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.
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
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.
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.
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
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 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.
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.
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.
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
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.
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.
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
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 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.
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.
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.
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.
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 defines oxygenation as the delivery of oxygen to body tissues and cells, describes the physiological process of oxygen transport from the lungs to cells, and outlines factors that can affect oxygen levels as well as signs and symptoms of hypoxia. It also provides details on administering oxygen to improve uptake and delivery through various methods and equipment.
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.
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.
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.
This document discusses oxygen therapy, including its definition, types, purposes, administration, and complications. Oxygen therapy delivers oxygen at concentrations greater than 21% to increase oxygen saturation in tissues. It is used to treat various respiratory conditions. Administration involves nasal cannulas, face masks, venturi masks, and other devices. Potential complications include oxygen toxicity, retrolental fibroplasia, and absorption atelectasis. Careful monitoring is needed with oxygen therapy.
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.
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.
The document discusses oxygen therapy, including:
1) Indications for oxygen therapy include both chronic and acute respiratory conditions, and it can be used therapeutically or for resuscitation in critical illnesses.
2) Potential complications of long-term oxygen therapy include drying of mucous membranes, pulmonary atelectasis, and oxygen toxicity affecting the central nervous system and lungs with long exposures.
3) Methods of oxygen delivery include nasal cannulas, face masks, venturi masks, reservoir masks, and high flow oxygen therapy. Proper humidification and positioning of the patient are also important.
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.
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.
Oxygen therapy involves administering supplemental oxygen to patients through various delivery methods like nasal cannulas, masks, and tents. It is used to treat hypoxemia by relieving symptoms, facilitating tissue metabolism, and reducing arterial oxygen deficiencies. Potential complications include infections, collapsed alveoli, oxygen toxicity, and drying of mucous membranes. Proper technique is required to safely deliver the prescribed flow rate of oxygen via the appropriate interface while monitoring for complications and therapeutic response.
Ventilation of the lungs occurs through breathing, which requires clear airways, an intact respiratory system, and a thoracic cavity capable of expanding and contracting. Oxygen diffuses from the alveoli into the blood while carbon dioxide diffuses from the blood into the alveoli. Factors like cardiac output, hematocrit levels, and exercise affect oxygen transport. Respiratory regulation maintains appropriate oxygen and carbon dioxide levels through neural and chemical controls. Alterations in respiratory function include hypoxia, hypoventilation, and hyperventilation which have signs and symptoms like anxiety, fatigue, and cyanosis.
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.
academic lecture about oxygen delivery system used in emergency room. The main principles of how to select proper device, the advatages and limitations of each device and how to monitor oxygen therapy.
Brief Note On Maintaining Patent AirwayBabitha Devu
This document discusses maintaining a patent airway, which refers to keeping an open airway between the lungs and outside world. It identifies potential causes of airway obstruction like foreign objects, infections, trauma, and altered consciousness. Signs of obstruction include abnormal breath sounds, respiratory changes, coughing, and hypoxemia. Interventions to maintain a patent airway include removing obstructions, positioning, deep breathing exercises, suctioning, medications, and artificial airways like oropharyngeal airways, nasopharyngeal airways, endotracheal tubes, or tracheostomies if needed. Airway maneuvers like head-tilt chin-lift and jaw-thrust are also described to open the airway.
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.
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.
oxygen is very very important for the human being. so i tried here to provide best content from the books and easy way to understand, if you like this slide comment it.
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.
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.
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.
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 defines oxygenation as the delivery of oxygen to body tissues and cells, describes the physiological process of oxygen transport from the lungs to cells, and outlines factors that can affect oxygen levels as well as signs and symptoms of hypoxia. It also provides details on administering oxygen to improve uptake and delivery through various methods and equipment.
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.
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.
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.
This document discusses oxygen therapy, including its definition, types, purposes, administration, and complications. Oxygen therapy delivers oxygen at concentrations greater than 21% to increase oxygen saturation in tissues. It is used to treat various respiratory conditions. Administration involves nasal cannulas, face masks, venturi masks, and other devices. Potential complications include oxygen toxicity, retrolental fibroplasia, and absorption atelectasis. Careful monitoring is needed with oxygen therapy.
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.
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.
The document discusses oxygen therapy, including:
1) Indications for oxygen therapy include both chronic and acute respiratory conditions, and it can be used therapeutically or for resuscitation in critical illnesses.
2) Potential complications of long-term oxygen therapy include drying of mucous membranes, pulmonary atelectasis, and oxygen toxicity affecting the central nervous system and lungs with long exposures.
