Respiratory Care Modalities Non-invasive Invasive Oxygen Therapy Has 2 Types of Delivery Systems: 1.

1. Low Flow Nasal Cannula/Nasal Prongs Most common and inexpensive 24-45% at 2-6 Lpm Well-tolerated by clients Simple Face Mask 40-60% at 5-8 Lpm Partial Rebreather Mask 60-90% at 10 Lpm Client breathes air from the bag 2. High Flow Venturi Mask 24-45% at 10 Lpm May contain holes of different size that enables the device to deliver precise conc. Face Tent Frequently inspect skin for dampness and chafing; dry and treat as needed 604 When masks are poorly tolerated by client Tracheostomy collar and T-piece Invasive Used to deliver any desire FiO2 to the client with a tracheostomy, laryngectomy or endotracheal tube

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G S EX H NG A D RESPIRA RY FU C N A CA E N TO N TIO

Nebulizer

T-piece

Incentive Spirometry T-piece Help clients improve their lung functioning Client is sitting or upright Client must create a tight seal on the mouthpiece Instruct client to inhale slowly and make the piston/ball reach the 600-900 marks Hold breath for 5 seconds, then exhale through pursed-lips Repeat procedure 10x/hour.

Ne

Collar

Tracheostom

to diminish the e ss build-up of ca xce rbon dioxide a to m innd a ta optima re in l spira tory functioning (Abra m, Bottre Fulme ha ll, r & Me y, 1999; Eliopoulos 2001). ze ,

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PRO TING HO AND C MMUNITY-BASED CARE MO ME O Teaching Patients Self-Care. At time oxyge must bea s n dministe d to the pa nt a hom . The nurs ins re tie t e e tructs the pa nt or tie

Conti ra tory ne ds e the p furth

Endotracheal Intubation Not used for longer than 3 weeks; if patient needs an assistive breathing device Disadvantages: Discomfort (-) Cough reflex Thick secretions (-) Swallowing = Increases risk for Aspiration Pneumonia Inability to talk Tracheostomy Invasive Mgt: Assess RR; Report if diminishing breath sounds Monitor ABG & SpO2 Position client on Semi/High Fowlers If (+) secretions, suction PRN Proper changing of tracheostomy ties: Apply new first, then remove the old Common Complications: Sore throat and hoarseness of voice Intermittent Positive Pressure Breathing Also known as Intermittent Positive Pressure Ventilaton Assists ventilation without the use of ET; uses ventilator and works by application of pressure only during the inspiratory phase to help patient breath more deeply Chest Physiotherapy Non-invasive Involves Percussion (rhythmic striking of the chest wall with cupped hands using rapid flexion and extension), vibration (tensing the arm and hand while maintaining firm but gentle pressure over the area) AREAS C/I: BREAST, STERNUM, SPINAL COLUMN, KIDNEY

and postural drainage (use of gravity to drain secretion from areas of the lungs) POSITION THE CLIENT WITH THE LUNG SEGMENT TO BE DRAINED, UPPERMOST); SEGMENT TO BE DRAINED SUPERIOR TO OR ABOVE THE TRACHEA OR BRONCHUS Best time for PD is 1 hour before meals, or 2-3 hours after If (+) pain, (+) cyanosis - stop postural drainage

Postural Drainage Positions

Mechanical Ventilation See ppt Coverage of Midterm Unit Test: Respiratory Medications Respiratory Care Modalities (up to Mech. Vent. ONLY)