Adults with Respiratory Disorders

External respiration is defined as

Breathing

Internal respiration is defined as

An exchange of oxygen and carbon dioxide a the cellular level.

What percent of oxygen do humans actually take in?

21%

What all does the upper respiratory tract consist of?

Nose, pharynx, larynx, and the trachea.

What all does the lower respiratory tract consist of?

The lungs and bronchial tree.

Where does oxygen enter the body?

The lungs.

Where does oxygen bind to hemoglobin?

Alveoli

What is oxygen delivered to the cells in exchange for?

Carbon Dioxide.

What happens to CO2 when it is carried back to the lungs?

It is exhaled.

What does the TCBD memnonic for?

Turn

Cough

Deep

Breath

Common sounds that are a signal of upper airway issues

Noisy breathing or stridor

Common signs that are signals of lower respiratory issues

Abnormal sounds like wheezes.

Nervous Control is defined as

Chemoreceptors regulating breathing levels & rate according to the CO2 in the blood.

Early signs of hypoxia

Restlessness, increased anxiety, and confusion.

Late signs of hypoxia

Cyanosis, hypotension, & tachycardia.

General symptoms associated with hypoxia include

Pale skin, cyanosis, decreased oxygen saturation, & restlessness.

Common sounds that can be heard while listening to the lungs include

Wheezing, ronchi, crackles, & pleural friction rub.

When does pleural friction rub occur?

Lungs rub against chest cavity.

Common diagnostic exams done for adults with respiratory conditions

Chest X-RAY, spiral CTs, angiography. ventilation, perfusion, scan, pulmonary functioning tests, mediastinoscopy, bronchoscopy, laryngoscopy, & sputum specimens.

Pneumothorax

Air in pleural space

Hemothorax

Blood in pleural space

Empyema

Pus in pleural space

Pleural effusion

Fluid in pleural space

PaO2 stands for

Partial pressure of oxygen

SaO2 stands for

Arterial oxygen saturation

Together, SaO2 and PaO2 provide measurement of

Pulmonary Function.

Normal Ph

7.35-7.45

Normal PaCO2/CO2

35-45

PaCO2/CO2 refers to

Respiratory

HCO3 refers to

Kidney (metabolic)

Normal HCO3

22-26

If Ph is above 7.45, it is

Alkalosis

If Ph is below 7.35, it is

Acidosis

EXAMPLE QUESTION:

Ph: 7.29

CO2: 49

HCO3: 23

What is present?

Respiratory Acidosis

EXAMPLE QUESTION:

Ph: 7.51

CO2:42

HCO3: 30

What is present?

Metabolic alkalosis

Epistaxis

Nose bleed

Common disorders of the upper airway include

Epistaxis, deviated septum/nasal polyps, allergic rhinitis, obstructive sleep apnea, upper airway obstruction, or cancer of the larynx.

Should a patient taste nasal spray when it is being used, if done properly?

NOPE

When a patient is post op from a laryngectomy, what can we expect to see their diet order to be?

NPO, feeding tubes may be required.

Lower respiratory disorders include

Bronchitis, tuberculosis, pneumonia, pleural effusion, empyema, pneumothorax, lung cancer, & pulmonary edema.

Clubbed nails often result from

A lack of oxygen.

Pulmonary edema often is hand-in-hand with...

Heart Failure.

What commonly impacts the airway??

Llung cancers, pulmonary edema, & thick secretions.

Hospitals are at an increased risk for

TB exposure

A patient with tuberculosis should be placed under which isolation precautions?

Airborne.

Tuberculosis

A chronic pulmonary and extra pulmonary infectious disease.

Although TB us highly contagious, does exposure automatically mean contraction?

Not always.

Examples of individuals who are at a higher risk of developing TB

Young children, elderly, & the immunocompromised.

Where does a closed-chest drain go?

Chest, NEVER the lungs.

Why is a closed-chest drain inserted?

Drainage of fluid, blood, or air from the pleural cavity; and in some cases medication administration.

Closed-chest drains often prevent

Lung from collapsing.

