This document provides an overview of the respiratory system including anatomy, physiology, assessment, common problems and diseases. It begins with the outline of topics to be covered, including the relevant anatomy and physiology of both the upper and lower respiratory tract. Assessment techniques such as history taking, physical exam, laboratory tests like ABG analysis and sputum analysis are described. Common respiratory conditions of the upper airway like rhinitis, sinusitis and pharyngitis are outlined along with associated findings and nursing interventions.
Theresa, a 20-year-old college student, was diagnosed with bacterial pneumonia and admitted to the hospital. High priority nursing interventions include obtaining specimens for culture prior to administering antibiotics to determine the causative agent. Theresa's symptoms include fever, chest pain, and increased breathing rate. She is being treated with penicillin and is expected to respond within 1-2 days. Complications of pneumonia can include decreased oxygen levels, requiring interventions like supplemental oxygen.
Mr. Howe presents with worsening weight loss, cough producing sputum, and night sweats. Additional questions should assess his cough characteristics. Diagnostic tests for suspected tuberculosis include a Mantoux test, sputum acid-fast bacillus smear and
The document discusses several respiratory disorders:
- Asthma is a chronic inflammatory disease of the airways causing hyperresponsiveness and mucus production. Common triggers include allergies, irritants, exercise and stress. Symptoms are coughing, wheezing and shortness of breath. Treatment includes preventative inhaled corticosteroids and bronchodilators for relief.
- Pneumonia is an infection of the lungs that causes inflammation in the air sacs. Symptoms are cough, fever, chest pain and shortness of breath. It can be caused by bacteria, viruses or fungi. Treatment involves antibiotics, fever relief medications and oxygen therapy.
- COPD is a lung disease characterized by obstruction of
Basics of Respiratory Emergencies for ED Nurses!Kane Guthrie
This document provides an overview of respiratory emergencies for emergency nurses. It discusses assessing the respiratory system and patient, common respiratory presentations and conditions, key diagnostic tools like pulse oximetry and capnography, and interpreting blood gases and chest x-rays. Causes of respiratory failure like hypoxia are outlined. The goal is to introduce nurses to respiratory emergencies and how to properly evaluate, monitor, and treat respiratory patients in the emergency department.
Respiratory diagnostic studies and nursing responsibilitiesRuma SEN
The document provides an overview of the respiratory system including its structure, functions, common disorders, diagnostic tests, and nursing responsibilities. It describes the respiratory system's role in gas exchange and acid-base balance. Key diagnostic tests covered include pulmonary function tests, arterial blood gas analysis, pulse oximetry, sputum culture, imaging studies like chest X-ray and CT, and procedures like bronchoscopy and thoracentesis. Nursing care is discussed for each test and procedure.
The document discusses various topics related to the respiratory and cardiovascular systems including:
1. Common respiratory disturbances like restrictive lung disease, COPD, and pulmonary vascular disease.
2. Measures that promote respiratory function such as adequate oxygen supply, deep breathing, coughing exercises, and chest physiotherapy.
3. Common cardiovascular conditions like coronary artery disease, angina, myocardial infarction, and congestive heart failure.
4. Risk factors for coronary artery disease and strategies for controlling cholesterol levels.
Respiratory emergencies Emergency medicinepratham b
The document discusses several respiratory emergencies including asthma, COPD, pneumonia, pneumothorax, and pulmonary embolism. Asthma is a chronic inflammatory disease characterized by recurrent episodes of impaired breathing. COPD is defined as a preventable disease involving persistent airflow limitation usually due to smoking. Pneumonia involves lower respiratory infection signs with abnormal chest x-rays. Pneumothorax is the presence of air in the pleural space ranging from benign to life-threatening. Pulmonary embolism occurs when a blood clot lodges in the pulmonary arteries.
This document provides an overview of oxygenation and the respiratory system. It begins with definitions of respiration and acute respiratory disorders. It then covers anatomy and physiology, describing the upper and lower respiratory tract including the nose, sinuses, pharynx, larynx, epiglottis, trachea, lungs, bronchioles, and alveoli. Accessory muscles, lung volumes, ventilation, gas exchange, and the neural control of respiration are discussed. Risk factors, health history questions, and assessments of dyspnea, cough, and sputum production are presented.
The document provides an overview of the respiratory system including anatomy, physiology, assessment, common problems, and nursing management. It covers the upper and lower respiratory tract, key structures like the nose, pharynx, and lungs. Assessment techniques like respiratory assessment, ABG analysis, sputum analysis, and pulmonary function tests are discussed. Common respiratory problems like dyspnea, cough, cyanosis, hemoptysis, and epistaxis and related nursing interventions are also summarized.
Theresa, a 20-year-old college student, was diagnosed with bacterial pneumonia and admitted to the hospital. High priority nursing interventions include obtaining specimens for culture prior to administering antibiotics to determine the causative agent. Theresa's symptoms include fever, chest pain, and increased breathing rate. She is being treated with penicillin and is expected to respond within 1-2 days. Complications of pneumonia can include decreased oxygen levels, requiring interventions like supplemental oxygen.
Mr. Howe presents with worsening weight loss, cough producing sputum, and night sweats. Additional questions should assess his cough characteristics. Diagnostic tests for suspected tuberculosis include a Mantoux test, sputum acid-fast bacillus smear and
The document discusses several respiratory disorders:
- Asthma is a chronic inflammatory disease of the airways causing hyperresponsiveness and mucus production. Common triggers include allergies, irritants, exercise and stress. Symptoms are coughing, wheezing and shortness of breath. Treatment includes preventative inhaled corticosteroids and bronchodilators for relief.
- Pneumonia is an infection of the lungs that causes inflammation in the air sacs. Symptoms are cough, fever, chest pain and shortness of breath. It can be caused by bacteria, viruses or fungi. Treatment involves antibiotics, fever relief medications and oxygen therapy.
- COPD is a lung disease characterized by obstruction of
Basics of Respiratory Emergencies for ED Nurses!Kane Guthrie
This document provides an overview of respiratory emergencies for emergency nurses. It discusses assessing the respiratory system and patient, common respiratory presentations and conditions, key diagnostic tools like pulse oximetry and capnography, and interpreting blood gases and chest x-rays. Causes of respiratory failure like hypoxia are outlined. The goal is to introduce nurses to respiratory emergencies and how to properly evaluate, monitor, and treat respiratory patients in the emergency department.
Respiratory diagnostic studies and nursing responsibilitiesRuma SEN
The document provides an overview of the respiratory system including its structure, functions, common disorders, diagnostic tests, and nursing responsibilities. It describes the respiratory system's role in gas exchange and acid-base balance. Key diagnostic tests covered include pulmonary function tests, arterial blood gas analysis, pulse oximetry, sputum culture, imaging studies like chest X-ray and CT, and procedures like bronchoscopy and thoracentesis. Nursing care is discussed for each test and procedure.
The document discusses various topics related to the respiratory and cardiovascular systems including:
1. Common respiratory disturbances like restrictive lung disease, COPD, and pulmonary vascular disease.
2. Measures that promote respiratory function such as adequate oxygen supply, deep breathing, coughing exercises, and chest physiotherapy.
3. Common cardiovascular conditions like coronary artery disease, angina, myocardial infarction, and congestive heart failure.
4. Risk factors for coronary artery disease and strategies for controlling cholesterol levels.
Respiratory emergencies Emergency medicinepratham b
The document discusses several respiratory emergencies including asthma, COPD, pneumonia, pneumothorax, and pulmonary embolism. Asthma is a chronic inflammatory disease characterized by recurrent episodes of impaired breathing. COPD is defined as a preventable disease involving persistent airflow limitation usually due to smoking. Pneumonia involves lower respiratory infection signs with abnormal chest x-rays. Pneumothorax is the presence of air in the pleural space ranging from benign to life-threatening. Pulmonary embolism occurs when a blood clot lodges in the pulmonary arteries.
This document provides an overview of oxygenation and the respiratory system. It begins with definitions of respiration and acute respiratory disorders. It then covers anatomy and physiology, describing the upper and lower respiratory tract including the nose, sinuses, pharynx, larynx, epiglottis, trachea, lungs, bronchioles, and alveoli. Accessory muscles, lung volumes, ventilation, gas exchange, and the neural control of respiration are discussed. Risk factors, health history questions, and assessments of dyspnea, cough, and sputum production are presented.
The document provides an overview of the respiratory system including anatomy, physiology, assessment, common problems, and nursing management. It covers the upper and lower respiratory tract, key structures like the nose, pharynx, and lungs. Assessment techniques like respiratory assessment, ABG analysis, sputum analysis, and pulmonary function tests are discussed. Common respiratory problems like dyspnea, cough, cyanosis, hemoptysis, and epistaxis and related nursing interventions are also summarized.
The document provides details on assessing a patient's oxygenation through nursing history, physical examination, and diagnostic tests. The nursing history focuses on collecting information on symptoms like chest pain, fatigue, dyspnea, cough, wheezing, respiratory infections, allergies, health risks, medications, smoking, and other exposures. The physical examination involves inspection of the skin, breathing patterns, and palpation techniques to examine thoracic excursion, tactile fremitus, thrills, and heaves.
This document provides an overview of respiratory emergencies for emergency medical responders. It describes the anatomy and physiology of the respiratory system and signs of adequate versus inadequate breathing. It then details the primary, secondary, and reassessment phases for responding to a respiratory emergency including assessing the scene, airway, breathing, circulation, and vital signs. Specific conditions are covered such as upper airway infections, pulmonary edema, COPD, asthma, pneumothorax, pleural effusion, airway obstruction, pulmonary embolism, and hyperventilation. For each, the document outlines management steps like positioning, oxygen administration, ventilation support, and prompt transport.
This document provides an overview of the approach to a child presenting with respiratory distress. It begins by defining respiratory distress and listing common signs and symptoms. It then describes how to grade the severity of respiratory distress and features of respiratory failure. The document outlines the pediatric assessment triangle and pentagon for evaluating a
This document provides information on managing respiratory emergencies. It defines respiratory emergencies as medical situations involving difficulty or inability to breathe. The physiology of respiration is described. Common causes of respiratory emergencies include chronic lung diseases, infections, and failure of ventilation, diffusion, or perfusion. Assessment involves evaluating breathing rate, effort, and oxygen saturation. Specific emergencies discussed include status asthmaticus, acute exacerbation of COPD, acute respiratory distress syndrome, and acute pulmonary edema. Treatment priorities are oxygen therapy, ventilation support, fluids, corticosteroids, bronchodilators, and antibiotics as needed.
Oxygenation is essential for life. The respiratory and cardiovascular systems work together to supply oxygen to the body through breathing, gas exchange in the lungs, and oxygen transport in the blood. Pulse oximetry noninvasively measures blood oxygen levels. Factors like ventilation, diffusion, and perfusion influence oxygenation. Alterations include hypoxia, breathing pattern changes, and airway obstructions. Nursing focuses on promoting adequate respiration through measures such as airway clearance, positioning, breathing exercises, hydration, and supplemental oxygen when needed.
