Respiratory system: Lung conditions
Definitions & Key takeaways
The lungs are vital organs that play a central role in the body's respiratory system. They are responsible for taking in oxygen and expelling carbon dioxide. However, many lung conditions can affect their function and cause symptoms such as shortness of breath, chest pain, coughing, and wheezing.
Common lung conditions include cystic fibrosis, asthma, chronic obstructive pulmonary disease (COPD), and cancer. Cystic fibrosis is caused by a genetic defect that results in the overproduction of thick mucus in the respiratory tract. Its symptoms include difficulty breathing, wheezing, and a productive cough. Treatment involves proper hydration, chest physiotherapy, exercise, medications to open up the airway and fight off infections, and sometimes, lung transplants. Asthma is reversible episodes of bronchoconstriction in response to allergies or environmental triggers, causing difficulty breathing, wheezing, cough, and chest pain. Asthma attacks are treated with bronchodilators, and long-term management involves inhaled or oral medications.
Emphysema and chronic bronchitis are chronic obstructive pulmonary diseases that interfere with gas exchange. In emphysema, the damage involves the alveoli, while chronic bronchitis involves the bronchi. Both are caused by long-term exposure to inhaled toxins, like tobacco smoke. Treatment can involve medications, supplemental oxygen, and smoking cessation. Cancers of the respiratory tract may produce respiratory symptoms, like shortness of breath or productive cough, as well as systemic symptoms, like fatigue or unintended weight loss. Treatments vary among the types of cancers, but they all may involve medications, radiation therapy, or surgery.
Intro0:00–0:26
There are a variety of conditions that can disrupt respiratory function. As a nursing assistant, you will be caring for clients with lung conditions, such as cystic fibrosis, asthma, chronic obstructive pulmonary disease, and cancer.We’ll begin with cystic fibrosis, which is a chronic disease caused by a genetic defect.
Cystic Fibrosis0:26–2:12
The disease causes excessive mucus production by the cells in the mucous membranes lining many of the organ systems in the body, including the respiratory system.
Normally, the mucus in our respiratory system is thin and watery, and it protects our respiratory tract from microbes, like bacteria and viruses and foreign particles, like dust or dirt, while keeping the respiratory tract warm and moist so that we can breathe comfortably.
In cystic fibrosis, though, the mucus is thick, sticky, and present in excess. So, it can build up and stick to the walls of the airway, restricting airflow and irritating and inflaming the respiratory tract.
This causes a client to have difficulty breathing; wheezing; and a productive cough, which means they cough up mucus. The thick, sticky mucus is also a great home for microbes, which can often remain in the respiratory tract, making clients with cystic fibrosis more susceptible to infections.
While there is no cure for cystic fibrosis, treatment is centered around maintaining healthy lung function and preventing complications.
This is generally accomplished through proper hydration to thin mucus secretions, chest physiotherapy to clear the airway, exercise to keep the respiratory muscles strong, medications to open up the airway and fight off infections, and sometimes lung transplants for clients that don’t respond to these therapies.
Okay. Next up is asthma.
Asthma2:12–3:40
Sudden episodes of airway constriction are called asthma attacks. These can be very scary for the individuals experiencing them because their airways can narrow almost to the point of closure, making it very difficult or nearly impossible for them to breathe.
In addition to shortness of breath, people with asthma commonly experience coughing as well as chest pain or tightness. A classic sign is wheezing, which is a high-pitched whistling sound they produce when breathing.
They can also have an increased heart rate or develop cyanosis, where their skin turns blue due to decreased oxygen in the blood.
Asthma attacks are usually treated with inhaled drugs, called bronchodilators, which reverse the bronchoconstriction, opening the airway and allowing normal breathing to resume.Long term management of asthma is focused on preventing asthma attacks with medications that may be inhaled as well as others that may be taken orally.
Next, we’ve got chronic obstructive pulmonary disease, or COPD, which is a term that refers to a pair of lung disorders: emphysema and chronic bronchitis.
COPD3:40–4:39
Both disorders can often present together in the same person as they’re both caused by long-term damage to the respiratory tract from inhaled toxins.
The most important risk factor is tobacco smoke, and other risk factors include air pollution and dust particles from industrial work.
Both disorders obstruct airflow, interfering with gas exchange. In addition, they cause the airways to secrete more mucus and increase the risk for respiratory infections.
