Terminology
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 pulmonary exacerbation - pertaining to the lungs; lung like. Increase the severity, bitterness, or violence of (disease, ill feeling, affecting the lungs); aggravate
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wheezing - to breathe with difficulty and with a whistling sound: Asthma caused him to wheeze, to make a sound resembling difficult breathing
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intercostal muscle retractions - A shortening, a drawing backward of the muscles that stabilize the rib cage and assist in respiration
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nasal flaring - an excessive widening of the openings of the nares
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Respiratory Rate - the rate at which a person inhales and exhales; usually measured to obtain a quick evaluation of a person's health
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Oxygen saturation - Oxygen content, oxygen saturation, and bicarbonate values are also measured. This is done through a blood sample drawn by arterial puncture
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productive cough - a cough that produces phlegm or sputum from the lungs
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auscultation - the act of listening, either directly or through a stethoscope or other instrument, to sounds within the body as a method of diagnosis
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bilateral lung fields - pertaining to the right and left lungs
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restricted air flow - any reduction in the amount of oxygen entering and carbon dioxide leaving the lungs. Usually as a result of a disease process or tumor
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Cystic Fibrosis - a hereditary chronic disease of the exocrine glands, characterized by the production of viscid mucus that obstructs the pancreatic ducts and bronchi, leading to infection and fibrosis
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asthma - a paroxysmal, often allergic disorder of respiration, characterized by bronchospasm, wheezing, and difficulty in expiration, often accompanied by coughing and a feeling of constriction in the chest
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inherited chronic disease - is a disease that will last for a long time or will come and go, but always be a part of your life and this disease was passed on to you through your parental DNA
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defective gene - a mutation of the DNA strand passed on through parental DNA
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mucus - a viscous, slimy mixture of mucins, water, electrolytes, epithelial cells, and leukocytes that is secreted by glands lining the nasal, esophageal, and other body cavities and serves primarily to protect and lubricate surfaces
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pancreas - a gland, situated near the stomach, that secretes a digestive fluid into the intestine through one or more ducts and also secretes the hormone insulin
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dialation - the act of dilating; state of being dilated
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enzymes - any of various proteins, as pepsin, originating from living cells and capable of producing certain chemical changes in organic substances by catalytic action, as in digestion
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immunizations - the fact or process of becoming immune, as against a disease
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chest physiotherapy - Chest physiotherapy (CPT) is a broad, non-specific term used to describe treatments generally performed by respiratory therapists whereby breathing is improved by the inhalation of antibiotics or steam
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inhaled antibiotics - Drugs that are used to combat infection and the delivery method is via inhalation administered by a Respiratory Therapist
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inhaled saline - Saline delivered via inhalation and administered by a Respiratory Therapist
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oral corticosteroid - medication orally inhaled used, as long-term treatment, to prevent inflammation
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nasal cannula - Nasal Cannula is a device used in a hospital, in a pre-hospital setting, or at home to deliver supplemental oxygen to a patient through the openings in the nose
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Arterial Blood Gases - Oxygen content, oxygen saturation, and bicarbonate values are also measured. This is done through a blood sample drawn by arterial puncture
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posterior-anterior - Directional description of the x-ray photon passage through the body. Passing from the patients’ posterior (back) to the anterior (front)
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lateral chest X-ray - an x-ray that shows the chest from a side position
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pulmonary function tests - a test or group of tests that define the health of the lungs and the respiratory system. Spirometry and lung volumes are examples of some of the tests that are used to test pulmonary function
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spirometry - an instrument for determining the capacity of the lungs
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sputum test - matter, as saliva mixed with mucus or pus, expectorated from the lungs and respiratory passages
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Case Study
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Nine-year old Olivia is brought to the pediatric emergency room by her parents after exhibiting symptoms of pulmonary exacerbation. She is audibly wheezing and short of breath when assessed by the ER nurse. There are no intercostal muscle retractions or nasal flaring. Her respiratory rate is 28 breaths per minute. Oxygen saturation on room air is 91%. She has a moist, productive cough. Upon auscultation, wheezes are noted throughout bilateral lung fields, right side greater than left side, as a result of restricted air flow.
Medical history reveals Olivia was diagnosed with Cystic Fibrosis (CF) and asthma when she was two-months old. Olivia’s parents are very knowledgeable about CF, stating it is an inherited chronic disease that affects the lungs and digestive system. A defective gene affects the way salt is managed within the cell. As a result, the body produces unusually thick and sticky mucus which clogs the lungs and can lead to life-threatening lung infections. The mucus also obstructs the pancreas and stops natural enzymes from helping the body break down and absorb food.
Olivia’s childhood immunizations are up to date. At home, her CF is managed with chest physiotherapy and breathing exercises. She is currently prescribed inhaled antibiotics and inhaled saline. She was recently taking an oral corticosteroid.
After Olivia is placed in pediatric room number six, oxygen via nasal cannula is applied. The ER physician orders tests including Arterial Blood Gases (ABG), posterior-anterior (PA) and lateral chest X-ray, and pulmonary function tests (PFT), including spirometry. A sputum test is also ordered.
Olivia appears more comfortable as she awaits test results with her parents.
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