Unit

unit 3

Respiratory assessment
 Respiratory system
• The respiratory system is composed of
the upper and lower respiratory tracts.
together the two tracts are responsible
for ventilation.
Anatomy of the respiratory system
 Functions of respiratory system
• Oxygen transport
• Respiration
• Ventilation
• Pulmonary diffusion and perfusion
• Ventilation and perfusion balance and
imbalance
• Gas exchange
 Assessment
• Health history
• Common symptoms
• Dyspnea
• Cough
• Sputum
• Chest pain
• Wheezing
• Hemoptysis
 Cont….
• Past health family and social history
Physical assessment of the respiratory
system
• General appearance
• Upper respiratory structures
• Lower respiratory structures and
breathing-
• Inspection
• Palpation
• Auscultation
Abnormal breath sounds
 Upper respiratory tract infections
• An upper respiratory tract infection (URTI) is
an illness caused by an acute infection, which
involves the upper respiratory tract, including
the nose, sinuses, pharynx, or larynx. This
commonly includes nasal obstruction, sore
throat, tonsillitis, pharyngitis, laryngitis,
sinusitis, otitis media, and the common cold
 Rhinitis
• Rhinitis is a group of disorders characterized
by inflammation and irritation of the mucous
membranes of the nose..
• It may be acute or chronic ,nonallergic or
allergic.
 Pathophysiology
• Rhinitis may be caused by a variety of
factors,including changes in temperature or
humidity; odors;infection; age; systemic
disease;use of over the counter and
prescribed nasal decongestants; and
presesnce of a foreign body
Example of common indoor and outdoor
allergens
Pathophysiologic process in rhinitis
 Clinical manifestations
• The signs and symptoms include rhinorrhea
(excessive nasal drainage, runny nose )
• Nasal congestion
• Nasal discharge
• Sneezing
• Pruritis of the nose, roof of the
mouth,throat,eyes and ears.
• Headache may occur.
 Medical management
• The management of rhinitis depends on the
cause,which may be identified through history
and physical examination.
• Pharmacologic therapy
• Nursing management
 Viral rhinitis (common cold)
• Acute viral rhinitis can be caused by a variety
of viruses, usually the common cold.
Symptoms consist of runny nose, sneezing,
congestion, postnasal drip, cough, and a low-
grade fever.
 Acute rhinosinusitis
• acute rhinosinusitis is an inflammation of the
paranasal sinuses and the nasal cavity lasting
no longer than 4 weeks. It can range
from acute viral rhinitis (the common cold)
to acute bacterial rhinosinusitis. Fewer than 5
in 1,000 colds are followed by
bacterial rhinosinusitis.
What causes acute sinusitis?
• Illnesses and conditions that can cause or lead to acute sinusitis
include:

• viruses
• bacteria
• fungi
• intranasal allergies, such as hay fever
• nasal polyps or other tumors
• deviated nasal septum
• infected adenoids
• cystic fibrosis, an inherited genetic disease where thick, sticky
mucus builds up in the body
Who’s at risk for acute sinusitis?
• The following factors can increase your risk of developing acute
sinusitis:

• intranasal allergies
• nasal passage abnormalities, such as a deviated septum or nasal polyp
• tobacco smoking or frequent breathing in of other pollutants
• large or inflamed adenoids
• spending a lot of time in a day care, preschool, or other areas where
infectious germs are frequently present
• activities that result in pressure changes, such as flying and scuba diving
• a weakened immune system
• cystic fibrosis
symptoms of acute sinusitis include:
• nasal congestion
• thick yellow or green mucus discharge from the nose
• sore throat
• a cough, usually worse at night
• drainage of mucus in the back of your throat
• headache
• pain, pressure, or tenderness behind your eyes, nose, cheeks, or forehead
• earache
• toothache
• bad breath
• reduced sense of smell
• reduced sense of taste
• fever
• fatigue
 Diagnostic evaluation
• Nasal endoscopy
• Your doctor may look into your nose using a nasal endoscope.
This is a thin, flexible fiber-optic scope. The scope helps your
doctor identify inflammation or other abnormalities in your
sinuses.
• Imaging tests
• Your doctor may order a CT scan or MRI to look for inflammation
or other nose or sinus abnormalities. A CT scan uses rotating X-
rays and computers to take detailed, cross-sectional images of
your body. An MRI takes 3-D images of your body using radio
waves and a magnetic field. Both these tests are noninvasive.
 Treatment
• Most cases of acute sinusitis can be treated at home:
• A moist, warm washcloth. Hold it over your sinuses to ease pain symptoms.
• A humidifier. This can help keep the air moist.
• Saline nasal sprays. Use them several times a day to rinse and clear your nasal
passages.
• Stay hydrated. Drink plenty of fluids in order to help thin mucus.
• Over-the-counter (OTC) nasal corticosteroid spray. Sprays such as fluticasone
propionate (Flonase) can reduce intranasal and sinus inflammation.
• OTC oral decongestant therapy. These therapies, such as pseudoephedrine (
Sudafed), can dry up mucus.
• OTC pain relievers. Pain relievers like acetaminophen (Tylenol) or ibuprofen
(Motrin, Advil) can help relieve sinus pain.
• Sleep with your head elevated. This encourages your sinuses to drain.
 Nursing management
• Instruct the client about symptoms of
complications,
• Use of medications
• And nuchal regidity signs and symptoms of
complications