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Is the dyspnea acute? If the dyspnea is acute onset, one should ask if there is a drug history, particularly a history of mainlining narcotics. If so, adult respiratory distress syndrome should be considered. Furthermore, is there an ... DIAGNOSTIC WORKUP
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... A patient with orthopnea is able to breathe without significant subjective difficulty in the sitting or upright position but almost invariably develops shortness of breath in the recumbent position. This symptom is most characteristic of congestive
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Is the patient an adult or a child? If the patient is a child, acute epiglottitis, acute laryngotracheitis, foreign body, congenital laryngeal stridor, laryngismus stridulus, and a retropharyngeal abscess ... DIAGNOSTIC WORKUP
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Is there excessive snoring? Excessive snoring would indicate obstructive sleep apnea from large tonsils, deviated nasal septum, cleft palate, other abnormalities, and obesity.
Is there obesity? More ... DIAGNOSTIC WORKUP
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...
Dyspnea is defined as an abnormally uncomfortable awareness of breathing. It is one of the cardinal symptoms of cardiac and pulmonary disease, but may also result from abnormalities of the chest wall, neurologic disorders, and anxiety. A complete history and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Orthopnea is defined as difficulty breathing (dyspnea) while in the recumbent position. The dyspnea is due to increased venous return to the lungs while recumbent, resulting in increased pulmonary venous and capillary pressures. Elevating the head/chest... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Paroxysmal nocturnal dyspnea is defined as severe difficulty breathing or air hunger that awakens the patient from sleep (usually 1–3 hours after lying down) and forces them to a sitting or standing position. The patient may gasp and proceed to an open window... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Stridor is characterized by a high-pitched grating sound on inhalation or exhalation, but it is caused by narrowing or obstruction of the upper airway. Wheezing is a high-pitched musical sound on inhalation or exhalation that is due to oscillations of narrowed lower airway walls... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Apnea is defined as the cessation of breathing; how long a pause is physiologically significant depends on age. History will often be more helpful than physical exam. Central apnea refers to a lack of respiratory effort accompanied by a lack of air flow;... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Dyspnea is defined as “shortness of breath,” so it is important to determine the effect of activity on breathing. Worsening when supine does not reliably differentiate left-sided cardiac disease from pulmonary causes of dyspnea in children. Attention to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Priority of stridor evaluation is based on history and clinical presentation. A child with new stridor and respiratory distress requires immediate intervention. The most common cause of chronic stridor in infants is laryngomalacia. Synchronous airway lesions... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Dyspnea is the subjective feeling of rapid or difficult breathing. The patient will often say, “I can’t get my breath!” Tachypnea is the objective finding of a rapid respiratory rate and may or may not be associated with the
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... Nurses frequently become distressed and summon the intern during the night about these signs. Cheyne–Stokes respirations are a frequent source of bewilderment because they may occur at times with no direct evidence of damage to the nervous system. It would be interesting
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... The differential diagnosis of sleep apnea may be arrived at by utilizing both physiology and anatomy. Normal sleep requires an unobstructed pathway from the nasopharynx to the lung and an intact central nervous system that responds to
... READ EXCERPTS »
... Both these symptoms are the result of the same pathophysiologic mechanism: obstruction in the upper air passages. That obstruction may be due to any one of the etiologies recalled by the mnemonic MINT.
M—Malformations that may
... READ EXCERPTS »
... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as occurs during Cheyne-Stokes and Biot’s respirations. More commonly, however, it’s a life-threatening emergency that requires immediate intervention to prevent death... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of fewer than 10 breaths/minute. This sign results from neurologic and metabolic disorders and drug overdose, which depress the brain's respiratory... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It's usually reported as shortness of breath. Its severity varies greatly and is usually unrelated to the severity of the underlying cause. Dyspnea may arise... Other causes ... Special considerations ... Pictures
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... Hyperpnea indicates increased respiratory effort for a sustained period — a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an increased rate (more than 20 breaths/minute) with normal depth, or increased rate and... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Orthopnea — difficulty breathing in the supine position — is a common symptom of cardiopulmonary disorders that produce dyspnea. It’s usually a subtle symptom; the patient may complain that he can’t catch his breath when lying down, or he may mention that... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Usually heard during inspiration, this sign may also occur during expiration in severe upper airway obstruction. It may begin as low-pitched “croaking” and progress... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest discomfort. The attack abates after the patient sits up or stands for several minutes... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Acute
Pleuropulmonary causes
Obstructive lung disease
Asthma
Acute tracheobronchitis
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... Signs and Symptoms Anxiety, dyspnea, agitation, confusion, decreased level of consciousness, apnea, tachypnea, bradypnea, decreased breath sounds, peripheral cyanosis
Treatment (Tx) CPR, intubation and
... READ EXCERPTS »
... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as in Cheyne-Stokes and Biot’s respirations. In most cases, though, it’s a life-threatening emergency that requires immediate intervention to prevent... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of fewer than 10 breaths/minute. This sign may result from neurologic or metabolic disorders or a drug overdose, all of which... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It’s usually described as shortness of breath. Its severity varies greatly and is usually unrelated to the severity of the underlying cause. Dyspnea may arise suddenly... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Hyperpnea indicates increased respiratory effort for a sustained period—a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an increased rate (more than 20 breaths/minute) with normal depth, or increased... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Orthopnea—difficulty breathing in the supine position—is a common symptom of cardiopulmonary disorders that produce dyspnea. It’s often a subtle symptom; the patient may complain that he can’t catch his breath when lying down, or he... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Usually heard during inspiration, this sign may also occur during expiration in severe upper airway obstruction. It may begin as low-pitched “croaking” and progress to... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest discomfort. The attack abates after the patient sits up or stands for... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Alexandra Duke and Tahany Maurice-Habashy
Stridor is a common type of wheezing (Chapter 8.9). It is characterized by a harsh, raspy, medium-pitched sound produced as air flows through a partially blocked airway. It is usually seen... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Differential Overview
❑ Asthma
❑ COPD exacerbation
❑ Left heart failure
❑ Pneumonia
❑ Pulmonary embolism ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Chronic obstructive pulmonary disease
❑ Congestive heart failure
❑ Asthma
❑ Recurrent pulmonary... Diagnostic Approach ... Clinical Findings
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... A condition of insufficient oxygen and accumulating carbon dioxide in the blood and tissues due to interference with respiration, asphyxia results in cardiopulmonary arrest. Without prompt treatment, it’s fatal.
