Respiratory Conditions and Interventions PDF

- [Common respiratory conditions we discussed in class: signs and symptoms, complications, and nursing interventions.] - **Asthma**: obstructive lung disease causing difficulty with exhaling air. - Three main components are bronchoconstriction, inflammation,...

- [Common respiratory conditions we discussed in class: signs and symptoms, complications, and nursing interventions.] - **Asthma**: obstructive lung disease causing difficulty with exhaling air. - Three main components are bronchoconstriction, inflammation, and mucous production - **COPD**: the airways in the lungs become inflamed and thickened, and the tissue where oxygen is exchanged is destroyed. Causes include airway obstruction, airway resistance, decreased gas exchange, and CO2 retention. Poorly reversed worsens over time. S/S include SOB cough with mucous production fatigue, frequent lung infections, fatigue - Emphysema/bronchitis, barrel chest/tripod position - **Pneumonia**: lung collapse occurs when secretions obstruct airways. S/S include accumulation of mucous fluid - **Altered Respiratory function:** abnormal breath sounds. Accessory muscle use is evident by leaning forward to breathe, see between the rib at the sternum, or straining the neck and shoulders - **Cyanosis**: bluish-grey skin discoloration, poor o2 sat - **Clubbing**: seen in respiratory or cardiac disease related to chronic severe tissue hypoxia - S/s: - Cough: response to irritation in airways - Sputum production: nose, throat, lungs, blood-filled mucus - Shortness of breath dyspnea - Bradypnea, tachypnea, Cheyenne stokes - [Respiratory assessment and interventions]: - increased breathing work - **Restricted lung movement**: caused decreased expansion of lung, lung volume, and lung capacity. It causes the lungs to stiffen and lung tissue to swell and reduces the diameter of the airways - **Examples**: pneumonia, atelectasis, foreign body aspiration, exposure to toxins, neuromuscular disease, skeletal conditions - **Airway obstruction**: any process that decreases the diameter of the airway causes increased airway resistance - **breath sounds**: crackles, wheezing, stridor - **nebulization treatments**: a suspension of liquid droplets in air or o2 delivered directly into the lungs- albuterol, Xopenex, or antibiotics - **Peak flow meter**: Measure peak expiratory flow rate with forced expiration reflect it in airway diameter. Green, yellow, and red zones based on personal best. Record am and pm and before and after treatment - **MDI**: metered dose inhalers are measured doses of medication power or das - **CPT: chest physiotherapy** - Vibration: helps loosen secretions - Flutter valve or acapella or a high frequency pulsator vest - postural drainage- is positioning in order to drain secretions from particular lobes or segments of lungs for easier removal - percussion: produces mechanical waves by clapping to remove secretions - **Spacer**: MDI with a spacer provides increased delivery of medication to the lungs and decreases the bad taste in the mouth - **pulse oximete**r: % of hemoglobin that is attached to oxygen - **positioning** - upright posture: sitting and standing promote ease of lung expansion, raise HOB, frequent position changes, good side down - **fluids**: encourage fluids water preferred to avoid caffeine and alc - **ambulation:** upright, OOB, walking, not supine - [Oxygen delivery systems: differences and types, use in patient conditions/illnesses] - Use for assistance vs. to meet full demands - **low flow vs. high flow** - Low flow: mix with room air. They do not provide enough gas flow to meet the patient's inspiratory demand. Therefore, part of the inspired volume is o2, and part is room air - High flow: The entire ventilatory demand of the patient is met. Pre-mixes the ratio of o2 to air before delivery to the patient and delivers the gas at a flow rate that exceeds the patient's inspiratory demand, making it a delivery system that delivers a fixed oxygen concentration. Used with patients with low O2 those that require o2 those that require humidification COPD patients - **partial re-breather vs. non-re-breather** - partial rebreather: 30-60% 10-15L/min low flow - non-rebreather: 55-90% 10-15L/min low flow - **Devices:** - Venturi mask: 24-60% colored valves tell you the flow rate to set deliver% - simple face mask: at\>5L/min 40-60% low flow delivery - nasal cannula: - 24-60%, 1-6L/min most common comfortable, convenient, low flow system - High flow NC reduces dead space, increases FIO2, pre-mixed, air/o2 blender, generates up to 60L/min flow , heated and humidified - Trach collar: 28-98% device provides high humidity - Oxygen hood: high concentration of o2 \>60% high humidity - **Artificial airways** - Oral or nasal pharyngeal airways - Endotracheal tubes - Tracheostomy tubes - **airway management** - Suctioning: removal of secretions through a tube in place in surgical opening, maintaining patent airway - need for suctioning - audible upper airway noise gurgle - adventitious breath sounds - cyanosis - decreased pao2 or decreased pulse ox - restlessness agitation - increased WOB retractions, nasal flaring SOB - correct technique. - Suction to end of tracheostomy - Apply suction only on the way out of the airway intermittently - Rotate the catheter as you apply suction - Do not suction longer than 10-15 seconds - Hyperoxygenate the patient before and between passes - No more than three passes with a catheter at one session