The document discusses various respiratory emergencies conditions including asthma, ARDS, pleural effusion, pulmonary embolism, and COPD. It describes asthma as an airway inflammation causing wheezing and dyspnea, managed with bronchodilators, steroids, and education. ARDS involves widespread lung inflammation reducing gas exchange, requiring intensive care and ventilator support to deliver oxygen and pressure to damaged lungs.
This document discusses various oxygen delivery devices and their indications. It describes low flow devices like nasal cannulas and masks that can deliver oxygen concentrations from 24-44% depending on flow rate. High flow devices like venturi masks and bag valve masks can deliver fixed high concentrations from 35-100%. Key factors in choosing a device include the needed oxygen level, humidification needs, patient comfort and breathing pattern. The document provides details on how each device works and guidelines for safe operation.
The document provides information about oxygenation and oxygen therapy. It begins with an introduction defining oxygenation and its importance for life. It then discusses factors that can influence oxygenation like physiological, developmental, lifestyle and environmental factors. The document also covers various methods for oxygen administration like nasal cannula, masks and tents. It concludes with discussing complications, preparation of patients and equipment, the procedure for administration and post care activities.
This document provides information on respiratory emergencies that may occur offshore, including asthma, its causes, recognition, and management. It defines asthma as an allergic reaction causing narrowing of the small airways. An acute asthma attack can be fatal if not treated properly. Recognition of mild, moderate, and severe asthma cases is outlined. Management of asthma includes reassuring the victim, assisting their position, administering bronchodilator medication, calling an ambulance, and providing oxygen if available. Other respiratory emergencies from conditions like epiglottitis or drug effects are also discussed.
Assessment of patient with respiratory disorderSanjaiKokila
The document provides guidance on examining the thorax and lungs. It outlines the objectives, guidelines, equipment, and specific steps for inspection, palpation, percussion, and auscultation. The physical exam involves assessing appearance, breath sounds, tactile fremitus, chest expansion and tracheal position. Signs of respiratory distress, cyanosis, clubbing and abnormal chest shapes are also examined. The goal is to evaluate for signs of respiratory diseases.
This document provides an overview of respiratory system anatomy and physiology and discusses several respiratory emergencies. It describes the functions of the upper and lower airways, gas exchange, ventilation, and respiratory assessment. Key respiratory emergencies covered include chronic obstructive pulmonary disease (COPD), asthma, pneumonia, pneumothorax, and hyperventilation syndrome. Patient presentation, treatment, and management are discussed for each condition.
The document provides information on the physiology of the respiratory system, including:
1. It describes the organs that make up the respiratory system including the trachea, bronchi, lungs, and alveoli where gas exchange occurs.
2. It explains the processes of respiration including how oxygen moves from the alveoli into the blood and carbon dioxide moves from the blood into the alveoli through diffusion.
3. It discusses how to assess the respiratory system through examination of the patient's history, vital signs, breathing sounds, and symptoms like cough, dyspnea, and chest pain.
The document summarizes key aspects of the respiratory system for EMTs, including anatomy, physiology, assessment, and initial management of respiratory emergencies. It describes the respiratory system's purpose of gas exchange, relevant anatomy such as the lungs and airways, normal physiology of breathing, common pathologies affecting ventilation and gas exchange, and the ABCDE approach to assessment and initial management of patients with respiratory distress or failure.
This document provides information on using continuous positive airway pressure (CPAP) devices for EMT providers. It discusses respiratory anatomy and physiology, conditions like respiratory distress and failure, asthma, pulmonary edema, and COPD that CPAP can help treat. It describes how CPAP works by maintaining a constant airway pressure to keep alveoli open and improve gas exchange. Indications for CPAP include severe respiratory distress, while contraindications include low blood pressure or inability to tolerate the device. The document emphasizes that pre-hospital studies show CPAP's effectiveness in treating respiratory problems and reducing need for intubation or mortality.
The document discusses the respiratory system, including its anatomy, physiology, and pathophysiology. It focuses on the initial assessment and management of a patient experiencing respiratory distress or failure. Key steps include assessing the patient's airway, breathing, circulation, and disability (ABCDS), providing oxygen, assisting ventilation if needed, and considering underlying conditions that may be causing respiratory distress.
The document discusses the respiratory system and its components. It describes:
- The pleural cavity containing a small amount of pleural fluid between the parietal and visceral pleura.
- The upper and lower respiratory tract, including the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs.
- The roles of respiration including gas exchange and maintaining acid-base balance.
This protocol provides guidelines for treating respiratory emergencies in adults, including asthma, chronic obstructive pulmonary disease (COPD), pulmonary edema/congestive heart failure (CHF), and suspected pneumonia. Basic treatment involves initial assessment, oxygen therapy, monitoring, and transport. Advanced life support may include CPAP, nebulized medications, intravenous fluids and medications, and intubation as needed. Medical control consultation is advised for any questions or problems.
The document discusses the stepwise management of hemoptysis. It defines hemoptysis and massive hemoptysis. The most common causes in Egypt are discussed. Steps in diagnosis include history, exams, labs, imaging like CXR, CT, bronchoscopy. Treatment depends on localization and cause but may include bronchoscopic interventions, bronchial artery embolization, or surgery. Disease-specific approaches are also outlined. Three case studies are presented to demonstrate tailored management of hemoptysis.
CPAP uses continuous positive airway pressure to keep the airways open and improve oxygen levels without the need for intubation. It increases lung volume, improves oxygen exchange, and reduces the work of breathing. While it avoids the risks of intubation and ventilation, CPAP requires an alert patient who can tolerate the tight-fitting mask. It is commonly used short-term for conditions like heart failure, COPD, and sleep apnea, or to facilitate weaning from mechanical ventilation.
The document discusses respiratory system terminology, anatomy, and physiology. It describes ventilation as air movement in and out of the lungs, and respiration as gas exchange between the external environment and tissues. It outlines the anatomy of the upper and lower respiratory systems, including the lungs, alveoli, and respiratory centers in the brain. It also summarizes lung volumes, factors affecting volumes, oxygen transport, and the role of red blood cells in carrying oxygen to tissues.
1) Acute respiratory distress syndrome (ARDS) is a condition characterized by rapid onset of respiratory failure without heart failure as a cause. It has a varied etiology including infections, burns, trauma, and sepsis.
2) Management involves treating the underlying cause, providing respiratory support through oxygen therapy or mechanical ventilation, and circulatory support. The goal is to maintain adequate oxygen levels while avoiding additional lung injury.
3) Even with optimal treatment, ARDS has a high mortality rate though outcomes have improved over time with specialized care and ventilation strategies focusing on low tidal volumes and adequate positive end-expiratory pressure. It often requires prolonged ventilator support.
This document discusses nursing care of the respiratory system. It covers respiratory system function, assessment techniques including inspection, auscultation and vital signs, common respiratory disorders like pneumonia, tuberculosis, and obstructive sleep apnea. It provides nursing diagnoses and interventions for various respiratory dysfunctions like inadequate oxygenation, infections, and upper airway problems.
The document provides details on assessing a patient's oxygenation through nursing history, physical examination, and diagnostic tests. The nursing history focuses on collecting information on symptoms like chest pain, fatigue, dyspnea, cough, wheezing, respiratory infections, allergies, health risks, medications, smoking, and other exposures. The physical examination involves inspection of the skin, breathing patterns, and palpation techniques to examine thoracic excursion, tactile fremitus, thrills, and heaves.
This document provides an overview of respiratory emergencies for emergency medical responders. It describes the anatomy and physiology of the respiratory system and signs of adequate versus inadequate breathing. It then details the primary, secondary, and reassessment phases for responding to a respiratory emergency including assessing the scene, airway, breathing, circulation, and vital signs. Specific conditions are covered such as upper airway infections, pulmonary edema, COPD, asthma, pneumothorax, pleural effusion, airway obstruction, pulmonary embolism, and hyperventilation. For each, the document outlines management steps like positioning, oxygen administration, ventilation support, and prompt transport.
This document provides an overview of the approach to a child presenting with respiratory distress. It begins by defining respiratory distress and listing common signs and symptoms. It then describes how to grade the severity of respiratory distress and features of respiratory failure. The document outlines the pediatric assessment triangle and pentagon for evaluating a
This document provides information on managing respiratory emergencies. It defines respiratory emergencies as medical situations involving difficulty or inability to breathe. The physiology of respiration is described. Common causes of respiratory emergencies include chronic lung diseases, infections, and failure of ventilation, diffusion, or perfusion. Assessment involves evaluating breathing rate, effort, and oxygen saturation. Specific emergencies discussed include status asthmaticus, acute exacerbation of COPD, acute respiratory distress syndrome, and acute pulmonary edema. Treatment priorities are oxygen therapy, ventilation support, fluids, corticosteroids, bronchodilators, and antibiotics as needed.
Oxygenation is essential for life. The respiratory and cardiovascular systems work together to supply oxygen to the body through breathing, gas exchange in the lungs, and oxygen transport in the blood. Pulse oximetry noninvasively measures blood oxygen levels. Factors like ventilation, diffusion, and perfusion influence oxygenation. Alterations include hypoxia, breathing pattern changes, and airway obstructions. Nursing focuses on promoting adequate respiration through measures such as airway clearance, positioning, breathing exercises, hydration, and supplemental oxygen when needed.
The document discusses various respiratory emergencies conditions including asthma, ARDS, pleural effusion, pulmonary embolism, and COPD. It describes asthma as an airway inflammation causing wheezing and dyspnea, managed with bronchodilators, steroids, and education. ARDS involves widespread lung inflammation reducing gas exchange, requiring intensive care and ventilator support to deliver oxygen and pressure to damaged lungs.
This document discusses various oxygen delivery devices and their indications. It describes low flow devices like nasal cannulas and masks that can deliver oxygen concentrations from 24-44% depending on flow rate. High flow devices like venturi masks and bag valve masks can deliver fixed high concentrations from 35-100%. Key factors in choosing a device include the needed oxygen level, humidification needs, patient comfort and breathing pattern. The document provides details on how each device works and guidelines for safe operation.
The document provides information about oxygenation and oxygen therapy. It begins with an introduction defining oxygenation and its importance for life. It then discusses factors that can influence oxygenation like physiological, developmental, lifestyle and environmental factors. The document also covers various methods for oxygen administration like nasal cannula, masks and tents. It concludes with discussing complications, preparation of patients and equipment, the procedure for administration and post care activities.
This document provides information on respiratory emergencies that may occur offshore, including asthma, its causes, recognition, and management. It defines asthma as an allergic reaction causing narrowing of the small airways. An acute asthma attack can be fatal if not treated properly. Recognition of mild, moderate, and severe asthma cases is outlined. Management of asthma includes reassuring the victim, assisting their position, administering bronchodilator medication, calling an ambulance, and providing oxygen if available. Other respiratory emergencies from conditions like epiglottitis or drug effects are also discussed.
Assessment of patient with respiratory disorderSanjaiKokila
The document provides guidance on examining the thorax and lungs. It outlines the objectives, guidelines, equipment, and specific steps for inspection, palpation, percussion, and auscultation. The physical exam involves assessing appearance, breath sounds, tactile fremitus, chest expansion and tracheal position. Signs of respiratory distress, cyanosis, clubbing and abnormal chest shapes are also examined. The goal is to evaluate for signs of respiratory diseases.
