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Special Education 519

Special Education 519. UNIT FOUR Respiratory, Circulatory, Digestive Systems Kevin Anderson Minnesota State University Moorhead 2006. Respiratory System. Respiratory Function. Structure Upper respiratory tract Lower respiratory tract Function Inspiration Expiration.

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Special Education 519

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  1. Special Education 519 UNIT FOUR Respiratory, Circulatory, Digestive Systems Kevin Anderson Minnesota State University Moorhead 2006

  2. Respiratory System

  3. Respiratory Function • Structure • Upper respiratory tract • Lower respiratory tract • Function • Inspiration • Expiration

  4. Respiratory Dysfunction • Asthma • Bronchopulmonary Dysplasia • Cystic Fibrosis

  5. Asthma • Etiology • Viral infections • Exercise • Allergies and irritants • Weather influence • Emotional factors

  6. Asthma • Prevalence • Most common chronic pulmonary disorder in children • Leading cause of death in children • 8 million U.S. children • 4.3% overall • Leading cause of absenteeism

  7. Characteristics • Asthmatic episode • Spasm of smooth muscle of bronchi • Inflammation of lining of bronchial tubes • Increased production of mucoid secretions • Wheezing • Coughing • Nocturnal asthma

  8. Diagnosis & Treatment • Diagnosis • Medical history • Physical examination • Lab work • Goals of treatment • Symptom reduction • Prevent chronic nature • Induce complete remission

  9. Interventions • Bronchodilators • Used PRN (as needed) • Relax bronchial muscles • Relieve airway obstruction • “Rescue medication” to alleviate symptoms • “Preventative” to prevent an attack • Anti-asthma medications • Reduce inflammation of airways and decrease phlegm • Improve pulmonary function • Reduce airway “hyper-responsiveness” • Environmental control • Reducing allergens and irritants • Avoidance of triggers • Immunotherapy • Non-pharmacological approaches • Natural foods, herbs, relaxation, biofeedback, breathing training

  10. Educational Implications • Inhalants • Metered-Dose Inhaler (MDI) • Powder inhaler • Nebulizer • Warning signs • Runny nose, cough, breathing changes, etc. • Emergency procedures • Emergency care plan • Look for signs of attack • Remove triggers • Reassurance • Medication • Drink clear fluids • Maintain record and supplies

  11. Emergency Response • Blue-gray lips or nail beds, fatigue from lack of breath, low level of alertness • Lack of response to medical interventions • Peak flow rate does not improve after treatment • Increased need for bronchodilators • Vomiting • Impaired function

  12. Educational Considerations • Maintain normalcy • Communication • Allow use of medical interventions as needed • Environmental concerns • Maintain physical capacity • Alternative to activity when needed • Allergy-free environment • Emotional impact • Watch for symptoms

  13. Tips for Attendance • Send child to school: • Stuffy nose with no wheezing • Mild wheezing which responds to treatment • Tolerates exercise • Lack of extra effort in breathing • Keep child at home: • Infection • Feverish • Continued wheezing • Weakness or extreme fatigue • Irregular breathing pattern

  14. Bronchopulmonary Dysplasia • Chronic respirator lung disease • VLBW • Prematurity • Leading cause of chronic lung disease in U.S. • Iatrogenic condition • Result of treatment that “force” oxygen into lungs • Leads to cellular changes, reduction in airway diameter, and increased effort to obtain oxygen

  15. Types • Mild to moderate • Bronchodilator • Diuretic • Severe • Tracheostomy • Ventilator support • Concomitant disabilities

  16. Educational Considerations • Accommodations for limited endurance • Respiratory infections • Increased breathing and effort • Language delay may require intervention • Chest percussion and medication needs • May lead to adult asthma

  17. Tuberculosis • Communicable disease • Primarily affects lungs • Children under age 3 and adolescent girls • Transmission through coughing, sneezing or laughing • Incubation period 2-10 weeks, may not develop an active case, but remain at-risk throughout life

  18. Implications • Symptoms • Fatigue or malaise • Weight loss or lack of appetite • Coughing or wheezing • Tightness in chest • Diagnosis • X-ray, skin test, sputum smear • Treatment • Medication

  19. Educational Considerations • Increasing concern in U.S. • Mostly non-communicable • May require rest periods • Stigma affects social interactions • Need for increased knowledge

  20. Oxygen Therapy • For students with chronic respiratory problems • Prevention of hypoxemia that leads to hypoxia • Promote growth rate, exercise tolerance, and chronic lethargy • Intermittent or continuous administration

  21. Considerations for Oxygen • Sources • Oxygen concentrator • Liquid oxygen • Compressed oxygen gas • Delivery • Nasal cannula • Face mask • Tracheostomy collar • Mechanical ventilation • Safety guidelines

  22. Mechanical Ventilators • Negative pressure machines • “pulling out” of abdominal wall • Used for persons with muscle weakness but normal pulmonary function • Positive pressure machines • “Inflate” lungs • Invasive or noninvasive

  23. Educational Considerations • Monitor battery power and use of electricity • Notify local electrical company and fire department • Monitor equipment and supplies • Equipment needs for students with tracheostomy • Maintain proper settings • Alarm system • Individualized alarm system • Watch for infection and illness • Safe transportation

  24. Special Considerations for Tracheostomy • Surgical opening of trachea • “trach tube” • “stoma” • Temporary or permanent • Educational considerations • “trach kit” and hygiene supplies • Emergency plan • Documentation and communication with caregiver • Communication limitations • Does not interfere in food ingestion

  25. Circulatory System

  26. Circulatory System • Cardiovascular Function and Dysfunction • Hematological Function and Dysfunction

  27. Cardiovascular Function • System • Heart • Blood vessels • Major functions • Transportation of blood • Transfer of waste products

