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KF - Resp

Respiratory System Alterations

Asthma inhaled agents - admin bronchodilators before anti-inflammatory medications
Status Asthmaticus Airway obstruction that is often unresponsive to Tx, high risk of cardiac or resp arrest, admin O2, EP and systemic steroid, prepare for emergency intubation
Chronic Obstructive Pulmonary Disease (COPD) encompasses pulmonary emphysema and chronic bronchitis - not reversible (chronic resp acidosis). Admin low flow O2, in fluid intake, high cal diet, immunization for pna and flu
Pulmonary emphysema destruction of alveoli, narrowing of bronchioles, trapping of air resulting in loss of lung elasticity
Chronic bronchitis inflammation of the bronchi and bronchioles cause by chronic exposure to irritants
Cor Pulmonale rt-side HF due to pulmonary dx (think COPD)
Carbon Dioxide Toxicity secondary to increased CO2 retention. Sx: drowsiness, irritabiltiy, hallucinations, convulsions, coma, tachycardia with dysrhy
Pneumonia an inflammatory process in the lungs that produces excess fluid and exudate that fill the alveoli
Tb highly communicable airborne infection, QFT-G diag test., avoid foods containing thyamine,
Pulmonary Embolism (PE) life-threat hypoxic condition cause by a collection of particulate matter that enters venous circulation and lodges in the pulmonary vessels - thrombolytics, anticoagulants, vena cava filter
Pneumothorax a cellection of air or gas in the chest or pleural space that causes part or all of a lung to collapse due to loss of negative pressure
Hemothorax accumulation of blood in the pleural cavity (can use thoracentesis or chest tube depending)
Tension pneumothorax tracheal deviation to unaffected side
Chest Tube Complication: Air leak continuous rapid bubbling in the water seal chamber - start at chest and move down tubing to locate leak
Chest Tube Complication: No tidaling Tidaling should occur in water seal chamber - assess for kinks in tubing, assess breathing sounds (lungs may be re-expanded)
Chest Tube Complication: No bubbling Bubbling should occur in suction chamber if suction is applied - verify tubing is attached, make sure water is filled to prescribed level, increase wall suction regulator
Chest Tube Complication: Disconnect from system insert open end of the chest tube into sterile water until system can be replace
Chest Tube Complication: Pulled from patient vasaline gause - tape 3 side
Early signs of hypoxia/hypoxemia tachypnea, tachycardia, restlessness, pale skin/muscous membranes, elevated B/P, use of acc muscles, nasal flaring, adventitious lung sounds
Late signs of hypoxia/hypoxemia bradypnea, bradycardia, confusion/stupor, cyanotic skin/mucous membranes, hypotension, cardiac dysrhythmias
Nasal Cannula FiO2: 24-44% Rate: 1-6 L/min
Simple Face Mask FiO2: 24-44% Rate: 1-6 L/min
Partial rebreather mask FiO2: 60-70% Rate: 6-11 L/min
Non-rebreather mask FiO2: 80-95% Rate: 10-15 L/min
Venturi mask FiO2: 24-55% Rate: 2-10 L/min
Aerosol mask, face tent FiO2: 24-100% Rate: at least 10 L/min
T-piece FiO2: 24-100% Rate: at least 10 L/min
Suctioning oral suction (medical aspetic), surgical aspetic technique, hyperoxygenate, 10-15 seconds (rotating motion), limit to 2-3 attempts, allow recovery btw attempts (20-30seconds)
Tracheostomy Care keep two extra trach tubes at bedside at all times! suction only if indicated, provide trach care Q8H, change trach tubs Q6-8wks
Created by: kmf06007