Mr. Chan

Pathophysiology

Bacteria pass through the upper
airway to lower airway

Trigger inflammatory response in alveoli

Increases mucus production

Leaking of the capillaries
cause mucus with blood

Mucus decreases the gas
exchange within the lung

Fluid fills up
in the alveoli

The debris results from
white blood cells fight
the infection fills up
the alveoli

Risk factor

Chronic smoker

Sign and symptoms

Dyspnea

Shallow respiration

Low SpO2

Fever

Pleural effusion

cough

Chest pain

Poor appetite

Diagnostic and laboratory findings

Diagnostic findings

Vital signs

Respiration rate

24 breaths per minute

SpO2

88% on room air

Body temperature

38^C

Body weight decreased from 70kg to 60kg

Hemoptysis

Laboratory findings

Chest x-ray

Right pleural effusion

C/ST

Check sputum

CBC

Monitor increase in WBC

RFT

Evaluate dehydration

Medical management

Medication therapy

Augmentin (amoxicillin and clavulanate)

Treat bacterial infection e.g. pneumonia

Tranexamic Acide (Tranexamine)

Treat bleeding

Bromhexine (Bisolvon)

Treat respiratory disorder with excessive mucus

Paracetamol (Panadol)

Treat fever and relieve pain

Intravenous fluid (IVF)

Reduce fluid loss

Therapeutic management

Pleurocentesis

Treat pleural effusion

Pathophysiology

Droplet containing tubercle bacilli inhales and reach to lung

Bacilli multiply in alveoli

Macrophages ingest and surround the bacilli. The cells then forms granuloma and keeps the bacilli inside and under control

When the immune system cannot make bacilli under control, bacilli start to multiply and form tuberculosis

Sign and symptoms

No appetite

Fever

Weight loss

Hemoptysis

Pleural effusion

Chest pain

Diagnostic findings

Vital Sign

Body Temperature: 38^C

Chest X- ray

Right pleural effusion

Sputum test

Paracetamol (Panadol)

Treat Fever

Tranexamic Acide (tranexamine)

Treat Bleeding

Pathophysiology

airway irritants cause neutrophils

inflammatory cells to accumulate in the airways

trigger an inflammatory response

airways constrict and narrow and swollen

excess mucus production

obstructive lung disease

airflow limitation

air trapping

Risk Factor

Smoking

a chronic smoker for more than 40 years

Sign and symptoms

shortness of breath

dyspnea

Respiration: 24 bpm (shallow)

poor appetite

breathing assist with month

weight loss

use accessory muscles to breathe

consume more energy

chest pain

due to air trapping

low blood oxygen level

bad gas exchange

Diagnostic findings

SpO2: 88% on room air

show low oxygen level in blood

Respiration: 24 bpm (shallow)

Respiratory rate is fast

body compensation due to low oxygen supply

Treatment

Oxygen 0 – 6 L/min via nasal cannula, keep SpO2 >= 95%

treat low blood oxygen level

NPO

Pathophysiology

Result from impaired cardiac functioning and excessive workload demands

Acute or chronic heart failure

Unable to provide sufficient pump action to maintain blood flow to meet the needs of body and lungs

One side fails first

Left heart failure

Right heart failure

Risk factors

Medical history

Hypertension

Coronary artery disease

Atrial fibrillation

Smoking

Sign and symptoms

anxiety

Fatigue

Dizziness

weakness

edema in the lower body

Chest pain

Tranexamic Acide

Treat bleeding

Shortness of breath

Occurs when lying down and can interrupt sleep

Low oxygen level in the blood

Cough

Brings up frothy phlegm that may be blood tinged

Because of congestion and fuild in the lung

Diagnostic findings

Vital sign

Respiration: 24 bpm(shallow)

Sp02: 88% on room air

low blood oxygen level

Blood pressure: 90/60 mmHg

Low blood pressure

Hemoptysis

Treatment

Medication therapy

Indapamide

Treat hypertension

Side effects

Hypokalemia

Muscle weakness

Hypotension

Dizziness

Nervousness

Fatigue

Lisinopril

Treat high blood pressure

Side effects

Dizziness

Anxiety

Amlodipine

Increases the flow of blood to the heart

Prevent heart pain (angina) resulting from reduced flow of blood to the heart

Side effects

Most common

Edema of the lower extremities

Less common

Dizziness

Fatigue

A heart attack on rare occasions

Metoprolol

Affects the heart and circulation

Treat hypertension

Treat or prevent heart attack

Side effects

Fluid retention

Low blood pressure

Oxygen therapy

Oxygen 0-6L/min via nasal cannula, keep SpO2 >=95%

Pathophysiology

Carcinogens

Damage cells &DNA

Mutation

Celluar changed & abnormal cell growth

Malignant cell developed
(Tumor)

Invasion

Spead

Lymphatic system

Other Organ

Hematogmous

Angrognes

Stages

1

Local affected

2

Lobar atelectasis
(lung cannot expand)
OR
Pneumonia

3

4

Risk factor

chronic smoker

Sign and symptoms

Sign

BP: 90/60mmHg
(<normal)

affect other organ

tumor: easy to bleed

lower cardiac output

Pulse: 58bmp & irregular

Respiratory centre affected

Heart's electrical system affected

Temp 38^C

Fever

SpO^2:88%

tumor cell

alveolar cells collapsed

lower the rate of gas exchange

Local & Regional Symptoms

Lung

Respiration

shallow

Limited expansion

Bronchus

dyspnea

hemoptysis

recurrent fever

pneumonia symptoms

Airborne precaution

Pleura

right pleural effusion

Non-specific Symptoms

poor appetite

weight loss

Diagnostic method

Specific test

CEA

tumor maker

Cytology

Other tests

NPA x PCA

Blood x C/ST (>38.5^C)

CBC

check the amount of WBC,platelet

LRFT

indicate the stage of Ca lung

Clotting Profile

check abnormal blood clot

Ca lung may produce mucin

risk of blood clot

T&S

prepare the right blood

Sputum x C/ST

PSA

test for prostate cancer

AFP

mean certain types of cancer

Medication therapy

Aspirin

low dosage
(80mg Daily)

lower the incidence rate of cancer
(about 1/4)

Augmentin

treat pneumonia

Bromhexine (Bisolvon)

treat excessive musus