Nurses should encourage individuals with an emphysema diagnosis to drink how much water a day?

2,000-3,000mL a day.

What do the air tubes do during chronic bronchitis?

They narrow, producing extra mucus as a result of swollen tissues.

Asthma

Edema of the respiratory mucosa & excess mucus production obstructs airways.

Emphysema

Walls of alveoli are torn and unable to be repaired; alveoli then fuse into large air spaces.

What is the treatment for the common cold?

There is no specific treatment!

Interventions for the common cold

Symptom relief

Neti Pot

Flushes the nasal passages with a saltwater solution.

Tonsillitis is a ___ infection...

Bacterial

Tonsillitis is most common among

School age children

What should patients be monitored for post tonsillectomy?

ANY signs of bleeding.

Individuals with rhinitis should be encouraged to

Increase their fluid intake.

What clinical manifestation is associated with acute follicular tonsillitis?

Tender cervical lymph nodes.

Laryngitis is known to produce

Hoarseness and sometimes a complete loss of voice.

Which organism commonly is a bacterial cause of pharyngitis?

Streptococcus Organism

Pharyngitis is typically what kind of infection?

Viral, but bacterial in some cases.

Sinusitis can be...

Acute or chronic

Sinusitis is an infection of the

Maxillary or frontal sinuses.

Treatment that is anticipated when a patient has sinusitis

Corticosteroids, decongestants, antibiotics, and nasal saline irrigations.

A sign that may be indicative of BLEEDING post tonsillectomy

Frequently swallowing.

When a patient is taking antibiotics for tonsillitis, the nurse should educate them about

Completing the entire course of antibiotics.

A patient with laryngitis should be educated on

Resting their voice and limit speaking.

Individuals with pharyngitis should be encouraged to

Gargle warm saltwater

Signs and symptoms that are often found in sinusitis patients?

Complaints of headache, nasal congestion, purulent sinus discharge, & reports of malaise.

Inflammation of trachea & bronchial tree causes

Congestion of mucous membranes

Inflammation of the trachea and bronchial tree results in

Retention of tenacious secretions.

Legionella microbe progresses through

Influenza and Legionnaires disease.

Legionnaires disease progresses

In less than a week

Legionanaire's Disease can result in

Respiratory/renal failure, bacteremia, shock, & ultimately death.

What caused a global pandemic in 2020??

COVID-19

Symptoms from COVID can be

Acute or long lasting.

Anthrax is defined as

An infectious disease that is caused by bacillus anthracis.

In nature, anthrax commonly impact

Both wild/domesticated hoofed animals.

When does the bacillus anthracis bacteria become active?

Once it enters a living host.

Atelectasis

A common post op complication from a mucous plug.

Atelectasis results from

Shallow breathing that interferes with coughing & effective clearance of secretions.

What medication would a nurse anticipate to be ordered for a patient diagnosed with Legionnaires Disease??

IV erythromycin.

Interventions that are commonly performed to prevent atelectasis include

Frequent repositioning and educating on coughing/deep breathing exercises.

Most lethal anthrax

Inhalants

Most common anthrax

Cutaneous

Least common anthrax

Gastrointestional

The QuantiFERON-TB gold (QFT-G) may detect TB with...

Greater specificity than the regular PPD test.

Hospitals and healthcare workers

Are high risk for TB.

TB is transmitted primarily by

Inhalation of minute droplet nuclei coughed/sneezed by a person whose sputum contains tubercle bacillus.

If a patient has a positive PPD skin test with a negative chest X-RAY & NO TB symptoms, do they have TB?

The patient is infected with TB.

Which meds are commonly used to treat TB?

Isoniazid and rifampin

Once a TB test is placed, when can it be read for results?

48-72 hours

Studies on hypoxia revealed that

Hypoxia worsens when the patient is placed on their back/side with the sick lung down.

Pneumothorax

Collapsed lung that occurs when a collection of air/other gases gather in the pleural space.

Where are chest tubes inserted?

5-6th intercostal spaces (armpit area)