Respiratory System
Help!
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| Epistaxis | nose bleed. Position patient upright, leaning forward. Apply direct lateral pressure to the nose for 5 mins & ice or cool compresses to nose if possible. Nasal packing may be needed. To prevent rebleeding, instruct not to blow nose for several hours.
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| Normal RBC range | 4.2-6.1 million/mm
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| Normal Hemoglobin range | 12-18 g/dl
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| Normal Hematocrit range | 37%-52% g/dl
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| Normal WBC Range | 5,000-10,000 /mm
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| PCO2 | 35-45 mm Hg
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| HCO3 | 21-28 mEq/L
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| Obstuctive sleep apnea | breathing disruption lasts atleast 10 sec and occurs min of 5 x per hr. S/S-daytime sleepiness, inability to concentrate, change sleep positons
TX-CPAP, change in sleep pos, weightloss, sur- adeniodectomy, uvulectomy, uvulopalatopharynoplasty
Study-(PSG
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| COPD | Charac: Bronchospasms, dysphnea. Tissue damage is not reversible & increases in severity eventually leading to respiratory failure.
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| Asthma | 1. Inflammation in mucous membrane-allergens, irritants.
2. Hyperresponsviness occurs w exercise, uri, unknown. S/S-cough, chest tightness, cyanosis, hypoexmia. Lab-ABG, ^ eosinophil
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| Pulmonary function test (PFT) | Most accurate test for asthma.
These tests evaluate lung volumes and
capacities.
Goal: Improve airflow. Test peak flow twice a day. Green=peak; Yellow=peak-50 (use rescue drugs) Red=below 50 (rescue drugs & emergency...serious res problem)
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| Bronchodilator | increase smooth muscle relaxation. NO affect on inflammation.
Short acting-Venalin, zopinx
Long acting-longer than short bc time is needed for drugs to build up.
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| Methylaxanthines | Lot of side effects; Hypertension, seizures. Drug levels need to be monitored.
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| Anti-inflammation Asthma drugs | Corticosteriods=use daily for severe asthma. NOT for rescue.
Nsaids=preventive-reduce airway inflammation.
Leukotriene=oral preventive-singular.
Immundulators=prevent allergens for binding.
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| Status asthmaticus | Severe, airway obstruction that intensifies once begins & often doesnt respond to common therapy. If not reversed=cardiac arrest
TX- Iv fluids, potent systemics, bronchodilators, steriods, epinephrine and oxygen.
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| Emphysema | loss of lung elasticity & hyperinflation of the lungs. S/S-dysphea & need for increase resp rate.
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| Rhinitis | inflammation of nasal mucosa. "allergies"
TX-antihistamines, decongestants, antibiotics, anti pyretics, Vit C & zinc.
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| Sinuitis | Inflammation of mucous membrane.
S/S-Sore throat, HA, fever.
TX-Antibiotics, decongestants, hot showers and steam.
Poss surgery-Endoscopic sinus
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| Pharyngitis | Inflammation of mucous membrane of pharynx.
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| Tonsillitis | Inflammation of tonsils. Penicellin 7-10days. Contagious.
S/S-sore throat, fever, chills, ear pain, HA, thickened voice, tonsils swollen & red w pus.
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| Whats a complication of tonsilitis? | Peritosillar abcess=puss behind the tonsils.
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| Laryngitis | Inflammation of the mucous membranes of the larynx.
S/S-Hoarseness, dry cough, aphonia (voice loss)
TX-relief & prevention
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| Post op care following sinus surgery | Semi-fowlers position, perform gentle oral hygiene, ice compresses for 24 hrs, teach changing of mustache dressing, recommend to sleep upright in a chair, no coughing, blowing nose or straining for 2 weeks, temp for first week aft surgery. over 100 report
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| Thoracentesis | aspiration of pleural fluid or air
from the pleural space:
Patient preparation for stinging sensation & feeling of pressure
Correct position-sitting up bend over a table, with nurse in front.
Motionless patient
Follow-up assessment for complicat
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| Lung Biopsy | Follow-up care:
Assess vital signs and breath sounds at least every 4 hr for 24 hr
Assess for respiratory distress
Report reduced or absent breath sounds immediately
Monitor for hemoptysis
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| CHRONIC AIRFLOW LIMITATION | Includes the chronic lung diseases:
Asthma
Chronic bronchitis
Pulmonary emphysema
Drug:
Warfarin
Calcium channel blockers
Endothelin-receptor antagonists
Natural and synthetic prostacyclin agents
Digoxin & diuretics
Oxygen therapy
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| SARCOIDOSIS | Granulomatous disorder of unknown cause that
affects the lungs most often
Autoimmune responses in which the normally
protective T-lymphocytes increase and damage
lung tissue
Corticosteroids are the main type of therapy
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