Care of the Patient with a Respiratory Disorder

1. Care of the Patient with a Respiratory Disorder Unit 6 Med-Surg 2

2. Care of Respiratory Disorders • What can you do if you have enough wind? Med-Surg 2

3. Care of Respiratory Disorders • Study those terms! • Review of A & P • Abnormal respiratory problems and their treatment • Dyspnea • Hypoxia • Hyperventilation • Hypoventilation • Apnea • Cheyne-Stokes • Asphyxia • Cyanosis Med-Surg 2

4. Care of Respiratory Disorders • Breath Sounds • Vesicular- soft, low pitch, breezy, heard over most of the lung • Bronchial-heard over trachea, loud and high pitched • Rales-crackling sounds made as air moves through moisture or secretions • Wheeze-high pitched, musical Med-Surg 2

5. Care of Respiratory Disorders • Breath Sounds • Rhonchi-bubbling sound as air passes through larger airways containing fluid or secretions • Stridor-croaking sound made when airways are partially obstructed • Rub-grating, squeaking sound caused by inflammed pleural linings rubbing together Med-Surg 2

6. Care of Respiratory Disorders • Treatments-review • Chest Tubes • Check water seal • Prevent air leaks • Keep tubes patent • Unit positioning • TCDB • Assessment • Hemostats • Disconnected from drainage system? • When will it be removed? Med-Surg 2

7. Care of Respiratory Disorders • Endotracheal Intubation • Tracheotomy • Nursing care • Maintain open airway • Suction prn • O2 as ordered • Humidification • Mid-Fowler’s • Routine VS • Frequent dressing changes • Use sterile technique • Never leave unsecured • Remain calm during all care • Call light! Med-Surg 2

8. Care of Respiratory Disorders • Tracheotomy • Trach care purpose • Precautions • Dressing change procedure review • Cleaning procedure review • Suctioning purposes • Suctioning procedure review Med-Surg 2

9. Care of Respiratory Disorders • Oxygen Therapy • Nasal Cannula • Nasal Catheter • Masks • Non-rebreather • Partial rebreathing • Venturi • Tents Med-Surg 2

10. Care of Respiratory Disorders • Oxygen safety • No smoking • No electrical appliances • Secure portable tanks • Do not place O2 source near heat source Med-Surg 2

11. Care of Respiratory Disorders • Charting • Note liter flow and type of delivery • Respiratory rate and effort, SOTB • HR, BP, O2 sat • Any cyanosis • Chart any changes in liter flow, or if dc’d • Chart any changes in your patient Med-Surg 2

12. Care of Respiratory Disorders • Review of suctioning procedure • Purposes • Procedure • Mechanical ventilation • Types • Purposes • Nursing responsibilities Med-Surg 2

13. Care of Respiratory Disorders • Therapeutic measures for the respiratory patient • Psychological care • Percussion • Postural drainage • Throat irrigations • Humidification • Aerosol therapy Med-Surg 2

14. Care of Respiratory Disorders • The Cough! • What is it? • What does it do? • How can we help to correct the underlying cause? Med-Surg 2

15. Care of Respiratory Disorders • Medications • Expectorants • Mucolytics • Demulcents • Antitussives • Antihistamines • Decongestants Med-Surg 2

16. Care of Respiratory Disorders • Non-infectious diseases of the respiratory system • Epistaxis • Chronic Obstructive Pulmonary Disease (COPD)-an overall term • Emphysema-destruction of alveolar walls • Chronic Bronchitis-inflammation of the bronchi with increased mucus production and chronic cough Med-Surg 2

17. Care of Respiratory Disorders • Non-infectious diseases of the respiratory system • Chronic Obstructive Pulmonary Disease (COPD)-an overall term • Asthma-spasms and/or swelling of bronchial tubes • Status Asthmaticus-severe, persistant bronchospasm • Respiratory Arrest-the patient can no longer sustain own respiratory effort Med-Surg 2

18. Care of Respiratory Disorders • Non-infectious diseases of the respiratory system • Pulmonary Embolism and Infarction-foreign body or clot in pulmonary artery/arteriole with resultant death of tissue • Pulmonary Edema-lung capillaries become engorged with blood as left ventricle fails to empty Med-Surg 2

19. Care of Respiratory Disorders • Non-infectious diseases of the respiratory system • Atelectasis-collapse of the alveoli, preventing gas exchange • ARDS-complication of another disease process, lung injury occurs with decreasing lung compliancy Med-Surg 2

20. Care of Respiratory Disorders • Infectious diseases of the respiratory system • Tuberculosis-caused by mycobacterium tuberculosis, it may attack any organ or tissue in the body • Acute Rhinitis-inflammatory condition of the nasal mucosal membranes • Acute Pharyngitis-inflammation of the throat • Acute Laryngitis-inflammation of the larynx • Tonsillitis-inflammation of the tonsils Med-Surg 2

21. Care of Respiratory Disorders • Infectious diseases of the respiratory system • Sinusitis-inflammation of the sinus mucosal membranes, most frequently the maxillary sinus • Influenza-a respiratory virus, types A, B, and C • Acute bronchitis-inflammation of the bronchial tree and trachea, secondary to URI • Pneumonia-inflammation of the lung tissue, usually bacterial in nature • Pleurisy and Empyema-inflammation of any part of the pleura and infection in the pleural space • Bronchiectasis-dilation of the bronchi/bronchioles from repeated infection Med-Surg 2

22. Care of Respiratory Disorders • Obstructions of the respiratory system • Deviated Septum • Nasal Polyps • Enlarged Tonsils and Adenoids • Foreign Bodies • Tumors of the Respiratory System • Lung CA Med-Surg 2

23. Care of Respiratory Disorders • Chest Surgeries • Thoracotomy-surgical opening into the chest wall • Segmental resection-small portion of lung tissue is removed • Lobectomy-entire lobe is removed • Pneumonectomy-entire lung is removed, most common • Chest Wounds End of Unit Med-Surg 2