NU
List the upper respiratory tract and the lower respiratory tract?
The upper respiratory tract includes the nose and sinuses, mouth, pharynx, and larynx above the vocal cords.
The larynx below the vocal cords and the trachea are considered lower airway structures but are frequently involved in upper airway conditions.
Strep Throat is also known as?
-Pharyngitis (inflammation of the pharynx), usually called a sore throat
What is a term called when the voice box is inflamed?
•Laryngitis
*Inflammation of the larynx with diminished voice or hoarseness
I am known as the blue bloater
I am known as the pink puffer
What am I ?
-chronic bronchitis
-emphysema
What acid base imbalance is COPD associated with?
Resp Acidosis
-Nutritional Suggestions for Patients With Chronic Obstructive Pulmonary Disease? tip:(Nutrition is very important for patients with COPD because the extra work of breathing uses more calories and anorexia may be present)
- page 305
Drink six to eight glasses of noncaffeinated fluids per day to keep mucus thin and easier to cough up. Check with your health care provider if you are on fluid restrictions.
• Rest before eating.
• Avoid overeating and avoid foods that cause gas or bloating because a distended stomach may make breathing more difficult.
• Eat four to six small meals a day rather than three regular meals, to decrease stomach fullness and reduce fatigue.
• Eat a well-balanced diet with adequate protein.
• Avoid lying down for an hour after eating.
• If you become short of breath while eating or right after meals:
• Take small bites and chew food slowly.
• Choose foods that are easy to chew.
• Use your oxygen cannula while you eat.
• Take in sufficient calcium via dairy products, vegetables, and supplements—steroid medications put you at risk for osteoporosis.
• Cook when feeling most energetic; make extra portions and freeze them for easy, quick, reheatable dinners.
What are some signs of resp distress?
Nasal flaring, accessory muscle use, SOB, fast breathing, assess v/s, lung sounds, Assess skin color
Normal O2 sats range for COPD
>87%
S/S of COPD
1. Cough
2. Exertional dyspnea
3. Wheezing and crackles
4. Sputum production
5. Weight loss
6. Barrel chest (emphysema)
7. Use of accessory muscles for breathing
8. Prolonged expiration
9. Orthopnea
10. Cardiac dysrhythmia
11. Congestion and hyperinflation on chest x-ray film (Fig. 47.9)
12. ABG levels that indicate respiratory acidosis and hypoxemia
13. Pulmonary function tests that demonstrate decreased vital capacity
-List factors that can increase your risk for developing an respiratory infection?
- Older than 65, immune compromised, cigarette smoking, chronic renal disease, DM, congenital cardiovascular disease, residing in extended care facilities (Powerpoint page 7)
Teaching for a pt dx with TB?
-wear mask
-complete medications
Patients and families should be educated about the importance of medication compliance and the basic principles of infection control: covering the mouth when coughing or sneezing, disposing of tissues in plastic bags, practicing good hand hygiene, and wearing a mask when in contact with crowds until medication effectively suppresses the infection. Sputum examinations are required monthly during treatment.
List three characteristics of sputum and the possible causes
-Pulmonary infection
-Pulmonary edema
-Pneumococcal pneumonia
-Chronic bronchitis, Emphysema
-PI-yellowish green or gray-yellow with foul odor
-PE:frothy,pinkish or blood tinged
-PP: scant,sticky,rust colored
-CB, E: Thick,tenacious and ropey; difficult to cough up
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What are the tx for pharyngitis and laryngitis? (list 4)
• Conservative measures
Ø Rest
Ø Warm saline gargles (1⁄2 to 1 tsp of table salt to a glass of
warm water)
Ø Throat lozenges or antiseptic spray
Ø Plenty of fluids
Ø Mild analgesic for aches and pains
Bacterial pharyngitis requires antibiotic therapy,
particularly if the infecting organism is Streptococcus.
-Treatment for pulmonary embolism?
-Oxygen therapy is initiated to decrease hypoxia. Treatment depends on the size and location of the embolus and the stability of the patient. Intravenous heparin is usually begun in patients
-PE is to remain calm, stay with the patient, raise the head of the bed to a high Fowler position, begin O2 therapy to maintain O2 saturation above 92%, assess vital signs, notify the health care provider of the patient’s symptoms, start a peripheral IV, and administer IV or subcutaneous heparin when it is ordered.