This document provides an overview of respiratory system anatomy and physiology and discusses several respiratory emergencies. It describes the functions of the upper and lower airways, gas exchange, ventilation, and respiratory assessment. Key respiratory emergencies covered include chronic obstructive pulmonary disease (COPD), asthma, pneumonia, pneumothorax, and hyperventilation syndrome. Patient presentation, treatment, and management are discussed for each condition.
The document provides information on the physiology of the respiratory system, including:
1. It describes the organs that make up the respiratory system including the trachea, bronchi, lungs, and alveoli where gas exchange occurs.
2. It explains the processes of respiration including how oxygen moves from the alveoli into the blood and carbon dioxide moves from the blood into the alveoli through diffusion.
3. It discusses how to assess the respiratory system through examination of the patient's history, vital signs, breathing sounds, and symptoms like cough, dyspnea, and chest pain.
The document summarizes key aspects of the respiratory system for EMTs, including anatomy, physiology, assessment, and initial management of respiratory emergencies. It describes the respiratory system's purpose of gas exchange, relevant anatomy such as the lungs and airways, normal physiology of breathing, common pathologies affecting ventilation and gas exchange, and the ABCDE approach to assessment and initial management of patients with respiratory distress or failure.
This document provides information on using continuous positive airway pressure (CPAP) devices for EMT providers. It discusses respiratory anatomy and physiology, conditions like respiratory distress and failure, asthma, pulmonary edema, and COPD that CPAP can help treat. It describes how CPAP works by maintaining a constant airway pressure to keep alveoli open and improve gas exchange. Indications for CPAP include severe respiratory distress, while contraindications include low blood pressure or inability to tolerate the device. The document emphasizes that pre-hospital studies show CPAP's effectiveness in treating respiratory problems and reducing need for intubation or mortality.
The document discusses the respiratory system, including its anatomy, physiology, and pathophysiology. It focuses on the initial assessment and management of a patient experiencing respiratory distress or failure. Key steps include assessing the patient's airway, breathing, circulation, and disability (ABCDS), providing oxygen, assisting ventilation if needed, and considering underlying conditions that may be causing respiratory distress.
The document discusses the respiratory system and its components. It describes:
- The pleural cavity containing a small amount of pleural fluid between the parietal and visceral pleura.
- The upper and lower respiratory tract, including the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs.
- The roles of respiration including gas exchange and maintaining acid-base balance.
This protocol provides guidelines for treating respiratory emergencies in adults, including asthma, chronic obstructive pulmonary disease (COPD), pulmonary edema/congestive heart failure (CHF), and suspected pneumonia. Basic treatment involves initial assessment, oxygen therapy, monitoring, and transport. Advanced life support may include CPAP, nebulized medications, intravenous fluids and medications, and intubation as needed. Medical control consultation is advised for any questions or problems.
The document discusses the stepwise management of hemoptysis. It defines hemoptysis and massive hemoptysis. The most common causes in Egypt are discussed. Steps in diagnosis include history, exams, labs, imaging like CXR, CT, bronchoscopy. Treatment depends on localization and cause but may include bronchoscopic interventions, bronchial artery embolization, or surgery. Disease-specific approaches are also outlined. Three case studies are presented to demonstrate tailored management of hemoptysis.
CPAP uses continuous positive airway pressure to keep the airways open and improve oxygen levels without the need for intubation. It increases lung volume, improves oxygen exchange, and reduces the work of breathing. While it avoids the risks of intubation and ventilation, CPAP requires an alert patient who can tolerate the tight-fitting mask. It is commonly used short-term for conditions like heart failure, COPD, and sleep apnea, or to facilitate weaning from mechanical ventilation.
The document discusses respiratory system terminology, anatomy, and physiology. It describes ventilation as air movement in and out of the lungs, and respiration as gas exchange between the external environment and tissues. It outlines the anatomy of the upper and lower respiratory systems, including the lungs, alveoli, and respiratory centers in the brain. It also summarizes lung volumes, factors affecting volumes, oxygen transport, and the role of red blood cells in carrying oxygen to tissues.
1) Acute respiratory distress syndrome (ARDS) is a condition characterized by rapid onset of respiratory failure without heart failure as a cause. It has a varied etiology including infections, burns, trauma, and sepsis.
2) Management involves treating the underlying cause, providing respiratory support through oxygen therapy or mechanical ventilation, and circulatory support. The goal is to maintain adequate oxygen levels while avoiding additional lung injury.
3) Even with optimal treatment, ARDS has a high mortality rate though outcomes have improved over time with specialized care and ventilation strategies focusing on low tidal volumes and adequate positive end-expiratory pressure. It often requires prolonged ventilator support.
This document discusses nursing care of the respiratory system. It covers respiratory system function, assessment techniques including inspection, auscultation and vital signs, common respiratory disorders like pneumonia, tuberculosis, and obstructive sleep apnea. It provides nursing diagnoses and interventions for various respiratory dysfunctions like inadequate oxygenation, infections, and upper airway problems.
This document discusses disorders of gas exchange, including hypercapnia (elevated carbon dioxide levels) and hypoxia (low oxygen levels). It provides mathematical equations to describe gas exchange in the lungs and blood. It then describes the causes, signs, and treatments of hypercapnia and hypoxia. Four case studies are presented to illustrate examples of patients experiencing hypercapnia or hypoxia.
This document discusses various respiratory therapies used to treat clients with respiratory conditions. It describes non-invasive therapies like oxygen therapy, incentive spirometry, mini-nebulizer therapy, and chest physiotherapy. It also discusses invasive modalities like endotracheal intubation, tracheostomy, and mechanical ventilation. For each therapy or modality, it provides details on the purpose, indications, complications, and procedures where relevant. The document serves as an overview of the different treatment options available based on the type of oxygenation disorder present.
Respiratory failure is characterized by severe dysfunction of pulmonary ventilation and/or oxygenation caused by various diseases, resulting in hypoxia and retention of carbon dioxide. It is defined as a PaO2 of less than 8.0 kPa (60 mmHg), and/or a PaCO2 of greater than 6.67 kPa (50 mmHg). The main causes are ventilation dysfunction due to airway obstruction or limitation, and oxygenation dysfunction due to pulmonary edema, interstitial lung disease, or ARDS. The key pathophysiological changes are hypoxia, retention of carbon dioxide, and acidosis, which can affect multiple organ systems and lead to complications.
Pulmonary function tests measure how well the lungs work. Some key tests include spirometry, which measures how much air the lungs can hold and exhale; diffusing capacity, which measures how well oxygen passes into the bloodstream; and arterial blood gas, which directly measures oxygen and carbon dioxide levels in the blood. Spirometry further evaluates the forced vital capacity (FVC), or maximum volume exhaled; and forced expiratory volume in 1 second (FEV1). A low FEV1/FVC ratio indicates obstruction like in COPD, while a low FVC alone suggests restriction. Severity is classified based on FEV1 percentages of predicted normal values.
Care of gas exchange and respiratory function careslideshareacount
This document discusses non-invasive respiratory therapies for oxygen therapy. The goal of oxygen therapy is to provide adequate oxygen while decreasing the workload of breathing and reducing heart stress. Oxygen therapy is indicated for changes in respiratory rate/pattern, hypoxemia (decreased oxygen in blood), or hypoxia (decreased oxygen to tissues). Oxygen can be administered via nasal cannula, mask, or other devices. Nurses should educate patients on oxygen safety and ensure proper administration to maximize benefits and avoid complications like oxygen toxicity or suppressed breathing.
This document discusses various respiratory symptoms and conditions including dyspnea, wheezing, cough, hypoxemia, hypercapnia, and their clinical features, diagnoses, and treatments. It defines key terms like dyspnea, tachypnea, orthopnea, and provides details on evaluating and differentiating cardiac vs pulmonary causes of respiratory distress. It also examines the pathophysiology and clinical implications of hypoxemia and hypercapnia.
The document outlines the step-by-step process for interpreting spirometry tests according to American Thoracic Society (ATS) guidelines. It discusses evaluating forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, total lung capacity (TLC), residual volume (RV), and diffusing capacity of the lung for carbon monoxide (DLCO) to determine if values are normal or indicate restrictive or obstructive lung disease. Severity is classified based on percentage of predicted values. The document also reviews procedures for informed consent, performing acceptable and reproducible spirometry tests, and documenting and communicating results.
Early experience of low flow extracorporeal carbon dioxide removal in managem...alungtech
Dr. Ravi Tiruvoipati presented the initial Australian experience with low-flow extracorporeal carbon dioxide removal (Hemolung RAS) at the 2015 Australian and New Zealand Intensive Care Society (ANZICS) meeting.
This document summarizes a study comparing non-invasive positive pressure ventilation (NIPPV) to high flow oxygen therapy in immunocompromised patients with acute respiratory failure. The study found that early use of NIPPV as compared to oxygen therapy alone did not reduce 28-day mortality or intubation rates. There were also no differences in ICU or hospital length of stay. While NIPPV did not provide benefits, the lower than expected mortality with oxygen therapy alone limited the study's ability to detect differences between the groups.
Critical thinking scenario Respiratory Therapy Students Dolifree
The document provides guidance for respiratory therapists on the skills needed for successful patient transport. It advises therapists to (1) prioritize and plan for expected and unexpected issues, (2) anticipate problems and solutions, and (3) communicate effectively with the healthcare team. When transporting an unstable patient for a CT scan, the therapist should gather clinical information from the patient assessment and chart, interpret the data to develop a transport plan, and collect the necessary equipment while prioritizing the patient's needs.
This document provides information about pulmonary function tests, specifically spirometry. It describes how spirometry is performed and what measurements are taken, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and ratios like FEV1/FVC. Normal values vary based on factors like age, height, sex, and race. Obstructive and restrictive lung patterns are identified based on these measurements. Spirometry is used to diagnose and monitor lung diseases.
Spirometry is a test used to measure lung function by having a patient forcefully exhale into a spirometer. It measures volumes like forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) to diagnose and monitor conditions like COPD. The document discusses the different types of spirometers, normal values, how to interpret tests for obstructive, restrictive, and mixed lung disease patterns, and practical considerations for administering spirometry tests.
Introduction Yoga Therapy For The Management Of Respiratory DisordersShama
Dr. Shamanthakamani discusses yoga therapy for respiratory disorders. Slow, deep breathing techniques like pranayama can help balance the respiratory system and reduce stress, a trigger for conditions like asthma. Pranayama techniques like anuloma viloma and ujjayi strengthen lung muscles. Yoga postures and breathing practices work together to relax muscles and increase lung capacity. Studies show yoga can help manage diseases like asthma, bronchitis, and tuberculosis by bridging the voluntary and involuntary breathing systems.
Advantages of deep breathing exercises to quit smokingJane Allen
Deep breathing is beneficial for quitting smoking as it strengthens lung capacity, eases nicotine cravings and improves mood. It releases toxins from the body and boosts energy levels. Experts recommend deep breathing exercises be practiced in the first few weeks after quitting smoking to provide physiological and psychological relief. Proper deep breathing techniques involve sitting up straight and inhaling through the nose for 10 seconds before exhaling through the mouth with a sigh.
