Respiratory and Hematologic Systems: Core Concepts and Disorders

Posted on Oct 30, 2025 in Medicine & Health

The Respiratory System: Anatomy, Function, and Disorders

Core Respiratory Topics

• Structure and function of the respiratory system
• Causes of respiratory disorders
• Diagnostic tools and nursing care
• Prevention strategies and patient teaching

1. Anatomy of the Respiratory System

Upper Respiratory Tract

• Nose
• Pharynx
• Larynx
• Epiglottis
• Paranasal sinuses

Lower Respiratory Tract

• Trachea
• Bronchi
• Bronchioles
• Alveoli
• Lungs

Key Function: Alveoli are the primary site where oxygen and carbon dioxide are exchanged with the blood.

2. Functions of the Respiratory System

• Filter, warm, and humidify air
• Deliver oxygen to the bloodstream
• Remove carbon dioxide
• Aid in speech (larynx)
• Assist in acid-base balance

3. Breath Sounds

• Vesicular: Soft, heard over most of lungs, longer inspiration
• Bronchovesicular: Medium pitch, equal inspiration/expiration
• Bronchial: Loud, heard over trachea, longer expiration

4. Causes of Respiratory Disorders

• Infection (bacterial or viral)
• Environmental exposures (pollution, smoking)
• Trauma or injury
• Chronic diseases (asthma, COPD)
• Cardiac issues (e.g., pulmonary embolism)

Sputum Characteristics

5. Diagnostic Tests

• Throat culture
• TB skin test (Mantoux)
• Peak flow meter (for asthma monitoring)
• Spirometry (lung function testing)
• Lung biopsy
• Chest x-ray

6. Nursing Concerns

• Airway obstruction
• Ineffective breathing pattern
• Risk for infection
• Fatigue
• Nutritional imbalance

7. Smoking Cessation (The 5 A’s)

1. Ask about tobacco use
2. Advise to quit
3. Assess readiness
4. Assist in quitting
5. Arrange follow-up

8. Prevention Strategies

• Wash hands frequently
• Avoid crowds during flu season
• Stop smoking
• Maintain a healthy diet, hydrate, and rest
• Avoid known allergens

Upper Respiratory Tract Disorders

Major Conditions

1. Rhinitis (Common cold)
2. Sinusitis
3. Pharyngitis
4. Laryngitis
5. Epistaxis (Nosebleed)
6. Obstructive Sleep Apnea (OSA)
7. Laryngeal Cancer
8. Tracheostomy Care

Rhinitis (Common Cold)

• Cause: Viral; highly contagious
• S/S: Runny nose, congestion, sore throat, sneezing, cough
• Tx: Rest, fluids, antihistamines, decongestants

Sinusitis

• Cause: Inflammation of sinus linings
• S/S: Headache, facial pressure, nasal drainage, fever, tooth pain
• Tx: Decongestants, nasal rinses, antibiotics (if bacterial)

Pharyngitis & Laryngitis

• Pharyngitis: Sore throat; Laryngitis: Hoarseness
• Cause: Infection or vocal overuse
• Tx: Rest, fluids, lozenges, warm gargles, antibiotics (if bacterial)

Epistaxis (Nosebleed)

• Management: Sit upright, lean forward, pinch soft part of nose. Avoid tilting head back.
• Causes: Trauma, dry air, blood thinners

Obstructive Sleep Apnea (OSA)

• Definition: Airway collapses during sleep
• S/S: Snoring, daytime fatigue, restless sleep
• Tx: CPAP, weight loss, avoid alcohol/sedatives

Laryngeal Cancer

• Risk Factors: Strongly linked to smoking and alcohol use
• S/S: Hoarseness lasting more than 2 weeks, sore throat, ear pain, swallowing issues
• Tx: Surgery (laryngectomy), radiation, chemotherapy
• Post-op Care: Includes airway maintenance and alternative communication methods

Tracheostomy Care

• Definition: Surgical airway opening
• Nursing Care: Sterile suctioning, stoma care, humidified air, infection prevention

Lower Respiratory Disorders and Emergencies

Focus Areas

Covers infections, chronic diseases, traumatic injuries, and emergencies affecting the lower airways and lungs:

• Bronchitis
• Influenza
• Pneumonia
• Atelectasis
• Tuberculosis (TB)
• COPD (Chronic Bronchitis & Emphysema)
• Asthma
• Status Asthmaticus
• Cystic Fibrosis
• Pneumothorax
• Lung Cancer
• Pulmonary Embolism
• Chest Injuries
• ARDS (Acute Respiratory Distress Syndrome)
• Respiratory Failure

