Clinical Manifestations and Assessment of Respiratory Disease

by Des Jardins & Burton

• ISBN13: 9780323010863
• ISBN10: 0323010865
• Edition: 4th
• Format: Paperback
• Copyright: 2001-04-10
• Publisher: Mosby

Summary

The new edition of this popular text has been extensively revised to reflect the latest changes in the field. The introductory chapters address the fundamental skills and protocols necessary for clinical assessment. Each disease is presented in relation to one of six clinical scenarios: atelectasis, consolidation, increased alveolar-capillary membrane thickness, bronchospasm, excessive bronchial secretions, and distal airway and alveolar weakening. Students are provided with an illustration of the major alterations of the lungs, the etiology of the disease, an overview of clinical manifestations, a discussion of management, and a series of self-assessment questions. Emphasis on clinical scenarios that allows the student to better understand the diseases. It shows them why they are seeing what they are seeing and why certain treatment modalities are being used. Focus on assessment and therapist-driven protocols (TDPs) so students can incorporate this into their care of patients. Full-color insert that aids the reader in visualizing and understanding the pathophysiology of the diseases. Clinical Manifestation Overview boxes that enable students to easily refer back to the most important information about the pathophysiologic mechanisms for each disorder of the lung and confirm that they have learned the key information. Case studies that aid the student and the instructor in applying the fundamental information to the assessment and treatment of respiratory patients. Twelve easily accessible appendices featuring commonly needed information such as abbreviations, equations, medications, hemodynamic measurements, and more. Two color design that engages the reader by highlighting different elements of the text and details within the line drawings. Access to the Evolve Learning System that includes additional case studies, a PowerPoint presentation of lecture material, a test bank, an image collection, and Weblinks

Table of Contents

Introduction	xxiv
PART I Assessment of Respiratory Disease	5	(2)
Section I Clinical Data Obtained at the Patient's Bedside	7	(50)
The Patient Interview	7	(10)
Patient History	7	(1)
Patient Interview	7	(1)
Techniques of Communication	8	(6)
Closing the Interview	14	(3)
The Physical Examination and Its Basis in Physiology	17	(40)
Vital Signs	17	(3)
Systematic Examination of the Chest and Lungs	20	(9)
In-Depth Discussion of Common Clinical Manifestations Observed during Inspection	29	(18)
Sputum Production, Cough, and Hemoptysis	47	(10)
Section II Clinical Data Obtained from Laboratory Tests and Special Procedures	57	(82)
Pulmonary Function Study Assessments	57	(16)
Normal Lung Volumes and Capacities	57	(1)
Expiratory Flow Rate Measurements	57	(6)
Expiratory Maneuver Findings Characteristic of Restrictive Lung Diseases	63	(1)
Lung Volume and Capacity Findings Characteristic of Restrictive Lung Diseases	63	(1)
Expiratory Maneuver Findings Characteristic of Obstructive Lung Diseases	64	(5)
Lung Volume and Capacity Findings Characteristic of Obstructive Lung Diseases	69	(1)
Pulmonary Diffusion Capacity	70	(3)
Arterial Blood Gas Assessments	73	(14)
Blood Gas Findings	73	(10)
Assessment of the Hypoxic State	83	(4)
Oxygenation Assessments	87	(12)
Oxygenation Indices	87	(4)
Hypoxia	91	(8)
Cardiovascular System Assessments	99	(16)
Normal Heart Sounds	99	(1)
Abnormal Heart Sounds	100	(1)
Murmurs	101	(2)
The ECG	103	(1)
Common Heart Arrhythmias	103	(4)
Noninvasive Hemodynamic Monitoring Assessments	107	(1)
Invasive Hemodynamic Monitoring Assessments	107	(4)
Determinants of Cardiac Output	111	(4)
Other Important Laboratory Tests and Procedures	115	(10)
Hematology, Blood Chemistry, and Electrolyte Findings	115	(6)
Sputum Examination	121	(1)
Bronchoscopy Findings	121	(1)