3) Methods of oxygen delivery include nasal cannulas, face masks, venturi masks, reservoir masks, and high flow oxygen therapy. Proper humidification and positioning of the patient are also important.
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.
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.
Oxygen therapy involves administering supplemental oxygen to patients through various delivery methods like nasal cannulas, masks, and tents. It is used to treat hypoxemia by relieving symptoms, facilitating tissue metabolism, and reducing arterial oxygen deficiencies. Potential complications include infections, collapsed alveoli, oxygen toxicity, and drying of mucous membranes. Proper technique is required to safely deliver the prescribed flow rate of oxygen via the appropriate interface while monitoring for complications and therapeutic response.
Ventilation of the lungs occurs through breathing, which requires clear airways, an intact respiratory system, and a thoracic cavity capable of expanding and contracting. Oxygen diffuses from the alveoli into the blood while carbon dioxide diffuses from the blood into the alveoli. Factors like cardiac output, hematocrit levels, and exercise affect oxygen transport. Respiratory regulation maintains appropriate oxygen and carbon dioxide levels through neural and chemical controls. Alterations in respiratory function include hypoxia, hypoventilation, and hyperventilation which have signs and symptoms like anxiety, fatigue, and cyanosis.
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.
academic lecture about oxygen delivery system used in emergency room. The main principles of how to select proper device, the advatages and limitations of each device and how to monitor oxygen therapy.
Brief Note On Maintaining Patent AirwayBabitha Devu
This document discusses maintaining a patent airway, which refers to keeping an open airway between the lungs and outside world. It identifies potential causes of airway obstruction like foreign objects, infections, trauma, and altered consciousness. Signs of obstruction include abnormal breath sounds, respiratory changes, coughing, and hypoxemia. Interventions to maintain a patent airway include removing obstructions, positioning, deep breathing exercises, suctioning, medications, and artificial airways like oropharyngeal airways, nasopharyngeal airways, endotracheal tubes, or tracheostomies if needed. Airway maneuvers like head-tilt chin-lift and jaw-thrust are also described to open the airway.
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.
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.
oxygen is very very important for the human being. so i tried here to provide best content from the books and easy way to understand, if you like this slide comment it.
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.
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.
Early Detection And Management Of Respiratory FailureDang Thanh Tuan
This document discusses early detection and treatment of respiratory failure in children. It defines respiratory failure as inadequate gas exchange leading to low oxygen and/or high carbon dioxide levels. Evaluation involves arterial blood gas analysis to measure oxygen and carbon dioxide levels. Causes include airway obstruction, lung disease, neurological issues, and muscle problems. Three clinical profiles - mechanical, neuromuscular, and breathing control dysfunction - help guide diagnosis and treatment. Supportive care includes oxygen therapy and ventilation, while specific therapies target the underlying cause.
A multi-disciplinary team is essential for effective home mechanical ventilation programs. The document discusses recommendations from Dr. Chan Yeow on setting up such a program in Singapore. Key points include:
- A home ventilation program should consist of an ICU-trained nurse, a technical provider, a family physician, and a respiratory therapist as a minimum.
- Initial ventilator settings are determined based on the patient's condition and disease progression, aiming to balance adequate ventilation with encouraging compliance.
- Challenges include managing changes in patient and caregiver situations long-term and supporting end-of-life decisions.
- Home care is more cost-effective than hospitalization, with costs in Singapore being around SGD
This document discusses airway secretion clearance techniques in the ICU, including mechanical insufflation-exsufflation (MIE). It provides a timeline of MIE devices including the CoughAssist. A case study describes how MIE was used successfully via face mask in an 18-year-old post-op patient to avoid intubation. Typical treatment protocols for the CoughAssist E-70 are outlined. Studies show MIE can improve respiratory parameters and allow extubation of restrictive patients to noninvasive ventilation. The evidence suggests MIE is safe and effective for both obstructive and restrictive lung diseases.
This document provides an overview of airway clearance techniques for therapists. It discusses the need for airway clearance during mechanical ventilation, weaning, and for various patient conditions. It then describes various techniques including postural drainage, chest percussion, active cycle of breathing, autogenic drainage, forced expiratory technique, and devices like the Acapella, Flutter, EzPAP, cornet, and inspiratory muscle trainers. The goal is to help therapists select the most appropriate airway clearance techniques based on the patient's condition and treatment needs.