Pathophysiology of hypoxic respiratory failureAndrew Ferguson
John, a 43-year-old man with asthma, presents with worsening respiratory symptoms and hypoxemia. His hypoxemia is caused by a combination of ventilation-perfusion mismatching and intrapulmonary shunting, likely due to his pneumonia and bronchospasm worsening gas exchange. After intubation and mechanical ventilation, his hypoxemia persists due to an elevated alveolar-arterial oxygen gradient, indicating significant underlying lung pathology beyond his hypercapnia. Shunting occurs when blood flows through unventilated lung regions, mixing deoxygenated blood back into the pulmonary circulation.
Spirometry is a common pulmonary function test that measures airflow in and out of the lungs through forced expiratory maneuvers. It is used to diagnose and monitor conditions like COPD by detecting and quantifying airflow limitation and distinguishing obstructive from restrictive patterns. The document provides details on how to properly perform spirometry, interpret the results, and evaluate for reversibility with bronchodilators.
Infection Control Guidelines for Respiratory Therapy Services[compatibility m...drnahla
Infection Control Guidelines for Respiratory Therapy Services
Infection Prevention in Respiratory Therapy Services
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
The document provides an overview of the respiratory system including anatomy, physiology, common conditions, diseases, and nursing management. It discusses the upper and lower respiratory tract, respiratory assessment, laboratory tests, common problems like dyspnea, cough and sputum production, and conditions such as tonsillitis, sinusitis, and laryngeal cancer. Nursing interventions focus on airway management, communication techniques, nutrition, and monitoring for post-operative complications.
histology of respiratory system upper lower
Histology is a vast and complex field, but it provides valuable insights into the structure and function of tissues in various organisms. It has played a major role in advancing our understanding of health, disease, and biology.
The respiratory system is essential for life. It provides your body with the oxygen it needs to function and removes the carbon dioxide that would otherwise build up and be toxic.
The respiratory system is a complex network of organs and tissues that work together to allow you to breathe. Its primary function is to take in oxygen from the air and release carbon dioxide, a waste product of cellular respiration. The system is made up of the following:
Upper respiratory tract: This includes the nose
nasal cavity,
sinuses,
pharynx (throat)
And
larynx (voice box).
Lower respiratory tract: This includes the trachea (windpipe)
bronchi, bronchioles, and alveoli air sacs
in the lungs.
histology of respiratory system upper and lower
rHistology is a vast and complex field, but it provides valuable insights into the structure and function of tissues in various organisms. It has played a major role in advancing our understanding of health, disease, and biology.
The respiratory system provides oxygen to the body's cells through respiration and removes carbon dioxide. It includes the nose, pharynx, larynx, trachea, bronchi, lungs, and muscles of respiration. Oxygen and carbon dioxide are exchanged between the alveoli and blood in the lungs through diffusion. Respiration is regulated by the respiratory center in the brainstem and chemoreceptors that detect changes in blood gases. Artificial respiration can prevent deaths by reopening the airway and exchanging gases until natural breathing resumes.
The document discusses upper airway obstruction including its anatomy, causes, clinical presentation, and management. It begins with describing the anatomy and physiology of the upper airway from the nose to the larynx. Upper airway obstruction is defined as an obstruction at or above the vocal cords, which can be functional, mechanical, or due to infections. Common causes include tumors, infections like epiglottitis, and trauma. Signs may include respiratory distress, stridor, and dysphagia. Management involves assessing the airway, providing basic support with maneuvers or airway devices, and performing advanced techniques like direct laryngoscopy or tracheostomy if needed.
Functional Anatomy of the Respiratory System.pptxSarojPoudel24
The respiratory system has four main functions: pulmonary ventilation, gas diffusion, gas transport, and regulation of ventilation. It is divided into an upper respiratory tract and lower respiratory tract. The lower tract includes the lungs, which are divided into lobes and bronchopulmonary segments. Gas exchange occurs in the alveoli via diffusion. Oxygenated blood returns to the heart while deoxygenated blood is carried to the lungs. The respiratory system works to provide oxygen to tissues and remove carbon dioxide through a series of branching airways and blood vessels in the lungs.
Human respiration involves two main processes: [1] External respiration which is the exchange of gases between the lungs and blood, and [2] Internal respiration which is the exchange of gases between blood and tissues at the cellular level. The ultimate goal of respiration is to release energy through cellular respiration in which oxygen is used to oxidize nutrients to produce carbon dioxide, water, and ATP as energy is stored.
The content in the slide are solely depended upon the syllabus of Purbanchal University for third-semester students. This content of the respiratory system will be enough for B.Pharmacy students studying anatomy and physiology
The document provides an overview of the histology of the respiratory system for medical students. It begins with an introduction to histology techniques used to study tissues. It then describes the major components of the respiratory system, including the upper and lower tracts. Several sections focus on detailed histology of specific regions, such as the bronchial tree, bronchioles, alveoli and the gas exchange that occurs. Diagrams and micrographs illustrate the transitions between different cell types and structures in the lungs from the bronchi to the alveoli where oxygen and carbon dioxide are exchanged.
RESPIRATORY SYSTEM.pptxv gnm first year studentsroy456393
The respiratory system can be divided into the upper and lower respiratory tract. The upper tract includes the nose, pharynx and larynx. The nose warms, filters and humidifies inhaled air and is also responsible for smell. The pharynx serves as a passageway for both air and food and connects to the nasal cavity, oral cavity and larynx. The larynx contains the vocal cords and connects the pharynx to the trachea and lungs below.
The document summarizes the development of the respiratory system from the 4th week of gestation. It describes how the laryngotracheal diverticulum forms and divides to form the dorsal esophagus and ventral respiratory tract structures including the larynx, trachea, bronchi and lungs. It discusses the recanalization of the larynx and maturation of the lungs through the pseudoglandular, canalicular, terminal sac and alveolar periods. Finally, it notes some important congenital anomalies of the respiratory system.
This document provides information on nursing management of respiratory disorders in adults and elderly patients. It discusses the anatomy and physiology of the respiratory system and assessment of respiratory issues. It then covers the etiology, pathophysiology, clinical manifestations, diagnosis, treatment and nursing management of various respiratory conditions including upper and lower respiratory tract infections, asthma, COPD, pneumonia, pulmonary embolism and others. It also mentions respiratory therapies, procedures, drugs and nursing assessments and interventions for respiratory disorders.
The document provides an overview of the respiratory system and control of respiration. It describes the key organs involved, including the nose, pharynx, larynx, trachea, bronchi, lungs and alveoli. It explains the mechanics of breathing through inspiration and expiration. Gas exchange occurs as oxygen passes from the alveoli into the blood and carbon dioxide passes from the blood into the alveoli to be exhaled. The lungs, diaphragm, ribs and autonomic nervous system work together to regulate breathing and ventilation.
The document summarizes the structure and function of the human respiratory system. It describes that the respiratory system consists of respiratory tract and lungs. The respiratory tract includes the nose, nasal passages, pharynx, larynx, trachea, and bronchial tree. The lungs are located in the thoracic cavity and contain bronchioles and alveoli where gas exchange takes place. The diaphragm and intercostal muscles help in the mechanism of breathing by contracting and relaxing during inhalation and exhalation.
The document summarizes the development of the lower respiratory tract from the 4th week of gestation. It begins as a laryngotracheal groove that envaginates to form the laryngotracheal diverticulum. This divides into the primordium of the lungs and bronchial tree ventrally and the esophagus dorsally. The endoderm lining gives rise to the respiratory epithelium and glands while the surrounding mesoderm forms the connective tissues, cartilage, and smooth muscles. The larynx, trachea, bronchi, and lungs continue developing through branching morphogenesis and cellular differentiation until birth and early childhood when full alveolar development is reached.
The respiratory system allows for gas exchange in animals. It consists of organs and structures used for breathing. In land animals, gas exchange occurs in microscopic air sacs called alveoli in the lungs. Air flows from the nose and pharynx into the trachea, bronchi and bronchioles before reaching the alveoli. External respiration is the exchange of oxygen and carbon dioxide between the lungs and blood. Internal respiration is the exchange between blood and tissues. Normal human respiration is nasal, diaphragmatic, slow at 12 breaths per minute at rest, and imperceptible. Each breath has a tidal volume of 500ml and the respiratory cycle involves inspiration and expiration over 1.5-2 seconds each.
pathology of the respiratory system plus review of anatomy and physiology
No copy right infringement is intended. This is a lecture note handout by Carey Francis Okinda
The human respiratory system consists of the upper and lower respiratory tract. The upper tract includes the nose, nasal cavity, sinuses, pharynx and larynx. The lower tract includes the trachea, bronchi, bronchioles and lungs. The nose warms and filters inhaled air. The lungs are the primary organs for gas exchange, extracting oxygen from inhaled air into the bloodstream and releasing carbon dioxide from the bloodstream. Respiration is controlled by respiratory centers in the brainstem which regulate the muscles of breathing.
The respiratory system has three main functions: gas exchange, regulating blood pH, and producing sounds. It consists of the upper respiratory tract including the nose and pharynx, and the lower tract including the lungs. Respiration has three steps: pulmonary ventilation, external respiration of gas exchange in the lungs, and internal respiration of gas exchange in tissues. The lungs obtain oxygen and expel carbon dioxide through breathing which involves the muscles and elastic recoil of the lungs and chest wall. The document then discusses various respiratory structures, processes, and disorders in more detail.
1. NurseReview.Org Respiratory System - Presentation Transcript
1. Medical and Surgical Nursing Review The Respiratory System Nurse Licensure Examination Review
2.