  28. Cardiovascular Function • Heart • “Mechanical pump” that propels blood to specific location of body • Muscle tissue and series of one-way openings • Four chambers • Upper atrium receives blood • Lower ventricles pump out blood • Blood vessels • Arteries - carries oxygenated blood away from the heart to the body tissues • Veins - returns de-oxygenated blood from the body tissues to the heart

  29. Cardiovascular Function • Cardiac rate and rhythm • Rate is the speed of contractions; rhythm is the regularity of contractions • Rate and rhythm combined is known as the “pulse” • Controlled by “electrical” system working with nervous system and endocrine system • 120 beats per minute (bpm) at birth; 100 bpm at school age; 70-75 at adolescence • Blood pressure • Pressure of blood on the arterial walls • Measured by blood pressure monitor • Systole is measurement of pressure on large arteries during contraction phase • Dystole is measurement of pressure during relaxation phase • 84-120 systole and 54-80 dystole at school age; 94-140 systole and 62-88 dystole at adolescence

  30. Cardiovascular Dysfunction • Dysfunction • Rate and rhythm problems • Bradycardia • Tachycardia • Blood pressure problems • Hypertension • Hypotension • Disease or disorders • Congenital • Acquired

  31. Cardiovascular Dysfunction • Congenital heart disease (CHD) • Increased or decreased pulmonary blood flow • Obstructive disorders • Mixed blood flow • Acquired cardiac disorders (ACD)

  32. Implications • Treatment • Surgical • Pharmacologic • Preventative • Diet • Exercise

  33. Educational Considerations • Physical activity demands • Structuring day appropriately • Determining what is safe to do • Self-limiting behavior • AHA guidelines • Strenuous • Moderately strenuous • Nonstrenuous

  34. Educational Considerations • Specific health concerns • Pacemaker • Signs and symptoms • Medication regimen • Modified diets • Fluid intake • Potential infection • Medic-alert bracelets • Social issues • Invisible disease • Determination and internalization of sexual identity • Peer influences • Occupational restrictions

  35. Hematological Function • Controlled by blood - organ of body composed of different tissue and specific function • Consists of plasma and formed elements • Plasma - clear liquid portion of blood • Formed elements - cellular portions floating in plasma • Blood cells formed in blood-forming organs (red bone marrow and lymphatic organs) • Only “organ” of body that is “fluid”

  36. Hematological Function • Plasma • 92% water; 8% protein, metabolites, and ions • Maintains “homeostasis” • Moving blood cells throughout body • Transporting nutrients • Maintaining acid-base balance of body • Removal of wastes • Formed elements • Red blood cells - carries oxygen • White blood cells - fights infection • Platelets - aids in clotting of blood

  37. Hematological Dysfunction • Red blood cells - oxygen deprivation • White blood cells - development of infection • Platelets - bleeding disorders

  38. Hematological Dysfunction • Disorders of red blood cells • Anemia - decrease or deficient concentration of red blood cells resulting in inadequate oxygenation of cells • Iron deficiency anemia - insufficient iron altering hemoglobin production • Sickle-cell anemia - abnormal forming of hemoglobin • Lead poisoning - acquired toxic condition due to concentration of lead or lead compounds in red blood cells

  39. Implications • Excessive bleeding • Invisible conditions • Need for replacement factor therapy • Contact with parent or medical personnel • Impact on physical endurance

  40. Educational Considerations • Teacher awareness and general understanding of condition • Fatigue and stamina issues • Encourage participation as possible • Provide rest breaks • Energy conservation activities • Absenteeism • Pain issues • No major diet restrictions • Potential for infection • Potential for intellectual impact • Use of science curriculum for education • Occupational goals

  41. Hematological Dysfunction • Disorders of white blood cells • Affects general health status and body’s ability to fight infection - leukemia is most common disease • Disorders of platelets and coagulation • Affects body’s blood clotting mechanism - thrombocytosis causes blood clotting in blood vessels • Thrombocytopenia is most common cause of bleeding disorders • Hemophilia is most common bleeding disorder

  42. Digestive System

  43. Digestive System • Gastrointestinal Function and Dysfunction • Urinary Function and Dysfunction

  44. Gastrointestinal System • Structures • Mouth • Throat • Stomach • Intestines • Accessory organs • Functions • Ingestion • Digestion • Absorption • Elimination

  45. Components • Upper GI • Mouth • Pharynx • Esophagus • Stomach • Lower GI • Small and large intestines • Anus

  46. Function • Layers • Mucosa - secretes mucus • Submucosa - absorbs nutrients • Muscles - peristalsis • Outermost tissue - lubrication • Catabolism • Mechanical actions • Breaking down food • Propelling food • Chemical actions • Conversion by enzymes

  47. Mouth and Salivary Glands • Oral cavity • Mastication - chewing and salivation • Digestive enzyme • Semisolid - bolus • Deglutition - swallowing

  48. Pharynx and Esophagus • Tongue • Pharynx • Esophagus • Soft palate • Epiglottis • Lower esophageal sphincter • Gastroesophageal reflux

  49. Stomach • Continued breaking down of bolus • Kneading action • Enzymes from gastric glands • Mixed with water, hydrochloric acid, and mucin • Water dilutes secretions • Hydrochloric acid softens bolus and kills bacteria • Mucin - protects lining of stomach - prevents ulcers • “Chyme” exits through pyloric sphincter

  50. Small Intestine • Long and narrow • Plicae increase surface capacity • Villi absorb nutrients • Parts • Duodenum • Jejunum • Ileum

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