Respiratory Disease: A Case Study Approach to Patient Care by James R. Dexter MD FACP FCCP, Robert L. Wilkins PhD RRT

By James R. Dexter MD FACP FCCP, Robert L. Wilkins PhD RRT FAARC, Philip M. Gold MD FACP FCCP

Now edited via a pulmonologist, the third variation continues to be the most well-written texts for college students studying to appreciate the evaluate and therapy of sufferers with respiration disorder. each one bankruptcy starts off with a history of chosen issues, via a case examine with questions and solutions designed to stimulate serious considering talents.

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Example text

The sudden deceleration of blood entering the left ventricle produces a third sound in a rhythm similar to a horse’s gallop. 14. Why does this patient have fine, late-inspiratory crackles in the bases? The fine, late-inspiratory crackles in the lung bases are due to the accumulation of pulmonary edema fluid in the small airways. Left heart failure increases the blood pressure in the capillaries, causing fluid to leak into the interstitial space and from there into the small airways. The airways collapse on exhalation and are stuck shut by the surface tension of the fluid within them.

Abdominal distention can limit function of the diaphragm and further increase the severity of respiratory failure in the patient with a compromised respiratory condition. An enlarged liver, known as hepatomegaly, is often present in the patient with right ventricular failure. Right heart failure occurs as a result of chronic left heart failure or when cor pulmonale is present as a result of chronic lung disease. Inspect the mouth for evidence of cyanosis. A cyanotic oral mucosa indicates the presence of central cyanosis.

Insertion of the endotracheal tube too far usually results in its passing into the right mainstem bronchus (Fig. 8). qxd 08/14/2006 02:07 PM Page 25 PMAC-122 27C:FABK010:Chapters:CH-01: TechBooks(PPG-Quark) Copyright © 2007 by F. A. Davis. 8 Chest radiograph showing endotracheal tube in the right mainstem bronchus. prone to accidental extubation (Fig. 9). After placement of a chest tube to drain fluid out of the pleural cavity, a chest x-ray is used to see if the tube is in good position and if the lung has reexpanded.

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