Podcast
Questions and Answers
What is the primary cause of a pneumothorax?
What is the primary cause of a pneumothorax?
Which of the following is a symptom of a large pneumothorax?
Which of the following is a symptom of a large pneumothorax?
What is the most significant characteristic of a tension pneumothorax?
What is the most significant characteristic of a tension pneumothorax?
What is the primary treatment for a large pneumothorax?
What is the primary treatment for a large pneumothorax?
Signup and view all the answers
What is a hemopneumothorax?
What is a hemopneumothorax?
Signup and view all the answers
What is a potential complication of a large hemothorax?
What is a potential complication of a large hemothorax?
Signup and view all the answers
Which of the following conditions is considered a medical emergency?
Which of the following conditions is considered a medical emergency?
Signup and view all the answers
What is the common cause of a pulmonary embolism?
What is the common cause of a pulmonary embolism?
Signup and view all the answers
What is the main goal of lung volume reduction surgery (LVRS)?
What is the main goal of lung volume reduction surgery (LVRS)?
Signup and view all the answers
What is the primary role of hydration therapy in managing COPD?
What is the primary role of hydration therapy in managing COPD?
Signup and view all the answers
Which of the following is a trigger for acute exacerbations of COPD?
Which of the following is a trigger for acute exacerbations of COPD?
Signup and view all the answers
What is the recommended approach to exercise for individuals with COPD?
What is the recommended approach to exercise for individuals with COPD?
Signup and view all the answers
What is the main reason why lung transplants are less common for COPD treatment?
What is the main reason why lung transplants are less common for COPD treatment?
Signup and view all the answers
What is a key characteristic of an acute exacerbation of COPD?
What is a key characteristic of an acute exacerbation of COPD?
Signup and view all the answers
Which of the following is NOT a recommended strategy to prevent COPD exacerbations?
Which of the following is NOT a recommended strategy to prevent COPD exacerbations?
Signup and view all the answers
What is the typical respiratory rate during an acute exacerbation of COPD?
What is the typical respiratory rate during an acute exacerbation of COPD?
Signup and view all the answers
What is the primary objective of incorporating 'pace and plan ADLs with rest periods' into a patient's care plan after discharge for COPD?
What is the primary objective of incorporating 'pace and plan ADLs with rest periods' into a patient's care plan after discharge for COPD?
Signup and view all the answers
Which of the following interventions is MOST EFFECTIVE in preventing exacerbations of COPD?
Which of the following interventions is MOST EFFECTIVE in preventing exacerbations of COPD?
Signup and view all the answers
In COPD, what is the rationale for taking short-acting inhalers before activity or when feeling short of breath?
In COPD, what is the rationale for taking short-acting inhalers before activity or when feeling short of breath?
Signup and view all the answers
Why would it be advisable to encourage a COPD patient to avoid crowds?
Why would it be advisable to encourage a COPD patient to avoid crowds?
Signup and view all the answers
What is the primary purpose of pursed-lip breathing in COPD patients?
What is the primary purpose of pursed-lip breathing in COPD patients?
Signup and view all the answers
Which of the following is NOT a key teaching point for a patient with COPD regarding medication management?
Which of the following is NOT a key teaching point for a patient with COPD regarding medication management?
Signup and view all the answers
What is one of the primary goals of the territory acknowledgment statement presented in the content?
What is one of the primary goals of the territory acknowledgment statement presented in the content?
Signup and view all the answers
Which of the following is NOT a learning outcome mentioned in the content?
Which of the following is NOT a learning outcome mentioned in the content?
Signup and view all the answers
What is a possible reason a patient would receive a filter inserted into their inferior vena cava?
What is a possible reason a patient would receive a filter inserted into their inferior vena cava?
Signup and view all the answers
What are some signs and symptoms of bleeding that a patient on anticoagulants should be monitored for?
What are some signs and symptoms of bleeding that a patient on anticoagulants should be monitored for?
Signup and view all the answers
After a pulmonary embolism, what factors need to be addressed before a patient can be discharged?
After a pulmonary embolism, what factors need to be addressed before a patient can be discharged?
Signup and view all the answers
What is the recommended time frame for patients on anticoagulants to call EMS if bleeding occurs and does not stop?
What is the recommended time frame for patients on anticoagulants to call EMS if bleeding occurs and does not stop?
Signup and view all the answers
What is a surgical option for patients with a pulmonary embolism who are not candidates for tPA?
