Professional Documents
Culture Documents
Ch.9 Care of the pt w/ a Respiratory Disorder Upper Respiratory Tract o Nose/nasal cavity/sinuses o pharynx o Larynx o Trachea Epistaxis (Nose Bleed) Etiology/pathophysiology o bright red coming from the nose from injury or irritation o congestion of the nasal membranes leading to capillary rupture o HTN o Primary or secondary Clinical Manifestations/assessments o bright red bleeding from one or both nostrils o can lose as much as 1 L/hr Medical management/nursing interventions o Fowlers position o direct pressure by pinching nose X15 min o ice compresses to nose o nasal packing o cauterize o balloon tamponade o silver nitrate Nasal Polyps o Tumors that look like small bunches of tiny grapes o Nasal polyps are tissue growths usually due to prolonged inflammation o Obstruct breathing and sinus drainage o removed via surgery under local anesthesia o nasal polypectomy Deviated Septum Etiology/pathophysiology o congenital abnormality o Injurymost likely cause o Nasal septum deviates from the midline and can cause a partial obstruction Diagnostic Studies o x-rays Clinical Manifestations/assessments o stertorous respirations o dyspnea o postnasal drip Medical management/nursing interventions o Medications: corticosteroids, antihistamines, antibiotics, analgesics o post-op nasal epinephrine to reduce bleeding o nasoseptoplasty o maintain airway Allergic Rhinitis & Allergic Conjunctivitis Etiology/pathophysiology antigen/antibody reactions in the nasal membranes, nasopharynx, and conjunctiva due to allergens Clinical Manifestations/assessments o edema o excessive tearing o photophobia o blurring vision o pruritus o excessive nasal secretions and/or congestion o sneezing o cough o headache Medical management/nursing interventions o antihistamines- to relieve congestion o hot baths o avoid allergen o topical or nasal corticosteroids o analgesics o Obstructive Sleep Apnea (OSA) o is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep o Apnea o Hypopnea o PaO2/hypoxemia o PaCO2 o some of these ppl are cranky. lack of sleep, H/A from too much CO2 o Risk Factors: obesity, age, being male, allergies, this can and does go away if the person loses weight, if its not from a deformity Hypoxia o Subjective data o SOB o Objective data o restlessness, anxious facial expression, fatigue, impaired coordination o respiratory distress, wheezes, or orthopnea o adventitious breath sounds o CPAP- nasal continuous positive airway pressure o BiPAP Bi-level positive airway pressure Upper Airway Obstruction Etiology/pathophysiology o aspiration o inflammation of tissue o dentures that dont fit well o tongue o Laryngeal spasm which can cause closure of the larynx Clinical Manifestations/assessments o well they will not be able to talk o Cyanosis o Stridor is a high pitched sound resulting from turbulent gas flow in the upper airway
Acute Follicular Tonsillitis Etiology/pathophysiology o inflammation of the tonsils o bacterial or viral infection o food/airborne infection Clinical Manifestations/assessments o enlarged, tender cervical lymph nodes o sore throat o fever; chill o enlarged, purulent tonsils o elevated WBC Medical management/nursing interventions o antibiotics; analgesics; antipyretics o warm saline gargles o tonsillectomy and adenoidectomy o Post-op assess for excessive bleeding ice cold liquids ice collar avoid coughing, sneezing, or vigorous nose blowing avoid coughing and clearing throat for the 1st week post-op Laryngitis Etiology/pathophysiology o inflammation of the larynx due to virus or bacteria o may cause severe respiratory distress in children under 5 yrs old Clinical Manifestations/assessments o hoarseness o voice loss o scratchy and irritated throat o persistent cough o sore throat and congestion Medical management/nursing interventions o viral o bacterial o analgesics o antipyretics o antitussives o warm or cool mist vaporizer o limit use of voice Pharyngitis Etiology/pathophysiology o inflammation of the pharynx o chronic or acute o frequently accompanies the common cold o viral
Pneumothorax Etiology/pathophysiology o a collection of air or gas in the pleural space; causing the lung to collapse Clinical manifestations/assessments o decreased breath sounds o sudden; sharp chest pain w/ dyspnea o Diaphoresis; tachycardia; tachypnea o no chest movement on affected side o sucking chest wound o trachea shift Medical Management/nursing interventions o chest tube to water seal drainage system o O2 o analgesics o encourage fluids Lung Cancer Etiology/pathophysiology o primary tumor or metastasis o small cell, non small cell, squamous cell, and large cell carcinoma Clinical manifestations/assessments o hemoptysis o dyspnea; wheezing o fever; chills o pleural effusion Medical Management/nursing interventions o Surgery o most are not diagnosed early enough for curative surgical intervention o segmental resection o Lobectomy o Pneumonectomy o Radiation o Chemotherapy Pulmonary Edema Etiology/pathophysiology o Accumulation of serous fluid in interstitial tissue and alveoli Clinical manifestations/assessments o dyspnea; cyanosis o tachypnea; tachycardia o pink or blood-tinged, frothy sputum o restlessness; agitation o wheezing; crackles