Managing Respiratory Symptoms in Advanced MS - Practical by Rachael MosesMS Trust
Practical guide to managing respiratory symptoms in Advanced MS presented at the MS Trust Annual Conference 2016 buy Consultant Physiotherapist Rachael Moses
Assisted Airway Clearance in Pediatric Respiratory Diseasejrhoffmann
This document discusses airway clearance techniques for pediatric respiratory disease. It begins with an overview of normal airway clearance mechanisms like mucociliary transport and cough. Pathophysiology that can impair clearance is described. The goals of assisted techniques are outlined. Several specific techniques are then reviewed in detail, including postural drainage, active cycle of breathing, high frequency chest wall oscillation, positive expiratory pressure, and intrapulmonary percussive ventilation. Each is described in terms of physiology, devices used, therapy protocols, available evidence, and pros and cons.
The document summarizes the pulmonary defense system. It describes the protective mechanisms in the nose, throat, cough reflex, mucociliary clearance, surfactants, immune cells and proteins that work together to defend the lungs from infection. These defenses are able to keep the lungs free of infection under normal conditions. Pulmonary function tests objectively measure lung function and are used to diagnose respiratory diseases.
The document discusses several lower respiratory tract disorders including pneumonia, tuberculosis, chronic obstructive pulmonary disease (COPD), chronic bronchitis, asthma, and emphysema. It covers clinical manifestations, risk factors, diagnostic assessments, nursing diagnoses, care planning interventions, and pharmacologic treatments for each condition.
spinal muscular atrophy sma by alleliehalengleng28
Spinal muscular atrophy (SMA) is a genetic disorder that attacks motor neurons, causing muscle weakness and wasting. It is caused by a deficiency of the SMN protein due to mutations in the SMN1 gene. There are several types of SMA classified by age of onset and highest physical milestone achieved. Treatment focuses on maintaining function, mobility, nutrition, and respiratory health to maximize quality of life. While there is no cure, ongoing research into new drugs and therapies provides hope for modifying the course of the disease.
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.
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.
The document summarizes key concepts about gas exchange in the respiratory system. It discusses Dalton's law of partial pressures and Henry's law, which explain how gases dissolve in liquids and exert pressure. The document then explains how atmospheric and alveolar air differ in composition due to differences in oxygen and carbon dioxide partial pressures. It also describes ventilation-perfusion coupling in the lungs and how this efficient gas exchange. Oxygen is transported in the blood by dissolving in plasma and binding reversibly to hemoglobin in red blood cells. Factors like temperature, pH, carbon dioxide levels, and 2,3-BPG affect the oxygen-hemoglobin binding curve. Carbon dioxide is transported in three forms in the blood - dissolved, bound to hem
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.
Bronchial asthma is a chronic inflammatory lung disease that causes narrowing of the airways. It is characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. Risk factors include allergens, air pollution, infections, stress, obesity, and family history. Symptoms are typically worse at night or early morning. Diagnosis involves assessing symptoms and lung function tests. Treatment focuses on preventing symptoms through avoidance of triggers and use of inhaled corticosteroids and bronchodilators. Nursing care emphasizes breathing treatments, monitoring for complications, patient education, and managing exacerbations.
This document provides information on respiratory disorders in children. It discusses how to assess the respiratory system and identifies signs of respiratory distress. Specific respiratory conditions covered include respiratory distress syndrome, croup, epiglottitis, bronchitis, bronchiolitis, bronchopulmonary dysplasia, otitis media, tonsillitis, and asthma. For each condition, the document describes the etiology, pathophysiology, clinical manifestations, diagnosis, and treatment/management. Nursing interventions are provided for various respiratory disorders. The respiratory anatomy of children is also reviewed, noting how it differs from adults.
This document provides an overview of pulmonology, including:
1) A review of respiratory anatomy and physiology, pathophysiology, assessment of the respiratory system, and management of respiratory disorders.
2) Descriptions of specific respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and lung cancer.
3) Details on respiratory assessment techniques, diagnostic testing, and treatment approaches for various respiratory conditions.
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.
The document summarizes key aspects of respiratory system anatomy and physiology, as well as respiratory assessment and management for an EMT. It describes the main components and functions of the respiratory system, signs of respiratory distress, methods for assessing breathing and circulation, and protocols for providing initial management and oxygenation based on a patient's responsiveness and breathing status. Treatment may involve opening the airway, suctioning, assisting ventilation, and administering oxygen and bronchodilators as appropriate.
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.
This document provides information on assessing and managing various respiratory emergencies. It discusses the anatomy and physiology of breathing and defines conditions such as asthma, chronic obstructive pulmonary disease (COPD), hyperventilation, epiglottitis, and pulmonary embolism. For each condition, it outlines signs and symptoms and guidelines for treatment, including administering oxygen, positioning the patient, and alerting emergency services. The overall goal is to familiarize first responders with respiratory systems and protocols for responding to breathing difficulties.
