Respiratory Therapies

Respiratory Therapies

Promoting Oxygenation

  • Monitor hydration status to maintain secretions.

  • Fluid intake: 1500 to 2500 mL/day.

  • Teach effective coughing techniques (turn, cough, deep breathe).

  • Suction airway as needed.

  • Chest physiotherapy aids in secretion removal.

Maintenance and Promotion of Lung Expansion

  • Early ambulation prevents atelectasis and pneumonia.

  • Proper positioning for respiratory function (e.g., 45° semi-Fowler’s position).

  • Frequent position changes are necessary.

Coughing and Deep Breathing Techniques

  • Diaphragmatic breathing increases lung capacity.

  • Coughing frequency: every 2 hours while awake; every hour for patients with significant secretions.

Pursed Lip Breathing

  • Deep inspiration and prolonged expiration help prevent alveolar collapse.

  • Recommended for COPD patients to alleviate shortness of breath.

Chest Physiotherapy

  • Aids in mobilizing secretions:

    • Chest percussion

    • Vibration

    • Postural drainage

Suctioning Techniques

  • Types include:

    • Oropharyngeal and nasopharyngeal (for coughing patients).

    • Orotracheal and nasotracheal (for patients unable to cough).

    • Tracheal (through artificial airways).

Oxygen Delivery Methods

  • Non-invasive ventilation: CPAP and BiPAP.

  • Different masks for varying oxygen concentrations (e.g., nasal cannula, simple face mask, non-rebreather).

Oxygen Therapy Considerations

  • Must increase oxygen concentration above room air (21%).

  • Potential complications: oxygen toxicity, skin breakdown, hypoxic drive in COPD patients.

Thoracentesis

  • Procedure to remove fluid from pleural space.

  • Nursing care includes monitoring vital signs and patient comfort.

Chest Tubes

  • Inserted to remove air/fluid from pleural space.

  • Regular assessment of lung sounds and drainage is critical.

  • Positioning: keep drainage system below chest; monitor for bubbling in the water seal chamber.

Tracheostomy Care

  • Indications: establish patent airway, facilitate secretion removal.

  • Cuffed trach tubes prevent aspiration.

  • Monitoring for dislodgment and maintaining a spare obturator is vital.

Bronchoscopy

  • Used for visualizing airways, obtaining biopsies, or treatments.

  • Pre-procedure care: obtain consent, check NPO status, and monitor vitals.

  • Post-procedure care: monitor for bleeding, respiratory issues, and re-establish diet post-anesthesia.