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Assessment of the Respiratory System Nelia B. Perez RN, MSN Northeastern College March 2009
History *  Biographical Data *  Current Health *  Chief Complaint *  Clinical Manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Non-Cardiac Chest Pain ,[object Object],[object Object],[object Object],[object Object]
Dyspnea ,[object Object],[object Object]
Cough ,[object Object],[object Object],[object Object]
Cough:  Sputum ,[object Object],[object Object],[object Object],[object Object],[object Object]
HEMOPTYSIS ,[object Object],[object Object],[object Object]
Wheezing ,[object Object],[object Object],[object Object],[object Object]
Stridor Given to high-pitched sounds produced when air passes through a partially obstructed or narrowed upper airway on inspiration. Inquire about changes in voice character, hoarseness, difficulty swallowing, sleep-related disorders, degree of snoring, hypersomnolence in the morning, early morning headaches, weight gain, fluid retention, apnea and restlessness.
Nasal and Sinus Complaints  Nosebleeds (epistaxis) Sinus infection Hay fever Postnasal drips Rhinitis Nasal, facial, or referred ear pain
Review of Systems Past Medical History Surgical History Allergies Medications  Dietary Habits Social History Family Health History
Physical Examination ,[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
DIAGNOSTIC TESTING : Noninvasive tests ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Testing: Invasive Tests ,[object Object],[object Object],[object Object],[object Object]
 
 
Laboratory Test ,[object Object],[object Object],[object Object]
Management of Clients with Upper Airway Disorders
Methods of Controlling the Airway ,[object Object]
Definition ,[object Object]
Indications ,[object Object],[object Object],[object Object]
Indications (cont) ,[object Object],[object Object]
 
Single Cannula Tracheostomy tube ,[object Object]
 
Double Cannula Tracheostomy Tubes ,[object Object]
 
Fenestrated Tracheostomy Tube ,[object Object]
 
 
 
Potential Problems Associated with Tracheostomy Tubes and Cuffs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Potential Problems Associated with Tracheostomy Tubes and Cuffs (Cont) ,[object Object],[object Object],[object Object],[object Object]
Weaning, Removal and Rescue Breathing :  Weaning from a Tracheostomy Tube ,[object Object]
[object Object]
[object Object],[object Object],[object Object]
… Inability to clear mucus ,[object Object],[object Object],[object Object],[object Object]
Removing a Tracheostomy Tube ,[object Object]
[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Performing Rescue Breathing ,[object Object]
Nursing Management of the Client with Tracheostomy  ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Replacing  Disposable Inner Cannula ,[object Object]
Applying Clean Dressing and Tape ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Postoperative Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Risk for impaired gas exchange ,[object Object],[object Object],[object Object],[object Object],[object Object]
Risk for infection ,[object Object],[object Object],[object Object]
Risk for Aspiration ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Risk for constipation ,[object Object],[object Object]
Anxiety and Fear ,[object Object],[object Object],[object Object]
Risk for Ineffective Therapeutic Regimen Management and Risk for ineffective Family Therapeutic Management ,[object Object],[object Object],[object Object]
 
 
 
