Medical Essentials: Respiratory & Hematology

Respiratory System Basics

Respiratory Key Terms

• Dyspnea: Difficulty breathing
• Orthopnea: Difficulty breathing when lying flat
• Tachypnea: Abnormally fast breathing
• Bradypnea: Abnormally slow breathing
• Hemoptysis: Coughing up blood
• Hypoxia: Tissue oxygen deficiency
• Clubbing: Fingertip rounding due to chronic hypoxia
• Barrel chest: Increased chest diameter often from emphysema
• Cyanosis: Bluish skin or mucous membrane discoloration from low oxygen
• Rales/Crackles: Abnormal lung sounds indicating fluid
• Wheezing: High-pitched whistling from narrowed airways
• Rhonchi: Low-pitched rattling sounds (often due to secretions)
• Productive cough: Cough producing mucus or sputum
• Hypertonia: Increased muscle tone causing stiffness
• Hypotonia: Decreased muscle tone making muscles feel soft
• Hypercapnia: Excess carbon dioxide in the bloodstream
• Hypocapnia: Reduced carbon dioxide in the bloodstream
• Tachycardia: Elevated heart rate
• Hypotension: Low blood pressure
• Adventitious breath sounds: Abnormal sounds like crackles, wheezes, or rhonchi

Normal Breath Sounds

• Vesicular: Soft, low-pitched sounds heard over peripheral lung areas
• Bronchovesicular: Moderate pitch heard over main bronchi
• Bronchial: Loud, high-pitched sounds heard over the trachea

Respiratory Disorder Essentials

Common Signs & Symptoms

• Shortness of breath
• Cough
• Chest pain
• Fever
• Increased respiratory rate
• Fatigue
• Hypoxia/Cyanosis
• Clubbing

Related Diagnostics, Equipment & Treatments

• Chest X-ray
• CT scan
• Bronchoscopy
• Sputum culture
• TB test
• ABGs (Arterial Blood Gases)
• PFT (Pulmonary Function Test)
• Peak flow meter
• Pulse oximetry
• Nasal cannula
• Face mask
• Non-rebreather mask
• CPAP (Continuous Positive Airway Pressure)
• Mechanical ventilator
• Bronchodilators
• Corticosteroids
• Antibiotics
• Antivirals
• Expectorants
• Antitussives
• Oxygen therapy
• Chest physiotherapy
• Smoking cessation

COPD (Chronic Bronchitis + Emphysema)

Characterized by barrel chest, chronic cough (worse in the morning), and dyspnea. Treatment includes bronchodilators, corticosteroids, oxygen, pulmonary rehabilitation, and a high-protein diet.

Asthma

Symptoms include wheezing, chest tightness, and cough. Treatment involves rescue inhalers (e.g., Albuterol), long-term steroids, and peak flow monitoring.

Pneumonia

Symptoms include cough with sputum, fever, chills, and pleuritic chest pain. Treatment involves antibiotics, oxygen, and fluids.

Tuberculosis (TB)

Symptoms include persistent cough >3 weeks, weight loss, night sweats, and low-grade afternoon fever. Treatment involves medications like INH, Rifampin (educate patient about orange secretions), Ethambutol, and PZA. Precautions include airborne isolation, negative pressure room, and N95 mask use.

Cystic Fibrosis

A genetic disorder affecting exocrine glands, leading to thick mucus production. Diagnosis is often made via a positive sweat test.

• Chest physiotherapy, enzymes, bronchodilators are common treatments.

Laryngeal Cancer

Symptoms may include hoarseness, throat pain, and ear pain. Treatment options include surgery, chemotherapy, and radiation.

Tracheostomy Care

Key aspects include suctioning, establishing a communication plan, and stoma care.

Sleep Apnea

Symptoms include snoring and fatigue. Treatment involves CPAP and lifestyle modifications.

Pulmonary Embolism

Characterized by sudden dyspnea, chest pain, and cough. Diagnosis may involve D-dimer testing and CT scan. Treatment includes oxygen, anticoagulants, and thrombolytics.

Pneumothorax

Symptoms include sudden sharp pain, shortness of breath (SOB), and absent breath sounds on the affected side. Treatment typically involves insertion of a chest tube.

Hematologic System Basics

Hematologic Key Terms

Key terms include anemia, thrombocytopenia, leukemia, erythropoietin, pancytopenia, and hemostasis.

Hematologic Lab Values

Hematologic Disorders & Treatments

• Iron Deficiency Anemia

  Caused by poor diet, pregnancy, or blood loss. Symptoms include pallor, fatigue, and brittle nails. Treatment involves iron supplements and an iron-rich diet.

• Pernicious Anemia

  Caused by a B12 deficiency due to lack of intrinsic factor. Symptoms include glossitis, fatigue, and neuropathy. Treatment involves IM Vitamin B12 injections.

• Aplastic Anemia

  Caused by bone marrow failure. Symptoms include bleeding, infections, and fatigue. Treatment involves blood transfusions and immunosuppressive therapy.

• Sickle Cell Anemia

  A genetic condition causing abnormal hemoglobin. Symptoms include pain crises, swelling, and infections. Treatment involves hydration, pain control, oxygen, rest, and avoiding triggers.

• Polycythemia Vera

  Caused by excessive red blood cell production. Symptoms include a ruddy complexion, headache, and hypertension. Treatment involves phlebotomy, hydration, and aspirin.

• Leukemia

  Symptoms include frequent infections, bleeding, fatigue, and enlarged spleen. Treatment involves chemotherapy and bone marrow transplants.

• Thrombocytopenia

  Caused by low platelet count. Symptoms include bleeding, petechiae, and bruising. Treatment involves platelet transfusions and safety precautions.

• DIC (Disseminated Intravascular Coagulation)

  Characterized by simultaneous clotting and bleeding. Symptoms include low platelet and fibrinogen levels, increased D-dimer and PT/PTT levels. Treatment involves treating the underlying cause, heparin, and blood products.

Blood Transfusion Reactions

Symptoms include fever, chills, back pain, hypotension, and rash. LPNs must stop the transfusion and notify the RN immediately. The transfusion should be completed within 4 hours. Only normal saline (0.9% NaCl) is allowed with blood products.

Neutropenic Precautions

Avoid fresh flowers, raw fruits/vegetables, crowds, and sick contacts. Wear appropriate PPE and follow strict hand hygiene.