DOC PREVIEW
respiratory

This preview shows page 1-2-3-4 out of 12 pages.

Save
View full document
View full document
Premium Document
Do you want full access? Go Premium and unlock all 12 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 12 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 12 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 12 pages.
Access to all documents
Download any document
Ad free experience
Premium Document
Do you want full access? Go Premium and unlock all 12 pages.
Access to all documents
Download any document
Ad free experience

Unformatted text preview:

Nursing Care for patients with Respiratory Dysfunction Nancy Finch May 22, 2003ReviewAnatomy of upper respiratory tractAnatomy of lower respiratory tractFunction of the respiratory system-- ventilation-- diffusion/perfusionAge changes pages 372-382Assessment Health HistoryChief complaint--reason for seeking healthcarecc…dyspnea, cough, hemoptysis, sputum production, pain, fatigue, weaknessAssess--respiratory signs/symptomsclubbing of the fingers, cyanosis, chest pain, cough,wheezing, dyspnea pages 382-393AssessmentRisk factors…smoking, family hx, personal hx, occupation, allergens/environmental pollutants, recreational exposurePsychosocial factors….-strategies used for coping-signs of anxiety, anger, withdrawal, isolation, noncompliance, denial-support sys…family, friends, communityPhysical ExamInspectionPalpationPercussionAuscultationAdventitious breath sounds…..crackles, wheezes, friction rubsDiagnostic Evaluationculturessputum studiespulmonary function test... PFTsarterial blood gas…. ABGspulse oximetryimaging…..CXR CT scansDiagnostic Evaluationfluoroscopic studies….ba swallow, angiolung scansbronchoscopythoracoscopythoracentesisbiopsy….pleural, lung, lymph nodespages 393-400Nursing management Pre/Post invasive procedureseducation…dec fear/anxietyNPO...6 hr before test (risk of aspiration re: cough reflex blocked)informed consentpre meds (atropine, sedation, opioids)conscious sedationpost--awake, alert, oriented, +cough reflex, +swallow, monitor resp status, vsNursing Interventions caring for pts resp dysfunctionFacilitate ventilationpromote removal of secretionsprovide supplemental O2decrease work of breathingeducate for self-careUpper airway infectionsCommon cold--nasal congestion, sore throat, coughrhinitis, pharyngitis, laryngitis, chest coldcontagiousrhinovirus---40% all coldsSx last 5 days---2 weeksTx symptomsUpper airway infectionsCold sores--- “herpes simplex virus”incubation period 2-12 daystransmitted by direct contactmay subside spontaneously 10-14 dysTx--Acyclovir (antiviral agent)Prevention URIIdentify strategies to prevent infectionhand washingavoid crowds/ individuals with known illnessflu vaccine, esp the elderlypractice good health habitsavoid allergensHome Care Teaching Checklist p. 403Upper airway infectionsAcute sinusitisaffects-- 32 million USSx--pressure, pain over sinus, purulent nasal secretionsTx- infection, shrink nasal mucosa, relieve painAmoxcillin, Bactrim DS, Septra DS, decongestantsnursing mng-- teach self-careChronic sinusitisSx persist for more than 8 weeks/adultetiology-- narrowing/obstruction of the sinuses that drain into the middle meatusblockage due to infect, allergy, structural abnormalityclinical--impaired mucociliary clearance, ventilation, cough, postnasal drip, chronic hoarseness, periorbital headaches,facial painfatigue, nasal stuffiness, decrease taste/smellMedical/Nsg managementTx--antimicrobial agents, Ceftin, Suprax, Biaxin, Cefzil, Zithromax, LorabidSurgery--correct structural deformities, excise/cauterize nasal polyps, I&D sinuses, correct deviated septum, remove tumorsNursing care--teach self-carepromote sinus drainage, increase humidity (steam bath, hot shower, facial sauna)inc fluid intake, compliance to medsAcute pharyngitisfebrile inflammation of the throatcaused by a virus---70%A streptococci = strep throatcomplications if not treated (otitis media, abscess, rheumatic fever, mastoiditis, nephritisclinical--fiery-red pharyngeal membrane/tonsils, lymphoid follicles swollen with exudate, enlarged tender cervical lymph nodes, fever, malaise, sore throatMedical/Nsg managementTx- antibiotics for at least 10 days, PCN, Erythromycin, cephalosporins, macrolidesanalgesics for pain, Tylenolantitussive meds with Codeine (Robitussin DM, Hycodan)Nursing care-- tx fever, rest, obs skin for rash, saline gargles, ice collar, compliance to meds, liquid/soft diet, oral fluidsChronic pharyngitisCommon in adults who work or live in dusty places, use the voice to excess, suffer from chronic cough, habitually use alcohol and tobaccoclinical--c/o of constant sense of irritation or fullness in the throat from mucus, dysphagiamedical mng--relieve sx, avoid exposure to irritants, correct resp conditions that may contribute to chronic coughTx--nasal spray, antihistamine decongestants, pain meds---ASA, TylenolNursing managementTeach--self-careprevent spread of infectionavoid contact with others until fever subsidesavoid alcohol, tobacco, second hand smoke, environment/occupational pollutants, cold exposure, wear face masks,fluids, saline gargle, lozenges, medsTonsilitis/adenoiditisTonsils--lymphatic tissue on either side of the oropharynx. site of acute infectionsAdenoids--abnormally large lymphoid tissue mass near center of nasopharynxClinical--sore throat, fever, snoring, dysphagia, mouth breathing, earaches, freq colds, bronchitis, bad breath, voice impairmentClinical--infect, nasal obstruction, mastoiditis, otitis mediaMedical managementTonsillectomy for recurrent infections, severe hypertrophy or peritonsillar abscess, obstruction endangering the airwayenlargement alone not an indicationusually T/A/adenoidectomy performed togetherantibiotics prior to surgery if infectedantibiotics for 7 days after surgery, PCN, amoxicillin, erythromycinNursing managementRisk of hemorrhage immediate post op/recoveryprone position with head to the sideobs for swallow reflex to returnice collar for comfortmonitor expectoration of mucus/bloodbright red bleeding/vomitus with bloodincreased pulse, temp, restlessnessreturn surgery--suture/ligation of bld vesselNursing managementPost op T/A--continuous observationice chips, water to drinkteach self-care--usually short hosp stay, make sure pt/family know s/s hemorrhage, usu hemm in the first 12-24 hours, notify MD of bleedingmonitor breathing/rest rate/airwaymonitor s/s infection, fevercompliance to meds, antibioticsNursing managementpain managementactivity/rest/sleepnutrition--liquid/semi-liquid diet, avoid spicy food, may restrict milk/productsoral hygiene--alkaline mouthwash, warm saline solutions to rinse mouthCare of the pt with upper airway infectionnursing process---assessment, nsg dx, plansnursing interventions--maintain patent airway--promote comfort--promote communication--encourage fluid intake--teach pt self-care—compliance, vaccine, avoid exposureprevention strategies--continuing care –home health referral, f/u primary care healthcare provider, MD, NPObstruction and trauma of


respiratory

Download respiratory
Our administrator received your request to download this document. We will send you the file to your email shortly.
Loading Unlocking...
Login

Join to view respiratory and access 3M+ class-specific study document.

or
We will never post anything without your permission.
Don't have an account?
Sign Up

Join to view respiratory 2 2 and access 3M+ class-specific study document.

or

By creating an account you agree to our Privacy Policy and Terms Of Use

Already a member?