Common Lower Respiratory Conditions

1. Bronchitis

• Cause: Inflammation of the bronchi (often viral)
• S/S: Cough, mucus production, wheezing
• Tx: Fluids, bronchodilators, rest, humidified air

2. Influenza

• S/S: Fever, chills, sore throat, muscle aches, cough
• Tx: Antivirals (e.g., oseltamivir), rest, hydration

3. Pneumonia

• Cause: Infection in the lungs (bacterial, viral, fungal)
• S/S: Productive cough, fever, chills, chest pain, crackles
• Dx: Chest x-ray
• Tx: Antibiotics, oxygen, fluids, rest

4. Atelectasis

• Cause: Collapse of alveoli
• S/S: Dyspnea, decreased breath sounds
• Tx: Incentive spirometry, coughing, deep breathing, early ambulation

5. Tuberculosis (TB)

• S/S: Cough lasting more than 3 weeks, night sweats, fever, weight loss
• Dx: TB skin test, chest x-ray, sputum culture
• Tx: INH, Rifampin (causes orange secretions), Ethambutol, PZA — often administered via Directly Observed Therapy (DOT)
• Precautions: Airborne isolation, N95 mask required, negative pressure room

6. COPD (Chronic Bronchitis & Emphysema)

• Cause: Smoking, air pollution, chronic irritants
• S/S: Chronic cough, sputum production, dyspnea, barrel chest
• Dx: Pulmonary Function Tests (PFT)
• Tx: Bronchodilators, corticosteroids, oxygen, pulmonary rehabilitation
• Diet: High protein, small frequent meals
• Positioning: Sit upright, lean forward (tripod position)

7. Asthma

• Cause: Inflammation + bronchospasm (often triggered by allergens or exercise)
• S/S: Wheezing, shortness of breath (SOB), chest tightness, coughing
• Tx: Bronchodilators (Albuterol), steroids, avoidance of triggers

8. Status Asthmaticus

• Definition: Severe asthma attack unresponsive to standard treatment
• Life-threatening emergency
• Requires: Emergency bronchodilators, oxygen, possible intubation

9. Cystic Fibrosis

• Definition: Genetic disorder affecting mucus glands
• S/S: Thick mucus, chronic cough, frequent lung infections
• Dx: Positive sweat test
• Tx: Chest physiotherapy, bronchodilators, pancreatic enzymes

10. Pneumothorax

• Cause: Air in the pleural space, leading to collapsed lung
• S/S: Sudden chest pain, dyspnea, absent breath sounds on one side
• Tx: Chest tube insertion

11. Lung Cancer

• Risk Factors: Smoking, asbestos exposure
• S/S: Chronic cough, hemoptysis (coughing up blood), weight loss, wheezing
• Dx: Imaging, biopsy
• Tx: Surgery, chemotherapy, radiation

12. Pulmonary Embolism (PE)

• Cause: Blood clot lodged in a lung artery
• S/S: Sudden SOB, chest pain, cough, anxiety
• Dx: D-dimer test, CT scan
• Tx: Oxygen, anticoagulants (heparin), thrombolytics

13. Chest Injuries

• Types: Rib fractures, flail chest, pneumothorax
• Tx: Pain control, oxygen, chest tube if necessary

14. ARDS (Acute Respiratory Distress Syndrome)

• Cause: Trauma, sepsis, inhalation injury
• S/S: Severe dyspnea, crackles, hypoxemia
• Tx: Mechanical ventilation, treatment of the underlying cause

15. Respiratory Failure

• S/S: Restlessness, confusion, dyspnea, decreased SpO2
• Tx: Oxygen therapy, possible intubation

The Hematologic System: Blood Components and Function

Core Hematology Topics

• Functions of blood
• Blood components
• Plasma proteins
• Blood cell production
• Immune and clotting functions
• Aging effects on the hematologic system
• Prevention and risks

1. Functions of Blood

• Transportation: Oxygen, nutrients, hormones, waste products
• Regulation: pH balance, fluid balance, body temperature
• Protection: Immune response and clotting mechanisms

2. Components of Blood

Blood is made up of formed elements and plasma:

Formed Elements

• Erythrocytes (RBCs): Carry oxygen via hemoglobin
• Leukocytes (WBCs): Fight infection
• Platelets (Thrombocytes): Aid in clotting

