Respiratory
Medical – Surgical Nursing
P10B
Nasal Cavity
• Location
– Btw mouth & cranium
• Function
–
–
–
–
Remove foreign bodies
Warm
Moisten
Olfactory
Nasal Cavity
• Contains
– Cilia
• Hair-like
– Sensitive nerve
endings:
• Sneeze
Para-Nasal Sinuses
• Description
– 4 pairs
– Facial area
– Continuous w/ nasal
cavity
• Function:
– Speech
Pharynx (throat)
• Passageway
– Food & liquids 
• Digestive tract
– Air 
• Respiratory tract
• Lowest portion
– Opens into 2 space
Pharynx (throat)
• Location
– Behind nasal cavity
• Contains
– Adenoids
– Tonsils
• Lymph system
– Eustachian tubes
Larynx (voice box)
• Location
– Btw pharynx & trachea
• Function
– Vocalization
– Facilitates
cough/sneeze
Larynx (voice box)
• Epiglottis
– Gateway / trap door
– Flap of elastic cartilage
• Thyroid cartilage
– Adam’s apple
Larynx (voice box)
• Vocal cords
– Speech
Trachea (Windpipe):
• Location
– Btw larynx & bronchi
• Description
– 4-5 inches long
– Palpate
• Above sternal notch
– C-shaped rings of
cartilage
Trachea (Windpipe):
• Function
– Conduct air
Bronchi
• Location
–
–
–
–
Below trachea
Center of chest
Behind the heart
Branches into 2 tubes
• Rt
– h diameter
– More vertical
– Shorter in length
Question?
Mr. Henderson had a CVA 5 days ago and is having
some difficulty swallowing. There is some question
that he may have aspirated some food and
developed pneumonia. What side pneumonia would
you except him to have?
A. Right sided
B. Left sided
Lungs
• Location
– Thoracic cage
• Description
Airtight
•
Mult. Air sacs
– Rt
•
• 3 lobes
– Lf
• 2 lobes
Lungs
• Bronchi
– Bronchial tree
• Bronchioles
– No cilia
– No cartilage
– Patency d/t
• elastic recoil of the
smooth muscles
• alveolar pressure
Lungs
• Alveolar ducts
– Smallest tubes
• Alveoli
–
–
–
–
Functional unit
Air sacs
Gas exchange
Surrounded by pulm.
Capillaries
Lungs
• Alveoli
– Thin membrane
– Tendency to
collapse
• Alveolar Pressure
• surfactant
Pleural membrane
• Location
– Surrounds surface of
lung & interior wall of
thorax
• Function
– Protects
– Neg. pressure
– Allows movement (i
friction)
Pleural membrane
• Pleural space/cavity
– Btw
– Contains fluid
Mediastinum
• Location
– Space btw lungs
• Contains
–
–
–
–
–
Heart
Large blood vessels
Esophagus
Trachea
Bronchi
Diaphragm
• Location
– Muscle btw lungs & abd.
Cavity
• Aids in resp
Skeletal System
• Ribs
– 12 pairs
– Thoracic cage
• Sternum
Pulmonary circulation
• Main function of resp.
system is to deviler O2
to the blood & remove
CO2 from it.
• Pulm. Art.
– CO2 / deoxygenated
• Pulm vein
– O2 / oxygenated
Blood flow: heart and lungs
• Inf/sup vena cave
• Rt atrium
– Tricuspid
• Rt ventricle
– Pulm
•
•
•
•
Pulm art
Pulm cap
Pulm vein
Lt atrium
– Bicuspid / mitral
• Left venticle
• Aorta
Small Group Questions
• Name the structures that air flows past on its
way to the lungs
• What is the function of the epiglottis?
• What are the supporting structures of the
trachea?
• Where in the circulation of blood do you find
deoxygenated blood?
• How many lobes do the rt and lf lungs each have?
• What is the purpose of the serous fluid btw the
pleural membranes?
Processes of respirations
Ventilation
• Movement of air in & out of the the tracheobronchial tree.
