lOMoARcPSD|46061986

Respi - Lecture notes

Bachelors in Science in Nursing (Ateneo de Zamboanga University)

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 lOMoARcPSD|46061986

Resp%at(y dis(d-s
MR. ARCEO (TOPRANK)
THORACENTESIS
PURPOSE:
MAIN ¥ Aspirate
SUB ¥ Instill
SUPPORTING DURATION:
PREPARATIONS:
THE RESPIRATORY TRACT ¥ Diet:
¥ Medications given:
Primary function:
¥ Medications withheld:
o Provides
o Removes SPUTUM COLLECTION
Secondary function: PURPOSE: Confirm
o Sense of PREPARATION
o Produces ¥ Diet:
o Maintains ¥ Procedure:
¥ Materials:
DIAGNOSTICS AND LABORATORIES DURING PROCEDURE
CHEST X-RAY ¥ Timing
PURPOSE: Determines ¥ Meals
CONTRAINDICATION: ¥ Avoid
¥ Amount
¥ Unless:
¥ If conscious:
¥ Assess:
¥ If unconscious:
PREPARATIONS
POST-PROCEDURE
¥ Materials-
¥ Viability
¥ Diet-
¥ Properly (CLT)
¥ Medication-
¥ Oracare
DURING
¥ Position-
¥ Instructions- RESPIRATORY DISORDERS
BRONCHOSCOPY EPISTAXIS
TYPES:
PURPOSE
¥ Anterior
¥ Direct visualization of
¥ Posterior
¥ Obtain
¥ Diagnose POSITION:
¥ Bronchial ¥ Prevents
APPLY
¥ washing
¥ Pressure:
¥ Removal of
¥ Provide
PREPARATION:
MEDICATIONS
¥ Medications:
¥ Route
¥ Diet:
NASAL PACKING
¥ Materials (at bedside):
¥ Duration
POST-PROCEDURE
¥ Diet
Diet:
¥ Avoid
NPO until
HOME INSTRUCTIONS
¥ Time:
¥ Assess: ¥ Activity
¥ Foods
¥ AFTER NPO:
WATCH OUT FOR TONSILITIS/ADENOIDITIS
¥ Breathing: RISK FACTORS:
¥ Circulation: ¥ Food
Blood-tinged Sputum vs.hemoptysis ¥ Temperature
CAUSATIVE AGENT

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 lOMoARcPSD|46061986

Resp%at(y dis(d-s
MR. ARCEO (TOPRANK)
DIAGNOSTIC TEST: ANTICHOLINERGIC AGENTS
S/SX: - Indication:
¥ Throat CORTICOSTEROIDS
¥ Temperature - Fast-acting?
¥ sleep MEDICAL MANAGEMENT (LONG-ACTING):
¥ Swallowing - LONG-ACTING BETA AGONISTS
¥ tonsils o Indication:
INTERVENTIONS CORTICOSTEROIDS
¥ Diet - Indication:
¥ Gargle o WOF:
INDICATIONS FOR TONSILLECTOMY: ANTILEUKOTRIENES
PREPARATIONS - Indication:
¥ Report - Timing:
POST-OPERATION: - OF (DIET AND ACTIVITY) TOPERANK
¥ Positions: |NURSING
¥ Apply: METHYLXANTHINES
¥ Activities: - Indication:
WATCH OUT FOR: - Therapeutic levels:
POST-OPERATION: - Diet:
¥ AVOID: USE OF METERED-DOSE INHALER
o Dark-colored - Inhaler
o Dairy products - Patient
o Soda/citrus-flavored drinks - Aftercare:
¥ DIET: SPACERS
¥ MEDICATIONS: - Indication
¥ MOUTH CARE: - Rationale
¥ Avoid NURSING MANAGEMENT: PREVENT/AVOID
BRONCHIAL ASTHMA TRIGGERS
CAUSE: - Pillow and mattress covers:
PATHOPHYSIOLOGIC MECHANISMS - House cleaning
- I - Pests:
- E - Rooms:
- M - Avoid adjunctive non-allergic
TYPES triggers:
- Intrinsic o Smoke:
- Extrinsic o Temperature
SIGNS AND SYMPTOMS (EARLY) o Humidity
- Reflex: o Odors:
- O2 level: PNEUMONIA
- Respiratory rate: - inflammation of
- Respiratory depth: CLASSIFICATIONS OF PNEUMONIA
- Breath sound: A. Health care-associated pneumonia
- ABG: - Criteria:
POSITION: B. Community-acquired pneumonia
SIGNS AND SYMPTOMS (LATE) - Criteria:
- Skin color: C. Hospital-acquired pneumonia
- Fingers: - Criteria
- Nail beds: D. Ventilator-associated pneumonia
MEDICAL MANAGEMENT (FAST-ACTING): - Criteria:
- SHORT-ACTING BETA AGONISTS INTERVENTIONS:
o WOF: A. Airway patency
o ¥ Fluids