3. Outline Of Review Concepts:
oReview of the relevant respiratory anatomy
oReview of the relevant respiratory physiology
oThe respiratory assessment
oCommon laboratory examinations
4. Outline Of Review Concepts:
o Review of the common respiratory problems and the nursing management
o Review of common respiratory diseases
Upper respiratory conditions
Lower respiratory conditions
5. Respiratory Anatomy & Physiology
o The respiratory system consists of two main parts - the upper and the lower tracts
6. Respiratory Anatomy & Physiology
o The UPPER respiratory system consists of:
o 1. nose
o 2. mouth
o 3. pharynx
o 4. larynx
7. Respiratory Anatomy & Physiology
o The LOWER respiratory system consists of:
o 1. Trachea
o 2. Bronchus
o 3. Bronchioles
o 4. Respiratory unit
8. Upper Respiratory Tract
9. The Nose
o This is the first part of the upper respiratory system that contains nasal bones and cartilages
o There are numerous hairs called vibrissae
o There are numerous superficial blood vessels in the nasal mucosa
10. The Nose
o The functions of the nose are:
o 1. To filter the air
o 2. To humidify the air
o 3. To aid in phonation
o 4. Olfaction
11. The Pharynx
o The pharynx is a musculo - membranous tube that is composed of three parts
o 1. Nasopharynx
o 2. Oropharynx
o 3. Laryngopharynx
12. The Pharynx
o The pharynx functions :
o 1. As passageway for both air and foods (in the oropharynx)
o 2. To protect the lower airway
13. The Larynx
o Also called the voice box
o Made of cartilage and membranes and connects the pharynx to the trachea
14. The Larynx
o Functions of the larynx:
o 1. Vocalization
o 2. Keeps the patency of the upper airway
o 3. Protects the lower airway
15. The Paranasal sinuses
2. o These are four paired bony cavities that are lined with nasal mucosa and ciliated pseudostratified
columnar epithelium
o Named after their location - frontal, ethmoidal, sphenoidal and maxillary
16. The Paranasal sinuses
o The function of the sinuses:
o Resonating chambers in speech
17. The Lower Respiratory System
o The lower respiratory system consists of
o 1. Trachea
o 2. Main bronchus
o 3. Bronchial tree
o 4. Lungs- 3R/ 2L
o to the terminal bronchioles is called the conducting airway◊The trachea
o to the alveoli is called the respiratory◊The respiratory bronchioles acinus
18. The Trachea
o A cartilaginous tube measures 10-12 centimeters
o Composed of about 20 C-shaped cartilages, incomplete posteriorly
19. The Trachea
o The function of the trachea is to conduct air towards the lungs
o The mucosa is lined up with mucus and cilia to trap particles and carry them towards the upper airway
20. The Bronchus
o The right and left primary bronchi begin at the carina
o The function is for air passage
21. The Primary Bronchus
o RIGHT BRONCHUS
o Wider
o Shorter
o More Vertical
o LEFT BRONCHUS
o Narrower
o Longer
o More horizontal
22. The Bronchioles
o The primary bronchus further divides into secondary, then tertiary then into bronchioles
o The terminal bronchiole is the last part of the conducting airway
23. The Respiratory Acinus
o The respiratory acinus is the chief respiratory unit
o It consists of
o 1. Respiratory bronchiole
o 2. Alveolar duct
o 3. alveolar sac
24. The Respiratory Acinus
o The respiratory acinus is the chief respiratory unit
o The function of the respiratory acinus is gas exchange through the respiratory membrane
25. The Respiratory Acinus
o The respiratory membrane is composed of two epithelial cells
o 1.The type 1 pneumocyte - most abundant, thin and flat. This is where gas exchange occurs
o 2. The type 2 pneumocyte - secretes the lung surfactant
26. The Respiratory Acinus
o A type III pneomocyte is just the macrophage that ingests foreign material and acts as an important
defense mechanism
27. Accessory Structures
o The PLEURA
o Epithelial serous membrane lining the lung parenchyma
o Composed of two parts- the visceral and parietal pleurae
o The space in between is the pleural space containing a minute amount of fluid for lubrication
28. Accessory Structures
o The Thoracic cavity
o The chest wall composed of the sternum and the rib cage
o The cavity is separated by the diaphragm, the most important respiratory muscle
3. 29. Accessory Structures
o The Mediastinum
o The space between the lungs, which includes the heart and pericardium, the aorta and the vena
cavae.
30. GENERAL FUNCTIONS OF THE Respiratory System
o Gas exchange through ventilation, external respiration and cellular respiration
o Oxygen and carbon dioxide transport
31. The Assessment
o HISTORY
o Reason for seeking care
o Present illness
o Previous illness
o Family history
o Social history
32. The Assessment
o PHYSICAL EXAMINATION
o Skin- cyanosis, pallor
o Nail clubbing
o Cough and sputum production
o Inspect - palpate - percuss - auscultate the thorax
33. The Assessment
o LABORATORY EXAMINATION
o 1. ABG analysis
o 2. Sputum analysis
o 3. Direct visualization - bronchoscopy
o 4. Indirect visualization - CXR, CT and MRI
o 5. Pulmonary function test
34. ABG Analysis
o This test helps to evaluate gas exchange in the lungs by measuring the gas pressures and pH of an
arterial sample
35. ABG Analysis
o Pre-test: choose site carefully, perform the Allen’s test, secure equipments- syringe, needle, container
with ice
o Intra-test: Obtain a 5 mL specimen from the artery (brachial, femoral and radial)
o Post-test: Apply firm pressure for 5 minutes, label specimen correctly, place in the container with ice
36. ABG Analysis
o ABG normal values
o PaO2 80-100 mmHg
o PaCO2 35-45 mmHg
o pH 7.35- 7.45
o HCO3 22- 26 mEq/L
o O2 Sat 95-99%
37. Sputum Analysis
o This test analyzes the sample of sputum to diagnose respiratory diseases, identify organism, and
identify abnormal cells
38. Sputum Analysis
o Pre-test: Encourage to increase fluid intake
o Intra-test: rinse mouth with WATER only, instruct the patient to take 3 deep breaths and force a deep
cough, steam nebulization, collect early morning sputum
o Post-test: provide oral hygiene, label specimen correctly
39. Pulse Oximetry
o Non-invasive method of continuously monitoring the oxygen saturation of hemoglobin
o A sensor or probe is attached to the earlobe, forehead, fingertip or the bridge of the nose
40. Bronchoscopy
o A direct inspection of the trachea and bronchi through a flexible fiber-optic or a rigid bronchoscope
o Done to determine location of pathologic lesions, to remove foreign objects, to collect tissue specimen
and remove secretions/aspirated materials
41. Bronchoscopy
o Pre-test: Consent, NPO x 6h, teaching
o Intra-test: position supine or sitting upright in a chair, administer sedative, gag reflex will be abolished,
remove dentures
4. o Post-test: NPO until gag reflex returns, position SEMI-fowler’s with head turned to sides, hoarseness
is temporary, CXR after the procedure, keep tracheostomy set and suction x 24 hours
42. Thoracentesis
o Pleural fluid aspiration for obtaining a specimen of pleural fluid for analysis, relief of lung compression
and biopsy specimen collection
43. Thoracentesis
o Pre-test: Consent
o Intra-test: position the patient sitting with arms on a table or side-lying fowler’s, instruct not to cough,
breathe deeply or move
o Post-test: position unaffected side to allow lung expansion of the affected side, CXR obtained,
maintain pressure dressing and monitor respiratory status
44. Pulmonary Function Tests
o Volume and capacity tests aid diagnosis in patient with suspected pulmonary dysfunction
o Evaluates ventilatory function
o Determines whether obstructive or restrictive disease
o Can be utilized as screening test
45. Pulmonary Function Test
o Lung Volumes
o Tidal volume
o Inspiratory reserve volume
o Expiratory reeve volume
o Residual volume
46. Pulmonary Function Test
o Lung capacities
o Inspiratory capacity
o Vital capacity
o Functional residual capacity
o Total lung capacity
47. Pulmonary Function Test
o Pre-test: Teaching, no smoking for 3 days, only light meal 4 hours before the test
o Intra-test: position sitting, bronchodilator, nose-clip and mouthpiece, fatigue and dyspnea during the
test
o Post-test: adequate rest periods, loosen tight clothing
48. Common Respiratory Problems and the common interventions
49. Dyspnea
o Breathing difficulty
o Associated with many conditions- CHF, MG, GBS, Muscular dystrophy, obstruction, etc…
50. Dyspnea
o General nursing interventions:
o 1. Fowler’s position to promote maximum lung expansion and promote comfort. An alternative position
is the ORTHOPNEIC position
o 2. O2 usually via nasal cannula
o 3. Provide comfort and distractions
51. Cough and sputum production
o Cough is a protective reflex
o Sputum production has many stimuli
o bacterial pneumonia◊Thick, yellow, green or rust-colored
o pulmonary edema◊Profuse, Pink, frothy
o Lung tumor◊Scant, pink-tinged, mucoid
52. Cough and sputum production
o General nursing Intervention
o 1. Provide adequate hydration
o 2. Administer aerosolized solutions
o 3. advise smoking cessation
o 4. oral hygiene
53. Cyanosis
o Bluish discoloration of the skin
o A LATE indicator of hypoxia
o Appears when the unoxygenated hemoglobin is more than 5 grams/dL
o observe color on the undersurface of tongue and lips◊Central cyanosis
5. o observe the nail beds, earlobes◊Peripheral cyanosis
54. Cyanosis
o Interventions:
Check for airway patency
Oxygen therapy
Positioning
Suctioning
Chest physiotherapy
Check for gas poisoning
Measures to increased hemoglobin
55. Hemoptysis
o Expectoration of blood from the respiratory tract
o Common causes: Pulmo infection, Lung CA, Bronchiectasis, Pulmo emboli
o acidic pH, coffee ground material◊Bleeding from stomach
56. Hemoptysis
o Interventions:
o Keep patent airway
o Determine the cause
o Suction and oxygen therapy
o Administer Fibrin stabilizers like aminocaproic acid and tranexamic acid
57. Epistaxis
o Bleeding from the nose caused by rupture of tiny, distended vessels in the mucus membrane
o Most common site- anterior septum
o Causes
o 1. trauma
o 2. infection
o 3. Hypertension
o 4. blood dyscrasias , nasal tumor, cardio diseases
58. Epistaxis
o Nursing Interventions
o prevents swallowing◊1. Position patient: Upright, leaning forward, tilted and aspiration
o 2. Apply direct pressure. Pinch nose against the middle septum x 5-10 minutes
o 3. If unrelieved, administer topical vasoconstrictors, silver nitrate, gel foams
o 4. Assist in electrocautery and nasal packing for posterior bleeding
59. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections
o 1. Rhinitis- allergic, non-allergic and infectious
o 2. Sinusitis- acute and chronic
o 3. Pharyngitis- acute and chronic
60. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections
o 1. Rhinitis- Assessment findings
o Rhinorrhea
o Nasal congestion
o Nasal itchiness
o Sneezing
o Headache
61. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections
o 2. sinusitis- Assessment findings
o Facial pain
o Tenderness over the paranasal sinuses
o Purulent nasal discharges
o Ear pain, headache, dental pain
o Decreased sense of smell
62. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections
o 3. Pharyngitis- Assessment findings
6. o Fiery-red pharyngeal membrane
o White-purple flecked exudates
o Enlarged and tender cervical lymph nodes
o Fever malaise ,sore throat
o Difficulty swallowing
o Cough may be absent
63. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections- Laboratory tests
o 1. CBC
o 2. Culture
64. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections: Nursing Interventions