Delivering O2 to the alveoli & removing CO2
Perfusion
• Blood flow in the capillary bed in the lungs
Diffusion
• Movement of gases (O2 & CO2) across the alveoli membrane
• Flows from area of greater concentration to lesser
concentration
Patient airway
• Choking
Changes assoc. with aging
•
•
•
•
Cartilage hardens
Muscles weaker
i cough reflex
i elasticity
Assessment: Subjective
•
•
•
•
•
•
Nasal Congestion
Sore throat
Change in voice
Difficulty breathing
Orthopnea
Pain
• Cough
• Sputum
• Affect on ADL’s
History
•
•
•
•
•
•
•
•
Physical problems
Function problems
Life style
Smoking
Family Hx
Occupation hx
Allergens / environment
Anxiety
Inspection
• Normal chest
– 2x as wide as deep
– Anterior/posterior
diameter
• 1:2
Inspection
• Barrel chest
– D/t over inflation of
lungs
– anterior-posterior
diameter
• 2:2
Inspection
• Kyphosis
– AKA
• Hunchback
– Abnormal curvature of
the thoracic spine
Inspection
• Lordosis
– AKA
• Sway-back
– Abnormal curvature of
the lumbar spine
Inspection
• Uniform expansion of
the chest
• Intercostal spaces
Inspection
• Shoulder rise
• Accessory muscles
• Posture
Inspection:
• Trachea
– midline
• Color
• LOC
• Emotional state
Inspection: Breathing patterns
Rate
• Eupnea
– Normal
– 12-20 / min
• Tachypnea
– h rate
• Bradypnea
– i rate
Inspection: Breathing patterns
Depth
• Hyperventilation
– h depth & rate
• Hypoventilation
– i depth & rate
Auscultation
Purpose
• Asses air flow through
bronchial tree
Procedure
• Diaphragm of
stethoscope
• Superior  inferior
• Compare rt to lf
Auscultation: Results
Normal
• Vesicular
– Lung field
– Soft and low
• Bronchial
– Trachea & bronchi
– Hollow
Auscultation: Results
Adventitious
• Crackles
– air  bronchi with
secretions
• Fine crackles
– Air  suddenly
reinflated
• Course Crackles
– Moist
Auscultation: Results
• Wheezes
– Sonorous wheezes
• Deep low pitched
• Snoring
• Caused by air 
narrowed passages
• D/t h secretions
– Sibilant Wheezes
• High pitched
• Whistle-like
• Caused by air 
narrowed passages
• D/t constriction
– Asthma
Early & late signs of hypoxia
•
•
•
•
•
•
•
Anxiety
Bradycardia
Cyanosis
Depressed respirations
Diaphoresis
Disorientation
Dyspnea
•
•
•
•
•
•
•
Restlessness
Headache
Agitation
Poor judgment
Retraction
Tachycardia
Tachypnea
Dyspnea
• Definition
– SOB
– SOB, flat affect, BS x 4
Dyspnea
• Significance
– Common with cardiac & resp. disease
Dyspnea
• Orthopnea
– Sit up to breath
• COPD
• CHF
Dyspnea
• Right ventricle
– If chronic airway resistance 
– h pressure 
– Rt ventricle h work 
– Rt. Vent damage
Dyspnea
• Nrs Management
– Find cause
– Give O2
– HOB h
– Communication
• KISS
Cough
•
Definition
– To expel air from the lungs suddenly
– Irritation of mucous membrane
Cough
• Significance
– Infection
– Irritants
– Protective mechanism
Cough
• Nrs management
– Assess
– Describe
– Directed
– Pain control
• Splinting
– Infection control
– Suppressants / Anti-tussives
Sputum Production
Definition
• Matter discharged
from resp. track that
contains mucus and
pus, blood, fibrin, or
bacteria
Sputum Production
Significance
• Purulent
– Thick, yellow/green
– Bacteria
Sputum Production
Nrs Management
• Thick
– Hydrate
• h water
• Nebulizer
• Humidifier
•
•
•
•
TCDB
No smoking
Oral care
h Appetite
Do You Know?????
What breath sound would you expect to hear on
a patient with increased sputum
production?
A. Vesicular
B. Crackles
C. Sonorous wheezes
D. Sibilant wheezes
Obtaining a sputum specimen
• Explain
– From lungs
•
•
•
•
•
Sterile cup
Deep breath x 3 
Cough deeply
Expectorate
Best time for
specimen collection?
– AM
Chest pain
Significance
• Cardiac or pulmonary
Chest pain
Nrs Management
• Assess
• Analgesics OK, but…
• Position for pain
– Affected side
– Splint
Hemoptysis
Definition
• Expectoration of
blood from the
respiratory tract
Hemoptysis
Significance
• Pulm or cardiac
Hemoptysis
• Hemoptysis
– Definition?
