Respiratory Care made INCREDIBLY EASY! 2nd edItion

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
Copyright
Title Page
Dedication
Contents
Chapter 1: ‘I’m thinking’ – Oh, but are you?
Chapter 2: Renegade perception
Chapter 3: The Pushbacker sting
Chapter 4: ‘Covid’: The calculated catastrophe
Chapter 5: There is no ‘virus’
Chapter 6: Sequence of deceit
Chapter 7: War on your mind
Chapter 8: ‘Reframing’ insanity
Chapter 9: We must have it? So what is it?
Chapter 10: Human 2.0
Chapter 11: Who controls the Cult?
Chapter 12: Escaping Wetiko
Postscript
Appendix: Cowan-Kaufman-Morell Statement on Virus Isolation
Bibliography
Index