What are some treatments for Sinusitis/Rhinosinusitis?
Hot, moist packs over the sinus area can be
helpful.
Inhaling moist steam thins secretions and helps to promote drainage.(assess drainage)
Medications to promote vasoconstriction, reduce swelling, and promote drainage.
Decongestants
Infection may be treated with an antibiotic or antiinfective agent, often for at least 10 days.
Rest, reduced stress, a balanced diet, and control of allergies can help prevent recurrence.
Analgesics are given for pain.
Fluid intake should be increased and dairy product intake lowered to decrease the thickness of secretions.
What are the symptoms of pharyngitis and laryngitis?(list 4 )
•Symptoms include
Ø Dry, “scratchy” feeling in the back of the throat
Ø Mild fever
Ø Headache
Ø Malaise
Ø Throat, tonsils, palate, and uvula may be involved and will
be reddened
Laryngitis, the voice may become hoarse or absent.
- What is Epistaxis?
- What teachings would you include for your patient with this dx?
- Nosebleeds
-Sit forward, apply direct pressure for 10-15 min, cold compress or ice; if bleeding continues, repeat process for another 10-15 min; if bleeding still continues, go to ED for cautery
-Once bleeding is stopped, avoid bending over, do not blow nose, do not pick at or rub nose for 24 hours
- After having recurrent tonsillitis, what surgery may be recommended?
- What complication would you want to inform your patient about after having this procedure?
-Tonsillectomy
-Excessive swallowing may indicate bleeding even if dressing remains dry
-What is pulmonary embolism?
-General s/s of pulmonary embolism?
-pulmonary=lung, embolism =clot. Occurs when a pulmonary vessel is plugged with a mass or clot.
-The general symptoms are respiratory distress with dyspnea, chest pain, cough, hemoptysis, and anxiety. Hypotension, tachycardia, or confusion may occur. A sudden onset of dyspnea and a drop in SpO 2 in a patient at risk of thrombus formation is very suggestive of PE.
-Excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs.
-What surgical procedure is used to remove the fluid?
-How is this procedure done?
-Pleural Effusion
-The HCP may perform a thoracentesis (removal of fluid from the pleural cavity) for diagnostic tests or symptom relief.
-Page 263 table thoracentesis: Monitor respirations and skin color during procedure. Assist patient to remain still. Chest radiograph may be ordered after procedure. Monitor vital signs q15min for 1 h or until stable, then routinely. Auscultate breath sounds frequently. Rapid breathing, cyanosis, hemoptysis, changes in breath sounds, and tachycardia should be reported immediately.
-How is TB spread?
-S/S of TB (list 3)
- What test is used to dx TB?
- Airborne (N95)
- Typical symptoms are cough, low-grade fever in the afternoon, anorexia, loss of weight, fatigue, night sweats, and sometimes hemoptysis (blood in sputum)
-A diagnosis of active TB is established when the tubercle bacillus has been found in the sputum or gastric washings
-Mantoux, chest x ray, sputum
-What is a thoracentesis?
-Which disorder may a person need to do thoracentesis?
-What complications can occur from this procedure?
-To remove pleural fluid, instill medication, or obtain fluid for diagnostic studies
-pleural effusion
-hemorrhage, puncuture of the lungs(listen to breath sounds), infection
- What is asthma?
- This occurs when asthma has gotten worst and not responding to tx, (medical emergency)?
-Asthma is a chronic lung disease characterized by reversible airway obstruction, airway edema or swelling from inflammation, and increased airway hypersensitivity to a variety of stimuli
-Unrelieved asthma attacks become status asthmaticus and are very serious. Respiratory distress without wheeze is an ominous sign for the asthma patient; this suggests further constriction with very little air movement.
-Inflammation of the pleura, the membrane that covers the lungs and lines the inside of the chest cavity
- when does this pt experience pain?
-TX?
-Pleurisy/ Pleuritis
-Pleuritic pain is sharp and abrupt in onset and is most evident on inspiration, pleural friction rub may be heard.
-Treatment is aimed at the underlying cause and at providing pain relief. Lying on the affected side or splinting the affected side during coughing may provide some relief. An intercostal nerve block may be performed for severe pleuritic pain.