• Coughed up blood
– From?
• Pulm hemorrhage
– Description
• Pink, red, mixed with
sputum
• Hematemesis
– Definition?
• Vomited blood
– From?
• Stomach / GI
– Description
• “Coffee ground”
Hemoptysis
Nrs Management
• Determine source
• Serious
Cyanosis
Definition
• Bluish coloring of skin
Dx tests
Pulse Oximeter
Purpose
• Noninvasive O2 Sat
Normal
• 95-100%
• <85% 
– Tissue is not receiving
enough O2
Pulse oximeter
Not reliable in…
• Cardiac arrest
• Dyes
• Anemia
Radiographic exams
•
•
•
•
•
•
Chest x-ray
CT scan
Angiography
Bronchoscopy
Thoracoscopy
Thoracentesis
Chest x-ray
Description
• 2-d image
Purpose
• Fluid
• Tumor
• Foreign bodies
Chest – X-ray
Nrs management
• Normal heart size & clear lung
field
CT Scan
Description
• Computerize Tomography
• With or without contrast
medium
Purpose
• Tissue
• Tumor
• Foreign bodies
• Fluid
CT scan
Nrs management
• Without contrast
medium
– No prep
• With contrast medium
– NPO 6 hrs
– Assess for allergies
Angiography
Purpose
• Visualize Pulm.
Circulation
Description
• Dye
• Femoral vein 
• Heart 
• Pulm Arteries
Angiography
Nrs. Management
• Pre-op
– NPO
– Check Allergies
• Shellfish/iodine
• Post-op
–
–
–
–
–
Lie flat 8 hrs
Sandbag
Check pedal pulses
Assess hemorrhaging
Push fluids
Bronchoscopy
Description
• Direct inspection of
larynx, trachea &
bronchi via flexible
tube (fiberoptic)
Purpose
• Examine
• Tissue sample
Bronchoscopy
• Nrs Management
• Pre-op
– NPO 6-8 hrs
– Sedation
•
Lung CA obstruction
Bronchoscopy
Nrs management
• Post-op
–
–
–
–
Side-ling until gag back
NPO till gag back
Check gag
Check bleeding
• Glottis stenosis
•
http://video.search.yahoo.com/search/vid
eo;_ylt=A0oGdXBnY59OcnwAuNNXNyoA?
ei=UTF-8&p=bronchoscopy&fr2=tabweb&fr=moz2-ytff-
Thoracentesis
Purpose
• Remove fluid
Thoracentesis
Nrs Management
• Position patient
• Support
• Post-op
– Vital signs q 15
• http://video.search.yahoo.com/search/video;_ylt=A0
oGdWeLZJ9OvQsAZ1lXNyoA?ei=UTF8&p=thoracentesis&fr2=tab-web&fr=moz2-ytff-
Sputum studies
• Check for
– Pathogens
• C&S
White Blood Cell Count
• Normal
– 5,000 – 10,000 cell/mm3
• Elevated
– Bacterial infection
• Decreased
– Viral infection
Hemoglobin
Normal
• Female: 12-16 g/dl
• Male:14-18 g/dl
Elevated
• COPD
• Dehydration
Decreased
• Anemia
• Hemorrhaging
Hematocrit
Normal
• Female: 37-47%
• Male: 42-52%
Elevated
• Dehydration
• Burns
• COPD
Decreased
• Anemia
• Leukemia
PTT/PT Partial Thromboplastin Time
• Prolonged
– Anticoagulant
Quiz?
•
A.
B.
C.
D.
The main function of platelets is to…
Provide oxygen to tissue
Fight viral infections
Fight bacterial infections
Form a blood clot
Platelets adhere to one another and play a very
important role in coagulation
Deep Breathing & Coughing
• Airway clearance
– Nrs Dx
• Ineffective airway
clearance
– h fluids
– Splinting
– Infection Control
Oxygen therapy
• Goal
– Provide adequate
transport of O2
– i work
– i stress to
myocardium
• Need for O2 based on
– ABG’s
– Clinical assessment
Oxygen therapy
• Cautions on O2 tx
– Med!
• Except in an emergency situation is
administered only with Dr. order
• Give O2 only to bring the pt back to baseline
– ***COPD
– WHY?