Managing for Stability ,[object Object],[object Object],[object Object],Managing for Change ,[object Object],[object Object],[object Object]
Discussion Questions #2 What are the most significant changes affecting your unit ? Has the unit been able to effectively respond to these changes ?
The Strategic Plan – A Tool for Managing Change Part Three: Review
Situation Audit ,[object Object],[object Object],“ Where Are We Now?”
Environmental Scan ,[object Object],[object Object],[object Object],How Did We Get in This Situation?” “ What Will Likely Happen if We Continue As We Are?”
ORGANIZATION strengths weaknesses opportunities threats
The Components of the Strategic Plan Strategic Plan Operational Plans Monitoring and Evaluation Action Plan Action Plan Action Plan Action Plan Action Plan Action Plan Vision and Values for Library Services Goals for Unit Service Strategic Directions The Mission
Definitions ,[object Object],[object Object]
[object Object],Definitions
[object Object],Definitions
[object Object],Definitions
[object Object],Definitions
Vision Goals Position the College of Nursing as an institution that is continually relevant and vital to the success of Santiago’s future, providing essential services for vibrant, healthy, sustainable and diverse communities. The Northeastern College – Nursing Department, rooted in Santiago’s vibrant and healthy community, are meeting places and destinations that enliven their neighborhoods, enhance understanding of cultural diversities, and link people to one another, to a sense of Santiago’s past, and to their shared future. Strategic Directions Community & Civic Role Information Gateway: Develop Community Facilities Marketing & Communication
Discussion Questions #3 How current are your UNIT’s Vision, Mission and Goals? Do you have an effective plan for dealing with your UNIT’s future?
Why Plans Fail Part Four:
Why We Fail # 1 Ineffective Vision
An Effective Vision for  Strategic Planning ,[object Object],[object Object],[object Object],[object Object]
Why We Fail # 2 No Follow-Through – Poor Implementation
Effective Implementation  and Evaluation Local Strategic Plan Unit Strategic Plan Action Plans Performance Measures Capital / Operating Budget Implementation Strategies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why We Fail # 3 Poor Leadership
[object Object],[object Object],[object Object],[object Object],Leadership Qualities
Why We Fail # 4 Poor Communication
[object Object],[object Object],[object Object],Your Strategic Plan
Discussion Questions #4 If your group has done a strategic plan, was it successful? Why / why not? If your group has not done a strategic plan, what are the barriers to doing the plan?
Part Five Doing A Plan – What’s Involved
Creating a Plan: Who is Involved ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Creating a Plan : Roles & Responsibilities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Creating a Plan : Other Considerations ,[object Object],[object Object],[object Object],[object Object]
Discussion Question #5 What are the options for your unit to prepare a strategic plan?
Thank You!

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Respi 2

  • 1. Assessment of the Respiratory System Nelia B. Perez RN, MSN Northeastern College March 2009
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  • 9. Stridor Given to high-pitched sounds produced when air passes through a partially obstructed or narrowed upper airway on inspiration. Inquire about changes in voice character, hoarseness, difficulty swallowing, sleep-related disorders, degree of snoring, hypersomnolence in the morning, early morning headaches, weight gain, fluid retention, apnea and restlessness.
  • 10. Nasal and Sinus Complaints Nosebleeds (epistaxis) Sinus infection Hay fever Postnasal drips Rhinitis Nasal, facial, or referred ear pain
  • 11. Review of Systems Past Medical History Surgical History Allergies Medications Dietary Habits Social History Family Health History
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  • 23. Management of Clients with Upper Airway Disorders
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  • 67. Discussion Questions #2 What are the most significant changes affecting your unit ? Has the unit been able to effectively respond to these changes ?
  • 68. The Strategic Plan – A Tool for Managing Change Part Three: Review
  • 69.
  • 70.
  • 71. ORGANIZATION strengths weaknesses opportunities threats
  • 72. The Components of the Strategic Plan Strategic Plan Operational Plans Monitoring and Evaluation Action Plan Action Plan Action Plan Action Plan Action Plan Action Plan Vision and Values for Library Services Goals for Unit Service Strategic Directions The Mission
  • 73.
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  • 78. Vision Goals Position the College of Nursing as an institution that is continually relevant and vital to the success of Santiago’s future, providing essential services for vibrant, healthy, sustainable and diverse communities. The Northeastern College – Nursing Department, rooted in Santiago’s vibrant and healthy community, are meeting places and destinations that enliven their neighborhoods, enhance understanding of cultural diversities, and link people to one another, to a sense of Santiago’s past, and to their shared future. Strategic Directions Community & Civic Role Information Gateway: Develop Community Facilities Marketing & Communication
  • 79. Discussion Questions #3 How current are your UNIT’s Vision, Mission and Goals? Do you have an effective plan for dealing with your UNIT’s future?
  • 80. Why Plans Fail Part Four:
  • 81. Why We Fail # 1 Ineffective Vision
  • 82.
  • 83. Why We Fail # 2 No Follow-Through – Poor Implementation
  • 84.
  • 85. Why We Fail # 3 Poor Leadership
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  • 87. Why We Fail # 4 Poor Communication
  • 88.
  • 89. Discussion Questions #4 If your group has done a strategic plan, was it successful? Why / why not? If your group has not done a strategic plan, what are the barriers to doing the plan?
  • 90. Part Five Doing A Plan – What’s Involved
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  • 94. Discussion Question #5 What are the options for your unit to prepare a strategic plan?