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Caring for Individuals Experiencing Respiratory Challenges

Caring for Individuals Experiencing Respiratory Challenges. NURS2016. Upper Respiratory Tract. Self-Study. Common Cold Acute/Chronic Sinusitis Rhinitis Acute/Chronic Pharyngitis. Tonsillitis and Adenoiditis Clinical Manifestations & Treatment.

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Caring for Individuals Experiencing Respiratory Challenges

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  1. Caring for Individuals Experiencing Respiratory Challenges NURS2016

  2. Upper Respiratory Tract

  3. Self-Study • Common Cold • Acute/Chronic Sinusitis • Rhinitis • Acute/Chronic Pharyngitis

  4. Tonsillitis and AdenoiditisClinical Manifestations & Treatment • Sore throat, fever, snoring and difficulty swallowing. • Mouth breathing, earaches, halitosis, frequent colds. • Antibiotics • Surgical tonsillectomy (& adenoidectomy)

  5. Pre-op assessment. Pre-op teaching Post-op Assess operative site Ice collar Analgesia Ice chips/water No straws, no coughing, limit talking Risk of Hemorrhage Assess expectorant Assessment swallowing Assess VS Restlessness Hemorrhage at operative site is an emergency. Nursing Care related to T&A

  6. Sleep apnea Obstructive Apnea>10sec. & >5x/hr Tx: +ve airway pressure or surgery Nurse educate pt re tx and use of oxygen Epistaxis Pressure, Head tilt Chemical cautery or vasoconstrictors Assess vital signs Preventative strategies Ostruction/Trauma of URT

  7. Cancer of Larynx • Glottic area, supraglottic area, subglottis • Risk factors: carcinogens & others • Radiation treatment • Surgical treatment • Partial laryngectomy • Supraglottic laryngectomy • Hemilaryngectomy • Total laryngectomy

  8. Airflow and Communication Post-Laryngectomy

  9. Primary Nursing Interventions: Laryngectomy • Pre-operative teaching • Reducing anxiety and depression • Maintaining a patent airway • Promoting alternative communication methods • Promoting adequate nutrition • Promoting home-based care

  10. Primary Nursing Interventions: Laryngectomy • Monitoring and managing potential complications • Respiratory distress and hpyoxia • Hemorrhage • Infection • Wound breakdown

  11. Lower Respiratory Tract

  12. AtelectasisClosure or collapse of alveoli Prevention: Education and Reinforcement • Frequent position change • Early ambulation • DB&C • Incentive spirometer

  13. Atelectasis Management: • Positive expiratory pressure • Suctioning secretions, chest physical therapy, bronchiodilators • Thoracentesis

  14. Respiratory Infections(lower RT) • Acute tracheobronchitis • Pneumonia • Pulmonary Tuberculosis

  15. Management Antibiotic treatment Expectorants Deep suctioning and ventilation support Nursing Care Increasing fluuid intake Breathing and coughing exercises Encourage rest Education related to medications Acute Tracheobronchitis

  16. PneumoniaInflammation of Lung Parenchyma • Caused by microbial agent: Strep pneumoniae, haemophilus influenzae, legionella, pseudomonas aeruginosa • Community Aquired Pneumonia • Hospital Aquired Pneumonia • Immunocompromised • Aspiration Pneumonia

  17. Management Antibiotic according to sensitivity and Gram stain. Supportive treatment when viral Oxygen if hypoxic Complications Shock and respiratory failure Atelectasis and pleural effusion (empyema) Superinfection Medical Managment & Complications

  18. Nursing AssessmentPneumonia • T & P • Secretions/expectorant • Cough • Respirations • Chest assessment

  19. Nursing Diagnoses

  20. Nursing InterventionsPneumonia • Improving airway patency • Promoting rest and conserving energy • Promoting fluid intake • Maintaining nutrition • Monitoring and managing potential complications

  21. Pulmonary Tuberculosis • Infectious disease of the lung parenchyma • Mycobacterium tuberculosis • Worldwide public health problem • Common TB meds: isoniazid, rifampin, streptomycin, pyrazinamide, ethamutol

  22. Fever Anorexia Weight loss Night sweats Fatigue Enlarged and painful lymph nodes Cough Sputum Ecophony, fremitus Diminished bronchial sounds & crackles Nursing AssessmentTB

  23. Nursing DiagnosisKnowledge deficit about tx regimen & preventative health measures Medication regimen is complex • TB is highly communicable – meds are the most effective means of preventing transmission Medication side effects are primary reason for D/C

  24. COPD • A disease state characterized by airflow limitation that is not fully reversible • Often include diseases such as chronic bronchitis and emphysema • Risk factors: active and passive smoking, occupational exposure, air pollution and genetic abnormalities

  25. Chronic Bronchitis • Presence of cough and sputum for at least 3 months past 2 years. • Bronchial walls thicken and lumen narrows • Increased susceptability to RTI

  26. Emphysema • Abnormal distention of the air spaces beyond the terminal bronchioles with destruction of the walls of the aveoli. • Usually long history of smoking • Dyspnea becomes the major symptoms

  27. Nursing Assessment Focus on symptoms Disease history Become familiar with chart pg 578 Nursing Diagnosis Impaired gas exchange Ineffective airway clearance Ineffective breathing pattern Self-care deficit Activity intolerance Ineffective coping Knowledge deficit Nursing CareCOPD

  28. Nursing InterventionsCOPD • Breathing exercises • Inspiratory muscle training • Activity pacing • Self-care activities • Physical conditioning • Oxygen therapy • Nutritional therapy • Coping measures

  29. Therapeutic ApproachCOPD • Treatment to improve ventilation and decrease work of breathing. • Prevention & tx of infection • Improve energy conservation techniques • Proper environmental conditions • Psychological support • Ongoing education

  30. Oxygen therapy and COPD • Because hypoxemia, rather than high carbon dioxide, drives respiration in COPD, and • Because oxygen therapy can raise oxygen levels in the blood • COPD patient receiving oxygen tx may experience decreased stimulation to breath

  31. Asthma • Inflammatory disease of airways • Hyper-responsiveness • Mucosal edema • Mucous production • Reversible process *Prevention: identify substances that precipitate symptoms

  32. Assess resp status Severity of symptoms Breath sounds Peak flow Pulse oxymetry Vital signs Hx of allergy to meds Current med regimen Admin and monitor medication Ensure hydration Monitor S&S infection Provide psychological support Nursing CareAsthma

  33. Obstruction of pulmonary artery by a thrombus Can also be air, fat, or amniotic fluid emboli Risk factors (p.472) Venous stasis Hypercoagulability Venous endothelial disease Certain disease state Other: age, obesity, clothing, pregnancy. Pulmonary Embolism

  34. Nursing CarePulmonary Embolism • Minimize the risk (know the risks) • Prevent thrombus formation • Monitor thrombolytic therapy • Manage pain • Oxygen therapy

  35. Pulmonary Embolism • Often sudden • Painful: ischemia • Immediate SOB

  36. Reminder • Self study upper respiratory track • Focus on promoting health through • Preventative approaches • Facilitate quality of life while living with chronic respiratory challenges

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