(To review, tidal volume is the amnt of gas inspired and expired during normal breathing). This type of labored breathing occurs whenever there is an increased work of breathing (i.e., exercise or metabolic acidosis). Kussmaul respirations (hyperpnea) is breathing with a slightly increased ventilatory rate, very large tidal volumes, and no expiratory pause. ((Images reflect rate/pattern of breathing) Slowed breathing is when respirations are 20 respirations/minute. A sigh, which is an occasional deeper breath helps to maintain normal lung function (and the healthy adult averages 10-12 sighs/hour). The text indicates that normal adults take 8-16 breaths per minute (14-20 is a standard range) and that a short expiratory pause occurs naturally with each breath. : Normal breathing is rhythmic and effortless. Lung CA and PE are other causes (bloody sputum). Hemoptysis as a result of a cough is usually bright, red in color and indicates either an infection or damage within the lungs as a result of inflammation. Bloody sputum/secretions is termed hemoptysis. Also, if the sputum is thick, this could potentially block airway, so medication may be warranted.

Earth-tone colors such as yellow or green may be a sign of infection. If sputum is present, we want the patient to describe it (what it looks like). When working with individuals that have a cough, something to assess is whether or not the cough is productive. Non-smoking related causes include postnasal drainage syndrome and asthma and smoking-related causes include chronic bronchitis and lung cancer. An acute cough usually lasts for 2-3 weeks and is usually result of a respiratory infection (laryngitis, pneumonia) Long-term coughs (chronic coughs) involve a cough lasting longer than 3 weeks (sometimes 7-8 weeks depending on infection). Those who are not able to cough effectively are at greater risk for developing respiratory complications such pneumonia. Cough=protective reflex to fight the irritation of foreign bodies within the airway. A form of severe orthopnea, called paroxysmal nocturnal dyspnea (PND), causes individuals to wake at night 'gasping for air.' Sitting/standing relieves the dyspnea. Orthopnea is a term that you may rember from cardiac content.orthopnea refers to dyspnea when lying flat (gravity puts pressure on the diaphragm). Dyspnea is what the individual says it is and is often described as 'a breathlessness, air hunger, shortness of air/breath, and labored' Assessment findings often include: flaring nostrils, use of accessory muscles, and/or retraction of intercostal spaces.

Causes of paroxysmal nocturnal dyspnea