The document provides information on asthma, including its pathophysiology, epidemiology, risk factors, clinical manifestations, diagnosis, and treatment. Asthma is a chronic inflammatory disease of the airways characterized by airway hyperresponsiveness and reversible airflow obstruction. It commonly presents with wheezing, cough, chest tightness, and shortness of breath. Diagnosis involves assessing symptoms and lung function tests. Treatment focuses on reducing inflammation and managing acute exacerbations.
The document provides information on asthma, including its pathophysiology, epidemiology, risk factors, clinical manifestations, diagnosis, and treatment. Asthma is a chronic inflammatory disease of the airways characterized by airway hyperresponsiveness and reversible airflow obstruction. It commonly presents with wheezing, cough, chest tightness, and shortness of breath. Diagnosis involves assessing symptoms and lung function tests. Treatment focuses on reducing inflammation and managing acute exacerbations.
This document describes the anatomy and physiology of the upper and lower respiratory tracts. It discusses the structures and functions of the nose, pharynx, larynx, trachea, lungs and associated muscles. It explains the processes of ventilation, gas exchange, oxygen transport and the role of pressure gradients in breathing. It covers clinical assessments of respiratory symptoms like dyspnea, cough and abnormal breath sounds. It also outlines diagnostic tests and treatments for upper respiratory infections.
This document outlines an EMT training course on advanced airway management and the use of the pharyngeal esophageal airway device (PEAD), also known as the Combitube. The agenda covers respiratory anatomy and physiology, respiratory volumes and management, assessing respiratory problems, respiratory/cardiac arrest management, basic airway techniques, suctioning, and the use of dual-lumen airway devices like the Combitube. Objectives are provided for each lesson, which include demonstrating techniques like Combitube insertion and ensuring correct placement. Practical skills testing with a physician is also mentioned.
The document provides an overview of the respiratory system, including its functions, anatomy, common diseases, and nursing management considerations. Key points include:
- The respiratory system obtains oxygen and removes carbon dioxide through a process of ventilation, diffusion, and perfusion.
- The upper respiratory tract includes the nose, pharynx and larynx which warm, moisten, and filter air. The lower respiratory tract includes the trachea, bronchi, lungs and alveoli where gas exchange occurs.
- Common respiratory diseases discussed include pneumonia, pulmonary tuberculosis, histoplasmosis, COPD and its types (chronic bronchitis, asthma, emphysema, bronchiectasis), as well as
The document provides an overview of pediatric airway anatomy, assessment, and common airway diseases. It discusses that the pediatric airway has unique characteristics including a large occiput, tongue, and adenoidal tissue. Assessment involves history, exam of respiratory status, signs of distress, and auscultation findings. Common upper airway diseases reviewed are croup, epiglottitis, foreign body, and bacterial tracheitis. Common lower airway diseases include asthma, bronchiolitis, and pneumonia. Croup symptoms include barking cough and stridor, treated with racemic epinephrine and steroids. Epiglottitis requires securing the airway due to risk of sudden obstruction. Bacterial tracheitis
Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance
Ok, heres the story. I was teaching this otherwise sharp EMT-Basic class that bombed two respiratory emergency tests in a ROW!
So this is the remedial lecture I inflicted on them. I don\'t know if they passed because of this fine work, or just because they were afraid of another lecture fo they failed.
Hope its useful to you.
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 an overview of the respiratory system, including its functions, anatomy, physiology and related pathologies. It describes the neurochemical control of breathing, the functions of respiration such as gas exchange, and the upper and lower respiratory tract. Details are given about ventilation, perfusion, lung volumes, compliance and resistance. The document also covers acid-base regulation, diagnostic tests like arterial blood gases and chest imaging, physical exam findings, and laboratory studies of the respiratory system.
This document summarizes information about cough from an Ayurvedic perspective. It defines cough and describes its protective function. It discusses the cough reflex and mechanisms. It outlines approaches to assessing acute versus chronic cough and evaluating chronic cough when chest imaging is normal. It provides details on the characteristics of cough originating from different levels of the respiratory tract. It also lists several Ayurvedic formulations used to treat cough including Kasahar Mahakashaya, Kaphketu Ras, Kaph Kuthar Ras, Shwasakuthar Ras, Sitopaladi Churna, Lavangadi Vati, Eladi Vati, Talisadi Churna, Vyaghri Haritaki, and Agastya
The document provides an overview of respiratory anatomy and physiology, focusing on the respiratory system, gas exchange, blood flow through the lungs, oxygenation, and sleep apnea. It defines obstructive sleep apnea as repeated cessation of breathing during sleep due to upper airway collapse. Risk factors include obesity, age, male gender, and anatomical abnormalities. Symptoms include loud snoring, witnessed breathing pauses, and daytime sleepiness. Consequences include cardiovascular disease, accidents, and decreased quality of life. Diagnosis involves assessing symptoms, risk factors, and polysomnography. Treatment aims to reduce risks and includes weight loss, positive airway pressure, and surgery.