What is a surgical option for patients with a pulmonary embolism who are not candidates for tPA?
Signup and view all the answers
What is the main reason for the swelling in the patient's lower extremities?
What is the main reason for the swelling in the patient's lower extremities?
Signup and view all the answers
What is the primary cause of the patient's shortness of breath (dyspnea)?
What is the primary cause of the patient's shortness of breath (dyspnea)?
Signup and view all the answers
What does the prolonged expiration heard during auscultation indicate?
What does the prolonged expiration heard during auscultation indicate?
Signup and view all the answers
Which of the following is NOT a typical treatment for COPD?
Which of the following is NOT a typical treatment for COPD?
Signup and view all the answers
What is the significance of the decreased PaO2 and increased PaCO2 in the arterial blood gases?
What is the significance of the decreased PaO2 and increased PaCO2 in the arterial blood gases?
Signup and view all the answers
What is the most likely reason the patient feels his shoes are tight at the end of the day?
What is the most likely reason the patient feels his shoes are tight at the end of the day?
Signup and view all the answers
What is the most appropriate initial management strategy for this patient?
What is the most appropriate initial management strategy for this patient?
Signup and view all the answers
Which of the following would be a cause of inadequate ventilation in a patient with a history of COPD?
Which of the following would be a cause of inadequate ventilation in a patient with a history of COPD?
Signup and view all the answers
Which of the following is a potential risk factor for inadequate ventilation?
Which of the following is a potential risk factor for inadequate ventilation?
Signup and view all the answers
Which type of imaging is helpful for visualizing lung abnormalities and evaluating treatment response?
Which type of imaging is helpful for visualizing lung abnormalities and evaluating treatment response?
Signup and view all the answers
What physical assessment finding might indicate inadequate ventilation?
What physical assessment finding might indicate inadequate ventilation?
Signup and view all the answers
Which of the following laboratory tests can provide information about a patient's blood oxygen levels and acid-base balance?
Which of the following laboratory tests can provide information about a patient's blood oxygen levels and acid-base balance?
Signup and view all the answers
What should be done before a patient undergoes a CT scan?
What should be done before a patient undergoes a CT scan?
Signup and view all the answers
Why is it important to consider family history when assessing a patient's respiratory health?
Why is it important to consider family history when assessing a patient's respiratory health?
Signup and view all the answers
Which of the following is a potential reason for inadequate ventilation in a patient whose chest is crushed by a steering wheel in a motor vehicle accident (MVA)?
Which of the following is a potential reason for inadequate ventilation in a patient whose chest is crushed by a steering wheel in a motor vehicle accident (MVA)?
Signup and view all the answers
Flashcards
Pneumothorax
Pneumothorax
Presence of air in the pleural space leading to lung collapse.
Open pneumothorax
Open pneumothorax
Pneumothorax due to an external wound allowing air in.
Closed pneumothorax
Closed pneumothorax
Pneumothorax caused by internal injuries without outside exposure.
Hemothorax
Hemothorax
Signup and view all the flashcards
Tension pneumothorax
Tension pneumothorax
Signup and view all the flashcards
Signs of respiratory distress
Signs of respiratory distress
Signup and view all the flashcards
Treatment for pneumothorax
Treatment for pneumothorax
Signup and view all the flashcards
Pulmonary Embolism (PE)
Pulmonary Embolism (PE)
Signup and view all the flashcards
Ongoing Monitoring for Anticoagulated Patients
Ongoing Monitoring for Anticoagulated Patients
Signup and view all the flashcards
Signs of Bleeding
Signs of Bleeding
Signup and view all the flashcards
Importance of Anticoagulant Timing
Importance of Anticoagulant Timing
Signup and view all the flashcards
INR Monitoring
INR Monitoring
Signup and view all the flashcards
Embolectomy
Embolectomy
Signup and view all the flashcards
Hydration Therapy
Hydration Therapy
Signup and view all the flashcards
Exercise Therapy
Exercise Therapy
Signup and view all the flashcards
Pulmonary Rehab Programs
Pulmonary Rehab Programs