Causes
... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Apnea is the cessation of spontaneous respiration and is usually a life-threatening emergency that requires immediate intervention to prevent death. It may occur as a temporary and self-limiting event, such as Cheyne-Stokes and Biot’s respirations.
... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of less than 10 breaths/minute. This sign results from neurologic and metabolic disorders and drug overdose, which depress the brain... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It’s usually reported as shortness of breath. Its severity varies greatly and is usually unrelated to the severity of the underlying... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Hyperpnea indicates increased respiratory effort for a sustained period — a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an increased rate (more than 20 breaths/minute) with... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Other causes include foreign-body aspiration, croup syndrome, laryngeal diphtheria, pertussis, retropharyngeal abscess, and congenital abnormalities... Assessment ... History ... Physical assessment ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of less than 10 breaths/minute. This sign results from neurologic and metabolic disorders and drug overdose, which depress the brain... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It’s usually reported as shortness of breath. Its severity varies greatly and is usually unrelated to the severity of the underlying cause. Dyspnea may arise... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... The typical patient with hyperpnea breathes at a normal or increased rate and inhales deeply, displaying marked chest expansion. He may complain of shortness of breath if a respiratory disorder is causing hypoxemia, or he may not be aware of his breathing if a... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Orthopnea — difficulty breathing in the supine position — is a common symptom of cardiopulmonary disorders that produce dyspnea. In many patients, it’s a subtle symptom; the patient may complain that he can’t catch his breath when lying... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Usually heard during inspiration, this sign may also occur during expiration in severe upper airway obstruction. It may begin as low-pitched &ldquo... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
...Signs of respiratory distress include tachypnea,dyspnea, nasal flaring, grunting, retractions, and cyanosis. Apneais an extreme form of respiratory distress. Respiratory distress(neonatal and postneonatal) is discussed in the first part of thechapter and apnea in the second part.... Principal Causes of Respiratory Distress (Neonatal) ... Clinical Features and Diagnosis: Respiratory Distress (Neonatal) ... Principal Causes of Respiratory Distress (Postneonatal) ... Clinical Features and Diagnosis: Respiratory Distress (Postneonatal) ... Diagnostic Approach: Respiratory Distress ... Principal Causes of Apnea ... Clinical Features and Diagnosis: Apnea ... Diagnostic Approach: Apnea ... References
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... Stertoris noisy, snoring-type breathing that results from airway obstructionin the nose, nasopharynx, or oropharynx. The sounds are heard onlyduring inspiration. Stridor is a low- to medium-pitchedsound that signifies airway obstruction in the... Principal Causes of Airway Obstruction ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as occurs during Cheyne-Stokes and Biot's respirations. More commonly, it's a life-threatening emergency that requires immediate intervention to prevent... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of fewer than 10 breaths/minute. This sign results from neurologic and metabolic disorders and drug overdose, which depress the brain's respiratory control centers... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It's usually reported as shortness of breath. Its severity varies greatly and is usually unrelated to the severity of the... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Hyperpnea indicates increased respiratory effort for a sustained period—a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an increased rate (more than 20 breaths/minute) with normal depth, or... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Orthopnea—difficulty breathing in the supine position—is a common symptom of cardiopulmonary disorders that produce dyspnea. It's usually a subtle symptom; the patient may complain that he can't catch his breath when lying down, or he may mention that he sleeps most... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A loud, harsh, musical respiratory sound, stridor results from a partial to near complete obstruction of the trachea or larynx. Usually heard during inspiration, this sign may also occur during expiration in severe upper airway obstruction. It may begin as low-pitched &ldquo... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest discomfort. The attack abates after the patient sits up or stands for... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
...
Dyspnea is the subjective feeling of rapid or difficult
breathing. The patient will often say, “I can’t get my breath!”
Tachypnea is the objective finding of a rapid respiratory rate, and may or
may not be associated... Pictures
... READ EXCERPTS »
...
Nurses frequently become distressed and summon the intern during the
night about these signs. Cheyne–Stokes respirations are a frequent source
of bewilderment because they may occur at times with no direct evidence... Pictures
... READ EXCERPTS »
...
The differential diagnosis of sleep apnea may be arrived at by
utilizing both physiology and anatomy. Normal sleep
requires an unobstructed pathway from the nasopharynx to the lung and an
intact central nervous system that responds to anoxia and... Pictures
... READ EXCERPTS »
...
Both these symptoms are the result of the same pathophysiologic
mechanism: obstruction in the upper air passages. That obstruction may be
due to any one of the etiologies recalled by the mnemonic MINT.
M—Malformations that may... Pictures
... READ EXCERPTS »
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