The document discusses chronic obstructive pulmonary disease (COPD), including its definition as a progressive lung disease characterized by limited airflow; causes such as smoking, air pollution, and genetic factors; symptoms like breathlessness, cough, and sputum production; diagnostic tests and medical management including bronchodilators, antibiotics, and oxygen therapy; preventive measures like smoking cessation and flu vaccines; and nursing interventions focused on assessment, education, and managing complications. COPD encompasses chronic bronchitis and emphysema and is a serious lung condition caused primarily by smoking.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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2. Nursing Dx: Respiratory
Dysfunction
Ineffective Airway Activity Intolerance
Clearance Anxiety
Impaired Gas
Exchange Altered Nutrition:
Less than body
Ineffective Breathing
Pattern requirement
Impaired Verbal Risk for Infection
Communication
3.
4.
5. Respiratory System
Its primary function is
delivery of oxygen to
the lungs and
removal of carbon
dioxide from the
lungs.
6. Respiration
Process of gas exchange
Supply cells with oxygen for carrying on
metabolism
Remove carbon dioxide produced as a waste
by-product.
Two types of respiration: external and internal.
7.
8. Respiratory Assessment
Health History
(allergies, occupation, lifestyle, health habits)
Inspection
(client's color, level of consciousness, emotional state)
(Rate, depth, quality, rhythm, effort relating to respiration)
Palpation and Percussion
Auscultation
(Listening for Normal and Adventitious Breath Sounds)
10. Assessment Review
Physical Assessment
Speak a sentence of 12 words without
stopping for breath
Walk and talk without stopping for breath
No cyanosis, pallor, or jaundice
Oral mucus membrane & nail beds pink with
rapid capillary refill
11. Assessment Review
Fingertips and nails normal shape, no clubbing
Anterior & posterior diameter of chest 2/3
smaller than lateral diameter
Space between each rib larger than breath of
patient’s finger
Breathes in through nose & out through mouth
& nose
12. Assessment Review
Breathing quiet
Air movement heard in all lobes of both lungs
Sputum production minimal, clear or white
Muscle development even with no muscle loss
on arms & legs
Weight proportionate to height; not
underweight
15. Assessment: Inadequate
Oxygenation
Resp rapid & shallow
Respirations noisy
Cannot speak >4 or 5 words without pausing
for breath
Change in cognition, acute confusion
Decreased oxygen saturation by pulse ox
16. Assessment: Inadequate
Oxygenation
Skin cyanosis or pallor (lighter-skinned pts)
Cyanosis or pallor of lips or oral mucus
membranes (pts of any skin color)
Tachycardia
Appears to strain to catch breath
Fatigue
17. Physical Assessment:
Inadequate O2
Take vital signs
Auscultate all lung fields
Monitor O2 sat
Check recent Hgb, Hct, ABGs
Assess cognition
Assess use of accessory muscles
27. Assessment: Upper Airway
Problems
Voice changes
nasal quality if above palate
“breathy” or “whispery” if larynx or trachea
Snoring
Mouth breathing
28. Assessment: Upper Airway
Problems
Change in cognition or LOC or acute
confusion
Decreased O2 sat
Skin cyanosis or pallor
Cyanosis or pallor of lips or oral mucus
membranes
Tachycardia & dysrhythmia
29. Physical Assessment: Upper Airway
Problems
Take vital signs
Monitor O2 sat
Assess for presence of thick or excessive
secretions
Assess ability to cough and clear airway
Assess nasal drainage & sputum for color &
blood
32. Obstructive Sleep Apnea
Intermittent absence of airflow through mouth
& nose during sleep
Occlusion of the oropharyngeal airway
Obstruction causes O2 sat, pO2, and pH to
rise & pCO2 to rise
44. Assessment: Infectious Resp
Problems
Resp shallow & rapid
Decreased O2 sat
Skin cyanosis or pallor
Cyanosis or pallor of lips & oral mucus
membranes
Tachycardia
Work hard to inhale & exhale
Restless anxious or confused
45. Physical Assessment: Infections
Vital signs
Auscultate all lung fields
Monitor O2 sat
Assess cognition
Assess sputum
Assess ability to cough & clear airway
46. Lab Values: Infections
Elevated WBC
ABG:
pH lower than 7.35
HCO3 at or below 24 mmHg
PaCO2 at or below 45 mmHg
PaO2 below 90 mm Hg
47. Interventions: Infectious Resp
Problems
Administer O2
Upright position with arms resting on table or
armrests
Chest physiotherapy/pulmonary hygiene
Pace activities to prevent fatigue
48. Interventions: Infectious Resp
Problems
Administer IV, oral, or inhaled drugs
Respiratory therapy treatments
Reassess resp status after resp therapy
Ensure fluid intake 3 liters/day
56. Sinusitis: Health Promotion
Promote nasal drainage
Encourage liberal fluid intake
Judicious use of nasal decongestants
Treat any obstructive process
57. Pneumonia
Inflammation of lung parenchyma
Infectious: Bacteria, viruses, fungal protozoa
Noninfectious: aspiration of gastric contents,
inhalation of toxic or irritating gases
Can be classified as community acquired,
nosocomial, or opportunistic
63. Theresa
A 20 year old college student
Lives in a small dormitory with 30 other
students.
