NU 206 Acute Respiratory Disorders S25 dark background-1

Page 1: Acute Respiratory Disorders

Instructor Information

• Cara Fizzuoglio MS, RN

• Course NU 206

Page 2: Objectives

• Understand Respiratory Diagnostic Procedures.

• Comprehend Pathophysiology of Acute Respiratory Disorders:

  • Atelectasis

  • Pneumonia- crackles

  • Pulmonary Embolism

  • Rhinitis

  • Sinusitis

  • Influenza

  • Rhonci can be coughed away, crackles cannot-

    • Rhonic- blowing out candled. clears it

• Assess and identify respiratory disorders- take a

• Plan care for patients

• Educate patients on health prevention

Page 3: [Content Not Provided]

Page 4: Respiratory Diagnostic Procedures

Arterial Blood Gases (ABG)

• Reports the status of oxygenation and acid-base balance of blood.

Procedure

1. Perform an arterial puncture using surgical aseptic technique.

2. Collect specimen into a heparinized syringe.

3. Place collected specimen in ice to preserve pH and oxygen pressure.

4. Transport specimen to laboratory immediately.

Post-Procedure

• Hold direct pressure on the site for at least 5 minutes (20 minutes if on anticoagulants).

Page 5: Complications from ABG

• Hematoma & Arterial Occlusion:

  • Observe for temperature change, swelling, color, loss of pulse, or pain.

  • Notify provider if symptoms persist.

• Air Embolism:

  • Air enters arterial system during catheter insertion.

  • Position client on left side in Trendelenburg position to prevent flow blockage.

  • Monitor for sudden onset of shortness of breath (SOB), decreased SaO2, chest pain.

  • Administer 100% oxygen if symptoms occur.

Page 6: Diagnostic Procedures - Bronchoscopy

Purpose

• Collect biopsy, aspirate sputum or lung abscesses for culture and sensitivity.

Visualization

• Allows visualization of larynx, trachea, and bronchi using flexible fiber-optic or rigid bronchoscope.

Procedure Options

• Can be outpatient, in surgical suite under general anesthesia, or at bedside under local anesthesia.

Page 7: Bronchoscopy - Pre-Procedure

• Assess for allergies to anesthetics or anticoagulants.

• Ensure consent form is signed.

• Remove dentures if applicable.

• Maintain NPO status for 4 to 8 hours pre-procedure.

• Administer pre-procedure medications like viscous lidocaine.

Intra-Procedure

• Position client sitting or supine.

• Assist in specimen collection and labeling.

• Monitor vital signs, respiratory pattern, and oxygen saturation.

Page 8: Bronchoscopy - Post-Procedure

Monitoring

• Continuously monitor respirations, vital signs, and level of consciousness.

Assessments

• Check gag reflex and swallowing ability before oral intake.

• Client cannot be discharged until adequate gag reflex and respiratory effort return.

Complications

• Laryngospasm, pneumothorax, aspiration.

Page 9: Thoracentesis

Overview

• Surgical perforation of the chest wall and pleural space with a large-bore needle.

Purpose

• Obtain specimens, instill medications, or remove fluids (effusion).

Procedure

• Pre-Procedure: Position client upright with arms supported.

• Post-Procedure: Apply dressing over puncture, monitor vital signs, and auscultate lungs.

Page 10: Acute Respiratory Disorders

Overview

• Include rhinitis, sinusitis, influenza, and pneumonia.

Population Vulnerability

• Older adults have reduced pulmonary reserves due to age-related lung changes.

Health Promotion

• Hand hygiene, immunizations (flu, pneumonia), and smoking cessation.

Page 11: Rhinitis

Definition

• Inflammation of the nasal mucosa caused by infection or allergens.

Common Causes

• Viral infections, allergies, and coexistence with asthma.

Page 12: Rhinitis - Clinical Manifestations

• Symptoms include excessive nasal drainage, nasal congestion, sneezing, and itchy watery eyes.

Page 13: Nursing Care for Rhinitis

• Encourage rest (8-10 hours/day) and hydration (at least 2000ml/day).

• Suggest humidifiers and proper tissue disposal.

Page 14: Medications for Rhinitis

• Antihistamines, decongestants, antipyretics, antibiotics for bacterial infections, intranasal glucocorticoids.

Client Education

• Importance of hand hygiene, complementary therapies, and limiting exposure to others.

Page 15: Sinusitis

Definition

• Inflammation of the mucosa membrane of sinuses.

Causes

• Occurs after rhinitis and can be linked to various factors, including infections and anatomical issues.

Page 16: Expected Findings for Sinusitis

• Symptoms include nasal congestion, headaches, facial pressure, cough, and low-grade fever.

Page 17: Nursing Care for Sinusitis

• Encourage use of steam humidification, saline nasal sprays, and adequate fluid intake.

Page 18: Medications for Sinusitis

• Nasal decongestants, broad-spectrum antibiotics, pain relief medications.

Complications

• Meningitis and encephalitis may occur if infections spread.