o 1. Maintain Patent Airway
o Increase fluid intake to loosen secretions
o Utilize room vaporizers or steam inhalation
o Administer medications to relieve nasal congestion
65. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections: Nursing Interventions
o 2. Promote comfort
o Administer prescribed analgesics
o Administer topical analgesics
o Warm gargles for the relief of sore throat
o Provide oral hygiene
66. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections: Nursing Interventions
o 3. Promote communication
o Instruct patient to refrain from speaking as much as possible
o Provide writing materials
67. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infections: Nursing Interventions
o 4. Administer prescribed antibiotics
o Monitor for possible complications like meningitis, otitis media, abscess formation
o 5. Assist in surgical intervention
68. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o Infection and inflammation of the tonsils
o Most common organism- Group A- beta hemolytic streptococcus (GABS)
69. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o ASSESSMENT FINDINGS
o Sore throat and mouth breathing
o Fever
o Difficulty swallowing
o Enlarged, reddish tonsils
o Foul-smelling breath
70. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o Laboratory test
o 1. CBC
o 2. throat culture
71. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o MEDICAL management
o 1. Antibiotics- penicillin
o 2. Tonsillectomy for chronic cases and abscess formation
72. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o NURSING INTERVENTION for tonsillectomy
o 1. Pre-operative care
7. o Consent
o Routine pre-op surgical care
73. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o NURSING INTERVENTION for tonsillectomy
o 2. POST-operative care
o Position: Most comfortable is PRONE, with head turned to side
o Maintain oral airway, until gag reflex returns
74. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o NURSING INTERVENTION for tonsillectomy
o 2. POST-operative care
o Apply ICE collar to the neck to reduce edema
o Advise patient to refrain from talking and coughing
o Ice chips are given when there is no bleeding and gag reflex returns
75. CONDITIONS OF THE UPPER AIRWAY
o Upper airway infection: Tonsillitis
o NURSING INTERVENTION for tonsillectomy
o 2. POST-operative care
o Notify physician if
o a. Patient swallows frequently
o b. vomiting of large amount of bright red or dark blood
o c. PR increased, restless and Temp is increased
76. Laryngeal Cancer
o A malignant tumor of the larynx
o More frequent in men
o 50-70 years old
o RISK FACTORS
o 1. Smoking
o 2. Alcohol
o 3. Exposure to chemicals
o 4. Straining of voice
o 5. chronic laryngitis
o 6. Deficiency of Riboflavin
o 7. family history
77. Laryngeal Cancer
o Growth can be anywhere in the larynx
o 1. Supraglottic- above the vocal cords
o 2. glottic- vocal cord area
o 3. infraglottic- below the vocal cords
o Most tumors are found in the glottic area
78. Laryngeal Cancer
o ASSESSMENT FINDINGS
o Hoarseness of more than TWO weeks duration
o Cough and sore throat
o Burning and pain in the throat especially after consuming HOT liquids and citrus foods
o Neck lump
o Dysphagia, dyspnea, foul breath, CLAD
79. Laryngeal Cancer
o LABORATORY FINDINGS
o 1. Indirect laryngoscopy
o 2. direct laryngoscopy
o 3. Biopsy
o 4. CT and MRI
o Most commonly- squamos carcinoma
80. Laryngeal Cancer
o MEDICAL MANAGEMENT
o Radiation therapy
8. o Chemotherapy
o Surgery
Partial laryngectomy
Supraglottic laryngectomy
Hemilaryngectomy
Total laryngectomy
81. Laryngeal Cancer
o NURSING MANAGEMENT: PRE-operative
o 1. Provide the patient pre-operative teachings
o Clarify misconceptions
o Tell that the natural voice will be lost
o Teach communication alternatives
o Collaborate with other team members
82. Laryngeal Cancer
o NURSING MANAGEMENT
o 2. reduce patient ANXIETY
o Provide opportunities for patient and family members to ask questions
o Referrals to previous patients with laryngeal cancers and cancer groups
83. Laryngeal Cancer
o NURSING MANAGEMENT: POST-op
o 3. Maintain PATENT Airway
o Position patient: Semi or High Fowler’s
o Suction secretions
o Encourage to deep breath, turn and cough
84. Laryngeal Cancer
o NURSING MANAGEMENT: POST-op
o 4. Administer care of the laryngectomy tube
o Suction as needed
o Cleanse the stoma with saline
o Administer humidified oxygen
o Laryngectomy tube is usually removed within 3-6 weeks after surgery
85. Laryngeal Cancer
o NURSING MANAGEMENT: POST-op
o 5. Promote alternative communication methods
o Call bell or hand bell
o Magic Slate
o Hand signals
o Collaborate with speech therapist
86. Laryngeal Cancer
o NURSING MANAGEMENT: POST-op
o 6. Promote adequate Nutrition
o NPO after operation
o No foods or drinks per orem for 10 days
o IVF, TPN are alternative nutrition routes
o Start oral feedings with thick liquids, avoid sweet foods
87. Laryngeal Cancer
o NURSING MANAGEMENT: POST-op
o 7. Promote positive body image and self-esteem
o Encourage verbalization of feelings
o Allow independence in self-care
88. Laryngeal Cancer
o NURSING MANAGEMENT: POST-op
o 8. Monitor for COMPLICATIONS
o Respiratory Distress
Suction
Coughing and deep breathing
Humidified oxygen
Alert the surgeon
89. Laryngeal Cancer
9. o NURSING MANAGEMENT: POST-op
o 8. Monitor for Complications
o Hemorrhage
Monitor for bleeding
Monitor vital signs
Apply direct pressure over the bleeding artery
Summon assistance and alert the surgeon
90. Laryngeal Cancer
o NURSING MANAGEMENT: POST-op
o 8. Monitor for COMPLICATIONS
o Wound infection and breakdown
o Monitor for increased temperature, purulent drainage and increased redness/tenderness
o Administer antibiotics
o Clean and change dressing OD
91. Laryngeal Cancer
o NURSING MANAGEMENT: HOME CARE
o Humidification system at home is needed
o AVOID swimming
o Cover the stoma with hands or plastic bib over the opening
o Advise beauty salons to avoid hair sprays, powders and loose hair near the opening
o Oral hygiene frequently
92. Acute Respiratory Failure
o Sudden and life-threatening deterioration of the gas-exchange function of the lungs
o Occurs when the lungs no longer meet the body’s metabolic needs
93. Acute Respiratory Failure
o Defined clinically as:
o 1. PaO2 of less than 50 mmHg
o 2. PaCO2 of greater than 5o mmHg
o 3. Arterial pH of less than 7.35
94. Acute Respiratory Failure
o CAUSES
o CNS depression- head trauma, sedatives
o CVS diseases- MI, CHF, pulmonary emboli
o Airway irritants- smoke, fumes
o Endocrine and metabolic disorders- myxedema, metabolic alkalosis
o Thoracic abnormalities- chest trauma, pneumothorax
95. Acute Respiratory Failure
o PATHOPHYSIOLOGY
o Decreased Respiratory Drive
o impair the normal response of◊Brain injury, sedatives, metabolic disorders the brain to normal
respiratory stimulation
96. Acute Respiratory Failure
o PATHOPHYSIOLOGY
o Dysfunction of the chest wall
o disrupt the impulse◊Dystrophy, MS disorders, peripheral nerve disorders abnormal
ventilation◊transmission from the nerve to the diaphragm
97. Acute Respiratory Failure
o PATHOPHYSIOLOGY
o Dysfunction of the Lung Parenchyma
o interfere◊Pleural effusion, hemothorax, pneumothorax, obstruction prevent lung
expansion◊ventilation
98. Acute Respiratory Failure
o ASSESSMENT FINDINGS
o Restlessness
o dyspnea
o Cyanosis
o Altered respiration
o Altered mentation
o Tachycardia
10. o Cardiac arrhythmias
o Respiratory arrest
99. Acute Respiratory Failure
o DIAGNOSTIC FINDINGS
o Pulmonary function test- pH below 7.35
o CXR- pulmonary infiltrates
o ECG- arrhythmias
100.Acute Respiratory Failure
o MEDICAL TREATMENT
o Intubation
o Mechanical ventilation
o Antibiotics
o Steroids
o Bronchodilators
101.Acute Respiratory Failure
o NURSING INTERVENTIONS
o 1. Maintain patent airway
o 2. Administer O2 to maintain Pa02 at more than 50 mmHg
o 3. Suction airways as required
o 4. Monitor serum electrolyte levels
o 5. Administer care of patient on mechanical ventilation
102.COPD
o These are group of disorders associated with recurrent or persistent obstruction of air passage and
airflow, usually irreversible.
103.COPD
o The most common cause of COPD is cigarette smoking. Asthma, Chronic bronchitis, Emphysema and
Bronchiectasis are the common disorders.
104.COPD
o The general pathophysiology:
o In COPD there is airflow limitation that is both progressive and associated with abnormal inflammatory
response of the lungs to stimuli, usually smoke, particles and dust
105.ASTHMA
o The acute episode of airway obstruction is characterized by airway hyperactivity to various stimuli that
results in recurrent wheezing brought about by edema and bronchospasm
106.Asthma Pathophysiology
o Immunologic/allergic reaction results in histamine release, which produces three main airway
responses
o a. Edema of mucous membranes
o b. Spasm of the smooth muscle of bronchi and bronchioles
o c. Accumulation of tenacious secretions
107.Asthma Assessment Findings
o Assessment findings
o 1. Family history of allergies
o 2. Client history of eczema
108.Asthma Assessment Findings
o Assessment findings
o 3. Pulmonary signs and symptoms- Respiratory distress: slow onset of shortness of breath, expiratory
wheeze , prolonged expiratory phase, air trapping (barrel chest if chronic), use of accessory muscles,
irritability (from hypoxia), diaphoresis, cough, anxiety, weak pulse, diaphoresis and change in
sensorium if severe attack
109.Asthma Assessment Findings
o Assessment findings
o 4. Use of accessory muscles of respiration, inspiratory retractions, prolonged I:E ratio
o 5. Cardiovascular symptoms: tachycardia, ECG changes, hypertension, decreased cardiac
contractility, pulsus paradoxus
o 6. CNS manifestations: anxiety, restlessness, fear and disorientation
110.Emphysema
o There is progressive and irreversible alveolocapillary destruction with abnormal alveolar enlargement
causing alveolar wall destruction. The result is INCREASED lung compliance, DECREASED oxygen
diffusion and INCREASED airway resistance!
111.Emphysema
o These changes cause a state of carbon dioxide retention, hypoxia, and respiratory acidosis.
11. 112.Emphysema
o Cigarette smoking
o Heredity, Bronchial asthma
o Aging process
o
o Disequilibrium between
o ELASTASE & ANTIELASTASE (alpha-1-antitrypsin)
o Destruction of distal airways and alveoli
o Overdistention of ALVEOLI
o Hyper-inflated and pale lungs
o Air traping, decreased gas exchange and Retention of CO2
o
o Hypoxia Respiratory acidosis
113.Emphysema Assessment
o 1. Anorexia, fatigue, weight loss
o 2. Feeling of breathlessness, cough, sputum production, flaring of the nostrils, use of accessory
muscles of respiration, increased rate and depth of breathing, dyspnea
114.Emphysema Assessment
o 3. Decreased respiratory excursion, resonance to hyper-resonance, decreased breath sounds with
prolonged expiration, normal or decreased fremitus
o 4. Diagnostic tests: pCO2 elevated or normal; PO2 normal or slightly decreased
115.Chronic bronchitis
o Chronic inflammation of the bronchial air passageway characterized by the presence of cough and
sputum production for at least 3 months in each 2 consecutive years.
o Excessive production of mucus in the bronchi with accompanying persistent cough.
116.Chronic Bronchitis pathophysiology
o Characteristic changes include hypertrophy/ hyperplasia of the mucus-secreting glands in the bronchi,
decreased ciliary activity, chronic inflammation, and narrowing of the small airways.