Percutaneous Lung Biopsy	122	(3)
Radiologic Examination of the Chest	125	(14)
Fundamentals of Radiography	125	(1)
Standard Positions and Techniques of Chest Radiography	125	(4)
Inspecting the Chest Radiograph	129	(4)
Other Radiologic Techniques	133	(6)
Section III The Therapist-Driven Protocol Approach	139	(22)
The Therapist-Driven Protocol Program and the Role of the Respiratory Practitioner	139	(26)
Essentials of a Good Therapist-Driven Protocol Program	139	(8)
Treatment Protocols Commonly Selected by the Respiratory Practitioner	147	(3)
Common Respiratory Disorders Seen in a TDP Program	150	(2)
Clinical Scenarios Activated by Common Anatomic Alterations of the Lungs	152	(13)
Recording Skills---the Basis for Data Collection, Organization, Assessmet Skills, and Treatment Plans	165	(48)
Types of Patient Records	165	(48)
PART II Obstructive Airway Diseases	117	(120)
Chronic Bronchitis	178	(12)
Anatomic Alterations of the Lungs	179	(1)
Etiology	179	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Chronic Bronchitis	180	(4)
General Management of Chronic Bronchitis	184	(1)
Chronic Bronchitis Case Study	185	(5)
Emphysema	190	(14)
Anatomic Alterations of the Lungs	191	(1)
Etiology	191	(2)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Emphysema	193	(4)
General Management of Emphysema	197	(1)
Emphysema Case Study	198	(6)
Bronchiectasis	204	(16)
Anatomic Alterations of the Lungs	205	(1)
Etiology	206	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Bronchiectasis	207	(7)
General Management of Bronchiectasis	214	(1)
Bronchiectasis Case Study	214	(6)
Asthma	220	(17)
Anatomic Alterations of the Lungs	221	(1)
Etiology	221	(3)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Asthma	224	(3)
General Management of Asthma	227	(3)
Asthma Case Study	230	(7)
PART III Infections Pulmonary Diseases	237	(64)
Pneumonia	238	(18)
Anatomic Alterations of the Lungs	239	(1)
Etiology	239	(7)
Overview of the Cardiopulmonary Clinical Manifestations Associatee with Pneumonia	246	(4)
General Management of Pneumonia	250	(1)
Pneumonia Case Study	251	(5)
Human Immunodeficiency Virus/AIDS	256	(10)
Etiology	257	(1)
HIV Transmission	258	(1)
Diagnosis of AIDS	259	(1)
Overview of the Clinical Manifestations Associated with HIV Infection and AIDS	259	(3)
General Management of AIDS	262	(1)
HIV Infection/AIDs with Pneumocystis Pneumonia Case Study	263	(3)
Lung Abscess	266	(10)
Anatomic Alterations of the Lungs	267	(1)
Etiology	267	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Lung Abscess	268	(3)
General Management of Lung Abscess	271	(2)
Lung Abscess Case Study	273	(3)
Tuberculosis	276	(12)
Anatomic Alterations of the Lungs	277	(1)
Etiology	278	(1)
Diagnosis	279	(1)
Overview of the Cardiopulmonary Clinical Manifestatios Associated with Tuberculosis	280	(3)
General Management of Tuberculosis	283	(1)
Tuberculosis Case Study	284	(4)
Fungal Diseases of the Lungs	288	(13)
Anatomic Alterations of the Lungs	289	(1)
Etiology	289	(1)
Primary Pathogens	289	(3)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Fungal Diseases of the Lungs	292	(4)
General Management of Fungal Disease	296	(1)
Fungal Disease of the Lung Case Study	297	(4)
PART IV Pulmonary Vascular Diseases	301	(26)
Pulmonary Edema	302	(12)
Anatomic Alterations of the Lungs	303	(1)
Etiology	303	(2)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Pulmonary Edema	305	(3)
General Management of Pulmonary Edema	308	(2)
Pulmonary Edema Case Study	310	(4)
Pulmonary Embolism and Infarction	314	(13)
Anatomic Alterations of the Lungs	315	(1)
Etiology	315	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Pulmonary Embolism	316	(7)
General Management of Pulmonary Embolism	323	(1)
Pulmonary Embolism and Infarction Case Study	324	(3)
PART V Chest and Pleural Trauma	327	(24)
Flail Chest	328	(10)
Anatomic Alterations of the Lungs	329	(1)
Etiology	329	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Flail Chest	330	(4)
General Management of Flail Chest	334	(1)
