This document discusses dyspnea (shortness of breath) and cough, including their definitions, causes, types, complications, assessments, and management. Dyspnea is a subjective symptom often seen in lung diseases and disorders that can decrease lung function. Its treatment varies and may include oxygen therapy, medications like opioids, bronchodilators, and non-pharmacological interventions. Cough is a reflex to clear the lungs and airways and can indicate various respiratory conditions. Nursing focuses on airway clearance and monitoring for dyspnea and cough.
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Respiratory obstruction / Airway Obstruction Aby Thankachan
Precise guide for DGNM, B.Sc Nursing & M.Sc Nursing Students .. regarding Respiratory obstruction / Airway Obstruction, and its management. Highly recommended for II B.Sc Nursing Students.
Constipation easy explanation -
Easy ppt for Student Nurses
Definition of Constipation
risk factors
Clinical manifestations of Constipation
Assessment & Diagnostic tests
Management of Constipation
Medical management of Constipation
Nursing Management of Constipation
BRONCHIAL ASTHMA
ntroduction
Definition
Etiological factors
Pathophysiology
Types of asthma
Clinical manifestation Restlessness Wheezing or crackles Absent or diminished lung sounds Hyper resonance Use of accessory muscles for breathing Tachypnea with hyperventilation
Clinical manifestation
Diagnostic evaluation
Bronchoprovocation Testing: Testing that is done to identify inhaled allergens; mucous membranes are directly exposed to suspected allergen in increasing amounts. Skin Testing: Done to identify specific allergens. Exercise Challenges: Exercise is used to identify the occurrence of exercise-induced bronchospasm. Radio allergosorbent Test: Blood test used to identify a specific allergen. Chest Radiograph: May show hyper expansion of the airways.
Managemnet
Goal- Promote bronchodilationn Reduce inflammation Remove secretions Prevent ongoing symptoms Prevent asthma attack Maintain normal lung function Avoid triggers
Pharmacological therapy 1. Long term control medication- Inhaled corticosteroid Leukotriene modifiers Long acting beta agonist Methylxanthines Combine inhaler
2 Quick relief medication Short acting beta agonist Anticholinergic Oral or I/V corticosteroid
3 Bronchial thermoplasty- Form severe asthma that does not respond to medication
Non- pharmacological
Oxygen therapy Postural drainage & chest physiotherapy Coughing & deep breathing exercise Avoidance of allergen relaxation technique acupuncture
Prevention
Patients with recurrent asthma should undergo tests to identify the substances that precipitate the symptoms. Possible causes are dust, dust mites, roaches, certain types of cloth, pets, horses, detergents, soaps, certain foods, molds, and pol- lens. If the attacks are seasonal, pollens can be strongly sus- pected. Patients are instructed to avoid the causative agents whenever possible.
Complications Complications of asthma may include status asthmaticus, respiratory failure, pneumonia, and atelectasis. Airway obstruction, particularly during acute asthmatic episodes, often results in hypoxemia, requiring the administration of oxygen and the monitoring of pulse oximetry and arterial blood gases. Fluids are administered, because people with asthma are frequently dehydrated from diaphoresis and in- sensible fluid loss with hyperventilation.
Nursing diagnosis
Impaired gas exchange r/t altered oxygen supply Ineffective airway clearance r/t bronchospasm & obstruction from narrow lumen Ineffective breathing pattern r/t bronchospasm Risk for increasing attack of r
espiratory distress r/t exposure to allergens
Respiratory obstruction / Airway Obstruction Aby Thankachan
Precise guide for DGNM, B.Sc Nursing & M.Sc Nursing Students .. regarding Respiratory obstruction / Airway Obstruction, and its management. Highly recommended for II B.Sc Nursing Students.