Plasma

• Comprises 55% of blood volume
• Composition: Water, electrolytes, hormones, waste products, gases (O₂, CO₂)
• Plasma Proteins:
  • Albumin – maintains osmotic pressure
  • Globulins – involved in immune response
  • Fibrinogen – essential for blood clotting

3. Red Blood Cells (RBCs)

• Function: Carry oxygen to tissues using hemoglobin
• Lifespan: Approximately 120 days
• Regulation: Production is regulated by Erythropoietin (released from the kidneys)

4. White Blood Cells (WBCs)

• Function: Defend the body against infection
• Types: Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils
• Lifespan: Approximately 13–20 days
• Normal Range: 4,500 – 11,000 cells/µL

5. Platelets

• Function: Control bleeding and aid in clot formation
• Normal Range: 150,000 – 450,000/µL

6. Lymphatic and Vascular Interaction

The lymphatic and vascular systems work together to transport immune cells and return fluid to the bloodstream.

7. Age-Related Hematologic Changes

• Reduced bone marrow function
• Lower immune response
• Slower recovery from illness
• Decreased iron levels and erythropoietin response

8. Genetic Tendencies

Some hematologic disorders, such as sickle cell disease or hemophilia, are inherited.

9. Prevention of Hematologic Disorders

• Good nutrition (adequate iron, B12, folic acid intake)
• Hydration
• Avoid environmental toxins
• Manage chronic illnesses effectively
• Routine blood screenings

Hematologic Disorders and Management

1. Anemias

Iron Deficiency Anemia

• Cause: Poor iron intake, chronic blood loss, pregnancy
• S/S: Fatigue, pallor, brittle nails, shortness of breath (SOB)
• Tx: Iron supplements, iron-rich diet (leafy greens, red meat, fortified cereals)

Pernicious Anemia

• Cause: Lack of intrinsic factor leading to B12 deficiency (often autoimmune)
• S/S: Glossitis (smooth, red tongue), fatigue, neuropathy, memory issues
• Tx: Monthly intramuscular (IM) B12 injections for life

Aplastic Anemia

• Cause: Bone marrow suppression (from virus, drugs, or autoimmune disease)
• S/S: Fatigue, frequent infections, bleeding
• Tx: Blood transfusions, bone marrow transplant, strict infection prevention

Sickle Cell Anemia

• Cause: Genetic disorder; abnormal hemoglobin causes crescent-shaped RBCs
• S/S: Pain crises, swelling, fatigue, jaundice, organ damage
• Tx: Oxygen, fluids, pain management, hydroxyurea; prevent triggers (cold, dehydration, stress)

2. Clotting Disorders

Thrombocytopenia

• Definition: Low platelet count (<150,000/µL)
• S/S: Easy bruising, petechiae, bleeding gums, prolonged bleeding
• Types:
  • ITP (Idiopathic Thrombocytopenic Purpura): Autoimmune destruction of platelets
  • HIT (Heparin-Induced Thrombocytopenia): Adverse reaction to heparin
  • TTP (Thrombotic Thrombocytopenic Purpura): Clots form in small blood vessels
• Tx: Treat underlying cause, implement bleeding precautions, platelet transfusions if necessary

3. Leukemia

• Definition: Cancer of the white blood cells (WBCs)
• S/S: Fatigue, weight loss, bruising, frequent infections, enlarged spleen/lymph nodes
• Tx: Chemotherapy, radiation, bone marrow transplant
• Nursing Care: Monitor for infection and bleeding; implement neutropenic precautions

4. DIC (Disseminated Intravascular Coagulation)

• Cause: Sepsis, trauma, shock, burns
• S/S: Simultaneous clotting and bleeding, petechiae, oozing from IV sites, organ failure
• Labs: Decreased Platelets, decreased Fibrinogen, increased D-dimer, increased PT/PTT
• Tx: Treat underlying cause, administer blood products, heparin (if clotting dominates)

5. Blood Transfusion Reactions

• S/S: Fever, chills, back pain, hypotension, rash, SOB
• Nursing Action:
  1. Stop transfusion immediately
  2. Notify RN/provider
  3. Monitor vital signs
• Administration Guidelines:
  • Must start within 30 minutes of receiving blood product
  • Must complete infusion within 4 hours
  • Only compatible IV fluid: Normal Saline (0.9% NaCl)

6. Neutropenic Precautions

For patients with low WBC counts or undergoing chemotherapy:

• No fresh fruits, vegetables, or flowers allowed
• Use PPE (gloves, mask) and strict hand hygiene
• Avoid crowds or contact with sick individuals

Important Hematologic Lab Values