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Chapter 86 Respiratory Disorders

Chapter 86 Respiratory Disorders. The Respiratory System. Respiration requires a patent airway for oxygen to reach the lungs, and lungs that are physically capable of exchanging oxygen for carbon dioxide. The respiratory system consists of the upper and lower respiratory tracts. Pulmonologist

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Chapter 86 Respiratory Disorders

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  1. Chapter 86Respiratory Disorders

  2. The Respiratory System • Respiration requires a patent airway for oxygen to reach the lungs, and lungs that are physically capable of exchanging oxygen for carbon dioxide. • The respiratory system consists of the upper and lower respiratory tracts. • Pulmonologist • Respiratory therapy • Respiratory therapists • Respiratory technicians

  3. Laboratory Tests • Sputum specimen • Lavage specimen • Throat culture • Blood gas determinations • Level of arterial blood gases (ABGs) • Partial pressure of oxygen (PaO2) • Partial pressure of carbon dioxide (PaCO2) • Hydrogen ion concentration (pH) of the blood

  4. X-ray and Fluoroscopy Examinations • Chest x-ray (CXR) • Computed tomography (CT) scan • Lung scan • Lung perfusion scan • Pulmonary angiography

  5. Other Diagnostic Tests • Magnetic resonance imaging (MRI) • Pulmonary function test (PFT) • Bronchoscopy • Skin and blood tests • Skin tests • Purified protein derivative (PPD) tuberculin test • Blood tests

  6. Question Is the following statement true or false? The spirometer can be used interchangeably with the incentive spirometer.

  7. Answer False The spirometer should not be confused with the incentive spirometer. The spirometer measures pulmonary function. The incentive spirometer also measures pulmonary function, in a sense, but it is used by the client. The incentive spirometer helps the client, such as after surgery, to perform respiratory exercises to maintain lung function.

  8. Common Medical Treatments • Postural drainage • Chest physiotherapy (CPT) • Inhalations

  9. Common Surgical Treatments • Thoracentesis • Paracentesis • Thoracotomy • Caring for the client after chest surgery • Chest suction • Closed water-seal drainage • Nursing implications

  10. Question Is the following statement true or false? During paracentesis or thoracentesis, the nurse must take the client’s blood pressure and pulse immediately after the procedure and every 15 minutes until readings are stable.

  11. Answer True A large amount of fluid withdrawn (>1,000 mL) during paracentesis or thoracentesis can result in vasodilation and hypovolemia (decreased circulating fluid volume). These situations can cause syncope (temporary loss of consciousness, fainting) and shock. The nurse should take the client’s blood pressure and pulse immediately after paracentesis or thoracentesis and every 15 minutes until readings are stable and within acceptable levels.

  12. Question Is the following statement true or false? It is perfectly safe for a client with a respiratory system disorder to receive a narcotic.

  13. Answer False If a person with any disorder of the respiratory system is receiving a narcotic, be particularly watchful for respiratory depression. Depressed respirations can be an undesirable side effect in anyone, but the situation is most dangerous for the client whose respiratory function is already compromised.

  14. Nursing Process • Data collection • Noting alterations in respiratory status • Aspiration • Hyperventilation • Hypoxia • Hypoxemic hypoxia • Circulation hypoxia • Anemic hypoxia • Histotoxic hypoxia

  15. Nursing Process (cont’d) • Planning and implementation • Relieving respiratory distress • Orthopneic position • Turning, coughing, and deep breathing • Administering respiratory treatments • Postural drainage • Breathing exercises and incentive spirometer • Breathing treatments, oxygen

  16. Nursing Process (cont’d) • Administering nasal treatments • Suctioning to remove oral–nasal secretions • Dysrhythmia and desaturation • Evaluation

  17. Possible Alterations in Respiratory Status • Biot’s respirations • Apnea • Central apnea • Obstructive apnea • Mixed apnea • Adult sleep apnea • Kussmaul’s respirations • Dyspnea • Orthopnea • Tachypnea • Hyperpnea • Bradypnea • Hypoventilation • Hyperventilation • Cheyne-Stokes breathing

  18. Infectious Respiratory Disorders • The common cold or acute rhinitis • Streptococcal sore throat • Influenza • Laryngitis • Bronchitis • Lung abscess

  19. Infectious Respiratory Disorders (cont’d) • Pneumonia • Bacterial pneumonia • Viral pneumonia • Pneumocystis carinii pneumonia • Chemical pneumonia • Aspiration pneumonia • Pleurisy • Histoplasmosis

  20. Infectious Respiratory Disorders (cont’d) • Tuberculosis (TB) • Latent and active TB • Pulmonary TB • Pott’s disease and miliary TB • Atypical TB • Multidrug-Resistant TB • Empyema • Acute empyema • Chronic empyema

  21. Question Is the following statement true or false? The number of cases of TB has decreased dramatically during the last several decades because of the developments in science and medicine.

  22. Answer False The number of cases of TB has increased dramatically during the last several decades because of the increase in multidrug-resistant TB organisms, increasing numbers of persons with HIV infection, substance abuse, homelessness, and poor compliance with medication treatment plans.

  23. Chronic Respiratory Disorders • Snoring • Sleep apnea syndrome • Allergic rhinitis • Pneumoconioses • Chronic obstructive pulmonary disease • Bronchial asthma, bronchiectasis, chronic bronchitis, pulmonary emphysema • Acute respiratory distress syndrome

  24. Question Is the following statement true or false? The continuous positive airway pressure apparatus is commonly used to assist persons with allergic rhinitis.

  25. Answer False The continuous positive airway pressure (CPAP) apparatus is commonly used to assist persons with sleep apnea. This machine looks like an oxygen-delivery system and is used at night so the person can sleep. It delivers air, and sometimes oxygen, to the person at a continuous positive pressure that holds the alveoli open. This positive pressure prevents respiratory obstruction, increases oxygenation, and reduces breathing effort.

  26. Trauma • Absence of air exchange • Chest trauma • Respiratory complications in drug poisoning • Drowning/near drowning • Pneumothorax

  27. Neoplasms • Benign neoplasms • Lung cancer

  28. Disorders of the Nose • Inflammatory disorders • Sinusitis • Acute sinusitis • Chronic sinusitis • Structural disorders • Deviated septum • Nasal polyps • Plastic surgery (rhinoplasty) • Care of the client undergoing nasal surgery

  29. Disorders of the Nose (cont’d) • Nasal trauma • Fractures • Epistaxis

  30. Disorders of the Throat • Trauma • Aspiration of foreign bodies • Cancer of the larynx • Nursing considerations • Communication and speech • Identification as a laryngectomee • Supportive resources • Water dangers

  31. End of Presentation

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