117.Chronic Bronchitis Assessment
o I. Productive (copious) cough, dyspnea on exertion, use of accessory muscles of respiration, scattered
rales and rhonchi
o 2. Feeling of epigastric fullness, cyanosis, distended neck veins, ankle edema
o 3. Diagnostic tests: increased pCO2 decreased PO2
118.Bronchiectasis
o Permanent abnormal dilation of the bronchi with destruction of muscular and elastic structure of the
bronchial wall
119.Bronchiectasis
o Caused by bacterial infection; recurrent lower respiratory tract infections; congenital defects (altered
bronchial structures); lung tumors
120.Bronchiectasis
o 1. Chronic cough with production of mucopurulent sputum, hemoptysis, exertional dyspnea, wheezing
o 2. Anorexia, fatigue, weight loss
o 3. Diagnostic tests
a. Bronchoscopy reveals sources and sites of secretions
b. Possible elevation of WBC
121.COPD Management
o Independent and Collaborative Management
o 1. Rest- To reduce oxygen demands of tissues
o 2. Increase fluid intake -To liquefy mucus secretions
o 3. Good oral care- To remove sputum and prevent infection
122.COPD Management
o Independent and Collaborative Management
o 4. Diet:
o High caloric diet provides source of energy
o High protein diet helps maintain integrity of alveolar walls
o Moderate fats
o Low carbohydrate diet limits carbon dioxide production (natural end product). The client has difficulty
exhaling carbon dioxide.
123.COPD Management
o Independent and Collaborative Management
o 5. O2 therapy 1 to 3 lpm ( 2 lpm is safest )
12. o Do not give high concentration of oxygen. The drive for breathing may be depressed.
124.COPD Management
o Independent and Collaborative Management
o 6 . Avoid cigarette smoking, alcohol, and environmental pollutants-These inhibit mucociliary function.
o 7. CPT –percussion, vibration, postural drainage
125.COPD Management
o Independent and Collaborative Management
o 8. Bronchial hygiene measures
o Steam inhalation
o Aerosol inhalation
o Medimist inhalation
126.COPD Management
o Pharmacotherapy
o 1. Expectorants (guaiafenessin)/ mucolytic (mucomyst/mucosolvan)
o 2. Antitussives
o Dextrometorphan
o Codeine
o Observe for drowsiness
o Avoid activities that involve mental alertness, e.g driving, operating electrical machines
o Cause decrease peristalsis thereby constipation
127.COPD Management
o Pharmacotherapy
o 3. Bronchodilators
o Aminophylline (Theophylline)
o Ventolin (Salbutamol)
o Bricanyl (Terbutaline)
o Alupent (Metaproterenol)
Observe for tachycardia
128.COPD Management
o Pharmacotherapy
o 4. Antihistamine
o Benadryl (Diphenhydramine)
o Observe for drowsiness
o 5. Steroids
o Anti-inflammatory effect
o 6. Antimicrobials
129.Flail Chest
o Complication of chest trauma occurring when 3 or more adjacent ribs are fractured at two or more
sites, resulting in free-floating rib segments.
130.Flail Chest
o Chest wall is no longer able to provide the bony structure necessary to maintain adequate ventilation;
consequently
o the flail portion and underlying tissue move paradoxically (in opposition) to the rest of the chest cage
and lungs.
131.Flail Chest
o The flail portion is sucked in on inspiration and bulges out on expiration.
o Result is hypoxia, hypercarbia, and increased retained secretions.
o Caused by trauma (sternal rib fracture with possible costochondral separations).
132.Flail Chest
o PATHOPHYSIOLOGY
o During inspiration, as the chest expands, the detached part of the rib segment (flail segment) moves in
a “paradoxical” manner
o The chest is pulled INWARD during inspiration, reducing the amount of air that can be drawn into the
lungs
o The chest bulges OUTWARD during expiration because the intrathoracic pressure exceeds
atmospheric pressure. The patient has impaired exhalation
133.Flail Chest
o This paradoxical action will lead to:
Increased dead space
Reduced alveolar ventilation
13. Decreased lung compliance
Hypoxemia and respiratory acidosis
Hypotension, inadequate tissue perfusion can also follow
134.Flail Chest
o Assessment findings
o 1. Severe dyspnea; rapid, shallow, grunty breathing; paradoxical chest motion. The chest will move
INWARDS on inhalation and OUTWARDS on exhalation.
o 2. Cyanosis, possible neck vein distension, tachycardia, hypotension
o 3. Diagnostic tests
a. PO2 decreased
b. pCO2 elevated
c. pH decreased
135.Flail Chest
o Nursing interventions
o 1. Maintain an open airway: suction secretions, blood from nose, throat, mouth, and via endotracheal
tube; note changes in amount, color, and characteristics.
o 2. Monitor mechanical ventilation
o 3. Encourage turning, coughing, and deep breathing.
o 4. Monitor for signs of shock: HYPOTENSION, TACHYCARDIA
136.Flail Chest
o Medical management: SUPPORTIVE
o 1. Internal stabilization with a volume-cycled ventilator
o 2. Drug therapy (narcotics, sedatives)
137.Pneumothorax
o Partial or complete collapse of the lung due to an accumulation of air or fluid in the pleural space
138.Pneumothorax
o Types
o a . Spontaneous pneumothorax : the most common type of closed pneumothorax; air accumulates
within the pleural space without an obvious cause. Rupture of a small bleb on the visceral pleura most
frequently produces this type of pneumothorax.
139.Pneumothorax
o Types
o b. Open pneumothorax : air enters the pleural space through an opening in the chest wall; usually
caused by stabbing or gunshot wound.
140.Pneumothorax
o Types
o c. Tension pneumothorax : air enters the pleural space with each inspiration but cannot escape;
causes increased intrathoracic pressure and shifting of the mediastinal contents to the unaffected side
(mediastinal shift ).
141.Pneumothorax
o Assessment findings
o 1. Sudden sharp pain in the chest, dyspnea, diminished or absent breath sounds on affected side ,
tracheal shift to the opposite side (tension pneumothorax accompanied by mediastinal shift)
o 2. Weak, rapid pulse; anxiety; diaphoresis
142.Pneumothorax
o Assessment findings
o 3. Diagnostic tests
a. Chest x-ray reveals area and degree of pneumothorax
b. pCO2 elevated
c. pH decreased
143.Pneumothorax
o Nursing interventions
o 1. Provide nursing care for the client with an endotracheal tube: suction secretions, vomitus, blood
from nose, mouth, throat, or via endotracheal tube; monitor mechanical ventilation.
144.Pneumothorax
o Nursing interventions
o 2. Restore/promote adequate respiratory function.
o a. Assist with thoracentesis and provide appropriate nursing care.
o b. Assist with insertion of a chest tube to water- seal drainage and provide appropriate nursing care.
o c. Continuously evaluate respiratory patterns and report any changes.
145.Pneumothorax
14. o Nursing interventions
o 3. Provide relief/control of pain.
o a. Administer narcotics/analgesics/sedatives as ordered and monitor effects.
o b. Position client in high-Fowler’s position.
146.Atelectasis
o Collapse of part or all of a lung due to bronchial obstruction
o May be caused by
intrabronchial obstruction
tumors, bronchospasm
foreign bodies
extrabronchial compression (tumors, enlarged lymph nodes); or
endobronchial disease (bronchogenic carcinoma, inflammatory structures)
147.Atelectasis
o Assessment findings
o 1. Signs and symptoms may be absent depending upon degree of collapse and rapidity with which
bronchial obstruction occurs
o 2. Dyspnea, decreased breath sounds on affected side, decreased respiratory excursion, dullness to
flatness upon percussion over affected area
148.Atelectasis
o Assessment findings
o 3. Cyanosis, tachycardia, tachypnea, elevated temperature, weakness, pain over affected area
149.Atelectasis
o Assessment findings
o 4. Diagnostic tests
o a. Bronchoscopy: may or may not reveal an obstruction
o b. Chest x-ray shows diminished size of affected lung and lack of radiance over atelectatic area
o c. pO2 decreased
150.Pleural Effusion
o Defined broadly as a collection of fluid in the pleural space
o A symptom, not a disease; may be produced by numerous conditions
151.Pleural Effusion
o General Classification
Transudative effusion: accumulation of protein-poor, cell-poor fluid
Exudative effusion: accumulation of protein rich fluid
152.Pleural Effusion
o Assessment findings
o 1. Dyspnea, dullness over affected area upon percussion, absent or decreased breath sounds over
affected area, pleural pain, dry cough, pleural friction rub
o 2. Pallor, fatigue, fever, and night sweats (with empyema)
153.Pleural Effusion
o Assessment findings
o 3. Diagnostic tests
o a. Chest x-ray positive if greater than 250 cc pleural fluid
o b. Pleural biopsy may reveal bronchogenic carcinoma
o c. Thoracentesis may contain blood if cause is cancer, pulmonary infarction, or tuberculosis; positive
for specific organism in empyema.
154.Pleural Effusion
o Nursing interventions: In general:
o 1. Assist with repeated thoracentesis.
o 2. Administer narcotics/sedatives as ordered to decrease pain.
o 3. Assist with instillation of medication into pleural space (reposition client every 15 minutes to
distribute the drug within the pleurae).
o 4. Place client in high-Fowler’s position to promote ventilation.
155.Pleural Effusion
o Medical management
o 1. Identification and treatment of the Underlying cause
o 2. Thoracentesis
o 3. Drug therapy
a. Antibiotics: either systemic or inserted directly into pleural space
15. b. Fibrinolytic enzymes: trypsin, streptokinase-. streptodornase to decrease thickness of pus and
dissolve fibrin clots
o 4. Closed chest drainage
o 5. Surgery: open drainage
156.Pneumonia
o An inflammation of the alveolar spaces of the lung, resulting in consolidation of lung tissue as the
alveoli fill with exudates
o The various types of pneumonias are classified according to the offending organism.
o Pneumonia can also be classified as COMMUNITY Acquired Pneumonia (CAP) and Hospital acquired
pneumonia (HAP)
157.Pneumonia
o PATHOPHYSIOLOGIC FINDINGS ARE:
o HYPERTROPHY OF MUCOUS MEMBRANE
Increased sputum production
Wheezing
Dyspnea
Cough
Rales
Ronchi
158.Pneumonia
o PATHOPHYSIOLOGIC FINDINGS ARE:
o INCREASED CAPILLARY PERMEABILITY
Increased Fluid Exudation
Consolidation-tissue that solidifies as a result of collapsed alveoli
Hypoxemia
159.Pneumonia
o PATHOPHYSIOLOGIC FINDINGS ARE:
o INFLAMMATION OF THE PLEURA
o Chest pain
o Pleural effusion
o Dullness
o Decreased Breath sounds
o Increased tactile fremitus
160.Pneumonia
o PATHOPHYSIOLOGIC FINDINGS ARE:
o HYPOVENTILATION
o Decreased Chest expansion
o Respiratory acidosis
o Depressed PROTECTIVE MECHANISM
o Increased WBC (leukocytosis)
o Increased RR and Fever
161.Pneumonia
o Assessment findings
o Cough with greenish to rust-colored sputum production
o rapid, shallow respirations with an expiratory grunt
o nasal flaring; intercostal rib retraction; use of accessory muscles of respiration
o rales or crackles (early) progressing to coarse (later).
o Tactile fremitus is INCREASED!
