CHAPTER 2 Respiratory System^105
HALLMARK SIGNS AND SYMPTOMS
- Cyanosis
- Fatigue due to hypoxia and heart failure
- Wheezing due to underlying lung condition such as COPD or emphysema
- Difficulty breathing (dyspnea) on exertion and when lying down (orthopnea)
due to increased oxygen needs with movement and increased respiratory
effort of the diaphragm when lying down - Productive cough due to underlying respiratory condition
- Edema due to right-sided failure; fluid build-up will be in dependent areas
- Weight gain due to fluid retention
- Respiration greater than 20 breaths per minute (tachypnea); rate increases to
meet body’s oxygen needs - Increased heart rate above 100 beats per minute (tachycardia) as the body
attempts to compensate for hypoxia and carry more oxygen
INTERPRETING TEST RESULTS
- Enlarged pulmonary arteries and right ventricle shown on a chest x-ray.
- Enlarged right ventricle shown on echocardiography as a result of pulmonary
hypertension. - Increased right ventricular and pulmonary artery pressures in a pulmonary
artery catheterization. The right ventricle is pumping against greater-than-
normal resistance within the pulmonary artery when sending blood to the lungs. - Decreased oxygen and increased carbon dioxide in arterial blood gas due to
underlying lung disease. - Pulse oximetry shows decreased oxygen saturation.
- Increased hemoglobin to compensate for hypoxia.
TREATMENT
- Bedrest or decreased activity.
- Oxygen therapy at 2 liters/minute (low flow rate) to help meet body’s needs.
The COPD patient cannot tolerate a high flow of oxygen. - Administer calcium channel blockers to vasodilate: