呼吸器科看護英語：必須語彙とフレーズ

"arterial blood gas"

A blood test taken from an artery that measures the partial pressures of oxygen and carbon dioxide, along with pH and bicarbonate, to assess respiratory and metabolic status

"The arterial blood gas drawn on 40% oxygen revealed a PaO2 of 7.9 kPa, confirming type one respiratory failure in the patient with community-acquired pneumonia."

"respiratory acidosis"

An abnormally low blood pH caused by carbon dioxide retention due to inadequate ventilation, characterised by an elevated PaCO2 above 6.0 kPa

"The blood gas showed a pH of 7.28 with a PaCO2 of 8.4 kPa, consistent with acute respiratory acidosis secondary to decompensated COPD."

"type one respiratory failure"

Respiratory failure characterised by hypoxaemia with a normal or low carbon dioxide level, indicating a failure of oxygenation without primary ventilatory insufficiency

"The patient's blood gas confirmed type one respiratory failure with a PaO2 of 6.2 kPa on room air, and high-flow oxygen was commenced immediately."

"type two respiratory failure"

Respiratory failure in which both hypoxaemia and hypercapnia are present, indicating inadequate alveolar ventilation and carbon dioxide retention

"Repeat blood gas showed rising PaCO2 at 9.1 kPa alongside worsening acidosis, confirming type two respiratory failure requiring non-invasive ventilation."

"PaO2"

The partial pressure of oxygen dissolved in arterial blood, a key measure of oxygenation; the normal range on room air is approximately 10–13.3 kPa in adults

"A PaO2 of 8 kPa on room air fell below the acceptable threshold, prompting the nurse to escalate the patient for urgent respiratory review."

"PaCO2"

The partial pressure of carbon dioxide in arterial blood, reflecting the adequacy of alveolar ventilation; the normal range is 4.7–6.0 kPa

"The nurse noted a rising PaCO2 over three consecutive blood gases and contacted the respiratory team to discuss initiating bilevel positive airway pressure therapy."

"base excess"

A calculated value from an arterial blood gas indicating the amount of excess or deficit of base in the blood, used to assess the metabolic component of acid-base disturbance

"A base excess of negative 8 mmol/L in conjunction with raised lactate suggested a mixed metabolic and respiratory acidosis in the septic patient."

"hypoxaemia"

An abnormally low concentration of oxygen in the arterial blood, typically defined as a PaO2 below 8 kPa or an oxygen saturation below 94% on room air

"The patient presented with acute hypoxaemia, with an oxygen saturation of 83% on room air, and was placed in a high-dependency bay for continuous monitoring."

"bronchospasm"

The sudden tightening of the smooth muscle surrounding the airways, causing narrowing of the bronchi and producing wheezing, coughing, and dyspnoea

"The patient developed severe bronchospasm after exposure to workplace chemicals and required back-to-back nebulised salbutamol to achieve adequate bronchodilation."

"peak expiratory flow rate"

The maximum speed of air expelled from the lungs during a forced exhalation, used to monitor airflow obstruction and gauge the severity and response to treatment in asthma

"The patient's peak expiratory flow rate improved from 40% to 75% of predicted following two hours of nebuliser therapy, indicating a good bronchodilator response."

"FEV1/FVC ratio"

The proportion of the forced vital capacity exhaled in the first second of a forced breath, used in spirometry to confirm airflow obstruction; a ratio below 0.70 indicates obstruction

"Spirometry confirmed a FEV1/FVC ratio of 0.58 with significant post-bronchodilator reversibility, supporting a diagnosis of asthma rather than fixed COPD."

"COPD exacerbation"

An acute worsening of chronic obstructive pulmonary disease symptoms beyond normal day-to-day variation, typically triggered by respiratory infection and characterised by increased breathlessness, sputum, and cough

"The patient was admitted with his third COPD exacerbation in six months and was commenced on controlled oxygen, nebulisers, oral prednisolone, and antibiotics."