Constipation easy explanation -
Easy ppt for Student Nurses
Definition of Constipation
risk factors
Clinical manifestations of Constipation
Assessment & Diagnostic tests
Management of Constipation
Medical management of Constipation
Nursing Management of Constipation
BRONCHIAL ASTHMA
ntroduction
Definition
Etiological factors
Pathophysiology
Types of asthma
Clinical manifestation Restlessness Wheezing or crackles Absent or diminished lung sounds Hyper resonance Use of accessory muscles for breathing Tachypnea with hyperventilation
Clinical manifestation
Diagnostic evaluation
Bronchoprovocation Testing: Testing that is done to identify inhaled allergens; mucous membranes are directly exposed to suspected allergen in increasing amounts. Skin Testing: Done to identify specific allergens. Exercise Challenges: Exercise is used to identify the occurrence of exercise-induced bronchospasm. Radio allergosorbent Test: Blood test used to identify a specific allergen. Chest Radiograph: May show hyper expansion of the airways.
Managemnet
Goal- Promote bronchodilationn Reduce inflammation Remove secretions Prevent ongoing symptoms Prevent asthma attack Maintain normal lung function Avoid triggers
Pharmacological therapy 1. Long term control medication- Inhaled corticosteroid Leukotriene modifiers Long acting beta agonist Methylxanthines Combine inhaler
2 Quick relief medication Short acting beta agonist Anticholinergic Oral or I/V corticosteroid
3 Bronchial thermoplasty- Form severe asthma that does not respond to medication
Non- pharmacological
Oxygen therapy Postural drainage & chest physiotherapy Coughing & deep breathing exercise Avoidance of allergen relaxation technique acupuncture
Prevention
Patients with recurrent asthma should undergo tests to identify the substances that precipitate the symptoms. Possible causes are dust, dust mites, roaches, certain types of cloth, pets, horses, detergents, soaps, certain foods, molds, and pol- lens. If the attacks are seasonal, pollens can be strongly sus- pected. Patients are instructed to avoid the causative agents whenever possible.
Complications Complications of asthma may include status asthmaticus, respiratory failure, pneumonia, and atelectasis. Airway obstruction, particularly during acute asthmatic episodes, often results in hypoxemia, requiring the administration of oxygen and the monitoring of pulse oximetry and arterial blood gases. Fluids are administered, because people with asthma are frequently dehydrated from diaphoresis and in- sensible fluid loss with hyperventilation.
Nursing diagnosis
Impaired gas exchange r/t altered oxygen supply Ineffective airway clearance r/t bronchospasm & obstruction from narrow lumen Ineffective breathing pattern r/t bronchospasm Risk for increasing attack of r
espiratory distress r/t exposure to allergens
Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance
Acute respiratory distress syndrome nursing care plan & managementNursing Path
1. Acute respiratory distress syndrome is a form of acute respiratory failure that occurs as a complication of some other condition, is caused by a diffuse lung injury, and leads to extravascular lung fluid.
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
COUGH AND DYSPNEA.pptx
1.
2. INTRODUCTION
• Dyspnea is a highly subjective symptom that
often is not associated with visible signs of
distress,such as Tachypnea,Diaphoresis,or
cyanosis.
• Patients with primary lung tumors,lung
metastases,pleural effusion or restrictive
lung disease may experience significant
dyspnea.
3. The causes of the dyspnea can be
identified and treated in some cases ,the
burdens of additional diagnostic
evaluation and treatment aimed at the
physiologic problem may outweigh the
benefits
The treatment of dyspnea varies
depending on the patients general
physical condition.
4. DEFINITIONS
“Dyspnea is the term used when the subject is
conscious of the increased respiratory effort
.In other words difficulty in breathing.”
[R.Chandra Mouli]
“Dyspnea is a symptom common to many
pulmonary and cardiac disorders,particularly
when there is decreased lung complicance or
increased airway resistance.”
[Suresh K.Sharma,S.Madhavi]
5. ETIOLOGY
Dyspnea may associated with neurologic or
neuromuscular disorders(eg;Myasthenia
gravis,Guillain-Barre syndrome,Muscular
dystrophy,post-polio syndrome) that affect
respiratory function .
Dyspnea occurs after physical exercise in
people without disese.
Dyspnea is a common at the end of the life
in patients with a variety of disorders.
