In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath...
-
Upload
ronald-arnold -
Category
Documents
-
view
216 -
download
0
Transcript of In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath...
![Page 1: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/1.jpg)
In the name of god
![Page 2: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/2.jpg)
History taking lung disease
![Page 3: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/3.jpg)
Common Symptoms:Chest pain
Shortness of breath (dyspnea)WheezingCoughBlood-streaked sputum (hemoptysis)
![Page 4: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/4.jpg)
CHEST PAIN
![Page 5: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/5.jpg)
•The myocardiumangina pectoris, myocardial infarction
•The pericardiumPericarditis
•The aortaDissecting aortic aneurysm
•The trachea and large bronchiBronchitis
![Page 6: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/6.jpg)
•The parietal pleuraPericarditis, pneumonia
•The chest wall, including the musculoskeletal system and skinCostochondritis, herpes zoster
![Page 7: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/7.jpg)
•The esophagusReflux esophagitis, esophageal spasm
•Extrathoracic structures such as the neck, gallbladder, and stomach.
Cervical arthritis, biliary colic, gastritis
![Page 8: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/8.jpg)
Your initial questions should be as broad as possible. “Do you have any discomfort or unpleasant feelings in your chest?” As you proceed to the full history, ask the patient to point to where the pain is in the chest .You should elicit all seven attributes of .this symptom
![Page 9: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/9.jpg)
THE SEVEN ATTRIBUTES OF A SYMPTOMLocation. Where is it? Does it radiate?Quality. What is it like?
Quantity or severity. How bad is it? (For pain, ask for a rating on a scale of 1 to 10.)Timing. When did (does) it start? How long does it
last? How often does it come?Setting in which it occurs. Include environmental factors, personal activities, emotional reactions, or other circumstances that may have contributed to the illness.
Remitting or exacerbating factors. Is there anything that makes it better or worse?
Associated manifestations. Have you noticed anything else that accompanies it?
![Page 10: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/10.jpg)
![Page 11: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/11.jpg)
:Pleuritic PainInflammation of the parietal pleura, as in pleurisy, pneumonia, pulmonary infarction, or neoplasmChest wall overlying the processSharp, knifelikeOften severePersistentInspiration, coughing, movements of the trunk
![Page 12: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/12.jpg)
Shortness of Breath (Dyspnea) and Wheezing
![Page 13: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/13.jpg)
Dyspnea is a nonpainful but uncomfortable awareness
of breathing
![Page 14: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/14.jpg)
dyspnea commonly results
from cardiac or pulmonary
disease.
![Page 15: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/15.jpg)
Ask “Have you had any difficulty breathing?” Find out when the symptom occurs, at rest or with exercise, and how much effort
produces onset.
![Page 16: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/16.jpg)
How many steps or flights of stairs
can the patient climb before pausing for
breath?
![Page 17: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/17.jpg)
Carefully elicit the timing and setting of dyspnea, any associated symptoms, and relieving or
aggravating factors.
![Page 18: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/18.jpg)
Most patients with dyspnea relate shortness of breath to their level
of activity
![Page 19: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/19.jpg)
Anxious patients may have episodic dyspnea during both rest and exercise, and hyperventilation, or rapid, shallow breathing. At other times, they may sigh frequently
![Page 20: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/20.jpg)
Heart failureAsthmaChronic bronchitisCopdDiffuse interstial lung diseasePnumoniaPneumothoraxPulmonary embolianxiety
![Page 21: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/21.jpg)
Anxiety With Hyperventilation
More often occurs at rest than after
exercise..Sighing,
lightheadedness, numbness or tingling of the hands and feet,
palpitations, chest pain
![Page 22: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/22.jpg)
Wheezing:
![Page 23: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/23.jpg)
Wheezes are musical respiratory sounds that may be audible to the patient and to others.
Wheezing suggests partial airway obstruction from secretions, tissue inflammation, or a foreign body.
![Page 24: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/24.jpg)
Cough:
cough is a reflex response to stimuli that irritate receptors in
the larynx, trachea, or large bronchi.
![Page 25: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/25.jpg)
These stimuli include mucus, pus, and blood, as well as external agents such as dust, foreign bodies, or even extremely hot or cold air. Other causes include inflammation of the respiratory mucosa and pressure or tension in the air passages from a tumor or enlarged peribronchial lymph nodes.
![Page 26: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/26.jpg)
Duration of the cough is important: is the cough acute, or lasting less than 3 weeks; subacute, or 3 to 8 weeks; or
chronic, more than 8 weeks?
![Page 27: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/27.jpg)
Viral upper respiratory infections are the most common cause of acute cough; also
consider acute bronchitis, pneumonia, left ventricular heart failure, asthma, foreign body. Postinfectious cough,
bacterial sinusitis, asthma in subacute cough; postnasal drip, asthma,
gastroesophageal reflux, chronic bronchitis, bronchiectasis in chronic
cough.
![Page 28: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/28.jpg)
Ask whether the cough is dry or produces sputum, or
phlegm?
![Page 29: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/29.jpg)
Mucoid sputum is translucent, white, or gray; purulent
sputum is yellowish or
greenish
![Page 30: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/30.jpg)
Ask the patient to describe the volume of any sputum and its
color, odor, and consistency
![Page 31: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/31.jpg)
Foul-smelling sputum in anaerobic lung abscess; tenacious sputum
in cystic fibrosis
![Page 32: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/32.jpg)
“How much do you think you cough up in 24 hours: a teaspoon, tablespoon, quarter cup, half cup, cupful?” If possible, ask the patient to cough into a tissue; inspect the phlegm and note its characteristics.
![Page 33: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/33.jpg)
:Hemoptysis
![Page 34: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/34.jpg)
Hemoptysis is the coughing up of blood from the lungs; it may vary from blood-streaked phlegm to frank, assess the volume of
blood .
![Page 35: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/35.jpg)
source of the bleeding:may originate in the mouth, pharynx, or gastrointestinal tract. When vomited, it probably originates in the gastrointestinal tract. Occasionally, however, blood from the nasopharynx or the gastrointestinal tract is aspirated and then coughed out.
![Page 36: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/36.jpg)
Blood originating in the stomach is usually darker than
blood from the respiratory tract and may be mixed with
food particles.
![Page 37: In the name of god. History taking lung disease Common Symptoms: Chest pain Shortness of breath (dyspnea) Wheezing Cough Blood-streaked sputum (hemoptysis)](https://reader030.fdocuments.us/reader030/viewer/2022032703/56649d0c5503460f949e1290/html5/thumbnails/37.jpg)