2. Review of Anatomy & Physiology of the
Respiratory system
Student Centered review
Students’ contribution from the previous module of Anatomy &
physiology
3. Overview of the Respiratory system
• The Respiratory System is a network of organs and tissues that help
one breathe. It includes the airways, lungs and blood vessels. The
muscles that empower the lungs are also part of the respiratory
system. These parts work together to move oxygen throughout the
body and clean out waste gases like carbon dioxide.
4. Functions of the Respiratory system
• Helping one to inhale (breathe in) and exhale (breathe out) air.
• Allows one to talk and to smell.
• Warms air to match your body temperature and moisturizes it to the
humidity level your body needs.
• Delivers oxygen to the cells in your body.
• Removes waste gases, including carbon dioxide, from the body when
you exhale.
• Protects your airways from harmful substances and irritants.
5. Conditions and Disorders
• The conditions affect the organs and tissues that make up the
respiratory system. Some develop due to irritants we breathe in
from the air, including viruses or bacteria that cause infection. Others
occur as a result of disease or getting older.
6. Conditions of the Respiratory system:
Are Either due to inflammation (swelling, irritation and pain) or
infections and these include:
Inflammations include
Allergies:
Inhaling proteins, such as dust, molds, and pollen, can cause
respiratory allergies in some people. These proteins can cause
inflammation in the airways.
• Asthma:
A chronic (long-term) disorder, asthma causes inflammation in the
airways that can make breathing difficult.
7. Cont.
• Infections:
Infections can lead to pneumonia (inflammation of the lungs) or
bronchitis (inflammation of the bronchial tubes). Common respiratory
infections include the flu (influenza) or a cold.
• Diseases like :
Respiratory disorders include lung cancer and chronic obstructive
pulmonary disease ( COPD). These conditions can harm the respiratory
system’s ability to deliver oxygen throughout the body and filter out waste
gases.
Others
• Aging:
Lung capacity decreases as you get older.
• Damage:
Damage to the respiratory system can cause breathing problems.
8. Common Respiratory conditions include:
• Pneumonia
Pneumonia can be inflammation or infection of one or both lungs
that may develop as a primary or secondary infection.
Is mostly caused by either bacterial, viral, or fungal infection.
and affects the alveoli inside the lungs filling them with fluid which
eventually can form pus, leading to coughing, chest pain, and
breathing difficulties.
9. Types of pneumonia
Types differ depending on their cause.
The different types and their associated causes include:
• Bacterial pneumonia:
• Many bacterial strains can cause pneumonia, but the most common
is Streptococcus pneumonia (S. pneumoniae).
• Viral pneumonia:
• Viral causes of pneumonia include Trusted Source the respiratory
syncytial virus and influenza types A and B.
• Fungal pneumonia:
• This can result from conditions like Valley fever caused by a fungus.
• .
10. Cont.
• Aspiration pneumonia:
This type occurs as a result of inhaling materials eg food, liquids, or
stomach contents into the lungs. Aspiration pneumonia is not
contagious.
• Hospital-acquired pneumonia:
This can occur in people receiving hospital treatment for other
conditions e.g. from use of respirators etc.
Regardless of the cause of pneumonia, the signs and symptoms will
be similar
11. Incidence
People most at high risk of developing pneumonia are young
children, elderly and those with preexisting medical conditions that
weaken the immune system.
These people are also have high risk of developing complications of
pneumonia.
12. Pathophysiology
The most frequent cause of bacterial pneumonia is infection with the
gram-positive S. pneumoniae.
These sources of microorganisms are either from the nasal
organisms, sinusitis, oropharynx, gastric, or tracheal colonization, and
hematogens
The pathogens reach the alveoli and the host defenses get
overwhelmed by the microorganism virulence or by the inoculum
size.
The development of the infection in in four stages ie congestion, red
hepatization, grey hepatization, and resolution.
13. The four stages are
• Stage 1 (Congestion)
Occurs within 24 hours of infection. Many bacteria are present in the
lungs but few white blood cells are available to fight the infection. The
lungs may look red from increased blood flow and the swelling of the
lung tissue.
• Stage 2 (red Hepatization)
Occurs after 48 to 72 hours and lasts for about 2 to 4 days. The
affected lung becomes more dry, granular and airless and resembles
the consistency of liver. Red cells, white cells, bacteria and cellular
debris can clog the lung airways.
14. Cont.
• Stage 3 (grey Hepatization)
Occurs on day 4 to 6 and continues for 4 to 8 days. The lung looks grey or
yellow in color like the liver. Fibrin, hemosiderin and red blood cells break
down and lead to a more fluid-like exudate. Macrophages (a type of large
white blood cells) start to form.
• Stage 4 (Resolution)
Is the final recovery stage which occurs during 8 to 10 days.
Fluids and breakdown products from cell destruction are reabsorbed.
Macrophages present help to clear white blood cells (neutrophils) and
leftover debris.
The patient may cough up this debris.
