Week 4 - Respiratory System PDF

HCAP 1210 Review!  Define the following:  SOBOE  SOB  Cyanosis  Dyspnea  Apnea  Orthopnea  Hyperventilation  Sputum  Respiration  Wheezing Oxygen Equipment Review! Oxygen Sources  Wall outlet  Oxyge...

HCAP 1210 Review!  Define the following:  SOBOE  SOB  Cyanosis  Dyspnea  Apnea  Orthopnea  Hyperventilation  Sputum  Respiration  Wheezing Oxygen Equipment Review! Oxygen Sources  Wall outlet  Oxygen tank  Oxygen concentrator Important Things to Remember as an HCA  The portable unit has enough oxygen for about 8 hours.  You should know how to read an oxygen gauge and how to replace the tank if its low  Power sources are required for oxygen concentrators. Residents are therefore limited in their mobility  If your resident is on oxygen you must know the flow rate and adjust as needed  Oxygen Administration Devices So we have the source, how do we get the oxygen into our residents?  Nasal Cannula  Two prongs are inserted into the nostrils  The tube is brought over the ears and under the chin  Allows eating and talking  Tight prongs irritate the nose, ears and cheekbones  2-5 l/pm  Which way do the prongs face?  Face Masks  Covers the nose and mouth  Examine carefully as moisture can built up under the mask  Keep face clean and dry. This helps prevent irritation from the mask  Masks are removed for eating  5-10 l/pm  Nebulizers  Used to administer medication  It should steam out, THAT IS NORMAL!  HCA Responsibilities:  Recognize when medication is finished  Remove mask and turn machine off  Wipe residents face and offer water to rinse out their mouth Oxygen Safety!!!  Never remove the device used to administer oxygen without permission  Check for signs of irritation:  Behind the ears  Under the nose  Face  Masks and tubing are replaced on Bath Day  Report any signs of hypoxia, respiratory distress or abnormal breathing patterns  Report any oral hygiene concerns Respiratory System The respiratory system brings oxygen into the lungs and removes carbon dioxide.  Respiration involves inhalation (inspiration) and exhalation (expiration)  The lungs are spongy tissues filled with alveoli, blood vessels, and nerves Respiratory  Each lung is divided into lobes  The right lung has three lobes; the left lung has two  The lungs are separated from the abdominal cavity by a muscle called the diaphragm System  Each lung is covered by a two-layered sac called the pleura  A bony framework made up of the ribs, sternum, and vertebrae protects the lungs Respiratory System  The respiratory system  Respiratory muscles weaken = SOB  Lung tissue becomes less elastic.  The person may lack the strength to cough and clear the airway of secretions. Pneumonia Videos  What is pneumonia?  https://www.youtube.com/watch?v=aKduNgfePLU  What is important care to teach patients?  https://www.youtube.com/watch?v=nC-goeA2vZc  Pneumonia  An infection of lung tissue  Alveoli fill with pus, mucus, other liquids; oxygen and carbon dioxide are not exchanged normally  Caused by bacteria, viruses, aspiration, or immobility  Can cause serious illness and result in death Symptoms of Pneumonia Fever, shaking, chills, painful cough, chest pain, and rapid breathing and pulse rate Cyanosis—blueish colour of lips, nail beds, ear lobes Sputum is clear, green, yellowish, or rust coloured, depending on cause Confusion Critical Thinking!  Mr. Bill is a 72yr old resident of Evergreen Baptiste. He is very active man who enjoys outings on the Bill, gardening, bowling and playing cards with fellow residents. Mr. Bieber refused the flu vaccine that was offered to all the residents of the facility. He subsequently developed a horrible cough as was expectorating yellowish/greenish sputum. Mr. Bill was diagnosed with Pneumonia.  What are some of the physiological age-related changes the contribute to a higher incidence of pneumonia in the elderly?  What is the mortality rate of pneumonia?  Develop a care plan that will best meet Mr. Bill needs. Think of his diagnosis. Chronic Obstructive Pulmonary Disease  Chronic obstructive pulmonary disease (COPD) refers to chronic bronchitis, asthma and emphysema  Smoking is the most common cause  Has no cure  Breathing exercises and oxygen therapy  Encourage fluid intake  Lung damage from the build ip of dangerous subatnces in lungs and airways Effects of Lung damage due to decreased ability to clear Smoking on mucus and debris from airway and lungs the Respiratory Increased risk of lung infection System Dreased elasticity of alveroli and inability to expel sufficient amount of air on exhalation Asthma  The air passages narrow = dyspnea  Paroxysmal dyspnea is intermittent spasms of shortness of breath  Allergies, exercise, cold air, smog, and emotional stress are common causes  Episodes occur suddenly—asthma attack  Wheezing, shortness of breath, coughing, rapid pulse, perspiration, and cyanosis  Very frightening—fear makes attack worse Asthma  Treatment  Medications are used to prevent or lessen attacks  Emergency room treatment may be necessary  Repeated attacks can damage the respiratory system Critical Thinking!  