Respiratory Disorders
Chronic Obstructive Pulmonary Disease (COPD)
Pathophysiology
◦ A disease that is characterized by
airflow obstruction and alveolar
◦ Exacerbated by infection caused
by emphysema or bronchitis.
Signs and symptoms
◦ Cough, excess mucus, wheezing, crackles
◦ barreled chest, use of accessory muscles, weight loss
◦ prolonged expiration, orthopnea
Nursing Intervention
◦
◦
◦
◦
Monitor vital signs
administer oxygen therapy
monitor. pulse oximetry
Instruct patient in diaphragmatic or abdominal breathing techniques.
(tripod position and pursed-lip breathing techniques)
◦ Suction patients airway prn.
Patient Education
◦ Avoid eating gas-producing foods, spicy foods, and extreme hot or cold
foods
◦ Avoid exposure to people with an infection, avoid crowds
◦ Receive immunizations as recommended
◦ stop smoking
◦ use pursed lip and diaphragmatic or abdominal breathing
Treatment
◦ Administer bronchodilators as prescribed, and instruct
the client in the use of oral and inhalant medication.
◦ Administer corticosteroids as prescribed for
exacerbation.
Asthma
Pathophysiology
◦ Chronic inflammatory disorder of the airways that causes vary degrees of
obstruction in airways.
Signs and symptoms
◦ Restlessness
◦
◦
◦
◦
wheezing and crackles
absent or diminished lung sounds
use of accessory muscles
hyperventilation
Nursing Intervention
◦
◦
◦
◦
◦
Monitor vital signs
Monitor pulse oximetry
Administer oxygen as prescribed
position patient in high fowlers position
stay with patient to decrease anxiety
Patient Education
◦
◦
◦
◦
Identify possible triggers and measures to prevent episode
Educate about the management of medication and proper administration
Educate about the correct use of a peak flowmeter
Educate about developing an asthma action plan with PHCP and what to do
if an asthma episode occurs.
Treatment
◦ bronchodilators as prescribed
◦ magnesium sulfate as prescribed
◦ corticosteroids as prescribed
Pneumonia
Pathophysiology
◦ Infection of the pulmonary tissue
◦ Pneumonia can be communityacquired or hospital acquired
Signs and Symptoms
◦
◦
◦
◦
◦
◦
◦
Chills
Elevated temperature
tachypnea
wheezing
use of accessory muscles for breathing
mental status change
sputum production
Nursing intervention
◦ Administer oxygen as prescribed
◦ Encourage coughing and deep breathing and use the incentive spirometer
◦ provide CPT
◦ position patient in semi-fowlers position
Patient Education
◦ Educate about the importance of rest, proper nutrition, and adequate fluid
intake
◦ Avoid exposure to individuals with respiratory infection and viruses
◦ Receive pneumococcal vaccine as recommended
◦ teach patient to use proper hand hygiene
Treatment
◦
◦
◦
◦
antipyretics
bronchodilators
cough suppressants
expectorants
Pleural Effusion
Pathophysiology
◦ Collection of fluid in pleural space
Signs and Symptoms
◦ Pleuritic pain that is sharp and increases with inspiration
◦ progressive dyspnea with decreased movement of the chest wall on the
affected side
◦ Dry, nonproductive cough
◦ tachycardia
◦ elevated temperature
◦ decreased breath sounds over affected area
Nursing Intervention
◦
◦
◦
◦
identify underlying cause
place patient in fowlers position
encourage coughing and deep breathing techniques
prepare the client for thoracentesis
Treatment
◦ Pleurectomy
◦ Pleurodesis
Acute Respiratory Distress Syndrome
Pathophysiology
◦ A form of acute respiratory failure occurs as a complication caused by a
diffuse lung injury or critical illness and leads to extravascular lung
fluid.
Sign and Symptoms
◦
◦
◦
◦
◦
◦
◦
Tachypnea
Dyspnea
Decreased breath sounds
Deteriorating ABG levels
Hypoxemia
Decreased Pulmonary compliance
Pulmonary infiltrates
Nursing Intervention
◦ Administer oxygen as prescribed
◦ place the patient in fowlers position
◦ restrict fluid intake as prescribed
Treatment
◦ Administer diuretics, anticoagulants, or corticosteroids as prescribed
◦ prepare the patient for intubation and mechanical ventilation using PEEP