Respiratory system: Lung conditions

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. 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. Asthma is a chronic lung condition characterized by reversible episodes of inflammation and constriction, or narrowing, of the bronchi and bronchioles in response to certain triggers, like allergies, exertional activity, cold air, smoke, stress, or respiratory infections.

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.

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.

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.