Signup and view all the flashcards
Lung Volume Reduction Surgery (LVRS)
Lung Volume Reduction Surgery (LVRS)
Signup and view all the flashcards
Lung Transplant
Lung Transplant
Signup and view all the flashcards
COPD Acute Exacerbation
COPD Acute Exacerbation
Signup and view all the flashcards
Preventing Exacerbations
Preventing Exacerbations
Signup and view all the flashcards
Monitor Respiratory Rate
Monitor Respiratory Rate
Signup and view all the flashcards
Inhaled bronchodilators
Inhaled bronchodilators
Signup and view all the flashcards
Cor Pulmonale
Cor Pulmonale
Signup and view all the flashcards
Symptoms of Cor Pulmonale
Symptoms of Cor Pulmonale
Signup and view all the flashcards
Dysrhythmias
Dysrhythmias
Signup and view all the flashcards
COPD and Depression
COPD and Depression
Signup and view all the flashcards
Plan for dyspnea
Plan for dyspnea
Signup and view all the flashcards
COPD Symptoms
COPD Symptoms
Signup and view all the flashcards
Arterial blood gases in COPD
Arterial blood gases in COPD
Signup and view all the flashcards
Pace and Plan ADLs
Pace and Plan ADLs
Signup and view all the flashcards
Smoking Cessation
Smoking Cessation
Signup and view all the flashcards
Hand Hygiene Importance
Hand Hygiene Importance
Signup and view all the flashcards
Vaccination Recommendations
Vaccination Recommendations
Signup and view all the flashcards
Recognizing S&S of Infection
Recognizing S&S of Infection
Signup and view all the flashcards
Medication Compliance
Medication Compliance
Signup and view all the flashcards
Inhaler Use
Inhaler Use
Signup and view all the flashcards
Pursed Lip Breathing Technique
Pursed Lip Breathing Technique
Signup and view all the flashcards
Inadequate ventilation causes
Inadequate ventilation causes
Signup and view all the flashcards
Risk factors for respiratory issues
Risk factors for respiratory issues
Signup and view all the flashcards
Family history and genetics
Family history and genetics
Signup and view all the flashcards
Key symptoms of respiratory issues
Key symptoms of respiratory issues
Signup and view all the flashcards
Physical assessment cues
Physical assessment cues
Signup and view all the flashcards
Analyzing respiratory data
Analyzing respiratory data
Signup and view all the flashcards
Radiology imaging purposes
Radiology imaging purposes
Signup and view all the flashcards
Pre-procedure care for imaging
Pre-procedure care for imaging
Signup and view all the flashcards
Study Notes
Concept of Gas Exchange: Exemplars
- Gas exchange is a crucial bodily function enabling oxygen uptake and carbon dioxide removal. Disruptions can manifest in various conditions.
- Laryngeal Cancer (LC) is a tumor growth in the larynx. Early diagnosis offers a good prognosis.
- Risk factors for LC include smoking and alcohol, voice abuse, and exposure to chemicals.
- Early LC cues include a lump in the neck, sore throat, and hoarseness.
- Late stage LC cues include pain, dysphagia, airway obstruction, shortness of breath, weight loss, and unilateral ear pain.
- Laryngeal Cancer diagnostics include laryngoscopy (visualizing and taking a biopsy of the tumor to determine the type and stage of cancer), X-rays, CT scan, and MRI to identify metastatic sites.
- Lab assessments including electrolytes, HCT, BUN, and HCT may be affected in malnourished/dehydrated patients with LC.
- Treatment for LC depends on tumor type, size, location, and patient/surgeon preference. Options include radiation, chemotherapy, biotherapy, laser surgery, and/or extensive traditional surgery.
- Partial laryngectomy may involve removal of only one vocal cord or no vocal cords, enabling speech and normal breathing capacity.
- Total laryngectomy often requires radical neck dissection where the entire larynx and vocal cords are removed, necessitating an alternative communication method.
Exemplars: Laryngeal Ca, Lung Ca
- Laryngeal Cancer (p 581 Lewis) and Lung Cancer (p 603 Lewis) are two severe respiratory disorders.
Recognize/Analyze Cues: Laryngeal Ca
- Laryngeal cancer (LC) is a tumor originating in the larynx. Early stage diagnosis is crucial.
- Key risk factors are smoking and alcohol use.
- Early stage symptoms include a lump in the neck, sore throat, and hoarseness.
- Late stage symptoms include pain, swallowing difficulties (dysphagia), airway blockage, shortness of breath, unexplained weight loss, and pain in a single ear.
Recognize/Analyze Cues: Labs & Diagnostics
- Diagnostic tests for laryngeal cancer (LC) include laryngoscopy, X-rays, CT scans, and MRIs to determine tumor type, extent, and the presence of metastasis.