"controlled oxygen therapy"

The deliberate delivery of oxygen at a precise, low concentration to hypoxic COPD patients to avoid suppressing the hypoxic respiratory drive and worsening carbon dioxide retention

"The nurse prescribed controlled oxygen therapy at 28% via Venturi mask, targeting a saturation of 88–92% in accordance with the patient's COPD care plan."

"hyperinflation"

Abnormal enlargement of the lungs due to air trapping distal to obstructed airways, leading to a barrel-shaped chest, flattened diaphragm, and impaired respiratory mechanics

"The chest X-ray showed marked hyperinflation with flattened hemidiaphragms, consistent with advanced COPD and significant air trapping."

"pursed-lip breathing"

A breathing technique in which the patient exhales slowly through partially closed lips, creating back-pressure that helps keep small airways open and reduces air trapping in obstructive lung disease

"The respiratory physiotherapist taught the patient pursed-lip breathing during exertion to reduce dyspnoea and improve activity tolerance at home."

"long-acting bronchodilator"

An inhaled medication such as a long-acting beta-agonist or long-acting muscarinic antagonist that maintains bronchial smooth muscle relaxation for 12 to 24 hours to prevent obstruction

"The patient was discharged on a combined long-acting bronchodilator inhaler and received an inhaler technique check from the respiratory nurse before leaving the ward."

"Venturi mask"

An oxygen delivery device that uses the Bernoulli principle to entrain room air and deliver a precise, fixed inspired oxygen concentration regardless of patient breathing pattern

"A 28% Venturi mask was applied immediately to prevent over-oxygenation in the COPD patient with known carbon dioxide retention on previous admissions."

"non-rebreather mask"

A high-flow oxygen delivery device with a reservoir bag and one-way valves that can deliver inspired oxygen concentrations of up to 60–80% for acutely hypoxic patients

"The emergency nurse applied a non-rebreather mask at 15 litres per minute while preparing for urgent intubation in the patient with flash pulmonary oedema."

"high-flow nasal cannula"

A system delivering heated, humidified oxygen at flow rates of up to 60 litres per minute through nasal prongs, capable of achieving high inspired oxygen fractions and reducing respiratory work

"The patient with COVID-19 pneumonia was commenced on high-flow nasal cannula therapy at 40 litres per minute and responded with an improvement in saturation from 88% to 96%."

"bilevel positive airway pressure"

A form of non-invasive ventilation that delivers separate higher inspiratory and lower expiratory pressure levels, assisting both inhalation and exhalation and commonly used for hypercapnic respiratory failure in COPD

"Bilevel positive airway pressure was commenced with an IPAP of 14 cm H2O and EPAP of 4 cm H2O after the blood gas confirmed worsening hypercapnia with acidosis."

"CPAP"

Continuous positive airway pressure; a non-invasive ventilation mode that delivers a constant single pressure level throughout the breathing cycle, used for acute pulmonary oedema and obstructive sleep apnoea

"CPAP at 10 cm H2O was applied in the emergency department and produced rapid improvement in the patient's oxygen saturation and respiratory rate within 20 minutes."

"inspiratory pressure"

The pressure delivered to the airway during the inhalation phase of non-invasive ventilation, determining the degree of ventilatory support and tidal volume achieved

"The nurse increased the inspiratory pressure from 16 to 20 cm H2O following a blood gas that showed persistent hypercapnia without improvement after two hours of bilevel therapy."

"oxygen saturation target"

A prescribed range of peripheral oxygen saturation to be maintained in a specific patient, balancing the risk of hypoxaemia against the risk of hypercapnia or oxygen toxicity

"The admitting doctor prescribed an oxygen saturation target of 88–92% for the COPD patient, and the nurse adjusted the Venturi concentration accordingly at each observation round."

"mask fit"

The secure and comfortable positioning of a non-invasive ventilation interface on the patient's face to minimise air leakage and ensure effective pressure delivery

"Poor mask fit was identified as the cause of NIV failure; the respiratory nurse replaced the full-face mask with a nasal pillows interface and re-titrated the pressures."