Four weeks into the Spring semester, she was
diagnosed with bacterial pneumonia
Admitted to the hospital
64. Teresa: High Priority Intervention
Specimens for culture are taken prior to
beginning the antibiotic
Administering prior to cultures may make it
impossible to determine the actual agent
causing the pneumonia.
65. Theresa: Bacterial Pneumonia
Sputume culture results
most frequent strain of found in community-
acquired pneumonia
Streptococcus pneumoniae
66. Teresa: Clinical Manifestations
Fever Elderly
Weakness
stabbing or pleuritic Fatigue
chest pain lethargy
Confusion
tachypnea poor appetite without
classic s & s
70. Interventions
Oxygen by nasal cannula
Plan for periods of rest during activities of daily
living.
Monitor pulse oximetry readings every 4 hours.
What oxygen delivery system would be most
effective for Theresa?
82. Tuberculosis
If patient has adequate Inadequate immune
immune response: response
Scar tissue develops
TB can develop
around tubercle rapidly
Walls off bacilli
Infected, does not
develop TB
84. Tuberculosis: Signs & Symptoms
Fatigue Dry cough
Weight loss Later productive,
Anorexia purelent/blood
tingled
pm fever
Night sweats
85. Tuberculosis: Interdisciplinary
Care
Early detection Tuberculin test
Accurate diagnosis Intradermal PPD
Effective disease (Mantoux) test
treatment Multiple-puncture
Preventing spread to (tine) testing
others
86. TB: Goals of Medication
Treatment
Make the disease noncommunicable to others
Reduce symptoms of the disease
Affect a cure in the shortest possible time
88. Mr. Howe
c/o dyspnea Dx: R/O TB
progressive wt loss What additional
for several months questions should you
Productive cough ask about Mr.
Howe’s cough?
Night sweats
“wringing wet”
89. Assessing Cough
How it feels
How bad it is
What makes it better or worse
When it started
Amount, color, odor, and consistency of sputum
90. Mr. Howe
Diagnostic test Mantoux test
expected for patient Sputum for acid-fast
bacillus
Chest X-ray
History and Physical
Examination
91. Mantoux Test
Positive result only indicate exposure or has
received BCG immunization
BCG immunization: Eastern Europe and
countries where TB is endemic
Is not diagnostic for active TB
92. Mantoux Test
Give upper 1/3 surface of the forearm
Needle is inserted with bevel up
0.1 ml of purified derivative (PPD) inserted
intradermally)
Read 48-78 hrs
Induration 1.5 mm or greater is + (HIV or
immunosuppressed pts 5 mm or greater +
93. Sputum Studies
Sputum Samples early morning
Expectoration tracheal 15 ml required
suction
Obtain prior to
Bronchoscopy
antibiotics
Used to
Ask pt to rinse mouth
identify infecting
before collecting
organisms
specimen
Confirm presence of
malignant cells
96. Mr. Howe: Post Bronchoscopy
Complications
Aspiration
Infection
Pneumothorax
97. Mr. Howe: Post Bronchoscopy
Care
NPO until gag reflex
Monitor vital signs
Assess for dyspnea, hemoptysis, & tachycardia
Notify MD if fever, difficulty breathing
Semi-Fowler’s position
Give H2O as first fluid
Inform pt of possible expectoration of blood
tingled mucus
99. Mr. Howe’s Medication Regime
Chemotherapy are Rifampicin
all Hepatotoxic
n/v
Ethambutol Thrombocytopenia
optic neuritis turns all bodily
skin rash secretions a red-
orange color
(tears, sweat, etc)
100. Mr. Howe’s Medication Regime
INH Streptomycin
peripheral neuritis 8th cranial nerve
(take Vitamin B 6 in damage
conjunction to routine hearing test
prevent)
caution in renal
hepatotoxicity disease
GI upset
101. Mr. Howe’s Medication Regime
Pyrazinamid
Heptoxicity
hyperuricemia
monitor uric acid & hepatic function
102. Mr. Howe’s Hospital Care
Teach handwashing, cover nose and mouth
when coughing, sneezing
Droplet Isolation-negative pressure room
Special particulate respirator mask
Psychosocial support-reinforce need to take
medication
103. Mr. Howe’s Teaching Plan
Preventive measures to avoid catching viral
infections
Taken drugs in combination to avoid bacterial