- Lab assessments include electrolytes, hematocrit (HCT), blood urea nitrogen (BUN), and more, important to consider nutritional and hydration status.
Take Action: Laryngeal Ca Treatment
- Treatment choices for laryngeal cancer (LC) vary based on patient factors and tumor characteristics.
- Options can include surgery (partial or total laryngectomy), radiation therapy, chemotherapy, biotherapy, and laser treatment.
- Choice of treatment is frequently based on individual patient circumstances and physician preference.
Take Action: Laryngectomy Post-op care
- Maintaining a patent airway is paramount, suction/clear stoma is vital
- Post-operative vital signs monitoring is essential.
- Positioning the patient in a midline position with a raised head of the bed (HOB) is crucial.
- Monitoring and managing the surgical site, if present, is critical.
- Adequate nutrition is crucial, often involving NPO status for 24-48 hrs followed by a gradual return to solid food.
- Monitoring for and preventing aspiration pneumonia is key.
- Physiotherapy and emotional support are essential.
Take Action: Voice Restoration (total laryngectomy)
- Individuals after a total laryngectomy may utilize either an electrolarynx or esophageal voice prosthesis to aid in communication.
- The electrolarynx creates sound by vibrating the throat; this is an external device.
- An esophageal voice (or esophageal speech) method creates sound by rerouting air from the trachea through a created speech channel to the esophagus.
Take Action: Discharge Teaching Laryngectomy
- Patients require education regarding stoma care, airway management, and nutrition.
- Teaching about safety measures such as smoke detectors and medical alert bracelets.
- Emotional support and counseling as necessary.
- Proper nutrition and hydration management.
- Important to recognize when and how to seek help.
Recognize/Analyze Cues: Lung Ca
- Cigarette smoking is the leading cause of lung cancer (LC).
- Environmental carcinogens, secondhand smoke, and asbestos exposure also contribute to LC risk.
- Symptoms often appear late in LC, showing nonspecific characteristics like a persistent cough (possibly blood-tinged), wheezing, chest pain, hoarseness, weight loss and breathlessness.
- Diagnosing LC typically involves a CT scan, sputum analysis for cytological studies, and biopsy to confirm the presence of cancer cells.
Take Action: Lung Ca
- Treatment options for lung cancer (LC) vary.
- Surgery (wedge resection, lobectomy, segmental resection, or pneumonectomy) may be an option.
- Radiation therapy targets cancer cells.
- Chemotherapy drugs act systemically to eliminate cancer cells.
- Targeted therapy disrupts cancer cell division, and immunotherapy prompts the body's own immune system to target cancer cells.
Thoracotomy
- Open Thoracotomy and Video Assisted Thoracotomy (VATS) are surgical approaches used in lung procedures.
Take Action: Lung Ca Post-Op Care for Thoracotomy
- Monitoring respiratory status, oxygenation, and chest tubes is crucial after thoracotomy.
- Positioning, pain management, and physiotherapy are critical aspects of patient care.
- Monitoring for post-operative infections.
Chest Tubes
- Post-thoracotomy chest tubes are used to remove fluid or air from the pleural space to promote lung expansion.
- Proper understanding of chest tube function is vital, including water seal, suction control mechanisms, and drainage collection.
Take Action: Discharge Planning
- Important respiratory health education is needed for patients post-lung procedures.
- Teaching includes recognizing and responding to disease progression, recurrence, and respiratory distress.
- Addressing home oxygen use, smoking cessation, symptom management (e.g., shortness of breath), and when appropriate to seek medical attention.
- Teaching about procedures like thoracentesis and pain management, as needed.
Exemplar: Thoracic Trauma (p610 Lewis)
- Thoracic trauma results when ribs fracture causing instability in the chest wall.
- Symptoms of a fractured chest include paradoxical chest motion (during inhalation, the affected part draws inward; during exhalation, it bulges outward), impaired ventilation, and hypoxemia.
- Treatment involves oxygen administration, pain management, and potential need for mechanical ventilation in severe cases.
Pneumothorax
- Pneumothorax is characterized by air presence within the pleural space.
- Causes can include penetrating chest wounds, and potentially, fractured ribs or even mechanical ventilation complications or other medical procedures.
- Severity varies.
- Small pneumothoraces present with mild symptoms (e.g., tachycardia and shortness of breath).
- Large pneumothoraces present with significant respiratory distress (e.g., rapid, shallow breathing, air hunger, decreased oxygen saturation, and lack of breath sounds).
