Respiratory Flashcards
Asthma
Patho: Clinical Manifestations: Ax: Management: Nursing Care:
Patho: - Airway inflammation - airway hyperresponsiveness - Mucus hyper secretion = airflow obstruction
- airway responds in abnormal exaggerated way to triggers such as allergens
= mast cell degranulation and release of inflamm mediators - increased inflamm results in increased mucuc, bronchial smooth muscle spasms
Clinical Manifestations:
- Wheeze,
- SOB
- Chest tightening
- use of accessory muscles
- In and exp wheeze
- Tachypnoea and cardia
Ax:
- Primary
- Secondary
- Focused (inspect, auscultate, percuss, palpate)
Mgmt:
- Correct hypoxamie
- reverse obstruction
- plan to prevent
Nursing care:
- Education
-
COPD
Patho:
Clinical Manifestations:
Management:
Nursing Care:
- Chronic bronchitis
- hyper secretion of mucus and productive cough.
- cigarette and inhalation of harmful particles
- Emphysema
- Destruction of alveolar space, creates large air spaces in lung tissue
- air spaces not able to participate effectively in gas exchange
- air trapping as expiration is challenged due to loss of elastic recoil
Mgmt:
- O2 therapy
- education
- reassurance
Pneumonia
Patho: Clinical Manifestations: Ax: Management: Nursing Care:
Patho:
- acute infection of lower resp tract
- pathogens pass defence mechanisms to reach lower resp tract
- acute inflamm response damages bronchial mucous membranes, causing accumulation of thickened fluid.
- impacts gas exchange
Clinical manifestations
- Tachypnoea
- SOB
- Accessory muscles
- Low O2 sats
- Productive cough
Mgmt:
- O2 therapy
- Meds
- Pain relief
- Deep breathing
Nursing care
- PPE
- Education
- ADL assistance
Tuberculosis
Patho: Clinical Manifestations: Ax: Management: Nursing Care:
Patho:
- Infection caused by mycobacterium tuberculosis
- settles in the lungs causing inflammation
- inflammation activates macrophages and neutrophils, engulfing bacteria forming lesions called tubercles. Infected tissue dies, forms necrotic scar tissue
Active:
- chronic cough
- sputum
- loss of apetite
- fever
Mgmt:
- Sputum collection
- Chest x ray
Treatment:
- antibiotics for 6 months
Nursing care:
- PPE
- Education
- ADL assistance
Pleural Effusion
patho:
Clinical manifestations:
Acute management:
Considerations
- abnormal collection of fluid in pleural space
- caused by increased pleural membrane permeability
- increased capillary pressure
Clinical manifestations
- dyspnoea
- cough
- sharp chest pain
Management
- O2 therapy is <94%
- pain ax
- med administration
Considerations:
- generally secondary to another illness (heart failure, liver disease, cancer)
Pneumothorax
Patho:
Clinical manifestations:
Acute management:
Considerations:
Tension Pneumothorax
- Presence of air or gas in the pleural space caused by a rupture in the visceral pleura
- Causes negative pressure and causes lung to collapse
- Closed = air does not enter through external wound
- Open = air enters through external wound
Tension:
- Pressure in pleural space pushes against collapsed lung, air pushes against mediastinum and compresses and displaces the heart. Compromising cardiac output
Management:
- O2 sats <94&
- Trauma: Cervical spine stabilisation
- ICC and UWD care
Nursing care:
- hourly jobs
- chest Physio
- ADLs support
Lung cancer
Patho:
Clinical manifestations:
Acute management:
Considerations:
- mutated epithelial cells
- cause: genetic, exposure to carcinogens
Clinical manifestations
- non-specific
- occur late
- cough, chest pain
- fatigue, weight loss
management and considerations
- pain
- support
Tracheostomy
indication
care
complications
- surgical opening in the trachea, placement of an indwelling tube to overcome upper airway obstruction\
care:
- DRSABCD
- focused ax
- emergency equipment (bag valve mask, suction, spare trashy)
suctioning
- less than 15secs
complications:
- leak
- bleeding
- aspiration
- tube displacement
UWSD & ICC
indication:
complications
nursing management:
ICCs: inserted in-between ribs to remove air, pus fluid in the pleural space
UWSD: collect fluid/air restore normal resp function
complications:
- haemorrhage
- infection
- pain
Management:
- safety checks
- pt ax
- pain
- check site
