Interactive Ready for Review: Interactivities

is a common complaint that may be caused by numerous medical problems, including infections of the upper or lower airways, acute pulmonary edema, chronic obstructive pulmonary disease, spontaneous pneumothorax, asthma or allergic reactions, pleural effusions, mechanical obstruction of the airway, pulmonary embolism, and hyperventilation. Each of these lung disorders interferes in one way or another with the exchange of oxygen and carbon dioxide that takes place during through problems with ventilation, diffusion, perfusion, or a combination. This interference may be in the form of damage to the alveoli, separation of the alveoli from the pulmonary vessels by fluid or infection, obstruction of the air passages, or air or excess fluid in the pleural space.

Because carbon dioxide levels tend to be elevated and oxygen levels to be decreased in patients with chronic respiratory diseases, the administration of high concentrations of may suppress the respiratory drive. If this occurs coach breathing or provide positive-pressure ventilations as needed. Never withhold oxygen from a patient who needs it.

Signs and symptoms of include unusual breath sounds, including wheezing, stridor, rales, and rhonchi. Other signs may include nasal flaring; pursed-lip breathing; cyanosis; inability to talk; use of accessory muscles to breathe; and sitting in the tripod position, which allows the diaphragm the most room to function.

In treating dyspnea, it is important to reassure the patient and provide supplemental oxygen. Remember to maintain the patient in a position that is comfortable for breathing, usually sitting upright. If the patient is not breathing or breathing inadequately, provide positive-pressure ventilations with a . Establish IV access and administer fluids as needed. Next, perform a focused history and physical exam, including vital signs. If the patient has a prescribed inhaler, or an epinephrine auto injector, consult medical control to assist with appropriate use of the inhaler or injector. Then transport the patient to the hospital, monitoring his or her condition en route. Talking with the patient is a good way to monitor some aspects of the patient's respiratory status.

Remember, a patient who is breathing rapidly may be getting insufficient oxygen as a result of respiratory distress from a variety of problems, including pneumonia or a pulmonary embolism; trying to "blow off" more carbon dioxide to compensate for acidosis caused by a poison, a severe infection, or a high level of blood glucose; or having a stress reaction. In every case, prompt recognition of the problem, giving oxygen or providing ventilatory support, and prompt transport are essential.