Illness
Cystic Fibrosis
What is it? What can it lead to? What causes it?
Genetic disorder causing blocked chloride transports in cell membranes creating sticky mucus in the lungs, pancreas, liver, salivary glands, and testes. Our glands secrete thick mucus causing DM, decreased O2, chronic respiratory infections, chronic bronchitis, dilated bronchioles, and lung abscesses
Cause: Both parents have recessive gene of chromosome 7
Impaired gas exchange
Epiglottitis
what is the priority nursing intervention?
Inflammation of the epiglottis, the valve that separates the traches from the esophagus to prevent aspiration. Caused by an infection, most commonly Haemophiles influenza B (Hib) Seen in ages 2-7 the most.
medical emergency if it closes off airway- secure the airway
Hypoxemia with 100% oxygen, dense pulmonary infiltrates on CXR, abnormal lung sounds not auscultated, dyspnea,
ARDs
Edema first occurs in interstitial spaces not in airway
Pulmonary Embolism Diagnosis
Pulmonary Angiography: Direct Visualization
V-Q scan: circulation and air flow in lungs
Spiral CT: Cross section visualization
PFT: Volume of inhaled and exhaled air
PT/INR: Hypercoagulability increases risk
Cystic fibrosis diagnosis and treatment
Dx: Sweat chloride analysis, genetic testing, CXR (persistent infiltrate and increased AP diameter), ABG's- Acidosis with exacerbation
Positive expiratory pressure, active cycle breathing technique, individualized regular exercise program, Daily chest physiotherapy with postural drainage [chest percussion, vibration, and dependent drainage], bronchodilators, anti-inflammatory agents, mucolytics, abx, pancrease,
prevent mechanical ventilation if possible
surgical: lung/pancreas transplant (not definitive)
Pleural Effusion
What is it? What's the cause?
Fluid leaking into pleural space caused by increased pressure in the blood vessels (HF) or a low protein count. Can be caused by lung cancer, lung injury, inflammation, blocked blood/lymph vessels.
RSV
nursing dx?
Highly contagious respiratory virus which targets the lungs and upper respiratory systems mostly in young children. Most common before age 2, can lead to bronchitis and pneumonia.
Ineffective breathing pattern
Frequent and chronic infections, chest congestion, decreased pulmonary function, abdominal distension, GERD, rectal prolapse, steatorrhea (fat in stool), malnourishment, DM, weight loss
Cystic fibrosis
Acute bronchitis
What is it?
Treatment:
Interventions:
Viral infection of bronchioles, very contagious. Thick mucus in bronchiole tubes= narrowing causes wheezing and coughing
thin secretions, cough suppressant, pain medications
Lung cancer treatments
Chemo: prevents growth of any new cell
Radiation: kills cells with UV radiation
Photodynamic therapy: remove small bronchial tumor with bronchoscopy
Surgery: Wedge resection: taking small area
lobectomy; entire lobe
pneumoectomy; entire lung
chest tube
Pulmonary Embolism
A particle causes an obstruction in pulmonary blood flow. Usually caused by a VTE or DVT.
Lung Cancer- What are the two types? Symptoms?
Small Cell: More likely to metastasize
New cough with frank hemoptysis, rust-tinged sputum, hoarseness, chest pain, reoccurring pleural effusion/resp. infections, wheezing, weight loss, clubbing, superior vena cava syndrome (facial and upper body edema from blockage of venous return, medical emergency)
Severe respiratory distress, high pitched whistling sound, muffled voice, fever, sore throat, drooling and leaning forward, use of accessory muscles
epiglottitis
Name the respiratory conditions that are medical emergencies
Epiglottitis, tension pneumothorax, PE, superior vena cava syndrome (lung cancer)
What is the treatment for ARD's?
Mechanical ventilation, steroids, and antibiotics
Conserve fluids w/ diuretics because of pulmonary edema
Nutritional measures may also be needed
Pneumothorax
What is it?
Partial or complete collapse of lung from trauma, injury, allowing air to enter space resulting in rise of cavity pressure.
STREP
Bacterial upper respiratory infection. Key symptoms include redness and visible white patches in the back of the mouth and a sore throat. May also have swollen lymph nodes in the neck.
Chest pain (worse with deep breath or cough), hiccups, lack of breath sounds below point of injury
Pleural Effusion
When do symptoms start to occur with a pleural effusion? (mL)
300+ mL
5-15 mL of fluid is normal, 25 is considered an effusion
What does pancrealipase do?
How long do pts have to be NPO before bronchoscopy?
How do we know if a pneumothorax is worsening?
What O2 range do we want a pneumothorax patient to have?
What does a humidification tent do?
Helps with absorption of nutrients for meals. Give before meals.
4-8hrs, check gag reflex before eating.
Deviation towards unaffected side.
Above 92%
Decreases stridor
ARDS- acute respiratory distress syndrome
risks?
Nursing dx?
An inflammatory response causes larger particles to be able to go through the alveolar-capillary membrane. Fluid builds up in the alveoli which impairs oxygen from going into the blood stream and CO2 from being exhaled from the body. Edema builds around airways which compromises expansion more, lymph channels are compressed so excess fluid can’t be moved.
Smoke from a fire increases risk!!!!!!!!!!
Impaired gas exchange
Croup
Upper airway infection (typically viral) that obstructs breathing and causes a deep cough (seal-barking like) stridor, and inflammation in the upper airway.
Clinical manifestation of a seal-barking cough and stridor
Sudden onset of dyspnea, sharp stabbing chest pain, apprehension, restlessness, feeling of impending doom, cough, hemoptysis, crackles, pleural friction rub
Pulmonary embolism
What precautions do we use for RSV
Droplet and contact precautions
Viral vs bacterial
Bacterial: Strep throat (penicillin tx)
Viral: RSV, acute bronchitis?, croup,