Lower Respiratory Disorders
Lower respiratory disorders are conditions that obstruct or restrict tracheo-
bronchial tubes and prevent the exchange of gas within the lungs. These condi-
tions are referred to as chronic obstructive pulmonary disease (COPD) and
includechronic bronchitis, bronchiectasis, emphysema, and asthma.
COPD obstructs the patient’s airway by increasing resistance of the airflow
during inspiration and expiration. The result is an impairment of oxygen reach-
ing lung tissues that can in some cases irreversibly damage lung tissues.
The airway obstruction occurs when the bronchioles constrict (bronchospasm)
and mucous secretions increase causing the patient to experience difficulty
breathing (dyspnea).
PNEUMONIA
Pneumonia is an infection in the lungs that can be caused by a variety of
microorganisms including viruses, bacteria, or fungus. It often starts after an
upper respiratory infection. Symptoms can occur 2 to 3 days after a cold or sore
throat. Symptoms include fever, chills, cough, rapid breathing, wheezing and/or
grunting respirations, labored breathing, vomiting, chest pain, abdominal pain,
loss of appetite, decreased activity, and, in extreme cases, signs of hypoxia (low
oxygen levels) or cyanosis such as a bluish tint around the mouth or fingernails.
There are vaccines to prevent certain types of pneumonia. Pneumonia is treated
based on the underlying cause. Viral pneumonia is usually treated symptomati-
cally. That is, bronchodilators, antipyretics (fever reducing), analgesics such as
ibuprofen, cough medications that include expectorants, mucolytics, as well as
suppressants to help the patient sleep. Bacterial and fungal pneumonia are
treated with antimicrobials as well as the above treatment for viral pneumonia.
The antimicrobial is chosen based on the specific microorganism causing the
pneumonia. Antimicrobials are discussed in Chapter 13. Antipyretics such as
ibuprofen are discussed in Chapter 12. Pneumonia is contagious and is spread
from person to person via droplets in the air from coughing and sneezing.
TUBERCULOSIS
Tuberculosis (TB) is caused by the acid-fast bacillus Mycobacterium tuberculo-
sis.The pathogen is frequently referred to as the tubercle bacillus. It is a major
health problem in the world and kills more persons than any other infectious
CHAPTER 14 Respiratory Diseases^261