NSG202D Topic 1 - Respiratory conditions

what are the 2 main parts of the respiratory tract

upper and lower

what structure makes up the upper resp tract

1. nose

2. nasal cavity

3. pharynx

4. larynx

what are the functions of the upper resp tract

filters, warms and humidifies inspired air

what structures make up the lower resp tract

1. trachea

2. bronchi

3. bronchioles

4. alveoli

what is the function of the trachea

conducts air from the upper airway into the lungs

what is the bronchial tree

the branching network of bronchi and bronchioles in the lungs

what is an alveoli

small air filled sacs where gas exchange occurs

how does gas change occur

by diffusion, from areas of high concentration to low

how does oxygen move in the lungs

moves from the alveoli into the blood

where does co2 come from

produces by the bodys tissues and cells

how does co2 leave the body

same as o2 from high to low during o2 exchange before being exhaled

what changes to the system in asthma

1. airway inflammed

2. bronchospasm

3. airways are narrowed

what are signs n symptoms of asthma

1. wheezing

2. SOB

3. cough

4. chest tightness

5. prolonged expiration

what assessments are conducted for asthma

1. RR

2. SpO2

3. WOB

4. wheeze and air entry

5. ability to speak

6. accessory muscle use

what are some nursing interventions and why for asthma

1. sit upright - improves lung expansion

2. salbutamol - relieves bronchospasm

3. prescribed oxygen - treats hypoxaemia

4. monitor resp status - identifies deterioration early

what are some risks/complications for asthma

1. severe airway obstruction

2. hypoxaemia

3. respiratory exhaustion

4. respiratory failure

5. silent chest = severe obstruction

how to encourage person-centred and safe care for asthma

1. check inhaler technique

2. explain treatment

3. involve pt in decisions

4. recognise and escalate deterioration early

what are the main meds used for asthma

1. short acting bronchodilators - salbutamol

2. inhaled corticosteroids

3. inhalers

what changes in COPD

1. chronic airway narrowing and damage

2. reduced airflow

3. difficulty fully exhaling

4. often progressive and not fully reversible

what are signs and symptoms of COPD

1. chronic shortness of breath

2. persistent cough

3. increased sputum

4. wheezing

5. reduced exercise tolerance

what assessments are necessary for COPD

1. RR

2. SpO2

3. WOB

4. Prolonged expiration

5. acessory muscle use

6. wheeze

7. sputum

what are nursing considerations for a pt with COPD

1. sit upright - improves ventilation

2. give prescribed o2 carefully

3. encourage clearance of airway - removes secretions

4. monitor SpO2 and RR - detects deterioration

5. encourage rest/energy conservation - reduces o2 needs

what are some risks or complications for COPD

1. Hypoxaemia

2. co2 retention

3. resp fatigue

4. resp failure

5. resp infections

how to promote person centred and safe care for COPD

1. give o2

2. teach correct inhaler technique

3. encourage no smoking

4. encourage pulmonary rehab

5. educate about recognising exacerbations

what are the main meds used for COPD

1. bronchodilator - salbutamol

2. corticosteroids - prednisolone

what changes does pneumonia cause

1. lower resp tract is infected

2. causes an inflammatory response

3. alveoli feels with fluid = less air

4. gas exchange is impaired

what are symptoms of pneumonia

1. fever

2. cough (productive)

3. chest pain

4. SOB

5. tachypnoea

6. crackles on auscultation

what are assessments necessary for pneumonia

1. full set of vitals

2. WOB/muscle use

3. lung ausc

4. cough and sputum

5. sign of sepsis

what are some nursing considerations for pneumonia

1. upright/high fowlers

2. o2 as prescribed

3. hydration - thins secretions

4. deep breathing n coughing

5. prescribed antimicrobials

6. monitor obs for deterioration

what is hospital vs community acquired pneumonia

1. CAP - acquired outside and can be diagnosed within the first 48hrs of admission (less antibiotic resistant)

2. HAP - pneumonia develops after 48hrs of admission

what are the main meds used for pneumonia

1. antibiotic like amoxicillin for CAP

2. broad-spectrum antis - piptaz for HAP

3. oxygen

what is the difference between benign and malignant tumours

1. benign - non cancerous and doesnt spread to other body parts

2. malignant - cancerous and can invade surrounding tissue and spread

what are the 3 stages of cancer

1. metatasis

2. remission

3. recurrence

what is metastasis

cancer that spreads from its original site to another body part

what is remission

signs and symptoms of cancer disappearing or reducing

what is recurrence

cancer returns after a period of remission

what is a biopsy for cancer

tissue sampled examined to diagnose cancer

what is staging for cancer

it dertemines the extent of cancer and how far it is spread to guide treatment

what is grading in cancer

it describes how abnormal cells look and how aggressively they may behave. it also assists in diagnosing

