DEVICES
Most common use. Goes into the nasal passages of the pt. Able to talk and eat fine. Low flow O2
Nasal cannula
sign of CHRONIC hypoxia
Finger and toe clubbing
What are vesicular breath sounds
low pitched, soft sound on EXPIRATION. Heard over most of the lung
These come before steroids! Dilates the bronchioles
Bronchodilators
Sudden onset of hypoxia can be caused by this lab value
Low hemoglobin (anemia) <12
Must inflate bag halfway before applying. PT does not rebreathe the Co2 that is expelled due to one way valve.
Non- rebreather
S&S of HYPOXEMIA
pallor, cyanosis, ANXIETY, restlessness, confusion, drowsiness, chest pain, anorexia, lack of energy, constipation, decrease libido. Can be detected in ALL body systems.
what are brochial breathe sounds?
Loud high-pitched sounds heard primarily over trachea
Breath activated delivery systems
Hint; PT needs to rinse mouth out after.
dry powder inhaler
Guide the PT in using an incentive spirometer
Exhale- lips cover the mouthpiece- inhale and try to get it to the highest setting you can. Hold for as long as they can. Expands the lungs.
what is CPAP? What is it used for?
Continuous Positive Air Pressure. Used for sleep disorders (sleep apnea) noninvasive, uses a mask.
REMEMBER: Pt’s are often non-compliant due to comfort/claustrophobia.
S&S of peripheral cyanosis
only skin is involved
cold and clammy feeling
no clubbing
cyanosis reduces when warmed up
oxygen improves cyanosis
What are bronchovesicular lung sounds?
Medium pitched blowing sounds heard over the major bronchi
Delivered a controlled dose of medication. uses a compression canister
Meter dose inhalers
2 position techniques that can assist PTs with breathing. describe them
Cupping- cupping you hand and patting their back to help break up mucus
Tripoding- The tripod position involves sitting and leaning forward with the arms resting on the knees. It may help reduce breathlessness and the fear that can come with it in people with chronic obstructive pulmonary disease
Covers PTs nose and mouth. Watch Claustrophobia. Check for skin breakdown around the mouth and face from the straps. Humidifier attachment available.
Hint: 5-8 L
Simple mask
S&S of central cyanosis
Arterial desaturation
warm temp
finger clubbing
ABG PO2 low
Skin, mucus membranes and oral cavity are blue tinted
oxygen improves the actual condition but not the cyanosis
Exercise worsens cyanosis
Proper way to listen to lung sounds?
ZIG/ZAG and flare out
Demonstrate
Disperses fine particles of liquid medication into the lower airway.
Think- mist
Nebulizer
4 ways a nurse educates a PT on breathing better.
Deep Breathing- In threw nose/out threw mouth. Controlled breathing
Incentive Spirometer- See above for directions. Done one 5-10 times an hour. (Every commercial while watching TV)
Pursed lip breathing- You slowly inhale through your nose and gently exhale through pursed lips. Pursed lip breathing makes it easier to perform physical activities and reduces stress. Controlled breathing. breathing exercise that helps you slow your breathing and inhale and exhale more air. Expel more CO2 and take in more Oxygen- better gas exchange
Coughing- voluntary coughing
MOST accurate and precise way to administer oxygen
Venturi mask
A major sign of hypoxia, often overlooked as something else.
Confusion
this is common with COPD. The chest has been expanded for so long that it STAYS that way.
Barrel chest
Describe it
DAILY DOUBLE
4 classifications of medications for coughing and breathing and what they do.
Antihistamines- blocks release of histamine that is released when there is inflammation- allergic reaction.
Antitussives- prevents coughing- used in nonproductive coughing. Used for PT comfort.
Expectorants- Increases productive cough- liquify lower respiratory track secretions, lowers viscosity of mucus.
Decongestive- constricts blood vessels in nasal passages to reduce inflammation.
What lifestyle changes can the PT make to help their breathing at home
Quit smoking
Sleep sitting up
Change jobs if the Environment is the problem
Clean house- dust