Respiratory System

IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

• Preface viii Acknowledgements x 1 Anatomy and Physiology: The Respiratory System 1 The Respiratory System 1 The Upper Respiratory Tract 2 The Lower Respiratory Tract 3 Blood Supply 7 Respiration 8 Pulmonary Ventilation 8 External Respiration 11 Ventilation and Perfusion 12 Transportation of Gases 12 Internal Respiration 14 Conclusion 14 Glossary of Terms 15 Multiple Choice Questions 16 References 17 2 Respiratory Assessment 18 Airway Obstruction 18 Rapid Breathing Assessment 18 Objective and Subjective Data 22 Vital Signs 22 Assessing Respirations 23 Oxygen Saturations 24 The Patient History 25 Cough 26 The Physical Examination 27 Interpretation of the Findings 37 Conclusion 37 Glossary of Terms 37 Multiple Choice Questions 38 References 39 3 Chronic Obstructive Pulmonary Disease 41 Pathophysiological Changes Associated with Chronic Obstructive Pulmonary Disease 41 Epidemiology 43 Risk Factors 44 Clinical Presentation 45 Clinical Investigations and Diagnosis 46 Management 49 Health Teaching 51 Conclusion 53 Glossary of Terms 53 Multiple Choice Questions 54 References 55 4 Asthma 57 Pathophysiological Changes Associated with Asthma 57 Asthma Triggers 60 Epidemiology 62 Risk Factors 62 Clinical Presentation 63 Clinical Investigations and Diagnosis 65 Management 68 Status Asthmaticus 69 Health Teaching 71 Inhalers 72 Spacers (Aerosol Holding Chambers) 73 Conclusion 74  Glossary of Terms 74 Multiple Choice Questions 75 References 76 5 Pneumonia 78 Pathophysiological Changes Associated with Pneumonia 78 Community-Acquired Pneumonia 79 Hospital-Acquired Pneumonia 79 Pathophysiology 79 Epidemiology 81 Risk Factors 81 Hospital-Acquired Pneumonia 83 Clinical Presentation 84 Clinical Investigations and Diagnosis 85 Management 86 Risk Stratification 86 Supportive Measures 87 Hospital-Acquired Pneumonia 87 Nebulisers 88 Advising Patients on Nebuliser Use 91 Care Provision 92 Health Teaching 93 Conclusion 93 Glossary of Terms 93 Multiple Choice Questions 94 References 96 6 Lung Cancer 97 Pathophysiological Changes Associated with Lung Cancer 97 Small-Cell Lung Carcinoma and Non-Small Cell Lung Carcinoma 97 Epidemiology 98 Risk Factors 99 Clinical Presentation 100 Clinical Investigations and Diagnosis 101 Staging and Grading 103 Tumour, Node and Metastasis Staging 104 Management 106 Rapid Diagnostic Centres 107 Surgery 108 Radiation Therapy with Curative Intent 108 Palliative Radiation Treatment 108 Chemotherapy, Targeted Therapy and Immunotherapy 108 Laser Therapy, Cryotherapy and Tracheobronchial Stents 108 Palliative Care 109 Health Teaching 109 Conclusion 109 Glossary of Terms 110 Multiple Choice Questions 111 References 112 7 Tuberculosis 114 Notifiable Diseases 114 Pathophysiological Changes Associated with TB 115 Aetiology of TB 116 Stages or Forms of TB 117 Primary TB infection 117 Latent TB 117 Active TB Disease 118 Reactivation of TB 118 Epidemiology 119 Risk Factors 119 Clinical Presentation 121 Clinical Investigations and Diagnosis 121 Management 123 Health Teaching 125 BCG Immunisation Programme 126 Conclusion 126 Glossary of Terms 127 Multiple Choice Questions 127 References 128 8 Pulmonary Embolism 130 Deep Vein Thrombosis 130 Venous Thromboembolism 130 Virchow’s Triad 130 Thrombogenesis 131 Pathophysiological Changes Associated with PE 133 Prognosis 135 Epidemiology 135 Risk Factors 136 Clinical Presentation 136 Clinical Investigations and Diagnosis 138 Management 140 Urgent Care 140 General Management 140 Anticoagulants 141 Health Teaching 142 Conclusion 143 Glossary of Terms 143 Multiple Choice Questions 144 References 145 MCQ Answers 147 Index 148