You are caring for Mr. Rogers at Delta Mountainview Manor. You are aware of his hx of his asthma attacks, however over the past few months he has been taking his medication regularly to manage any precipitating attacks, and aware of the environmental triggers that can cause it.  Today his wife has shown up to take him out to lunch for the 58 year wedding anniversary, she is dressed up and bought flowers. Prior to them leaving the facility Mr. Rogers begins to have an asthma attack.  The wife yells “Give him his inhaler, its right there beside you on his bedside!!!!!!!!!” which it is.  What do you?  What caused this asthma attack? Emphysema  The alveoli enlarge and become less elastic  Some air is trapped in the alveoli when exhaling  O2 and CO2 exchange cannot occur in affected alveoli  The client has shortness of breath and a cough  Breathing is easier when the client sits upright and slightly forward  Treatments  Antibiotics, oxygen therapy  Medications to ease chest pain, cough, and fever  Proper diet  Proper fluid and hydration  Fowler’s or semi-Fowler’s position to make breathing easier Tuberculosis  Tuberculosis (TB) is a potentially serious infectious disease that mainly affects your lungs.  The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.  Many strains of tuberculosis resist the drugs most used to treat the disease. People with active tuberculosis must take several types of medications for many months to eradicate the infection and prevent development of antibiotic resistance Tuberculosis  There are two types of TB  Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB.  Active TB. This condition makes you sick and in most cases can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later.  Tuberculosis  Regular contact with people who are ill increases your chances of exposure to TB bacteria. Wearing a mask and frequent hand-washing greatly reduce your risk.  If your patient/resident have active TB, keep the germs confied. It generally takes a few weeks of treatment with TB medications before you're not contagious anymore. Follow these tips to help keep your friends and family from getting sick:  Stay home. Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.  Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn't move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside = Negative Pressure Room  Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.  Wear a mask. Wearing a surgical mask (N95) when you're around other people during the first three weeks of treatment may help lessen the risk of transmission. Critical Thinking!  Mary is a 75 year old woman who lives at home with her daughter and her family. You are her home care HCA, as she has a dx of COPD, and her health condition is declining. Her family just wants to ensure she is safe and comfortable in the comfort of her own home.  While speaking to Mary about her health hx you find out that when she was a teenage she tended to her mother who TB. Mary did not have clinically significant case of TB at that time. With her current health decline due to the COPD, and impaired immune system, you suspect a reactivation of latent TB.  What additional symptoms should you inquire about?  What risk factors does Mary have that including the reactivation of her TB  How is TB transmitted?  How is TB treated?  What care plan would you suggest for Mary and her family? Influenza  Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza is commonly called the flu  It's not the same as stomach "flu" viruses that cause diarrhea and vomiting.  For most people, influenza resolves on its own. But sometimes, influenza and its complications can be deadly. People at higher risk of developing flu complications include:  Young children  Older adults over the age of 65  Residents of long-care nursing homes  People with weakened immune system \ Influenza  Flu viruses travel through the air in droplets when someone with the infection coughs, sneezes or talks. You can inhale the droplets directly, or you can pick up the germs from an object — such as a telephone or computer keyboard — and then transfer them to your eyes, nose or mouth  The Centers for Disease Control and Prevention (CDC) recommends annual flu vaccination for everyone age 6 months or older  To control the spread of infection  Wash your hands  Contain your cough and sneezes, INTO YOUR ELBOW!! Summary of what is a coronaviruses?  