Respiratory System Alterations
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| Asthma | inhaled agents - admin bronchodilators before anti-inflammatory medications
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| 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
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| 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
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| Pulmonary emphysema | destruction of alveoli, narrowing of bronchioles, trapping of air resulting in loss of lung elasticity
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| Chronic bronchitis | inflammation of the bronchi and bronchioles cause by chronic exposure to irritants
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| Cor Pulmonale | rt-side HF due to pulmonary dx (think COPD)
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| Carbon Dioxide Toxicity | secondary to increased CO2 retention. Sx: drowsiness, irritabiltiy, hallucinations, convulsions, coma, tachycardia with dysrhy
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| Pneumonia | an inflammatory process in the lungs that produces excess fluid and exudate that fill the alveoli
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| Tb | highly communicable airborne infection, QFT-G diag test., avoid foods containing thyamine,
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| 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
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| 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
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| Hemothorax | accumulation of blood in the pleural cavity (can use thoracentesis or chest tube depending)
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| Tension pneumothorax | tracheal deviation to unaffected side
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| Chest Tube Complication: Air leak | continuous rapid bubbling in the water seal chamber - start at chest and move down tubing to locate leak
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| 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)
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| 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
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| Chest Tube Complication: Disconnect from system | insert open end of the chest tube into sterile water until system can be replace
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| Chest Tube Complication: Pulled from patient | vasaline gause - tape 3 side
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| Early signs of hypoxia/hypoxemia | tachypnea, tachycardia, restlessness, pale skin/muscous membranes, elevated B/P, use of acc muscles, nasal flaring, adventitious lung sounds
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| Late signs of hypoxia/hypoxemia | bradypnea, bradycardia, confusion/stupor, cyanotic skin/mucous membranes, hypotension, cardiac dysrhythmias
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| Nasal Cannula | FiO2: 24-44% Rate: 1-6 L/min
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| Simple Face Mask | FiO2: 24-44% Rate: 1-6 L/min
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| Partial rebreather mask | FiO2: 60-70% Rate: 6-11 L/min
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| Non-rebreather mask | FiO2: 80-95% Rate: 10-15 L/min
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| Venturi mask | FiO2: 24-55% Rate: 2-10 L/min
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| Aerosol mask, face tent | FiO2: 24-100% Rate: at least 10 L/min
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| T-piece | FiO2: 24-100% Rate: at least 10 L/min
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| 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)
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| 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
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