
✓ Pallor, Cyanosis
RESPIRATORY 55
DISORDERS
❑ Signs & Symptoms:

✓ Cyanosis
✓ Chronic barrel chest
✓ Elevated shoulders
✓ Distended neck veins
✓ Orthopnea
✓ Tenacious mucoid sputum
RESPIRATORY 56
DISORDERS
ASTHMA ALLERGY (Extrinsic)

INFLAMMATION (Intrinsic)
Histamine, A. Bronchospasm
Bradykinin, B. Edema of the mucus membrane
PG, Serotonin, C. Hypersecretion of mucus
Leukotrienes…
Exhaustion Respiratory Narrowing of AWs,

effort  work of breathing
Hypoventilation
Air trapping Hypoxia, Respiratory Acidosis
RESPIRATORY 57
DISORDERS
❑COMPLICATION
✓STATUS ASTHMATICUS- a life-threatening
asthmatic attack in w/c symptoms of asthma
continues and do not respond to treatment.
RESPIRATORY 58
DISORDERS
RESPIRATORY 59
DISORDERS

❑ Diagnostic tests:
✓ Pulmonary functional tests [VC, FVC]
❑ Management:
✓ Pharmacotherapy
▪ Beta agonists [Epinephrine, Terbutaline..]
▪ Methylxanthines [Aminophylline]
▪ Corticosteroids
▪ Anticholinergics [Atropine]
▪ Mast cell inhibitors [Cromolyn Na]
✓ Oxygen via nasal cannula
✓ Fluids to 3L/day
✓ Breathing exercises
✓ Metered dose inhaler
RESPIRATORY 60
DISORDERS

❑ Diagnostic tests:
✓ Pulmonary functional tests [VC, FVC]
❑ Management:
✓ Pharmacotherapy
▪ Beta agonists [Epinephrine, Terbutaline..]
▪ Methylxanthines [Aminophylline]
▪ Corticosteroids
▪ Anticholinergics [Atropine]
▪ Mast cell inhibitors [Cromolyn Na]
✓ Oxygen via nasal cannula
✓ Fluids to 3L/day
✓ Breathing exercises
✓ Metered dose inhaler
RESPIRATORY 61
DISORDERS

❑ Nursing management
✓Promote pulmonary ventilation
✓Facilitate expectorant
✓Health teaching
▪ Breathing techniques
▪ Stress management
▪ Avoid allergens
RESPIRATORY 62
DISORDERS

❑ Nursing management
✓Promote pulmonary ventilation
✓Facilitate expectorant
✓Health teaching
▪ Breathing techniques
▪ Stress management
▪ Avoid allergens
RESPIRATORY 63
DISORDERS
RESPIRATORY DISORDERS (ATELECTASIS)

❑ Collapse of part or the entire lung due to
bronchial obstruction
❑ Closure or collapse of alveoli
❑ Acute or chronic in nature
❑ Maybe due to:
✓ Intrabronchial obstruction (secretions,
tumors, bronchospasm, foreign bodies)
✓ Extrabronchail compression ( tumors,
enlarged lymph nodes)
✓ Intrabronchail disease (carcinoma,
inflamed structures)
RESPIRATORY 64
DISORDERS
RESPIRATORY 65
DISORDERS

❑ SIGNS AND SYMPTOMS
✓ Cough
✓ Sputum production
✓ Low grade fever
✓ Dyspnea
✓ Tachycardia
✓ Pleural pain
✓ Central cyanosis
✓ Crackles upon auscultation
✓ Decreased breath sounds on the affected side
RESPIRATORY 66
DISORDERS

❑ DIAGNOSTICS
✓ CXR reveals patch infiltrates
✓ ABG reveals decreased PO2
✓ Bronchoscopy
RESPIRATORY 67
DISORDERS
RESPIRATORY 68
DISORDERS
RESPIRATORY 69
DISORDERS
RESPIRATORY 70
DISORDERS
RESPIRATORY 71
DISORDERS

❑ NURSING MANAGEMENT
✓ Prevention of atelectasis in hospitalized patient is
an important nursing responsibility
✓ Turn and reposition patient every 1 – 2 hours while
bedridden or obtunded
✓ Encourage early mobility if permitted
✓ Promote liquification and removal of secretions
✓ Avoid administration of large does of sedatives
and opiates that depresses respiratory and cough
reflexes
✓ Prevent abdominal distention
✓ Administer prophylactic antibiotics to prevent
respiratory infection
RESPIRATORY 72
DISORDERS

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RESPIRATORY DISORDERS

WILFREDO D. QUIJENCIO JR. MD RN RM MAN

➢ To maintain oxygenation, the body requires a

➢ Oxygenation may be impaired when airways are

➢ Oxygenation may be impaired when the

➢ Oxygen therapy is necessary to restore

PROCESSES INVOLVED IN RESPIRATION

❑ DIFFUSION or GAS EXCHANGE

❑ PERFUSION or CIRCULATION or BLOODFLOW

FACTORS INFLUENCING RESPIRATION

1. Respiration [breathing patterns]

2. Cough and secretions

4. Degree of chest pain and origin

❑ Visualization of the interior of the TB tree w/ a tube-

❑ A needle puncture through the chest wall

Pulmonary Function Studies

❑ Vital capacity – max volume of air that can be

Arterial Blood Gas Studies

❑ To assess ventilation by measuring :

• PTB • Asthma • Pleural • Open Wound

RESPIRATORY DISORDERS (Upper Airway)

RESPIRATORY DISORDERS (Upper Airway)

RESPIRATORY DISORDERS (Upper Airway)

RESPIRATORY DISORDERS (Upper Airway)

RESPIRATORY DISORDERS (Upper Airway)

❑ Signs and symptoms

RESPIRATORY DISORDERS (Upper Airway)

RESPIRATORY DISORDERS (Upper Airway)

RESPIRATORY DISORDERS (Upper Airway)

RESPIRATORY DISORDERS (Upper Airway)

• PTB • Asthma • Pleural • Open Wound

Emphysema vs Chronic Bronchitis

permanent overdistention of long-term inflammation of

“PINK PUFFER” “BLUE BLOATER”

RESPIRATORY DISORDERS (COPD)

Emphysema Chronic Bronchitis

Cigarette smoking, Heredity, Cig. smoking, RTI, Pollutants

Hypoxia, Respiratory Acidosis Persistent Cough

RESPIRATORY DISORDERS (COPD)

Emphysema Chronic Bronchitis

No cyanosis (Pink) Cyanosis (Blue)

R-sided Heart Failure R-sided Heart Failure

RESPIRATORY DISORDERS (COPD)

RESPIRATORY DISORDERS (BRONCHIECTASIS)

RESPIRATORY DISORDERS (BRONCHIECTASIS)

RESPIRATORY DISORDERS (BRONCHIECTASIS)

RESPIRATORY DISORDERS (ASTHMA)

❑Chronic inflammatory disease of the airways

❑Disorder of the bronchial airways characterized

❑Also known as the “reactive airway disease”

RESPIRATORY DISORDERS (ASTHMA)

✓Immunologic asthma- occurs in childhood

RESPIRATORY DISORDERS (ASTHMA)

✓Family history of asthma

RESPIRATORY DISORDERS (ASTHMA)

❑ Signs & Symptoms:

RESPIRATORY DISORDERS (ASTHMA)

❑ Signs & Symptoms:

RESPIRATORY DISORDERS (ASTHMA)

ASTHMA ALLERGY (Extrinsic)

Exhaustion Respiratory Narrowing of AWs,

Air trapping Hypoxia, Respiratory Acidosis

RESPIRATORY DISORDERS (ASTHMA)