The airways and air sacs (alveoli) return to normal lung function. Any
remaining lung swelling may lead to chronic lung disease (such as airway
narrowing or pleural adhesions).
15. Cont.
Most common symptoms in most of the pneumonias are:
fever
Cough with sputum
shortness of breath
and fatigue.
In older patients, fatigue or confusion can be the only or most
noticeable symptom.
In viral pneumonia, a dry cough without sputum is more common.
16. Diagnosis
Observe for signs of confusion and paleness of the lips, fingernails
or hands as indication for low levels of oxygen in the blood
Physical exam will reveal rapid breathing
Percussion to listen for abnormal sounds from the lungs.
Chest X-ray Is a confirmatory investigation
17. Nursing interventions aimed at
• Maintaining a patent airway /improve respiratory function.
• Preventing complications.
• Supporting recuperative process.
• Providing information about disease process, prognosis, and
treatment.
18. Nursing Management
• Therapeutic interventions and nursing interventions for patients
with pneumonia may include:
• Maintaining Patent / clear Airway.
• Improving Gas exchange.
• Promoting Effective Breathing Pattern and Breathing Exercises.
• Administering Medications and Pharmacological Support.
• Initiating Measures for Infection Control & Management.
20. Nursing care plan
• Nursing care planning begins when the patient is admitted and is
continuously updated throughout in response to the changes in
condition and evaluation of goal achievement.
• Planning and delivering individualized or patient-centered care is the
basis for excellence in nursing practice.
21. Types of Nursing Care Plans
• Care plans can be informal or formal:
An informal nursing care plan is a strategy of action that exists in the
nurse‘s mind.
A formal nursing care plan is a written or computerized guide that
organizes the patient’s care information.
22. Care plans cont.
Formal care plans are further subdivided into standardized care plans
and individualized care plans:
Standardized care plans specify the nursing care to be provided to
the groups of patients with everyday needs.
Individualized care plans are tailored to meet a specific client’s
unique needs or needs that are not addressed by the standardized
care plan.
23. Cont.
• Standardized care plans
are pre-developed guides by the nursing staff and health care
providers to ensure that patients with a particular condition receive
consistent care.
These care plans are used to ensure that minimally acceptable
criteria are met and to promote the efficient use of the care
provider’s time by removing the need to develop common activities
that are done repeatedly for many of the clients on a nursing unit.
Standardized care plans are not tailored to a patient’s specific needs
and goals and can provide a starting point for developing an
individualized care plan.
24. Individualized Care Plans
Involve are directed towards meeting the specific needs and goals of
the individual patient / client and use approaches shown to be
effective for a particular patient / client. This approach allows more
personalized and holistic care better suited to the patient’s / client’s
unique needs, strengths, and goals.
Can improve patient satisfaction. When patients feel that the care
provided is tailored to the specific needs, they feel heard and valued
leading to increased satisfaction with the care.
25. Components of Individualized care plan
• Include nursing Client Assessment, Diagnoses, Planning (goal &
expected outcomes), Nursing Interventions, and rationales and
Evaluation. These components are elaborated on below:
• Client assessment
medical results, and diagnostic reports are the first steps to
developing a care plan. In particular, client assessment relates to the
following areas and abilities: physical, emotional, sexual,
psychosocial, cultural, spiritual/transpersonal, cognitive, functional,
age-related, economic, and environmental. Information in this area
can be subjective and objective.
• Nursing diagnosis
A nursing diagnosis is a statement that describes the patient’s health
issue or concern. It is based on the information gathered about the
patient’s health status during the assessment.
26. Cont.
• Planning ( goal & expected outcomes)
These are specific goals that will be achieved through nursing
interventions. These may be long and short-term.
• Nursing interventions.
These are specific actions that will be taken to address the nursing
diagnosis and achieve expected outcomes. They should be based on
best practices and evidence-based guidelines.
Rationales.
These are evidence-based explanations for the nursing interventions
specified.
• Evaluation.
These includes plans for monitoring and evaluating a patient’s
progress and making necessary adjustments to the care plan as the
patient’s health status and goals change.
27. Difference between Actual & Potential
Nursing diagnosis
ACTUAL NURSING DIAGNOSIS
IS A PROBLEM-FOCUSED DIAGNOSIS
Expressed as related to________(Related Factors) as evidenced by
_____________ (Defining Characteristics).
• In a problem-focused diagnostic statement, use the problem-etiology-
symptom method.
• Start with the diagnosis itself, followed by the etiologic factors
(related factors in an actual diagnosis), then identify the major
signs/symptoms (defining characteristics) that are appearing in the
patient.
28. Cont.
Potential is developed as
• Risk for_____as evidenced by_____(Risk Factors)
E.g.
• For risk diagnoses, there are no related factors (etiological factors) as
you are identifying a vulnerability in a patient for a potential problem;
the problem is not yet present. Therefore, you identify the risk factors
that predispose the individual to a potential problem.
• An example would be “Risk for (infection) as evidenced by
(suppressed inflammatory response).”