- Diagnosis and treatment need careful monitoring and assessment.
Hemothorax
- Hemothorax is marked by the presence of blood in the pleural cavity, frequently resulting from trauma or medical procedures.
- Symptoms may mirror those of pneumothorax and severity will depend on the amount of blood loss which can lead to hypovolemic shock, in severe cases.
- Treatment often involves draining the accumulated blood with a chest tube.
Tension Pneumothorax
- Tension pneumothorax is a sudden, life-threatening condition in which air accumulates within the pleural space, placing excessive pressure on the vital structures in the chest.
- Critical features include significant respiratory distress, decreased breath sounds, and possible mediastinal shift.
- Immediate interventions, such as chest tube placement, are needed.
Hemothorax/Pneumothorax Tension Pneumothorax Treatment
- Treatment for hemothorax, pneumothorax, and tension pneumothorax varies depending on severity.
- Small hemothoraces, and stable hemodynamic patients may only require supportive care to heal spontaneously.
- Large pneumothoraces, hemothoraces or tension pneumothoraces often require insertion of chest tubes with or without needle aspiration if needed.
Exemplar: Pulmonary Embolus (PE) (p 622 Lewis)
- Pulmonary embolism (PE) is a blood clot that lodges in a pulmonary artery, often originating from a deep vein thrombosis (DVT).
- Risk factors for PE include prolonged immobility, surgery, pregnancy, obesity, advanced age, certain genetic conditions, history of thromboembolism, smoking, estrogen therapy, heart failure, fractures, and foreign objects such as IV catheters.
- Symptoms of PE can range from mild chest pain to life-threatening respiratory and hemodynamic compromise, requiring immediate medical attention.
Recognize Cues: PE
- Determining the urgency and severity of PE is critical; major symptoms include abrupt chest pain, shortness of breath, dyspnea, apprehension, restlessness, cough (possibly bloody), increased heart rate and respiratory rate, low oxygen saturation, and even changes in mental status.
- Lab assessments and diagnostics such as ABGs, general metabolic panel, D-dimer, and troponin levels aid in diagnosis and treatment planning.
Take Action: PE- Drug Therapy
- Anticoagulant therapy is vital to prevent further PE enlargement, starting immediately.
- Treatment type depends on the severity of the PE, with massive PE cases requiring fibrinolytic therapy (e.g., tPA) in an intensive care unit (ICU) setting.
- Low-risk PE patients are commonly treated with heparin or low molecular weight heparin(LMWH) for several days, usually followed by oral anticoagulants (e.g., warfarin or direct thrombin inhibitors).
Take Action: PE General Nursing Care
- General nursing care for patients with pulmonary embolism (PE) focuses on optimizing ventilation, providing oxygen therapy, and closely monitoring vital signs.
- Positioning the patient to help with better breathing, maintaining IV access for medications, monitoring for signs of bleeding, and providing emotional support are vital parts of this care.
Take Action: PE Discharge Teaching
- Discharge education for PE patients emphasizes medication adherence, lifestyle adjustments, potential complications, and recognizing complications.
- Teaching addresses the importance of regular follow-up appointments for monitoring with appropriate blood work.
- Patient education also includes avoiding activities that could increase the risk of further blood clots, understanding how to modify activities as needed.
Take Action: PE Surgical Therapy
- Treatment options include embolectomy surgery (removal of the embolus—used in cases where anticoagulation is inappropriate or the patient is hemodynamically unstable); and insertion of a vena cava filter (a device placed in the vena cava to trap any further emboli that may develop).
Exemplar: COPD (p 648 Lewis)
- Chronic airflow limitations and airway obstructions are hallmarks of COPD, often stemming from chronic bronchitis or emphysema.
- Risk factors for COPD include smoking, chemical exposure, recurrent infections, and genetic predisposition (AAT gene), and ageing.
Recognize/Analyze Cues: COPD
- Persistent cough, frequent respiratory infections, wheezing, and pursed-lip breathing characterize COPD.
- Additionally, signs include barrel chest, prolonged expiratory time, and digital clubbing (often late-stage presentation).
- Difficulty breathing (dyspnea) is a common, escalating symptom.
Lab Assessments COPD
- Diagnosing COPD frequently involves assessing blood gases (ABGs), including oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2).
- Elevated PaCO2 often indicates poor lung function, and low PaO2 suggest hypoxia.
- Complete blood count (CBC) may reveal elevated white blood cell count (WBC), reflecting infection.