resistance
Take meds at the same time of day on an empty
stomach
Follow med regimen 6-12 months as prescribed
104. Mr. Howe’s Teaching Plan
Adequate nutritional status
Annual check-up
Annual Check-up: liver function tests
Notify MD if signs of hepatitis, hepatoxicity,
neurotoxicity, & visual changes occur
105. Thoracentesis
Used to obtain pleural fluid for
analysis
Needle inserted between ribs
second and third intercostal
spaces
Fluid withdrawn with syringe
or tubing connected to sterile
vacuum bottle
106. Thoracentesis
Pre-Procedure Baseline vital signs
Informed consent- Make sure that a
explained & signed CXR has been
Inform about completed
pressure sensations
that will be
experienced during
the procedure
107. Thoracentesis: Positioning
Lying on the unaffected side with the bed
elevated 30 – 40 degrees
Sitting on the edge of the bed with her feet
supported and her arms and head on a
padded overbed table.
Straddling a chair with her arms and head
resting on the back of the chair.
108. Post Thoracentesis
Apply pressure to Monitor for blood-
puncture site tingled mucus
Assess bleeding & Assess for
crepitus hypoxemia,
Semi-fowlers or Assess for
puncture site up tachycardia
Assess breath
sounds
110. Assessment: Lower Resp
Problems
Resp shallow and rapid
Decreased oxygen saturation
Skin cyanosis or pallor
Cyanosis or pallor of lips & mucus membranes
Tachycardia
Work hard to inhale & exhale
111. Assessment: Lower Resp
Problems
Restless & anxious
Thin compared to height
Muscles of neck appear thick
Arm & leg muscles appear thin
Clubbed fingers
Chest is barrel shaped
Rib space more than a finger breath apart
112. Physical Assessment: Lower Resp
Problems
Take vital signs
Monitor O2 sat
Assess cognition
Assess sputum
Assess ability to cough & clear airway
114. Interventions: Lower Resp
Problems
Upright position
Chest Physiotherapy
O2 low to maintain resp of 16 breaths minute
Pace activities
Administer inhaled drugs
Respiratory therapy
Fluid intake at least 3L daily
115. Bronchitis
Common in adults Acute bronchitis
follows a viral URI
Risk factors Chronic bronchitis is
a component of
Impaired immune
COPD
defenses
Cigarette smoking
124. Asthma: Patho
Inflammatory Impaired mucus
mediators released clearing
Activation of SOB
inflammatory cells trapping of air
Bronchoconstriction impairs gas
Airway edema exchange
132. John
Emphysema for 25 years
H/O smoking
Diagnosis: Bronchitis
133. John: Cigarette Smoking
Major causative factor in the development of
respiratory disorders
lung cancer
cancer of the larynx
Emphysema
chronic bronchitis
134. During assessment you note the presence of a
“barrel chest”.
“air trapping” in the lungs
135. Barrel Chest
Slow progressive obstruction of airways
Airways narrow
Resistance to airflow increase
Expiration slow and difficult
Result: mismatch between alveolar ventilation and
perfusion, leading to impaired gas exchange
136. Major symptoms to assess John
for
You should be alert for the following
presenting symptom of COPD?
Increased dyspnea
Sputum production
137. Emphysema
John is medicated with a bronchodilator to reduce
airway obstruction. Assess for
Dysrhythmias
Central nervous system excitement
Tachycardia
138. Purse Lip Breathing
Recommended for John to:
Decrease respiratory rate
Increase alveolar ventilation
Reduce functional residual
capacity
139. Venturi Mask is prescribed for John
because:
Moderate Oxygen Flow
Delivers precise, high-flow
rates
24%-50%
Humidification available
Requires face mask
140. Bronchiectasis
A chronic dilation of the
bronchi caused by:
pulmonary TB infection
chronic upper
respiratory tract
infections
complications of other
respiratory disorders
141. Obstruction of a
pulmonary artery by a
bloodborne
substance
144. Other sources of Pulmonary
Emboli
Fat Emboli
From fractured long bones
Air Emboli
From IVs
Amniotic fluid
Tumors
145. Mrs. Perkins
Mrs Perkins is suspected of having a
pulmonary embolus.