Treatment for both is similar and may involve medications to help limit airway obstruction, supplemental oxygen, physical activity, and most importantly, smoking cessation as well as avoiding exposure to other inhaled toxins.Now, in emphysema, the damage is done to the alveoli, which are the small air sacs in the lungs that allow for air exchange.
COPD: Emphysema4:39–5:50
The walls of some alveoli can break, leaving fewer, enlarged alveoli behind, and the lung tissue becomes less elastic. The decreased elasticity reduces the ability to spring back and push air out during exhalation.
So, air is trapped, not exhaled, and cannot be exchanged for oxygen-rich air. This means less oxygen is able to enter the blood.
As a result, a person with emphysema will commonly breathe rapidly as they try to get enough oxygen-rich air in, and they will often experience difficulty breathing, even with simple daily activities, like walking and talking.
When caring for clients with emphysema, you may notice that their breathing is fast and shallow, and some have a large, rounded chest.
This is called a “barrel chest,” and it is a consequence of trapped air in the lungs which, over time, causes the chest cavity to enlarge.Now, in chronic bronchitis, the damage is done to the bronchi over time.
COPD: Chronic Bronchitis5:50–6:18
It also causes individuals to produce more mucus, which builds up in the airway and obstructs airflow. This results in difficulty breathing as well as a productive cough as individuals try to expel the excess mucus.
The irritation of the bronchi, along with the airway obstruction, may also produce chest pain or tightness. Next up is cancer.
Cancer6:18–7:22
Cancers involving the respiratory tract are the leading cause of cancer-related death in the United States. The most important risk factor is smoking.
Now, cancer can develop anywhere in the respiratory tract: from the nose and throat down to the lungs. Cancer in the lungs and lower respiratory tract can cause symptoms such as shortness of breath or a productive cough as well as systemic symptoms such as fatigue or unintended weight loss.
Treatments vary among the types of cancers, but they all may involve medications, radiation therapy, or surgery. When caring for a client that has or is suspected to have cancer, it’s important to be mindful of what they and their family members might be thinking and how they might be feeling.
They may be afraid, sad, or even angry, and it is important to be patient and supportive by listening to them and doing your best to comfort and reassure them.As a nursing assistant caring for clients with lung conditions, remember that clients struggling with lung conditions often have difficulty breathing, which can be very frightening, and they may frequently utilize their call button or call light to reach out for help.
Care Considerations 7:22–8:09
In addition, some clients will be able to breathe more easily if positioned in Fowler's or semi-Fowler’s position. Be sure to check with the nurse and the client's plan of care and remember to document the date, time, and any observations regarding the client's lung condition.It’s also important to be alert to the many different signs, symptoms, or situations that warrant immediate reporting to the nurse, such as chest pain, difficult or noisy breathing, cyanosis, a productive cough, or changes to breathing pattern.
Reporting8:09–8:42
It is also important to remain non-judgmental, especially with clients struggling with a smoking-related illness, as smoking is physically addictive.
Finally, it is important to help clients with lung conditions remain as comfortable as possible. All right, as a quick recap… Common lung conditions include cystic fibrosis, asthma, COPD, and cancer.
Recap8:42–10:36
Cystic fibrosis is caused by a genetic defect that results in overproduction of thick mucus in the respiratory tract. Signs and symptoms include difficulty breathing, wheezing, and a productive cough.
Treatment involves proper hydration, chest physiotherapy, exercise, medications to open up the airway and fight off infections, and sometimes, lung transplants.
Asthma is reversible episodes of bronchoconstriction in response to allergies or environmental triggers, causing difficulty breathing, wheezing, cough, and chest pain.
Asthma attacks are treated with bronchodilators, and long term management involves inhaled or oral medications. Emphysema and chronic bronchitis are chronic obstructive pulmonary diseases that interfere with gas exchange.
In emphysema, the damage involves the alveoli, while chronic bronchitis involves the bronchi. Both are caused by long-term exposure to inhaled toxins, like tobacco smoke.
Treatment can involve medications, supplemental oxygen, and smoking cessation. Cancers of the respiratory tract may produce respiratory symptoms, like shortness of breath or a productive cough, as well as systemic symptoms, like fatigue or unintended weight loss.
When caring for clients with lung conditions, it is important to be patient, supportive, and non-judgmental regarding client decisions.
Finally, remember to report any unusual signs or symptoms you
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