Oxygen therapy
• COPD & O2
– Normal - CO2 indicator to breath
– COPD – O2 indicator to breath
• d/t h CO2 levels “burned” medulla sensor for CO2
• Medulla uses O2 to initiate breath
COPD & O2
• COPD + h O2 
• i Resp
Oxygen therapy
• Precautions
–
–
–
–
Catalyst for combustion
“No smoking” sign
Tanks  missiles
No friction toys
Smoker's home destroyed and
neighbor injured
• Kalispell MO, 15 July 2004 A home on Kalispell's west side was
extensively damaged Wednesday morning by a fire that was
probably started by a cigarette and was accelerated by oxygen
from medical oxygen tanks. A neighbor, who was trying to
help was knocked down by the explosion of one oxygen tank,
which also caused temporary hearing loss for a police officer.
• A report by F. Ray Ruffatto of the fire department's prevention
division said that while the exact cause of the fire is still
undetermined, "initial investigation indicates the fire may be
the result of carelessly discarded smoking materials."
Smoker dies in house fire
Hudson MA 21 July 2004—
• The victim of yestrerday's fire died after suffering second- and thirddegree burns from a devastating blaze at her Manning Street home
Sunday.
• The resident was a smoker, according to State Fire Marshal Stephen Coan,
and he said the combination of cigarettes and the multiple oxygen tanks in
the home either caused or exacerbated the fire.
• She was in critical condition after being pulled from the house by a
neighbor and then died yesterday at UMass Memorial Medical Center,
University Campus in Worcester.
• The combination of oxygen tanks and cigarettes have sparked fires that
since 1997 have killed 16 people in the state and caused severe burns or
smoke inhalation in 20, said Coan.
The nurse is to teach a client with Chronic Obstructed
Pulmonary Disease safety precautions for using
oxygen at home. The nurse knows that the client
understands the safety principles discussed when he
says the following:
A. "Smoking is permitted when oxygen is in use."
B. "Fire extinguishers do not need to be stored."
C. "Acetone, oil, and alcohol are appropriate substances
to use with clients who are using oxygen."
D. "Avoid materials that generate static electricity."
A client is being discharged and will receive oxygen therapy
at home. The nurse is teaching the client and family
oxygen safety measures. Which of the following
statements by the cleint indicated the need for further
teaching?
A. I realize that I should check the oxygen level of the
portable tank on a consistent basis
B. I will keep my scented candles within 5 feet of my
oxygen tank
C. I will not sit in front of my wood-burning fireplace with
my oxygen on.
D. I will call the physician if I experience any shortness of
breath
A cyanotic client with an unknown diagnosis is
admitted to the emergency room. In relation to
oxygen, the first nursing action would be to…
A. Wait until the client’s lab work is done (ABG’s)
B. Not administer oxygen unless ordered by the
physician
C. Administer oxygen at 2 Liters flow per minute
D. Administer oxygen at 10 Liters flow per minute
and check the client’s nail beds frequently
Oxygen
Side effects
• O2 
• Hyper or hypo
ventilation?
– Hypoventilation 
Method of O2 Administration
Nasal Cannula
• Flow rate
– 1-6 L/min
• FiO2
– 20-40%
• Nrs
– Talk & eat
– Comfort
– Nose breather
Method of O2 Administration
Simple Mask
• Flow rate
– 6-10 L/min
• FiO2
– 40-60%
• Nrs
– Higher flow rate
Method of O2 Administration
Partial Re-breather Mask
(Reservoir)
• Flow rate
– 6-10 L/min
• FiO2
– 60-100%
• Nrs
– Uses reservoir to capture
some exhaled gas for
rebreathing
– Vents allow room air to mix
with O2
Method of O2 Administration
Non-rebreather Mask
• Flow rate
– 6-10 L/min
• FiO2
– 70-100%
Method of O2 Administration
• Nrs
– Side vents closed
– Reservoir vent closed
for I, open for E
– Reservoir bag stores
O2 for I but does not
allow E air in
– Reservoir never
collapse to <½
Method of O2 Administration
Venturi
• Flow rate
– 4-8 %
• FiO2
– 20-40%
• Nrs.
– Precise % of O2
– i.e. COPD
• Which one of the following conditions
could lead to an inaccurate pulse oximetry
reading if the sensor is attached to the
clients ear?