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 lOMoARcPSD|46061986

Resp%at(y dis(d-s
MR. ARCEO (TOPRANK)
¥ Oxygen delivery labored breathing >- increased
¥ Exercises: blood to the face
¥ PRN: o Hypoxia >- polycythemia
B. Activity: vera >- pinkish appearance
¥ Position DIAGNOSIS:
C. Diet: - Results:
D. Psychosocial: ¥ NURSING INTERVENTIONS
PREVENTION - Smoking:
¥ If with secretions and shallow - Coughing:
breaths, - Breathing:
¥ If smoking and alcoholic, - DIET
¥ If immunocompromised o Meals (timing and
¥ If shallow breaths, composition)
¥ fI advanced age, o fluids
DIFFERENCE WITH TRACHEOBRONCHITIS EXERCISE
= SIMILARITY WITH TRACHEOBRONCHITIS ¥ Programs
¥ If bacterial ¥ During exercise,
¥ If viral Oxygen therapy:
CHRONIC OBSTRUCTIVE PULMONARY ¥ Mode:
DISEASE MEDICATIONS:
¥ Diuretics
RISK FACTORS:
¥ Vaccination
Sex:
ENVIRONMENT
Medical Hx:
Vice:
Environmental: PNEUMOTHORAX
Genetics: - Breached pleural space exposure to
positive pressure à accumulation of air in
the intrathoracic cavity à decreased
lung expansion à atelectasis
CAUSE:
RIB FRACTURE FLAIL CHEST
CHRONIC BRONCHITIS: RIBS
PAIN
¥ Mucus production that is trapped =
Chronic, productive cough; crackles; PRIORITY
hypoxemia; hypercapnia; respiratory MGT
acidosis ¥ Closed pneumothorax
o Hypoxemia >- cyanosis ¥ Open pneumothorax
o Hypoxemia >- pulmonary - Sign:
vasoconstriction >- cor ¥ Spontaneous pneumothorax
pulmonale - Related to:
¥ Airway narrowing = Wheezes; ¥ Tension pneumothorax
dyspnea - Pathognomonic sign:
EMPHYSEMA
¥ Decreased airway compliance >-
narrowing = dyspnea, chronic cough
¥ Decreased lung compliance -> lung
distention = dyspned -> prolonged
lung distention >- barrel chest
¥ loss of alveoli elasticity >- alveoli
distention = hypoxia, hypercapnia >-

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 lOMoARcPSD|46061986

Resp%at(y dis(d-s
MR. ARCEO (TOPRANK)
PLEURAL EFFUSION ¥ If nurse suspects recovery,
¥ Hemothorax ¥ Report to physician à anticipate
¥ Pyothorax/empyema SIGNS AND chest X-ray
SYMPTOMS o If lungs are not yet
¥ LOC: expanded,
¥ Respiratory rhythm: o If lungs are expanded,
¥ Respiratory rate: § Patient
¥ Breath sounds: §
¥ Fremitus: Dressing
¥ Chest contour:
¥ Percussion:
¥ Hydrothorax
DIAGNOSTIC PROCEDURES
¥ Chest X-ray:
¥ Lung ultrasound:
¥ Thoracentesis:
REMOVE OBTAIN RELIEVE

CHEST DRAINAGE SYSTEM: returns

¥ Drainage chamber: collects
¥ Water seal chamber: prevents
¥ Suction chamber: maintains

NURSING INTERVENTIONS
¥ Ensure patency
¥ Monitor drainage
- Expected
- Too much
- Recovered
¥ Monitor water seal chamber
- Expected
- Abnormal
- Recovered
- Depth of Tube
¥ Monitor suction control chamber
- Expected
- Wet
- Abnormal
¥ Proper placement of the chest tube
¥ Keep at bedside
- Clamp
- Non-occlussive dressing
¥ Patient position:
¥ Keep at bedside
- Bottle of sterile water
- Bandage scissors

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