6. MANAGEMENT OF DYSPNEA
This can be achieved by pursuing one or,more
strategies including both pharmacological
and non-pharmacological interventions.
9. NON-PHARMACOLOGICAL
INTERVENTIONS
1. Deep breathing and coughing
exercises,diaphramatic breathing and
pursed lip breathing.
2. Chest physiotherapy
3. Postural drainage
4. Chest percussion and chest vibration
5. Psychotherapy
6. Exercise training and Relaxation training
7. Acupuncture
10. OXYGEN THERAPY
Supplemental oxygen can reverse
hypoxemia.If lack of oxygen is the cause
of dyspnea ,oxygen may be the only
required therapy.
Patients who can’t breath enough oxygen
from the air may be given supplemental
oxygen to inhale from
tanks/cylinders.Devices that concentrate
oxygen already in the air maybe also
prescribed.
11. MEDICATIONS
Opoids may reduce physical and mental
distress and exhaustion,and improve the
patients quality of life.
Opoids,steroids,bronchodilators and
antianxiety medication maybe helpful for
some people.Steroids drugs are used to
reduce the inflammation and swelling of
lymph vessels in the lungs.
12. Bronchodilators are prescribed to open
up the bronchioles (small airways)in the
lungs.
Bronchodilators such as Albutamol 2.5
mg prn /q4h via Nebulizer and
Ipatropium (atrovent)125mcg prn/q6h
and 250 mcg prn/q6h via Nebulizer treat
reversible bronchospasm.
13. COMPLICATIONS
Acute disease of the lungs produce a
more severe grade of dyspnea than do
chronic diseases.
Sudden dyspnea in healthy person
indicate pneumothorax ,acute
respiratory obstruction,allergic reaction
or myocardial obstruction.
In immobilized patients sudden dyspnea
denote pulmonary embolism.
14. Orthopnea may found in patients with
heart disease and occasionally with
patient with COPD.
Dyspnea with expiratory wheeze occurs
with COPD.
Noisy breathing may results from a
narrowing of the airway or localized
obstruction of a major bronchus by a
tumor or foreign body.
15. The presence of both inspiratory and
expiratory wheezhing usually signifies
Asthma.
Dyspnea can occur with other disorders
like;
Cardiac disease
Anaphylactic reactions
Severe anemia
16. NURSING ASSESSMENT AND
NURSING INTERVENTIONS
As with assessment of pain ,reports of
dyspnea by patients must be believed.
The nurse should conduct a careful
assessment of the psychosocial and
spiritual components of the dyspnea.
Physical assessment parameters include;
Symptom intensity ,distress and
interference with activities(scale 0 to 10)
17. Assessment of fluid balance
Measurement of abdominal grith
Temperature
Sputum quantity and character
cough
Auscultation of lung sounds
18. The physical assessment findings may assisst
in locating the source of the dyspnea and
selecting the nursing interventions to relieve
the symptom.
Pharmacological intervention is aimed at
modifying lung physiology and improving
performance as well as altering the perception
of the symptom.
Low doses of opids are very effective in
relieving dyspnea.
19. Dyspnea may be exacerbated by anxiety
,and anxiety may trigger episodes of
dyspnea,setting of respiratory crisis in
which the patient and family may panic.
For patients receiving care at home,patient
and family instruction should include
anticipation and management of crisis
situations and clearly communicted
emergency plan.
20. RELIEF MEASURES
The management of dyspnea is aimed at
identifying and correcting its cause.
Relief of the symptom sometimes is
achieved by placing the patient at rest
with the head elevated position(high
fowler’s position).
In severe case,by administering oxygen.
21. NURSES RESPONSIBILITY
It is important to assess the patient’s rating
of the intensity of breathlessness,the effort
required to breath and the severity of the
breathelessness or dyspnea.
Patients use a variety of terms and phases
to describe breathlessness and the nurse
needs to clarify what terms are most
familiar to the patient and what these terms
means .
