Appearance: cyanotic, ashen, abdominal distension, jugular vein distension, tachycardic, inability to lie flat, dependant edema

LOC: Confusion or normal

Lung Condition: Wet with Rhonnchi, wheezing, or rales

Cough: Wet with possible fluid expulsion, pink, frothy sputum

Appearance: thin with barrel chest, tripod position, pink skin, puffing type of breathing, normal BP

LOC: normal or altered

Skin: pink, normal, dry

Lung Condition: dry, little or no cough, wheezing

Appearnace: May be obese, use of accesory muscles, difficulty with expiration, often cyanotic, jugular vein distention if CHF is present, normal to high BP

LOC: normal or altered

Skin: cyanotic,

Lung condition: wet if CHF is present, rhonchi, wheezing, or rales, frequent cough with excessive mucus

Diseases: Asthma, COPD, CHF, pulmonary edema, Pneumonia, Bronchitis, Anaphylaxis

Signs/Symptoms: Dyspnea, productive/nonproductive cough, dependant edema, pink, frothy sputum, fever, pleuritic chest pain, Clear/white sputum, hives and stridor, non productive cough

Diseases: COPD, Pneumonia, Bronchitis

Signs/Symptoms: Productive cough, fever, plearitic chest pain, clear/white sputum

Diseases: CHF, Pulmonary edema, Pneumonia

Signs/Symptoms: Dependant edema, pink, frothy sputum, fever, pleuritic chest pain

Diseases: Croup, epiglottitis

Signs/Symptoms: Fever, barking cough, fever,sore throat, drooling.

Disease:Asthma, COPD, Pneumonia, Hemothorax:Shock, respiratory distress, Pneumothorax: Fever, Pleuritic Chest pain, Atelectasis: Fever, decreased O₂ saturation

Signs/Symptoms:Nonproductive cough, dyspnea, Productive cough, Fever, pleuritic chest pain, blood in chest, Air in chest, Collapsed lung

Chronic Obstructive Pulmonary Disease: lung disease characterized by shortness of breath and wheezing.

Overview: breathing progressively gets worse over time, usually caused by smoking for long periods of time, shortness of breath after exertion, chronic coughing, producing thick sputum, Pt. is usually thin with a barrel chest. No jugular vein distention or edema.

Tx:Home oxygen, bronchodilaters, and steroids

Congestive Heart Failure: A disease of the heart characterized by shortness of breath, edema, and weakness

Overview: Sudden onset of shortness of breath that is constant, pt may or may not smoke, coughing with pink, frothy sputum, there will be jugular vein distention and dependant edema and abdomen may also be distended

• An acute or chronic inflammation of the air passages often due to infection often associated with productive cough
• Accumulation of fluid and swelling restricts air flow. Often associated with rhonchi, may lead to pneumonia in which case, rales will be heard.
• pt. may experience tachypnea even though breathing pattern does not indicate major airway obstruction

• A viral infection associated with swollen nasal mucous membranes and production of fluid
• Dyspnea is not severe

• Disease that can lay dormant for decades and then reactivate
• Many strains are resistant to antibiotics
• Spread by cough and droplets
• Always use HEPA mask when treating a pt. with TB

• Highly contageous though rare, due to vaccines
• Causes the formation of a diptheritic membrane lining the pharynx that is composed of debris, inflammatory cells, and mucus. Can rapidly severly obstruct the passage of air into the larynx

• An acute bacterial or viral infection of the lung that damages tissue, uaually accompanied by fever, cough, and mucus
• Fluid can also accumulate in normal lung tissues separating the alveoli from their capillaries and impeding lungs ability to exchange O₂ and Co₂
• Pt. may experience tachypnea as body compensates for decrease in lung tissue

• Inflammation and swelling of the whole airway, usually in children 6 mo-3 yrs. Rare in adults due to larger airway.
• Causes stridor and seal bark cough, narrowing of airway may cause airway obstruction
• Responds well to humidified oxygen.

• Most comonly seen in preschool age children
• bacteria causes epiglottis to swell, blocking airway, causing stridor, and severe sore throat
• Less common today than it was 20 years ago.

• Major cause of illness in young children. Caused by infection of the lungs and breathing passages. Can lead to other serious conditions of heart, lungs.
• highly contageous, spread through droplets and can survive on surfaces such as clothing and hands.
• Look for signs of dehydration. humidified O₂ is helpful.

• Airborne bacterial infection common in children younger than 6 years.
• Pt. will be feverish with "whoop" sound when coughing.
• Highly contageous through droplet.
• Children may turn red or purple when coughing spells last long enough
• Can cause pneumonia or other serious illness if contracted by an adult

• Potentially life threatening condition caused by recently discovered family of viruses best known as second most common cause of common cold.
• Usually starts with fluelike symptoms, progressing to pneumonia, respiratory failure, or death.
• transmitted through close person to person contact

• virus that has crossed animal/human barrier and infected humans.
• Flue has potential to spread at pandemic level

• Inflammation of meningeal coverings of brain and spinal cord. Highly contageous.Spread through coughing/sneezing.
• Can be lethal. Survivors can suffer brain damage, hearing loss, or learning disabilities.
• May present with fluelike symptoms, but uniques symptoms are: high fever, severe headache, light sensitivity, and a stiff neck (in adults). May have altered LOC and have red blotches on skin
• use respiratory protectiona dnreport any potential cases

A measure of the the volume of blood that is passed through the heart in 1 minute.

