Deck 08_Respiratory-kayrene Flashcards
Compare and contrast therapeutic modalities and diagnostic tests used for the respiratory system
See attached picture
Room air 21%
Incentive spirometry (IS) (help patient to fully expand lungs
- 5 – 10 x/hour while awake, inhale deeply and hold breathe
- Chest physiotherapy (positioning and padding the back to help mobilize secretions pat at different parts of the lungs)
- Nebulizer treatment (filled with fluid so can be air cyclized
- Intermittent positive-pressure breathing (more complicated that’s specially fir to face to create enough pressure down in the lungs to keep alveoli present)
Identify complications of oxygen therapy
-Oxygen toxicity( patient has been on high levels of oxygen greater than 40% over several days happens at a cellular level the body isn’t able to process is and damage lung itself)
-Absorption atelectasis ( can occur when high level of oxygen)
-Mucous membrane dryness :Humidify at 4 L/min or more
-Infection ( different devices used to deliver oxygen)
-Skin break down
Discuss complications prevention of oxygen therapy
Complication prevention: Assess face, ear & neck skin Q 4-8 hours, Mouth care
At home Education: •Oxygen supply company – referral, delivery & demonstration
- Educate patient & caregiver
- Oxygen is a fire hazard
- No smoking while O2 in use
- Use “no smoking” signs
- Keep 6 feet from flames and heat sources
- Check electrial equipment
- keep fire extinguisher near O2 source
- stores tanks upright position
- Do not change settings
- check amount & order in advance
- discuss emergency plan
What changes occur with the aging respiratory system?
- decreased chest walls compliance
- increased residual volumes
- decreased function/strength of intercostals
- increased potential for bronchoconstriction
- decreased cough reflex
- decrease ventilatory response to hypoxia & hypercapnia
What are the signs, symptoms, risk factors, and complications of obstructive sleep apnea (OSA)?
Obstructive sleep apnea (OSA) : upper airway narrow or collapse
Signs/Symptoms: snoring, daytime sleepiness, morning headache
Risk factors: Male gender, age 40-65-, Obesity, cig smoking, alcohol use, narrowed airway, chronic nasal congestion, diabetes mellitus, FX, squatty neck
complications: Hypoxia, Hypercapnia, Acidosis, increased sympathetic vasoconstriction activity
What are the complications of OSA?
-Hypertension
- cardiac ischemia
- myocardial infarction
- stroke
- atrial fibrillation
- HF
- sudden cardiac death
- erectile dysfunction
- surgical complications
- motor vehicle collision (MVC)
Identify risk factors for pneumonia
- Advanced age: long-term care residence
- smoking
- chronic respiratory disease
- asthma, COPD
- immune system dysfunction
- altered mental status (AMS)
- prolonged immobility
- aspiration
- prolonged NPO
- exposure to inhalants
- hospitalizations > 48 hrs
Identify signs and symptoms of pneumonia
- tachycardia/dyspnea
- fever
- chills
- cough
- pleuritic chest pain
- adventitious breath sounds: Rales, ronchi, wheezing (diminished breath sounds bilaterally)
- fatigue
- myalgia/arthalgia
- purulent or blood-streaked sputum
- hypotension
- dysrhythmias
What is the medical and nursing management for pneumonia?
Medical management: depends upon pathogen & severity, Supplemental oxygen, IV fluid, Antimicrobials, Bronchodilators
Nursing management :
- Assess: Changes in mental status, Vital sign trends, Breath sounds, I&O, Respiratory secretions
- Monitor: Laboratory results, Oxygen therapy
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Actions:
- Pulmonary hygiene
- Position HOB 30°, Clustering care (i.e., Activity grouping)
- Encourage fluid intake if not contraindicated, Administer antibiotic
- Teaching: Hand hygiene, Hydration & nutrition, Vaccination – self or others
What are the signs and symptoms of a pulmonary embolism?
Often non-specific dyspnea
- accessory muscle use
- pleuritic chest pain
- dyspnea
- tachycardia
- tachypnea
- rales
- cough
- hemoptysis
- unilateral lower extremity edema
What are the signs and symptoms of a pneumothorax?
Pneumothorax–Partial or complete collapse of lung
Presentation:
- Rapid HR
- Rapid shallow respirations
- New onset nagging cough
- Air hunger
- Chest pain with inhalation or cough,
- Tracheal deviation (tension pneumothorax), Cyanosis
- There will be no sounds on one side. On the other side there will be.
What are the presenting signs and symptoms of asthma?
- Wheezing, dyspnea, coughing, recurrent, prolonged Expiration > Inspiration, Increased sputum
- Increased respiratory rate, Chest tightness, Tachycardia, Inability to speak in full sentences
- Bronchospasm, beta-2 agonists help with the bronchospasms.
What’s the difference between asthma and COPD?
Asthma is reversible, COPD is not.
What health teaching is provided to patients with asthma?
- Monitoring – Peak flow meter
- Avoid Triggers (Cigarette smoke, Mold, Pollen, Dust, Animal Dander, Air pollutants)
- control environmental factors
- medications
- step-wise approach
- long-term controllers
- quick-relief
- They should always have their inhaler (albuterol)
What are the signs, symptoms, and nursing management considerations of COPD?
- Signs: Progressive airflow limitation/obstruction, Nonreversible, Emphysema, Destruction of alveoli, Chronic bronchiti;increase sputum production., Inflammation of bronchiole, Hyperinflation of lungs, Exacerbation
- Symptoms: Dyspnea, Cough, Sputum production, Tachypnea, Retractions, Use of accessory muscles, Abnormal breath sounds, Dyspnea, Cough, Sputum production, Tachypnea, Retractions, Use of accessory muscles, Abnormal breath sounds
- Dependent edema, Nail Clubbing, Cyanosis, Low O2 sat, Orthopnea, Tripod position
- RFS: Cigarette smoking history – pack years, Occupational dusts & chemicals, Outdoor air pollution, Secondhand smoke, Alpha-1 antitrypsin (ATT) disease, Enzyme produced in liver & present in lungs
- Nursing Management:
- Assess: VS, dyspnea, cough, weight.
- Actions: Monitor oxygen, Collaborate with RT, Encourage nutrition & hydration, Encourage pursed lip breathing, Positioning
- Teaching: Breathing techniques, Pacing activities, Symptoms of exacerbation, Vaccine prophylaxis