Take Action: COPD Drug Therapy
- Chronic obstructive pulmonary disease (COPD) treatment focuses on long-term control with short- and long-acting inhaled medications.
- Short-acting bronchodilators (SABAs), such as albuterol, help quickly alleviate symptoms.
- Long-acting bronchodilators (LABAs) are crucial for maintaining respiratory function.
- Inhalers containing a combination of these provide added benefit.
- Oral and intravenous corticosteroids can be used during acute exacerbations
- Antibiotics need to be administered as needed to treat infections.
Take Action: COPD Pursed Lip Breathing
- The technique of pursed-lip breathing involves inhaling slowly through the nose, pursing lips, and exhaling slowly.
- This technique helps facilitate airflow and decrease shortness of breath.
Take Action: COPD Oxygen Therapy
- Oxygen therapy is essential for individuals with COPD, especially when oxygen saturation (sats) falls below 88-92% or as prescribed.
- Therapy aims to improve oxygenation and reduce the workload on the heart.
- Various delivery methods, such as nasal cannula or nasal prongs, may be used.
- Humidification is often recommended to thin lung secretions.
Take Action: COPD Nutritional Therapy
- Nutritional therapy is crucial to address weight loss and malnutrition, common in COPD.
- Strategies emphasize minimizing dyspnea during eating, such as eating smaller meals throughout the day and resting before eating.
- Prioritizing high-calorie, high-protein foods, and adequate hydration is also important.
Take Action: COPD Exercise Therapy
- Regular exercise can be beneficial for COPD patients, though it should be started slowly and gradually increased.
- Monitoring for symptoms and limiting exercise intensity is important; stopping and resting when necessary is key.
- Pulmonary rehabilitation programs provide vital education and supervised exercise programs to improve lung function and overall quality of life.
Take Action: COPD Surgical Management
- Lung volume reduction surgery (LVRS) may be considered in certain COPD cases.
- This involves surgically removing hyperinflated lung tissue to improve lung function and oxygen exchange.
- A lung transplant may be needed in advanced COPD, if no other treatment options work and the patient's health allows.
COPD Acute Exacerbation
- COPD acute exacerbations are worsenings of the disease process and can include increased dyspnea and other severe respiratory symptoms, potentially triggering hospitalization.
- Treatment strategies often focus on improving oxygenation and addressing any co-existing infections/triggers which may require intensive care unit (ICU) or hospital level care, oxygen support, and medication adjustments.
COPD: Cor Pulmonale
- Cor pulmonale results when the right side of the heart thickens and becomes enlarged as a response to long-term pulmonary hypertension.
- Right-sided heart failure is often a result.
- Typical presenting symptoms include central venous distention and edema, commonly in the lower extremities.
COPD: Depression/Anxiety/Panic
- Individuals with COPD often experience increased rates of depression, anxiety and panic.
- Common causes for depression and anxiety in patients with COPD may include loss and guilt related to the disease and lifestyle, and the psychological distress related to their conditions.
- Interventions for emotional distress related to the illness can include referrals to mental health professionals and support groups.
Let's Go Clinical
- The case study describes a 77-year-old man presenting with shortness of breath, frequent cough, and leg swelling.
- Presenting symptoms suggest likely COPD and, possibly, right-sided heart failure.
- The arterial blood gases (ABGs), chest X-rays, and assessment of bilateral lower-extremity edema are additional diagnostic indicators.
Discuss with Neighbor
- Discussion points regarding a COPD diagnosis focus on the patient's present health status and appropriate, individualized teaching/treatment plans.
- Considerations/questions would include the reasons behind the diagnosis, the causes of edema, and effective teaching measures.
COPD: Discharge Teaching
- Patients with COPD should be meticulously educated regarding pacing of activities, prevention techniques (such as avoiding crowds and practicing good hygiene), and recognizing when to seek medical attention promptly.
- Discharge plans address medication adherence, the proper use of inhalers, and the recognition of asthma triggers.
- Discharge will include managing activities to avoid potential exacerbations and strategies for maintaining comfort.
Altered Gas Exchange: Pediatrics: Respiratory Disorders
- Pediatric respiratory disorders require specific nursing interventions targeting symptoms such as pneumonia, RSV (Respiratory Syncytial Virus), Bronchiolitis, and Asthma.
- This often involves careful assessment of patient's overall health, management of treatment plans to aid in resolution, and prevention of future complications
Abnormal Breath Sounds in Pediatric Patients
- A hallmark of pediatric respiratory distress is an assessment of abnormal breath sounds.