Heart rate x volume (Stroke volume)

Onset of pain: Gradual with additional symptoms

Quality of pain: Tightness or pressure

Severity of pain: Increases with time

Timing of pain: May wax and wane

Region/radiation: Substernal; back is rarely involved

Clinical Signs: peripheral pulses equal

Onset of pain: Abrupt, without additional symptoms

Quality of pain: Sharp or stabbing

Severity of pain: Maximal from the outset

Timing of pain: Does not abate once it has started

Region/ Radiation: Back possibly involved, between the shoulder blades

Clinical signs: BP descrepancy between arms or decrease in a femoral or carotid pulse.

O-Onset

P- provocation

Q- quality

R- Region/radiation

S-severity

T-timing

perfusion: the circulation of blood within and organ or tissue in adequate amounts to meet the cell's current need for oxygen, nutrients, and waste removal

In order for perfusion to be effective, three things need to be functioning:

• The Pump (Heart)
• The Container (Blood vesssels)
• and there needs to be adequate contents in the container (Blood)

if part or all of the triange aren't working, you get shock

• Deoxygenated blood enters R atrium through the Inferior and Superior Vena Cava.
• Blood then travelsl through AV node (tricuspid valve) to the R ventricle
• As ventricles contract, blood is forced throught the pulmonary semilunar valve into the pulmonary artery
• Blood passes into lungs where it exchanges waste for oxygen

• Blood returns to the heart after oxygenation via the pulmonary veins into the L Atrium
• Blood then enters into L ventricle throught the AV valve (Bicuspid valve)
• As ventricles contract, blood is forced up into the aorta through the aortic semilunar valve. Aorts eventally becomes capilaries where oxygen is exchanged for carbon dioxide. 

Pump Failure

Cardiogenic shock

obstructive shock

Poor Vessel function

Distributive shock

Septic shock

neurogenic shock

Anaphalactic shock

Physiogenic shock

Low Fluid Volume

Hypovolemic shock

Hemorrhagic shock

Nonhemorrhagic shock

Compensated shock: the early stage of shock, in which the body can still compensate for blood loss.

Decompensated Shock: Late stage of shock when BP is falling.

Irreversible shock: Final stage of shock, resulting in death.

• Chest pain
• Weak/Irregular pulse
• Low BP
• cyanosis
• cool, clammy skin
• Anxiety
• Rales
• Pulmonary edema

Dependant on cause:

Dyspnea  Rapid, weak pulse  Rapid shallow breaths,  Decreased lung compliance,  Unilateral decreased or absent breath sounds,  Decreased BP,  Jugular vein distention, subcutaneous emphysema,  cyanosis,  trachial deviation toward affected side,  Beck's triade: jugular vein distention, narrowing pulse pressure, muffled heart tones.

• Warm skin
• Tachycardia
• Low BP

• Bradycardia
• Low BP
• Signs of neck injury

Can develope within seconds.

• mild itching or rash
• burning skin
• vascualr dilation
• generalized edema
• coma
• rapid death

• Rapid pulse
• Normal or low BP

• Rapid, weak pulse
• Low BP
• changes in mental status (AMS)
• cyanosis
• cool, clammy skin
• increased respiratory rate

• rapid, weak pulse
• low BP
• changes in mental status
• cyanosis
• cool, clammy skin
• increased respiratory rate

• Agitation
• anxiety
• restlesness
• feeling of impending doom
• AMS
• weak, rapid, thready pulse
• clammy (pale, cool, moist) skin
• pallor, with cyanosis around the lips
• shallow rapid breathing
• air hunger
• nausea or vomiting
• capillary refill of longer than 2 seconds in infants in children
• marked thirst

P-progression

A-associated chest pain

S-sputum

T- talking tiredness

E-exercise tolerance

Food intake: Insufficient

Insulin dosage: Excessive

Onset: Rapid, within minutes

Skin: Pale, cool, and moist

Infection: Uncommon

Hunger: Absent

Thirst: Intense

Vomiting: Uncommon

Breathing: Normal, or rapid

Odor of breath: Normal

Blood Pressure: Normal to low

Pulse: Rapid, weak

Consciousness: Irritability, confusion, seizure, or coma; unsteady gait

Response: Immediately after administration of glucose

Food intake: Excessive

Insulin dosage: Insufficient

Onset: Gradual (hours to days)

Skin: warm and dry

Infection: Common

Thirst: intense

Hunger: Absent

Vomiting: Common

Breathing: Rapid, deep (Kussmaul respirations)

Odor of breath: Sweet , fruity

Blood Pressure: Normal to low

Pulse: Rapid, weak, and thready

Consciousness: Restless, possibly progressing to coma; abnormal or slurred speech; unsteady gait

Response: Gradual, within 6 to 12 hours following medical treatment