"consolidation"

The replacement of air in the alveoli with inflammatory fluid, pus, or blood, appearing as an opaque area on chest X-ray and confirmed by dull percussion and bronchial breath sounds

"Chest X-ray demonstrated right lower lobe consolidation consistent with lobar pneumonia, and the patient was commenced on intravenous amoxicillin-clavulanate."

"CURB-65 score"

A validated clinical severity scoring tool for community-acquired pneumonia that assesses confusion, urea, respiratory rate, blood pressure, and age to guide the decision between outpatient and hospital treatment

"The CURB-65 score of 3 indicated severe pneumonia, and the patient was admitted directly to the respiratory ward for intravenous antibiotics and close monitoring."

"pleuritic chest pain"

Sharp, well-localised chest pain that worsens on inspiration or coughing and is caused by inflammation of the pleural membranes surrounding the lung

"The patient reported pleuritic chest pain on the right side that worsened with deep breathing, prompting a D-dimer test and CT pulmonary angiogram to exclude pulmonary embolism."

"pulmonary embolism"

The obstruction of a pulmonary artery or one of its branches by a blood clot, typically originating from a deep vein thrombosis, causing impaired gas exchange and potentially life-threatening haemodynamic compromise

"The CT pulmonary angiogram confirmed bilateral pulmonary embolism, and anticoagulation with low-molecular-weight heparin was commenced within the hour."

"Wells score"

A clinical pre-test probability scoring system used to estimate the likelihood of pulmonary embolism or deep vein thrombosis before requesting confirmatory investigations

"A Wells score of 6 placed the patient in the high-probability category for pulmonary embolism, and empirical anticoagulation was started while awaiting CT pulmonary angiography."

"anticoagulation"

The use of medications such as heparin, warfarin, or direct oral anticoagulants to prevent the formation or extension of blood clots, the cornerstone of pulmonary embolism treatment

"Following confirmed pulmonary embolism, anticoagulation with rivaroxaban was prescribed for six months, and the nurse counselled the patient on bleeding precautions and drug interactions."

"sputum culture"

A microbiological analysis of expectorated sputum to identify the causative organism of a respiratory infection and guide targeted antibiotic therapy

"A sputum culture sent on admission grew Streptococcus pneumoniae, allowing the team to rationalise antibiotic therapy and de-escalate to oral amoxicillin after 48 hours."

"pleural effusion"

An abnormal accumulation of fluid in the pleural space between the lung and chest wall, causing dull percussion and reduced breath sounds at the base of the affected lung

"Ultrasound-guided thoracentesis was performed to drain a large right-sided pleural effusion that was restricting the patient's ventilation and causing worsening dyspnoea."

"pneumothorax"

The presence of air in the pleural space causing partial or complete lung collapse, classified as spontaneous, traumatic, or tension, with tension pneumothorax being a life-threatening emergency

"Chest X-ray confirmed a large right-sided pneumothorax with greater than 2 cm rim of air, and the on-call surgeon was contacted for urgent chest drain insertion."

"chest drain"

A flexible plastic tube inserted through the chest wall into the pleural space to drain air, blood, or fluid and allow lung re-expansion

"The chest drain was inserted in the fourth intercostal space, mid-axillary line, with the patient in a sitting position, and immediately drained 600 mL of bloodstained fluid."

"underwater seal"

A drainage system in which the distal end of the chest drain tubing is submerged beneath a column of sterile water, allowing one-way drainage of air and fluid while preventing backflow

"The nurse checked the underwater seal drain and noted satisfactory swinging of the fluid level with respiration, confirming correct placement and a functioning drain."

"bubbling in drain"

The appearance of air bubbles in the underwater seal chamber of a chest drain system, indicating that air is actively being evacuated from the pleural space

"Continuous bubbling in the drain throughout the respiratory cycle suggested a persistent air leak from the lung, and the patient was referred for thoracic surgical review."

