Shortness of

breath

Intermittent
Cough

Low grade fever

Temp: 37.5 C.
Night sweats

Back pain
Blood streaked
Sputum

CR:142/min.

RR: 36/min

Tracheal
deviation

intercostal
retractions

Shortness of breath can be related to various factors. One factor is the

decreased elasticity of the alveolar tissue wherein there is changes in the
airway size. Another is decreased lung compliance which causes the
lungs inability to circulate sufficient air. An increase in the residual
volume contributes to the occurrence of SOB. An increased in trapped air
over distends the alveoli. This causes the patient to breath with partially
inflated lungs and with a flat diaphragm. A flat diaphragm decreases the
effectivity of abdominal breathing.
Patients cough is caused by the excessive mucus production as a result
of the increased number of goblet cells and enlarged mucosal glands,
which is the response to the chronic irritation of smoke and other
inhalants.
Fever can be related to the concurrent infection resulted from the pooling
of the excessive mucosal secretions
The release of inflammatory mediators during infections, autoimmune
diseases, and malignancies can temporarily raise the thermal threshold,
inducing chills and shivering that causes core body temperature to rise.
To compensate, sweating is activated to lower the body temperature. The
activation of the inflammatory cascade stimulates the release of
interleukins (IL-1, IL-2, IL-4, IL-6) and tumor necrosis factor. Tumor
necrosis factor is said to be actively produced during nigh time. Hence,
the night sweats.
Presence of cancerous growth resulting to the compression of different
organs, airways, nerves, and blood vessels.
Vascular engorgement with erosion is a mechanism of hemoptysis. It
occurs as a result of acute infection such as viral or bacterial bronchitis,
chronic infection such as bronchiectasis, or a toxic exposure such as
cigarette smoke. The shearing force of coughing can result in erosion and
bleeding.
A compensatory mechanism for the decreased oxygenation caused by
the obstructive conditions such as bronchial spasms, mucosal edem abd
increased mucosal secretions.
A compensatory mechanism for the decreased oxygenation caused by
the obstructive conditions such as bronchial spasms, mucosal edem abd
increased mucosal secretions.
Presence of a growing cancerous tumor can displace the trachea. An
increase in the negative pressure resulted from the overdistention of the
alveoli, concurrently with the increase in the residual volume would be
another factor.
An increased in trapped air over distends the alveoli. This causes the
patient to breathe with partially inflated lungs and with a flat diaphragm.
A flat diaphragm decreases the effectivity of abdominal breathing. To
compensate, the patient breathes through the chest. Chest breathing is not

Hyperresonance
on the left

inspiratory and
expiratory
wheezing
thin and lanky

efficient as abdominal breathing and mainly relies on the intercostal and

accessory muscles. Thus, the visible intercostal retractions.
Hyperresonant sounds that are louder and lower pitched than resonant
sounds are normally heard when percussing the chests of children and
very thin adults. It indicates that air-filled area being percussed. This
occurs when there is the over distention of alveoli and there is retention
of excess air that the patient is unable to expire.
The presence of mucosal edema, bronchial spasms and increased
mucosal secretions results to the narrowing or airway.
Metabolism puts a great demand for oxygenation. Due to the obstructive
conditions such as bronchial spasms, mucosal edema and increased
mucosal secretions, patient would then have a decreased oxygen supply
resulting to the decreased oxygen supply to the GI system to metabolize
nutritional intake.