RNSG 1327 Transition to Professional Nursing Unit V – Care of the Patient Experiencing Commonly Occurring Health Problems Part G – Respiratory 1. 2. 3. Behavioral Objectives Apply the terms listed in the content column appropriate to the patient situations involving the respiratory system. Compare and contrast the normal anatomy and physiology to the pathophysiology of selected commonly occurring disease processes in the respiratory system. Analyze factors included in the assessment of the patient experiencing common occurring respiratory problems, including the developmental and cultural considerations. I. Content Outline Application of terms A. Bronchitis B. Dyspnea C. Hypercapnia (Hypercarbia) D. Paroxysmal nocturnal dyspnea (PND) E. Polycythemia F. Pulmonary toilet G. Pulsus paradoxes H. Sensoruim I. Ventilation J. Virus II. Anatomy & Physiology of Respiratory system A. Developmental considerations 1. Infant 2. Child 3. Adolescent 4. Adult 5. Older adult B. Pathophysiology of respiratory system 1. Impaired gas exchange 2. Immune/inflammatory process III. Selected commonly occurring problems A. Interview 1. Chief complaint 2. Precipitating event 3. Medical history 4. Family/ Social/occupational history 5. Medication history 1. Prescription 2. Nonprescription 6. Knowledge of health maintenance 7. Risk factors B. Physical exam – respiratory 1. Breathing pattern (rate, depth, rhythm, effort, symmetry) Clinical Objectives Learning Opportunities Readings: McKinney Lewis Berman & Snyder Adams Estes TVCC Library – Nursing Education in Video http://tvcc.ent.sirsi.net/client/tvcclibraries Anti-Infective Medication Therapy Series: Antifungal and Antiviral Agents Assessment of an Infection Cephalosporins, Aminoglycosides, Macrolides and Quinolones Nursing Implications Sulfonamides and Penicillins Assessment of Respiratory Distress in the Pediatric Patient Tuberculosis: New Strategies for the Healthcare Worker The Basics of Oxygen Administration RNSG 1327 Transition to Professional Nursing Unit V – Care of the Patient Experiencing Commonly Occurring Health Problems Part G – Respiratory Behavioral Objectives . Content Outline 2. Breath sounds 3. Color (central & peripheral) 4. Cough & sputum 5. Activity level 6. Capillary refill 7. Chest pain 8. Nasal flaring, chest retractions 9. Nails (clubbing) C. Diagnostic tests 1. Radiology 1. Chest x-ray 2. Laboratory studies 1. Complete blood count (CBC) (1) Electrolytes (2) Culture & sensitivity (3) Sputum (4) Peak and trough 3. Other 1. Pulmonary function test 2. Pulse oximeter D. Risks 1. Cultural influences 2. Hereditary 3. Environmental 4. Health beliefs/practices 5. Developmental (1) Age specific assessment data (a) (b) (c) (d) Vital signs Fluid /electrolytes Nutritional Behavioral/emotional response to health care providers Clinical Objectives Learning Opportunities #6009 – The Respiratory System Mosby’s Videos: Physical Examination and Health Assessment Nursing Video Skills Care of Infants and Children RNSG 1327 Transition to Professional Nursing Unit V – Care of the Patient Experiencing Commonly Occurring Health Problems Part G – Respiratory 4. 5. Behavioral Objectives Differentiate between the etiology, pathophysiology, and clinical manifestations of selected commonly occurring respiratory disease processes including immune – inflammatory process. Content Outline IV. Common Occurring Respiratory Problems A. Respiratory 1. Asthma 2. Upper respiratory infection 1. Colds 3. Lower respiratory infection 1. Pneumonia 2. Bronchitis Discuss analysis, planning, implementation, and evaluation for the nursing management of patients with commonly occurring respiratory disease processes. V. Selected Nursing Diagnoses/Implementation/ Evaluation A. Impaired gas exchange 1. Independent Interventions 1. See respiratory assessment 2. Pulmonary toilet 3. Positioning for maximum ventilation 4. Energy conservation measures 5. Breathing techniques 6. Monitor pertinent diagnostic tests 7. Decrease sputum viscosity 8. Allergen control 9. Avoid cigarette smoke 10. Turn, cough and deep breathe 2. Collaborative interventions 1. Oxygen support 2. Collaborate with respiratory therapy (1) Aerosol therapy (2) Chest physiotherapy with postural drainage (3) IPPB (4) Mist tent 3. Administer medications and monitor for desired/adverse/side effects Clinical Objectives Learning Opportunities RNSG 1327 Transition to Professional Nursing Unit V – Care of the Patient Experiencing Commonly Occurring Health Problems Part G – Respiratory Behavioral Objectives 3. 4. N/AND/Transition/RNSG 1327 Unit V Part G Respiratory Content Outline (1) Bronchodilators (2) Corticosteroids (3) Antibiotics (4) Mast cell inhibitors (5) Leukotrienes (6) Anticholinergics (7) Epinephrine Recognition of complications 1. Atelectasis 2. Pneumothorax 3. Respiratory failure 4. Pulmonary hypertension 5. Status asthmaticus Evaluation of Outcomes: The patient will have improved gas exchange as evidenced by: 1. Breathing pattern 2. Level of consciousness 3. Vital signs 4. Color 5. Cough /sputum 6. Activity tolerance level 7. Pulse oximeter Clinical Objectives Learning Opportunities Reviewed 03/12 Reviewed 03/13