what are the main cancer treatment treatments

1. surgery - removes the tumour and affected tissue

2. chemotherapy - drugs destroy or slow the growth of cancer

3. radiotherapy - high energy radiation damages cancer cells in specific areas

4. immunotherapy - helps the immune system to recognise and attack cancer cells

5. targeted therapy - targets the specific type of cancer cells

6. hormone therapy - blocks hormones or their effects when they promote cancer growth

what factors influence cancer treatment decisions

1. type, grade and stage

2. pts age, general health

3. potential benefits, risks and side effects

4. patient preference and treatment goals

what are the side effects of chemotherapy

1. nausea

2. vomiting

3. hair loss

4. neutropenia - low neutrophils (WBC)

5. mucositis - painful inflammation and breakdown of the mucous membranes that line the digestive tract

what are some nursing considerations for chemotherapy

1. monitor bloods and signs of infection

2. administer PRN antiemetics

3. use appropriate PPE

what are the side effects of radiotherapy

1. skin irritation

2. fatigue

3. effects to the specific targeted area

what are the nursing considerations for radiotherapy

1. monitor skin for irritation

2. assess skin integrity

3. monitor fatigue and support rest

what are nursing considerations for immunotherapy

1. monitor GI tract - diarrhoea, abdo pain

2. monitor SOB

what are nursing considerations after cancer surgery

1. monitor wound for infection

2. assess pain and administer PRN analgesia if needed

3. observe for bleeding

what are the side effects of cancer treatment

1. neutropenia

2. anaemia

3. thrombocytopenia

4. mucositis

5. alopecia

6. cancer-related fatigue

what is neutropenia

low neutrophil count which can increase risk of infection

what is anaemia

reduced RBC or haemoglobin which can cause fatigue or breathlessness

what is thrombocytopenia

low platelet count which increases risk of bleeding

what is mucositis

inflammation and ulcers in the mouth or GI tract which may impair eating or drinking

how can nurses manage common cancer-related symptoms

1. pain - assess using a tool and administer pain meds and reassess effectiveness

2. fatigue - assess the impact on daily activities and encourage small and frequent meals

3. mucositis - assess the mouth, support oral hygiene and manage pain

4. poor nutrition - monitor weight and intake, refer to a dietitian when needed

what are the main nursing priorities in oncology care

1. assessment - monitor vitalsm pain, fatigue, nutrition and bloods

2. safety - follow meds and chemo precautions

3. education - explain all treatments, side effects and when to seek help

4. psychological support - assess distress and provide emotional support or referrals

5. communication

6. coordination - collaborate w oncologists, pharmacy, dietitans and others

what is the role of palliative and end of life care in oncology

1. focus on comfort, symptom relief and quality of life

2. manage pain, nausea and others

3. respect pt preferences, values and goals of care

4. support families

what signs indicate a pt needs supplemental oxygen

1. low o2 sats

2. increased RR

3. SOB

4. accessory muscle use

5. cyanosis

6. restlessness

7. confusion

8. reduced consciousness

what should a nurse do when a pt deteriorates

1. assess the pt

2. escalate

3. initiate emergency response if needed

4. administer oxygen

5. reassess

what is HFNP o2 therapy

delivers heated, humidified o2 at highrates

what are the benefits for HFNP

1. improved oxygenation (more consistent)

2. reduced WOB

3. flushes out exhaled CO2 from upper airway

4. maintains moisture in airway

5. generates mild airway pressure that helps keep alveoli open & improve gas exchange

what are precautions for high flow oxygen

1. nasal trauma/nosebleeds

2. nasal obstructions

3. facial trauma

what should a nurse monitor w HFNP

1. o2 sats and RR

2. WOB

3. signs of resp failure

4. mental state and overall clinical condition