162.Pneumonia
o Assessment findings
o Fever, chills, chest pain, weakness, generalized malaise
o Tachycardia, cyanosis, profuse perspiration, abdominal distension
o Rapid shallow breathing
163.Pneumonia
o Diagnostic tests
o a. Chest x-ray shows consolidation over affected areas
o b. WBC increased
o c. pO2 decreased
o d. Sputum specimen- culture reveal particular causative organism
16. 164.Pneumonia
o 1. Facilitate adequate ventilation.
o a. Administer oxygen as needed and assess its effectiveness.
o b. Place client in Fowler’s position .
o c. Turn and reposition frequently clients who are immobilized/obtunded.
o d. Administer analgesics as ordered to relieve pain associated with breathing
o e. Auscultate breath sounds every 2—4 hours.
o f. Monitor ABGs.
165.Pneumonia
o GENERAL Nursing interventions
o 2. Facilitate removal of secretions
o general hydration
o deep breathing and coughing
o Suctioning
o Expectorants
o aerosol treatments via nebulizer, humidification of inhaled air
o chest physical therapy
166.Pneumonia
o GENERAL Nursing interventions
o 3. Observe color, characteristics of sputum and report any changes; encourage client to perform good
oral hygiene after expectoration.
167.Pneumonia
o GENERAL Nursing interventions
o 4. Provide adequate rest and relief/control of pain.
o a. Provide bed rest with limited physical activity.
o b. Limit visits and minimize conversations.
o c. Plan for uninterrupted rest periods.
o d. Institute nursing care in blocks to ensure periods of rest.
o e. Maintain pleasant and restful environment
168.Pneumonia
o GENERAL Nursing interventions
o 5. Administer antibiotics as ordered. Monitor effects and possible toxicity.
o 6. Prevent transmission (respiratory isolation may be required for clients with staphylococcal
pneumonia).
o 7. Control fever and chills: monitor temperature and administer
antipyretics as ordered, maintain increased fluid intake, provide frequent clothing and linen
changes.
169.Pneumonia
o GENERAL Nursing interventions
o 8. Provide client teaching and discharge planning concerning prevention of recurrence.
a. Medication regimen/antibiotic therapy
b. Need for adequate rest,
c. Need to continue deep breathing and coughing
170.Pneumonia
o GENERAL Nursing interventions
o 8. Provide client teaching and discharge planning concerning prevention of recurrence.
d. Availability of vaccines
e. Techniques that prevent transmission (use of tissues when coughing, adequate disposal of
secretions)
f. Avoidance of persons with known respiratory infections
g. Need to report signs and symptoms of respiratory infection
171.Lung Cancer
o Primary pulmonary tumors arise from the bronchial epithelium and are therefore referred to as
bronchogenic carcinomas.
o FACTORS: Possibly caused by inhaled carcinogens (primarily cigarette smoke but also asbestos,
nickel, iron oxides, air silicone pollution; preexisting pulmonary disorders PTB, COPD)
172.Lung Cancer
o Assessment findings
o Persistent cough (may be productive or blood tinged)
o chest pain
17. o dyspnea
o unilateral wheezing, friction rub, possible unilateral paralysis of the diaphragm
o Fatigue, anorexia, nausea, vomiting, pallor
173.Lung Cancer
o Diagnostic tests.
o a. Chest x-ray may show presence of tumor or evidence of metastasis to surrounding structures
o b. Sputum for cytology reveals malignant cells
o c. Bronchoscopy: biopsy reveals malignancy
o d. Thoracentesis: pleural fluid contains malignant cells
o e. Biopsy of lymph nodes may reveal metastasis
174.Lung Cancer
o 1. Provide support and guidance to client as needed.
o 2. Provide relief/control of pain.
o 3. Administer medications as ordered and monitor effects/side effects.
o 4. Control nausea: administer medications as ordered, provide good oral hygiene, provide small and
more frequent feedings.
175.Lung Cancer
o 5. Provide nursing care for a client with a thoracotomy.
o 6. Provide client teaching and discharge planning concerning
a. Disease process, diagnostic and therapeutic interventions
b. Side effects of radiation and chemotherapy
c. Realistic information about prognosis
176.Lung Cancer
o Medical management
o 1. Radiation therapy
o 2. Chemotherapy: usually includes cyclophosphamide, methotrexate, vincristine, doxorubicin, and
procarbazine; concurrently in some combination
o 3. Surgery: when entire tumor can be removed
177.Lung Cancer
o Quick Notes on Bronchogenic Cancer
o Predisposing factors
o Cigarette smoking
o Asbestosis
o Emphysema
o Smoke from burnt wood
o Types
o Squamous cell Ca- with good prognosis
o Adenocarcinoma- with good prognosis
o Oat cell Ca- with good prognosis
o Undifferentiated Ca- with poor prognosis
178.Lung Cancer
o Quick Notes on Bronchogenic Cancer
o Nursing Interventions
o Patent airway
o O2 / Aerosol therapy
o Deep breathing exercises
o Relief of pain
o Protection from infection
o Adequate nutrition
o Chest tube management
179.Lung Cancer
o Quick Notes on Bronchogenic Cancer
o Surgery
o Pneumonectomy= Removal of a lung (either left or right)
o Lobectomy =Removal of a lobe.
o Segmentectomy= Removal of a segment.
o Wedge resection =Removal of the entire tumor regardless of the segment.
o Decortication= Stripping off of fibrinous membrane enclosing the lung
18. o Thoracoplasty= Removal of rib/s. Usually done after pneumonectomy, to reduce the size of the empty
thorax thereby prevent mediastinal shift.
180.Pulmonary Embolism
o This refers to the obstruction of the pulmonary artery or one of its branches by a blood clot (thrombus)
that originates somewhere in the venous system or in the right side of the heart.
o Most commonly, pulmonary embolism is due to a clot or thrombus from the deep veins of the lower
legs.
181.Pulmonary Embolism
o Causes
o Fat embolism. Air embolism
o Multiple trauma
o PVD’s
o Abdominal surgery
o Immobility
o Hypercoagulability
182.Pulmonary Embolism
o PATHOPHYSIOLOGY
o The thrombus that travels from any part of the venous system obstructs either completely or partially .
Then the lungs will have inadequate blood supply, with resultant increase in dead space in the lungs
o Gas exchange will be impaired or absent in the involved area
183.Pulmonary Embolism
o PATHOPHYSIOLOGY
o The regional pulmonary vasculature will constrict causing increased resistance, increased pulmonary
arterial pressure and then increase workload of the right side of the heart.
184.Pulmonary Embolism
o PATHOPHYSIOLOGY
o When the work of the right side of the heart exceeds its capacity, right ventricular failure will result,
leading to a decrease in cardiac output followed by decreased systemic perfusion and eventually,
SHOCK
185.Pulmonary Embolism
o Assessment
o Restlessness (cardinal initial sign)
o Dyspnea
o Stabbing chest pain
o Cyanosis
o Tachycardia
o Dilated pupils
o Apprehension/ fear
o Diaphoresis
o Dysrhythmias
o Hypoxia
186.Pulmonary Embolism
o Diagnostic Tests:
o Ventilation-perfusion scan
o Pulmonary arteriography
o CXR
o ECG
o ABG
187.Pulmonary Embolism
o Nursing Interventions
o Oxygen therapy STAT
o Early ambulation postop
o Monitor obese patient
o Do not massage legs
o Relieve pain- analgesics
o HOB elevated
o Heparin (2 weeks) then Coumadin (3-6 months)
188.Pulmonary Embolism
o Patient Teaching for prevention of Pulmonary Embolism
o Active leg exercises to avoid venous stasis
19. o Early ambulation
o Use of elastic compression stockings
o Avoidance of leg-crossing and sitting for prolonged periods
o Drink fluids
189.Surgical Aspect of Respiratory Care
o Thoracic Surgery
o a. Exploratory thoracotomy : anterior or posterolateral incision through the fourth, fifth, sixth, or
seventh intercostal spaces to expose and examine the pleura and lung
190.Surgical Aspect of Respiratory Care
o Thoracic Surgery
o b. Lobectomy : removal of one lobe of a lung; treatment for bronchiectasis, bronchogenic carcinoma,
emphysematous blebs, lung abscesses
191.Surgical Aspect of Respiratory Care
o Thoracic Surgery
o c. Pneumonectomy : removal of an entire lung; most commonly done as treatment for bronchogenic
carcinoma
192.Surgical Aspect of Respiratory Care
o Thoracic Surgery
o d. Segmental resection : removal of one or more segments of lung; most often done as treatment for
bronchiectasis
193.Surgical Aspect of Respiratory Care
o Thoracic Surgery
o e. Wedge resection : removal of lesions that occupy only part of a segment of lung tissue; for excision
of small nodules or to obtain a biopsy
194.Surgical Aspect of Respiratory Care
o Nursing interventions: PREOPERATIVE
o 1. Provide routine pre-op care.
o 2. Perform a complete physical assessment of the lungs to obtain baseline data.
o 3. Explain expected post-op measures: care of incision site, oxygen, suctioning, chest tubes (except if
pneumonectomy performed)
195.Surgical Aspect of Respiratory Care
o Nursing interventions: PREOPERATIVE
o 4. Teach client adequate splinting of incision with hands or pillow for turning, coughing, and deep
breathing.
o 5. Demonstrate ROM exercises for affected side.
o 6. Provide chest physical therapy to help remove secretions.
196.Surgical Aspect of Respiratory Care
o Nursing interventions: POSTOPERATIVE
o 1. Provide routine post-op care.
o 2. Promote adequate ventilation.
o a. Perform complete physical assessment of lungs and compare with pre-op findings.
o b. Auscultate lung fields every 1—2 hours.
o c. Encourage turning, coughing, and deep breathing every 1—2 hours after pain relief obtained.
197.Surgical Aspect of Respiratory Care
o Nursing interventions: POSTOPERATIVE
o 2. Promote adequate ventilation.
o d. Perform tracheobronchial suctioning if needed.
o e. Assess for proper maintenance of chest drainage system (except after pneumonectomy).
o f. Monitor ABGs and report significant changes.
o g. Place client in semi-Fowler’s position
198.Surgical Aspect of Respiratory Care
o Nursing interventions: POSTOPERATIVE
o If pneumonectomy is performed, follow surgeon’s orders about positioning, often on back or
OPERATIVE SIDE
o If Lobectomy , patient is usually positioned on the UNOPERATIVE SIDE
199.Surgical Aspect of Respiratory Care
o Nursing interventions: POSTOPERATIVE
o 3. Provide pain relief.
o a. Administer narcotics/analgesics prior to turning, coughing, and deep breathing.
o b. Assist with splinting while turning, coughing, deep breathing.
200.Surgical Aspect of Respiratory Care
20. o Nursing interventions: POSTOPERATIVE
o 4. Provide client teaching and discharge planning concerning
o a. Need to continue with coughing/deep breathing for 6—8 weeks post-op and to continue ROM
exercises
o b. Importance of adequate rest with gradual increases in activity levels
201.Surgical Aspect of Respiratory Care
o Nursing interventions: POSTOPERATIVE
o 4. Provide client teaching and discharge planning concerning
o c. High-protein diet with inclusion of adequate fluids
o d. Chest physical therapy
o e. Good oral hygiene
o f. Need to avoid persons with known upper respiratory infection
o g. Adverse signs and symptoms
o h. Avoidance of crowds and poorly ventilated areas.