Pediatric Respiratory Infections: Facts
- Respiratory infections in children are frequently viral in origin.
- Anatomical features, such as narrow airways, in children contribute to greater susceptibility to infections.
Take Action: Nursing Care (Pediatrics) Easing Respiratory Efforts
- Nursing care for children with respiratory issues frequently involves strategies aimed at easing their breathing.
- Consideration for home-based restorative care such as frequent use of steamy showers.
- Preventing infections/complications and managing respiratory distress at home.
Take Action: Nursing Care (Pediatrics) Promoting Comfort & Infection Prevention
- Comfort measures for infants and children with respiratory infections involve administering saline drops to clear nasal passages effectively.
- Respiratory hygiene/proper handwashing techniques are vital.
Take Action: Nursing Care (Pediatrics) Reduce Temperature & Hydration
- Assessing and managing fever in children involves providing acetaminophen/ibuprofen as prescribed, ensuring adequate hydration and maintaining comfort.
- Observing for signs of dehydration including mucous membranes and weight loss.
- Oral rehydration fluids (pedialyte) may be required.
Exemplar Respiratory Synctial Virus (RSV) & Bronchiolitis (p1133 Perry)
- Recognition of respiratory illnesses like RSV, bronchiolitis, and asthma in children necessitates familiarity with their symptoms.
- Effective management needs a multipronged approach, including respiratory support, hydration, temperature control, and symptom relief, alongside appropriate isolation procedures.
RSV & Bronchiolitis: Recognize Analyze Cues
- RSV bronchiolitis, a frequent viral illness in children, is indicated by a progression of upper respiratory symptoms that quickly descends into lower respiratory tract infections.
- Inflammation of the bronchioles, increased mucus production, and bronchospasm are core symptoms.
RSV & Bronchiolitis: Recognize Cues Initial, Progression, and Severe Illness
- Typical initial indicators include rhinorrhea (“runny nose”), pharyngitis (“sore throat”), coughing, and wheezing.
- As the condition worsens, increased breathing difficulty, retractions (visible inward movement), and cyanosis (bluish discoloration) may manifest.
- Severe RSV can cause apnea (cessation of breathing) which needs immediate medical care.
RSV & Bronchiolitis: Take Action
- Handling RSV patients needs careful isolation procedures to prevent cross-contamination in healthcare settings.
- Supplemental oxygen to maintain oxygen saturation levels above 90% and humidification.
RSV & Bronchiolitis: Take Action Medications & Hydration
- Medications and treatment plans (especially for children who require intensive care) include nebulized epinephrine (to help with breathing), and analgesics like Tylenol or ibuprofen, as directed.
- Adequate hydration and observing/monitoring for dehydration are integral parts of this care.
RSV & Bronchiolitis: Prevention (and Vaccine Palivizumab)
- Implementing measures aimed at avoiding spread of infection in the pediatric population is key part of RSV and Bronchiolitis prevention.
- Preventing exposure to other contagious diseases.
- The potential for use of Palivizumab, an RSV vaccine, is especially important for vulnerable children.
Potential Complication of RSV: Otitis Media (p1126 Perry)
- Otitis media, a complication of RSV, is indicated by inflammation/fluid in the middle ear and is often preceded by a viral respiratory infection.
- Key recognition cues include abrupt onset of earaches, fever, and pus/discharge from the ear.
- Intervention may require antibiotic therapy, tympanostomy tube placement, and appropriate pain/fever management, often with physician involvement.
Exemplar: Asthma (p1143 Perry)
- Asthma, a chronic disorder, is a response to an inflammation/obstruction of the bronchial passages (bronchioles) resulting in compromised respiratory function and airflow.
Asthma: Recognize Cues
- Common cues in asthma include repeated episodes of wheezing, shortness of breath, tightness in the chest, and frequent nighttime/early morning coughs.
- Indicators include restlessness, agitation, and possible itching prior to an attack.
- Pulmonary function tests (PFTs) are objective tools to measure lung function, assessing both severity and responses to treatment.
- Asthma symptoms are often assessed using a peak flow meter to assess the individual's lung function.
Asthma: Take Action, Therapeutic Management- Long Term
- Long-term asthma treatment focuses on reducing/controlling inflammation and minimizing the frequency and/or severity of acute attacks.