Page 19: Rhinitis and Rhinosinusitis

Symptoms Presentation

• Description of nasal cavity conditions and mucus discharge.

Page 20: Influenza

Overview

• Highly contagious viral infection seen in fall-winter months.

Vaccination

• Recommended for all ages above 6 months.

Page 21: Nursing Care for Influenza

• Maintain droplet precautions, monitor hydration, admin medications like Tamiflu.

Client Education

• Stress importance of vaccination and hygiene practices.

Page 22: Atelectasis

Definition

• Collapse of alveoli, a common abnormality on chest x-ray.

Page 23: Pathophysiology of Atelectasis

• Can be caused by obstruction, retained secretions, prolonged supine positioning, and specific surgeries.

Page 24: Clinical Findings of Atelectasis

• Marked respiratory distress, elevated heart rate, cyanosis, and decreased breath sounds.

Page 25: Prevention Strategies for Atelectasis

• Frequent turning, early mobilization, deep breathing exercises, and incentive spirometry.

Page 26: Risk Factors for Atelectasis in Post-Op Patients

• Low tidal breathing, pain, anesthesia effects, and immobility.

Page 27: Management: ICOUGH Program

Teach Patients

• Incentive spirometry, coughing, oral care, and mobility encourage.

Page 28: Management Techniques

• Use PEEP, CPAP, bronchoscopy, or mechanical ventilation when necessary.

Page 29: Pneumonia

Overview

• Inflammation of lung parenchyma caused by microorganisms.

Classifications

• Community-acquired, healthcare-associated, hospital-acquired, ventilator-associated.

Page 30: Risk Factors for Pneumonia

• Includes heart failure, COPD, AIDS, and chronic illness.

Page 31: Clinical Findings of Pneumonia

• Symptoms like anxiety, confusion, fever, and chills are common.

Page 32: More Clinical Findings of Pneumonia

• Similar symptoms with emphasis on respiratory distress and altered breath sounds.

Page 33: Laboratory Tests for Pneumonia

• Include sputum culture, CBC, ABGs, blood cultures, chest x-ray, and pulse oximetry.

Page 34: Nursing Care for Pneumonia

• Position to maximize ventilation, encourage coughing, administer oxygen, and promote hydration and nutrition.

Page 35: Medical Management for Pneumonia

• Administer appropriate antibiotics and supportive treatment like fluids and antipyretics.

Important Notes

• Culture specimens should be obtained before antibiotics are given.

Page 36: Considerations with Antibiotic Therapy

• Monitor for side effects, especially in older adults.

Page 37: Client Education for Pneumonia

• Importance of adherence to medication, rest, and avoiding crowded places.

Page 38: Complications of Pneumonia

• Possible sepsis, acute respiratory distress syndrome, and atelectasis.

Page 39: Prevention of Pneumonia

• Pneumococcal vaccination recommended for at-risk populations.

Page 40: Expected Outcomes for Pneumonia Patients

• Monitor for improvements in breathing, hydration, and education.

Page 41: Aspiration Pneumonia

Definition

• Inhalation of foreign material causing serious complications.

Manifestations

• Symptoms can lead to severe respiratory distress and potential death.

Page 42: Risk Factors for Aspiration Pneumonia

• Includes coma, alcohol overdose, and poor gag reflex.

Page 43: Nursing Interventions for Aspiration Pneumonia

• Maintain head of bed elevation, check tube placement, use thickened fluids.

Page 44: Question on Pneumonia Risk Factors

• Identify clients at risk for developing pneumonia.

Page 45: Pulmonary Embolism

Definition

• Blocking of pulmonary vasculature due to emboli.

Common Cause

• Most commonly caused by DVT.

Page 46: Risk Factors for Pulmonary Embolism

• Includes long-term immobility, surgery, smoking, and advanced age.

Page 47: Expected Findings for Pulmonary Embolism

• Symptoms include anxiety, chest pressure, dyspnea, and hemoptysis.

Page 48: Diagnosis of Pulmonary Embolism

• Utilize various tests, including ABG, D-dimer, CT scans, and pulmonary angiograms.

Page 49: Nursing Care for Pulmonary Embolism

• Administer oxygen, maintain IV access, and assess client status.

Page 50: Prevention and Treatment of Pulmonary Embolism

• Encouraging exercises and ambulation, anticoagulation therapy.

Page 51: Anticoagulants for Pulmonary Embolism

• Overview of medications used to prevent clot growth.

Nursing Considerations

• Monitor for bleeding and educate on medication interactions.

Page 52: Therapeutic Procedures for Pulmonary Embolism

• Embolectomy and vena cava filter are surgical interventions.

Page 53: Client Education for Home Care

• Instructions about monitoring and lifestyle changes to reduce PE risk.

Page 54: More Client Education for PE

• Advise on monitoring for signs of bleeding and safe grooming practices.

Page 55: Education for Travelers

• Remind of preventive measures to avoid PE during long travels.