Guided Lecture Notes, Chapter 10, Nursing Management: Patients With Chest and Lower
Respiratory Tract Disorders
Learning Objective 1. Identify patients at risk for atelectasis and describe nursing interventions
related to its prevention and management (refer to PowerPoint slide 2)

Briefly review the anatomy and physiology of the lower respiratory system.

Describe the pathophysiology of atelectasis (refer to Figure 10-1).

Explain the risk factors, manifestations, and management of atelectasis:
o Emphasize preventative measures.
Learning Objective 2. Compare the various pulmonary infections with regard to causes,
clinical manifestations, nursing management, complications, and prevention.

Describe the pathophysiology, risk factors, diagnosis, manifestations, and management of
pulmonary tuberculosis (refer to PowerPoint slide 12):
o Ensure that students understand the unique characteristics of diagnostic testing
and pharmacologic treatment of TB (including the critical need for adherence).
o Give an overview of drugs and drug regimens relevant to the treatment of TB.

Differentiate between the major types of pneumonia (refer to PowerPoint slide 3).

Explain the pathophysiology and risk factors for pneumonia (refer to Box 10-3).
Learning Objective 3. Use the nursing process as a framework for care of the patient with
pneumonia (refer to PowerPoint slide 11)

Describe the manifestations of pneumonia, and relate these to relevant nursing
assessments.

Elicit nursing diagnoses relevant to pneumonia.

Describe interventions aimed at goals such as improved airway patency, energy
conservation, maintenance of proper fluid volume, maintenance of adequate nutrition, an
understanding of the treatment protocol and preventive measures, and absence of
complications (refer to PowerPoint slide 6)

Address the common complications of pneumonia and measures to address these:
o Emphasize the susceptibility of older adult patients.
Learning Objective 4. Describe the nursing management for patients receiving oxygen therapy,
mini-nebulizer therapy, incentive spirometry, chest physiotherapy, and breathing retraining.

Discuss indications for oxygen therapy (refer to Table 10-2 and PowerPoint slides 7
and 8).

Differentiate between the most common methods of oxygen delivery (refer to Figure 104).

Discuss the potential risks and benefits of oxygen therapy.

Describe the indications and technique for nebulizer administration.

Explain the role of incentive spirometry in preventing respiratory health problems and the
need for patient education about spirometry.

List indications for chest physiotherapy and breathing retraining.
Learning Objective 5. Relate pleurisy, pleural effusion, and empyema to pulmonary infection.

Describe the pathophysiology, risk factors, diagnosis, manifestations, and management
of:
o Pulmonary edema (refer to PowerPoint slide 15)
o Pleurisy (refer to PowerPoint slide 16)
o Pleural effusion (refer to PowerPoint slide 17)
o Empyema
Learning Objective 6. Relate the therapeutic management techniques of acute respiratory
distress syndrome (ARDS) to the underlying pathophysiology of the syndrome.

Discuss the pathophysiology and varied causes of acute respiratory failure (refer to
PowerPoint slide 18):
o Relate the pathophysiology of the condition to relevant nursing interventions.

Describe the pathophysiology of ARDS (refer to Figure 10-7).

Describe risk factors for ARDS (refer to Box 10-8).

Explain the nursing care of the patient with ARDS, with an emphasis on mechanical
ventilation (refer to PowerPoint slide 19)

Outline the pathophysiology, risk factors, diagnosis, manifestations, and management of
pulmonary arterial hypertension (refer to PowerPoint slide 22)
Learning Objective 7. Describe risk factors and measures appropriate for the prevention and
management of pulmonary embolism (PE).

Describe the pathophysiology, risk factors, diagnosis, manifestations, and management of
PE (refer to PowerPoint slide 23)
o Emphasize the importance of preventative measures, and elicit relevant measures.
o Differentiate between the various diagnostic tests relevant to PE.
o Emphasize the relationship between DVT and PE.
o Describe treatment measures, including anticoagulants and the related nursing
responsibilities (refer to PowerPoint slide 24)
Learning Objective 8. Describe risk factors for the development occupational lung disease.

Discuss the risk factors for silicosis, asbestosis, and coal worker’s pneumoconiosis (refer
to PowerPoint slide 25)
Learning Objective 9. Discuss the modes of therapy and related nursing management for
patients with lung cancer.

Give an overview of the epidemiological characteristics of lung cancer (refer to
PowerPoint slide 26).

Differentiate between the major types of lung cancer.

Explain risk factors and manifestations of lung cancer (refer to PowerPoint slide 27)

Describe the roles of surgery, radiotherapy, and chemotherapy in lung cancer treatment.

Elicit nursing interventions that address the physiological and psychosocial needs of the
patient with lung cancer.
Learning Objective 10. Describe the complications of chest trauma and their clinical
manifestations and nursing management (refer to PowerPoint slide 28)

Differentiate blunt from penetrating trauma and describe the common causes of each.

Explain the Advanced Trauma Life Support algorithm of Airway, Breathing, Circulation,
Disability (neurologic), and Exposure.

Give an overview of the medical management of chest trauma:
o Explain the use of chest tubes (refer to Figures 10-9 and 10-10).
o Provide a detailed explanation of intrathoracic pressures, in order to aid
understanding of the physics surround the use of chest tubes.
o Explain the major nursing responsibilities surrounding the use of chest drainage
systems (refer to Box 10-12).

Describe the major complications of chest trauma, with an emphasis on pneumothorax
(refer to PowerPoint slides 29 and 31)
o Differentiate between the types of pneumothorax (refer to Figure 10-12 and
PowerPoint slide 29).
o Describe nursing care relevant to the treatment of pneumothorax and link this
with the use of chest tubes (refer to PowerPoint slide 30)
Learning Objective 11. Describe nursing measures to prevent aspiration (refer to PowerPoint
slide 34)

Explain the importance of the prevention of aspiration and elicit nursing interventions to
achieve prevention.

Discuss emergency measures for a patient who is aspirating.
Learning Objective 12. Explain the principles of chest drainage and the nursing responsibilities
related to the care of the patient with a chest drainage system (refer to PowerPoint slide 30)

Provide an overview of the major types of chest drainage systems

Describe nursing assessments and interventions relevant to the patient with a chest tube