Visual analogue or other scales can be used
to assess changes in the severity in the
dyspnea over time.
22. COUGH
INTRODUCTION
Cough is a reflex that produces the lungs from
the accumulation of secreations or the
inhalation of foreign body .
It can be a symptom of a number of disorders
of the pulmonary system or it can be
suppressed in other disorders.
Cough results from irritation of the mucous
membranes anywhere in the respiratory tract.
Cough may indicate serious pulmonary
disease.
23. DEFINITION
“Cough is a reflex that protects the lungs
from the accumulation of secreation of
foreign bodies.its presence or absence
can be diagnostic clue because some
disorders cause coughing and others
suppress it.”
[Brunner and Suddarth]
24. ETIOLOGY
The cough reflex may be;
Impaired by weakness or paralyses of the
respiratory muscles.
Prolonged inactivity.
Presence of a nasogastric tube.
Depressed function of the medullary
centers in the brain.
eg;anesthesia,brain disorders
25. TYPES OF COUGH
Dry cough
Hacking cough
Brassy cough
Wheezing cough
Loose or severe cough
26. RESULTS OF COUGH
A dry,irritated cough is characterized of
an upper respiratory tract infection of
viral origin or it may be a side effect of
ACE inhibitory therapy.
An irritated,high pitched cough can be
caused by laryngotracheitis.
A brassy cough is result of a tracheal
lesion.
Severe or changing cough may indicate
Bronchogenic carcinoma.
27. Coughing at night indicate the onset of
left side heart failure/bronchial asthma.
A cough in the morning with sputum
production indicate bronchitis.
Coughing after food intake indicate
aspiration of material into the
tracheobronchial tree.
28. Violent coughing causes bronchial
spasm,obstruction,and further irritation
of the bronchi and result in syncope.
A severe,repeated or uncontrolled cough
that is non-productive is exchausting and
potentially harmful.
29. COMPLICATIONS
o Cough results from irritation of the
mucous membranes anywhere in the
respiratory tract.
o The stimulus that produces a cough may
arise from an infectious process or form
an airbone irritant ,such
as;smoke,smog,dust/gas.
o A persistant and frequent cough can be
exhausting and cause pain.
30. NURSING MANAGEMENT
NURSING DIAGNOSIS
Ineffective airway clearance:-in ability to
clear secreations or obstructions from the
respiratory tract to maintain a clear airway.
Impaired gas exchange:-excess or definit in
oxygenation and/or CO2 elimination at the
alveolar capillary membrane.
Risk for aspiration:-at risk for entry of
gastrointestinal secretions,oropharyngeal
secretions,solids,or fluids into
tracheobronchial passage.
31. NURSING INTERVENTIONS
Respiratory monitoring:-collection and
analysis of patient data to ensure airway
patency and adequate gas exchange.
Airway management:-facilitations of
patency of air passages.
Airway suctioning:-removal of airway
secretions by inserting a suction catheter
into the patients oral airway and trachea.
Aspiration precautions:-prevention or
minimization of risk factors in the
patient at risk for aspiration.
32. NURSING OUTCOMES
Respiratory status;airway patency:-
extent to which the tracheobronchial
passages remain open.
Respiratory status;gas exchange:-the
alveolar exchange of CO2 and O2 to
maintain arterial blood gas
concentration.
Respiratory status;ventilation:-
movement of air in and out of the lungs.
33. RELIEF MEASURES
Cough suppressants must be used with
caution,because they may relieve the cough but
do not address the cause of cough.
Drinking warm beverages may relieve cough
caused by throat irritation.
The use of first generation antihistamines with
decongestant for treatment of acute cough or
upper airway cough syndrome secondary to
rhinosinus disease instead of over the counter
cough expectorants or suppresants(ie,cough
syrups ,cough drops)
34. NURSES RESPONSIBILITY
To help determine the course of
cough,the nurse describe the cough.
Nurse inquires about the onset and the
time of coughing.
Nurse should explore the effect of a
chronic cough on the patient and the
patients view about the significance of
the cough and its effect on his or her life.