What diagnostic test confirms this diagnosis?
146. Pulmonary Embolism
The plasma D-dimer test is highly specific for
the presence of a thrombus.
An elevated d-dimer indicates a thrombus
formation and lysis.
What assessment data would support that Mrs.
Perkins has experienced a pulmonary
embolus?
147. Clinical Manifestations of Pulmonary
Embolus
Sudden, unexplained dyspnea, tachypnea
or tachycardia
Cough
Chest pain
Hemoptysis
Sudden changes in mental status (hypoxia)
148. Diagnosing Pulmonary Embolism
Ventilation-Perfusion Scan
Nuclear imaging test
Determines percentage of each lung that is
functioning normally
Pulmonary Angiography
149. Pulmonary Embolism
Mrs. Perkins pulse oximetry has decreased
to 90%. What does this indicate?
The normal pulse oximeter reading is 93% -
100%.
A reading of 90% indicates Mrs Perkins has an
arterial oxygen level of about 60
150. Pulmonary Embolism
With a diagnosis of PE, what intervention is
crucial for
Mrs. Perkins?
Institute and maintain bedrest
Bedrest reduces metabolic demands and
tissue needs for oxygen.
151. Management: Pulmonary Emboli
Anticoagulation therapy
Heparin
Coumadin for ~6 months
Thrombolytic therapy
Use very cautiously only for acute, massive PE
Urokinase, Streptokinase & tPA
Inferior Vena Cava filter
152. Mrs. Perkins
Mrs. Perkins is receiving a heparin drip.
The bag hanging is 20,000 units/500 ml of
D5W infusing at 22 ml/hr. How many units of
heparin is Mrs Perkins receiving each hour?
153. Heparin Infusion
880 units
20,000 divided by 500 = 40 units
If 22 ml are infused per hour, then 880 units
of heparin are infused each hour
40 x 22 = 880
154. Heparin Therapy
What nursing interventions should you implement for
Mrs Perkins receiving Heparin?
Keep protamine sulfate readily available
Assess for overt & covert signs of bleeding
Avoid invasive procedures and injections
Administer stool softeners as ordered
155. Pulmonary Embolism
Mrs Perkins PT is 12.9 and PTT is 98. What are
your
implications for administering heparin to Mrs
Perkins?
A normal PTT is 39 seconds
58-78 is 1.5 to 2 times the normal value and is
within the normal therapeutic range
A PTT of 98 means Mrs Perkins is not clotting;
medication should be held.
156.
157. Pulmonary Embolism
The doctor has ordered Coumadin for Mrs.
Perkins. PT = 22 PTT = 39 INR = 2.8
What action should you implement
Give the Coumadin because the theurapeutic
INR level is 2-3.
What is the antidote for Coumadin?
158. Pulmonary Embolism: Teaching
Use a soft bristle toothbrush to reduce the risk
of bleeding
Avoid aspirin
Aspirin is an antiplatlet which may increase
bleeding tendencies.
159. Pulmonary Embolism: Teaching
Wear a medic alert band
Increase fluid intake to 2-3L day (increases fluid
volume which prevents DVT the common cause
of PE)
Primary function of respiratory system is transport of O2 and CO2. This requires the four processes collectively known as respiration: 1. Pulmonary ventilation is the movement of air into and out of the lungs (breathing). This involves gas pressures and muscle contractions.2. External respiration is the exchange of O2 (loading) and CO2 (unloading) between blood and alveoli (air sacs). 3. Transport of respiratory gases between lungs and tissues. 4. Internal respiration is gas exchange between blood and tissue cells. Cellular respiration - the includes the metabolic pathways which utilize O2 and produce CO2, which will not be included in this unit.
What should you expect to Notice in a patient with adequate oxygenation and tissue perfusion related to respiratory function?
Loss of normal pharyngeal muscle tonePharynx collapse during inspirationTongue falls against posterior pharyngeal wallAsphyxia causes brief arousal from sleepRestores airway patency & airflowMay occur 100s of times a night
Inflammation of the mucus membranes of sinusesFollows a upper respiratory infectionRisks high in patients with impaired immunity
Obstruction of sinusImpaired drainage
Nursing diagnosisPainImbalanced Nutrition: Less than Body Requirements