Flail Chest Case Study	334	(4)
Pneumothorax	338	(13)
Anatomic Alterations of the Lungs	339	(1)
Etiology	339	(2)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Pneumothorax	341	(6)
General Management of Pneumothorax	347	(1)
Spontaneous Pneumothorax Case Study	348	(3)
PART VI Disorders of the Pleura and of the Chest Wall	351	(22)
Pleural Diseases	352	(12)
Anatomic Alterations of the Lungs	353	(1)
Etiology	353	(2)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Pleural Effusion	355	(4)
General Management of Pleural Effusion	359	(1)
Pleural Disease Case Study	360	(4)
Kyphoscoliosis	364	(9)
Anatomic Alterations of the Lungs	365	(1)
Etiology	364	(2)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Kyphoscoliosis	366	(3)
General Management of Kyphoscoliosis	369	(1)
Kyphoscoliosis Case Study	370	(3)
PART VII Environmental Lung Diseases	373	(12)
Pneumoconiosis	374	(11)
Anatomic Alterations of the Lungs	375	(1)
Etiology	376	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Pneumoconiosis	377	(5)
General Management of Pneumoconiosis	382	(1)
Pneumoconiosis Case Study	382	(3)
PART VIII Neoplastic Disease	385	(12)
Cancer of the Lung	386	(11)
Anatomic Alterations of the Lungs	387	(1)
Etiology	388	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Cancer of the Lung	389	(3)
General Comments	392	(1)
General Management of Cancer of the Lung	392	(2)
Bronchogenic Carcinoma Case Study	394	(3)
PART IX Diffuse Alveolar Disease	397	(10)
Adult Respiratory Distress Syndrome	398	(9)
Anatomic Alterations of the Lungs	399	(1)
Etiology	400	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Adult Respiratory Distress Syndrome	401	(3)
General Management of ARDS	404	(1)
ARDS Case Study	404	(3)
PART X Chronic Noninfectious Parenchymal Disease	407	(20)
Chronic Interstitial Lung Diseases	408	(19)
Anatomic Alterations of the Lungs	409	(1)
Etiology	410	(7)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Chronic Interstitial Lung Disease	417	(4)
General Management of Chronic Interstitial Lung Diseases	421	(1)
Interstitial Lung Disease Case Study	422	(5)
PART XI Neurologic Disorders and Sleep Apnea	427	(34)
Guillain-Barre Syndrome	428	(10)
Anatomic Alterations Associated with Guillain-Barre Syndrome	429	(1)
Etiology	429	(1)
Common Noncardiopulmonary Manifestations	430	(1)
Overviwe of the Cardiopulmonary Clinical Manifestations Associated with Guillain-Barre Syndrome	431	(2)
General Management of Guillain-Barre Syndrome	433	(1)
Guillain-Barre Syndrome Case Study	434	(4)
Myasthenia Gravis	438	(8)
Anatomic Alterations Associated with Myasthenia Gravis	439	(1)
Etiology	439	(1)
Common Noncardiopulmonary Manifestations	440	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Myasthenia Gravis	441	(1)
General Management of Myasthenia Gravis	442	(2)
Myasthenia Gravis Case Study	444	(2)
Sleep Apnea	446	(15)
Stages of Sleep and Characteristic Cardiopulmonary Patterns	447	(1)
Types of Sleep Apnea	448	(2)
Diagnosis	450	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Sleep Apnea	451	(3)
General Management of Sleep Apnea	454	(2)
Obstructive Sleep Apnea Case Study	456	(5)
PART XII Newborn and Early Childhood Respiratory Disorders	461	(104)
Clinical Manifestations Common with Newborn and Early Childhood Respiratory Disorders	463	(11)
Clinical Manifestations Associated with Increased Negative Intrapleural Pressures during Inspiration	463	(5)
Assessment of the Newborn	468	(6)
Meconium Aspiration syndrome	474	(10)
Anatomic Alterations of the Lungs	475	(1)
Etiology	476	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Meconium Aspiration Syndrome	477	(2)
General Management of MAS	479	(1)
MAS Case Study	480	(4)
Transient Tachypnea of the Newborn	484	(8)
Anatomic Alterations of the Lungs	485	(1)
Etiology	485	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Transient Tachypnea of the Newborn	486	(3)
General Management of TTN	489	(1)
Transient Tachypnea of the Newborn Case Study	489	(3)
Idiopathic (Infant) Respiratory Distress Syndrome	492	(10)