"clamping the drain"

The temporary closure of a chest drain using a clamp, performed only in specific circumstances such as accidental disconnection or when collecting fluid for analysis

"The nurse was reminded that routine clamping of the drain was not indicated and could be dangerous in the presence of an active air leak, risking tension pneumothorax."

"bronchoscopy"

An endoscopic procedure in which a flexible or rigid camera is passed through the airway to visualise the bronchi, obtain biopsies, and aspirate secretions or foreign bodies

"Flexible bronchoscopy was performed under conscious sedation to obtain bronchoalveolar lavage samples from the patient with diffuse bilateral infiltrates of unknown cause."

"suction catheter"

A soft, sterile flexible tube connected to a vacuum source, used to clear excessive secretions from the oropharynx or endotracheal tube when a patient is unable to expectorate effectively

"The nurse passed a size 14 suction catheter through the nasopharyngeal airway to clear thick secretions from the patient who was too drowsy to cough effectively."

"intercostal nerve block"

The injection of local anaesthetic around an intercostal nerve to provide analgesia for chest wall pain, facilitating deeper breathing and physiotherapy after chest drain insertion or thoracic surgery

"Following chest drain insertion, an intercostal nerve block was performed to reduce pain and allow the patient to participate in breathing exercises with the physiotherapist."

"obstructive sleep apnoea"

A sleep disorder characterised by repeated episodes of upper airway collapse during sleep, causing breathing pauses, oxygen desaturation, and fragmented sleep with daytime somnolence

"The Epworth Sleepiness Scale score of 16 and witnessed apnoeas reported by the partner led to referral for overnight oximetry, which confirmed obstructive sleep apnoea."

"apnoea-hypopnoea index"

The number of apnoeas and hypopnoeas per hour of sleep recorded during polysomnography, used to classify the severity of obstructive sleep apnoea as mild, moderate, or severe

"An apnoea-hypopnoea index of 42 events per hour confirmed severe obstructive sleep apnoea, and CPAP therapy was initiated at a pressure of 10 cm H2O."

"CPAP compliance"

The degree to which a patient with sleep apnoea uses their prescribed continuous positive airway pressure device, typically measured in hours per night, with adequate compliance usually defined as more than four hours on 70% of nights

"Device data download showed poor CPAP compliance of only 2.1 hours per night, and the sleep nurse arranged a review to address mask discomfort and adjust the pressure."

"pulmonary rehabilitation"

A structured, evidence-based programme combining supervised exercise, education, and behaviour change to reduce breathlessness and improve quality of life in patients with chronic respiratory disease

"Following hospital discharge after a COPD exacerbation, the patient was enrolled in a six-week pulmonary rehabilitation programme and reported a significant improvement in exercise tolerance at completion."

"MRC dyspnoea scale"

The Medical Research Council dyspnoea scale, a five-point grading system used to classify the severity of breathlessness in relation to physical activity, widely used in COPD management

"The patient rated herself as grade 4 on the MRC dyspnoea scale, reporting that she stopped for breath after walking about 100 metres on level ground."

"inhaler technique"

The correct sequence of steps required to use a pressurised metered-dose inhaler, dry powder inhaler, or other device to ensure optimal drug delivery to the lungs

"The respiratory nurse demonstrated inhaler technique to the newly diagnosed asthma patient and used the teach-back method to confirm understanding before discharge."

"smoking cessation"

The process of stopping cigarette or tobacco use, including pharmacological and behavioural support strategies, which is the single most effective intervention for slowing COPD progression

"The respiratory nurse offered brief smoking cessation advice, prescribed nicotine replacement therapy, and referred the patient to the local stop-smoking service at every clinic contact."

"rescue medication"

A short-acting bronchodilator such as salbutamol that a patient uses as needed to relieve acute symptoms of bronchoconstriction, distinct from regular controller or preventer inhalers

"Increased use of rescue medication more than three times per week indicated poor asthma control, and the nurse contacted the GP to discuss stepping up the preventer therapy."