Coronaviruses are a large family of viruses. Some cause illness in people and others cause illness in animals. Human coronaviruses are common and are typically associated with mild illnesses, similar to the common cold.  COVID-19 is a new disease that has not been previously identified in humans. Rarely, animal coronaviruses can infect people, and more rarely, these can then spread from person to person through close contact.  There have been 2 other specific coronaviruses that have spread from animals to humans and which have caused severe illness in humans. These are the:  Severe Acute Respiratory Syndrome Coronavirus (SARS CoV)  Middle East Respiratory Syndrome Coronavirus (MER CoV)  Shortness of breath New or worsening Temperature equal or difficulty cough to or over 38°C breathing Symptoms and Feeling feverish Chills Fatigue or weakness Treatment of COVID-19 Muscle or body aches New loss of smell or taste Headache Gastrointestinal symptoms Feeling very unwell (abdominal pain, diarrhea, vomiting)  Close contact: Breathing in someone's respiratory droplets after they cough, sneeze, laugh or sing. How does Contaminated surfaces: Touching something with the virus on it, then COVID-19 touching your mouth, nose or eyes with unwashed hands. Spread? Common greetings: Handshakes, hugs or kisses. How to Prevent the Spread of COVID-19 Avoid Stay Stick Talk Limit Go Keep Avoid closed Stay home and Stick to a small Talk to your Limit contact Go outside to Keep a spaces, away from and consistent employer with people at exercise distance of at crowded others if you social circle about working higher risk, least 2 arms places, and feel sick and avoid at home if such as older lengths close contact gathering in possible adults and (approximately large groups those with 2 metres) from underlying others medical Household conditions or contacts (people weakened you live with) immune don't need to distance from systems each other unless they're sick or have travelled in the last 14 days  Maintaining good hand and respiratory hygiene are very important personal practices that help reduce the risk of infection or spreading infection to others. Wash your hands often with soap and warm water for at least 20 seconds. If soap and water aren't available, use a hand sanitizer containing at least 60% alcohol. How to Prevent When coughing or sneezing: cough or sneeze into a tissue or the bend of your arm, not the Spread of COVID-19 your hand dispose of any tissues you've used as soon as possible in a lined waste basket and wash your hands immediately afterwards Avoid touching your eyes, nose, or mouth with unwashed hands.   Wearing a non-medical mask or face covering while out in public is recommended for periods of time when it's not possible to consistently maintain a 2-metre physical distance from others, particularly in crowded public settings, such How to Prevent as: shopping areas the Spread of public transportation COVID-19 stores and personal service settings  Masks alone won't prevent the spread of COVID-19. You must consistently and strictly adhere to good hygiene and public health measures, including core personal practices like frequent hand washing and physical distancing.  Most people with mild coronavirus illness will recover on their own. Currently there are four approved vaccines in Canada to help Treating alleviate the signs & symptoms of COVID-19 COVID-19 If you have received a flu vaccine, it will not protect against coronaviruses, but will help prevent the flu. Getting the flu could make you more vulnerable to other infections. Getting the flu vaccine will not increase your risk of illness from coronavirus. Critical Thinking!  You are working at Carelife Fleetwood, Spruce Unit for your shift today. Upon caring for your first resident of the day, you notice they are warm to touch, lethargic, decreased LOC, and a slight cough. You inform the nurse in charge immediately, and a COVID-19 swab has been completed.  Until the results come back the patient is now placed on droplet and contact precautions as a precautionary measure, what type of PPE is required, how will the meals be delivered to the resident, and what other equipment are you required to have outside the room?  The COVID-19 test comes back positive, and two other residents are also experiencing similar symptoms. They COVID-19 tests also come back positive, and the unit is now on enhanced surveillance, as an outbreak has been declared.  Explain two ways HCWs can provide treatment to their residents diagnosed with COVID-19.  What is the most effectively proven way to protect oneself from COVID-19 (HINT two answers).  What is the difference between COVID-19 and Influenza?