Anatomic Alterations of the Lungs	493	(1)
Etiology	493	(2)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Infant Respiratory Distress Syndrome	495	(3)
General Management of IRDS	498	(1)
Idiopathic (Infant) Respiratory Distress Syndrome Case Study	499	(3)
Pulmonary Air Leak Syndromes	502	(10)
Anatomic Alterations of the Lungs	503	(1)
Etiology	504	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Pulmonary Air Leak Syndromes	504	(3)
General Management of Pulmonary Air Leak Syndromes	507	(1)
Pulmonary Air Leak Syndrome Case Study	508	(4)
Respiratory Syncytial Virus	512	(10)
Anatomic Alterations of the Lungs	513	(1)
Etiology	513	(1)
Overview of the Cartiopulmonary Clinical Manifestations Associated with Respiratory Syncytial Virus	514	(3)
General Management of RSV	517	(1)
Respiratory Syncytial Virus Infection Case Study	517	(5)
Bronchopulmonary Dysplasia	522	(10)
Anatomic Alterations of the Lungs	523	(2)
Etiology	525	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Bronchopulmonary Dysplasia	525	(3)
Geneeral Management of BPD	528	(1)
Bronchopulmonary Dysplasia Case Study	529	(3)
Diaphragmatic Hernia	532	(10)
Anatomic Alterations of the Lungs	533	(1)
Etiology	534	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Diaphragmatic Hernia	534	(3)
Treatment of a Diaphragmatic Hernia	537	(1)
Diaphragmatic Hernia Case Study	538	(4)
Croup Syndrome: Laryngotracheobronchitis and Acute Epiglottitis	542	(10)
Anatomic alterations of the Upper Airway	543	(1)
Etiology	544	(1)
Overview of the Cardiopulmonary Clinical Manifestations associated with Laryngotracheobronchitis and Epiglottitis	545	(2)
General Management of Laryngotracheobronchitis and Epiglottitis	547	(1)
Laryngotracheobronchitis Case Study	548	(1)
Acute Epiglottitis Case Study	549	(3)
Cystic Fibrosis	552	(13)
Anatomic Alterations of the Lungs	553	(1)
Etiology	553	(2)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Cystic Fibrosis	555	(3)
Common Nonrespiratory Clinical Manifestations	558	(1)
General Management of Cystic Fibrosis	559	(1)
Cystic Fibrosis Case Study	560	(5)
PART XIII Other Important Topics	565	(48)
Near Drowning	566	(10)
Anatomic Alterations of the Lungs	567	(1)
Etiology	568	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Near Wet Drowning	569	(2)
General Management	571	(1)
Near Drowning Case Study	572	(4)
Smoke Inhalation and Thermal Injuries	576	(18)
Anatomic Alterations of the Lungs	577	(2)
Etiology	579	(1)
Body Surface Burns	580	(1)
Overview o the Cardiopulmonary Clinical Manifestations Associated with Smoke Inhalation and Thermal Injuries	581	(5)
General Management of Hot Gas and Smoke Inhalation	586	(2)
Smoke Inhalation and Thermal Injury Case Study	588	(6)
Postoperative Atelectasis	594	(9)
Anatomic Alterations of the Lungs	595	(1)
Etiology	595	(1)
Overview of the Cardiopulmonary Clinical Manifestations associated with Postoperative Atelectasis	596	(3)
General Management of Postoperative Atelectasis	599	(1)
Postoperative Atelectasis Case Study	600	(3)
Respiratory Failure	603	(10)
Etiology and Pathogenesis	603	(1)
Deterioration Despite Intensive Respiratory Care	604	(1)
Overview of the Cardiopulmonary Clinical Manifestations Associated with Acute Respiratory Failure	605	(1)
The Fifth Protocol-General Management	606	(1)
Ventilator and Ventilator Weaning Modes	606	(1)
Use of Other Protocols	606	(1)
Acute Respiratory Failure Case Study	607	(6)
References	613	(14)
Appendices	627	(38)
I Symbols and Abbreviations Commonly Used in Respiratory Physiology	629	(2)
II Additional Medications Commonly Used in the Treatment of Cardiopulmonary Diseases	631	(4)
III The Ideal Alveolar Gas Equation	635	(1)
IV Physiologic Dead Space Calculation	635	(1)
V Units of Measure	636	(4)
VI Poiseuille's Law	640	(2)
VII PCO2/HCO3-/pH Nomogram	642	(1)
VIII Calculated Hemodynamic Measurements	643	(4)
IX DuBois Body Surface Area Chart	647	(1)
X Cardiopulmonary Profile	648	(3)
XI Answers to the Self-Assessment Questions	651	(14)
Glossary	665