- Key components include consistent doctor visits, accurate medication administration, and diligent avoidance of asthma triggers.
Asthma: Take Action - Med Therapy
- Management of asthma often involves controllers/preventers to decrease inflammation and relievers to quickly manage symptoms.
Asthma Triggers
- Several factors can trigger asthmatic episodes.
- Nurses must be aware of what triggers/aggravates asthma symptoms and educate patients on avoidance strategies. Recognizing potential triggers is vital for preventative support.
Asthma: Take Action, Action plan (Asthma Canada, 2019)
- Use of Asthma Action Plans (e.g. from Asthma Canada) aids in appropriate self-management and planning of interventions.
- The Plan provides a structured method for tracking, managing symptoms, and adjusting medication as needed.
Asthma: Take Action Exercise Induced Bronchospasm
- Exercise-induced bronchospasm (EIB) is common in asthmatic patients and characterized by breathing difficulties during or after exertion.
- Management of EIB may involve medication use (e.g., inhalers) prior to exertion for preventative support.
Asthma: Status Asthmaticus
- Status asthmaticus is characterized by a persistent and severe asthma attack, that does not respond to common treatments.
- Significant symptoms include severe shortness of breath, low blood oxygen levels, and extreme respiratory distress that may require hospitalization and possibly even intubation.
Learning Outcomes
- Student learning outcomes are typically focused on critical aspects of patient care, including accurate assessment and appropriate responses tailored to the individual patient's needs.
- Comprehensive knowledge is expected for various scenarios, such as respiratory issues, including assessments and care plans for adults, children/infants, and interventions related to specific conditions.
What is Required for Adequate Gas Exchange?
- Effective gas exchange relies upon several factors; a functioning central nervous system for regulating breathing, a properly functioning diaphragm and skeletal muscles supporting respiration, and full function of the alveoli, with sufficient blood flow in the capillaries surrounding the alveoli for proper oxygen and carbon dioxide transport.
Hypoxia and Hypercapnia
- Hypoxia and hypercapnia are conditions frequently stemming from impaired gas exchange where tissues fail to receive enough oxygen (hypoxia) and carbon dioxide buildup occur (hypercapnia), leading to potential damage in both adults and children.
- Causes for respiratory failure and their outcomes are often evaluated by medical staff to determine and prioritize appropriate interventions and medications.
Shunt vs Dead Space
- Shunt and dead space phenomena indicate issues causing decreased gas exchange.
- Shunt occurs when blood passes through the lungs without proper gas exchange.
- Dead space exists when ventilation occurs without adequate blood flow and gas exchange.
Think Pair Share
- Prompt questions designed to engage learners in analysis of scenarios of respiratory concerns and how they necessitate effective nursing intervention.
Gas Exchange Recognize Cues: Patient History, Physical Assessment, Analyze Data
- Analyzing patient history to gather pertinent respiratory data (e.g., family history, environmental factors, smoking history), physically assessing abnormal breath sounds, respiratory function, and patient status, such as observing nasal discharge or skin color.
- Use of clinical data (e.g., blood tests, X-rays, and other imaging assessments) as a vital source of information for complete patient care.
Radiology Imaging, Bronchoscopy; Thoracentesis; Pulmonary Function Tests
- Radiology imaging, bronchoscopy, Thoracentesis, and Pulmonary function tests.
- Specific procedures and considerations tailored for managing respiratory conditions in patients, including preparation, procedure, and monitoring needs.
Percutaneous Lung Biopsy
- In certain cases, requiring a tissue sample analysis from the lung, a percutaneous lung biopsy may be required.
Altered Gas Exchange: Take Action
- Effective management of altered gas exchange requires a coordinated approach to optimizing oxygenation such as monitoring and adjusting oxygen levels, as needed; managing ventilation, administering effective medications, and managing secretions.
- Providing adequate nutrition, and ensuring patient comfort to maximize respiratory function.
Practice Question
- Multiple-choice scenarios often assess students' understanding of priorities in managing breathing disorders. The questions stress the critical aspects of assessing, analyzing, and prioritizing patient interventions.
Gas Exchange Pediatrics: Respiratory Disorders
- Recognition of signs of respiratory distress in pediatric patients requires special awareness and expertise; often involving early intervention and symptom monitoring.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers essential topics related to pulmonary disorders such as pneumothorax, COPD, and pulmonary embolism. Test your knowledge on symptoms, treatment options, and management strategies for these conditions. Perfect for medical students and healthcare professionals!
