Respiratory 3 B Upper Respiratory Condi Flashcards
Problems of the trache and laryns
Airway obstruction
Tracheostomy
Laryngeal polyps
Head and neck cancer
Airway obstruction
Acute obstruction is a medical emergency
Tracheostomy
A surgically created stoma in the trachea in order to establish an airway
Laryngeal polyps
Develop on the vocal cords from trauma to the cords (excessive talking, singing) or irritation (smoking, intubation
Head and neck cancer
Categorised according to the location of the cancer
Obstruxtive sleep apnoea
A disorder in which brrathing is repeated interrupted during sleep
Result from the repetitive collapse of the upper airway
Central sleep apnoea is due to decreased output from ventilatory control centre in the brain
Risk factors of osa
Gender Obesity Age Medical history Obstructive upper airway anatomy Social
SRBD
Only occur when pharyngeal muscle tone progressively falls as one fall into a deeper sleep 💤
Impacts on health and wellbeing
Neurocognitive effect
Cardiovascular effect
Metabolic syndrome
Other social impact
Treatment options for osa
Behavioural changes Weight loss Lifestyle changes Introral appliences Cpap- gold standard treatment
Other considerations
There is that patients with untreated osa are more sensitive opiates
Tracheostomy
Surgically created stoma in anterior wall of the trachea which performed to:
Bypass upper airway obstruction
Facilitate removal of secretion
Allow long term mechanical ventilation
Insertion of tracheostomy
Surgical tracheostomy
Percutaneous tracheostomy
Contraindication
Severe localised sepsis
Uncontrollable coagulopathy
Previous major neck surgery where anatomy cannot be visualised
Benefits of tracheostomy
Kore scure airway
Less risk of long term damage to vocal cords
Decreased work of breathing
Increased patient comfort
Eventually may facilitate oral intake and speech
Tubes types
Cuffed or cuff less
Fenestrated or unfenestrated
Problems of the trachea: tracheostomy
Nursing management
Ensure emergency equipment available for each patient
Ensure you know what type of tube is insitu (cuffed, uncuffed, fenestrated) and why it has been inserted
Maintajn oxygen
Maintain tube patency
Stomaand oral care
Maintain ties and change as per protocol or as necessary
Facilitate alternate means of communication fkr those patients who are conscious and unable to speak
Tracheostomy problem
Airway obstruction Bleeding Aspiration Airwayeaj Fistrula formation Altered body image Tube displacement Impaired cough Subcutaneous emphysema Tracheal stenosis Tracheal necrosis Hypoxia Cardiac arrhythmia Rasied icp