A.
B.
C.
D.
Artificial nails
Vasodilation
Hypothermia
Movement of the head
A nurse is having difficulty setting up humidified
oxygen at 40% per Venturi mask and does not
know how many liters of flow she should use.
Which of the following actions is most
appropriate to ensure safe oxygen
administration?
A. Consult with a respiratory therapist.
B. Look at the package directions and try to figure
it out.
C. Ask the nursing assistant how to set it up.
D. Use a regular oxygen mask.
When oxygen therapy via nasal cannula is ordered for
a patient, the first action by the nurse is to:
A. Post an “oxygen in use” sign on the door to the
room
B. Adjust the oxygen level before applying the cannula
C. Explain the rules of fire safety and oxygen use
D. Lubricate the nares with water-soluble jelly
The nurse is beginning the shift and is assessing the
oxygen exchange on a neonate. The nurse reviews
the chart for pulse oximetry reading for the last 8
hours.
Time
7am
9am
11am
1am
3am
Reading
95%
90%
90%
85%
80%
The pulse oximetry reading at 3:30 PM is
75%. What should the nurse do first?
A. Administer oxygen via mask
B. Swaddle the neonate in heated blankets
C. Reassess the oximetry reading in 30
minutes
D. Draw blood gases for oxygen and carbon
dioxide levels.
Nebulizer Mist Treatment
• Deliver Moisture OR
medication directly
into the lungs
• Topical – i systemic
S/E
• Indications:
– Must be able to deep
breath
Nebulizer Mist Treatment
Meds:
• Bronchodilators
– Albuteral (ventolin)
• Corticosteroids
• Mucolytic agents
– Acetylcysteine
• Antibiotics
Metered Dose Inhaler
• Admin. Topical meds
directly into the lungs
• i systemic S/E
• Meds:
– Corticosteroids
– Bronchodilators
– Mast cell inhibitors
Metered Dose Inhaler
Procedure
• Canister into unit
correctly
• Shake gently
• Hold inhaler – breath
out slowly (not into
inhaler)
Metered Dose Inhaler
• Place mouthpiece into
your mouth
• Close lips around it
• Tilt head back
• Keep tongue out of way
• Press top of the canister
firmly & breath in through
your mouth
Metered Dose Inhaler
• Remove inhaler from
mouth
• Hold breath for
several seconds
• Breath out slowly
Metered Dose Inhaler
Rinse your mouth afterward to help reduce
unwanted side effects
The nurse is teaching a client with asthma about the
proper use of a metered-dose inhaler. Which
statement by the client indicates that the
teaching was effective?
A. "I'll flex my head forward and breathe out
forcefully before inhaling the drug."
B. "As I press down on the canister, I'll inhale slowly
over 10 seconds."
C. "I'll hold my breath for 5 seconds after inhaling
the drug to allow the drug to reach my lungs."
D. "I'll wait one minute between puffs."
Incentive Spirometry
• Device enc. Deep
breath
• Prevent & tx
Atelectasis
• Procedure
– Inhale!
Nursing Diagnosis
- Respiration
•
•
•
•
Airway Clearance, ineffective
Aspiration, risk for
Breathing Pattern, ineffective
Gas Exchange, impaired
Ineffective Airway Clearance
• R/T
– Artificial airway
– Excessive or thick secretions
– Inability to cough effectiviely
– Infection
– Obstruction / restriction
– Pain
– Other
Ineffective Airway Clearance
• AMB (AEB)
– Ineffective cough
– Inability to remove airway secretions
– Abnormal breath sounds
– Abnormal respiratory rate, rythm depth
Ineffective Airway Clearance
• Plan / Outcome / Goal
– Maintain patent airway AEB
• Clear breath sounds
• Respiratory easy and unlabored
• Normal respiratory rate
Ineffective Airway Clearance
Nursing interventions
•
•
•
•
•
•
•
Assess respiratory rate, depth, •
rhythm, effort and breath sounds
Position: HOB elevated
Promote optimum level of activity
for best possible lung expansion
•
Ambulate / Chair
Turn/reposition
Suction prn
Encourage fluids
Facilitate airway clearance
–
–
–
–
Deep breathing
Pursed lips
Incentive spirometry
Cough Aerosol therapy
Chest physiotherapy
COPD - overview
COPD?
–
•
Chronic Obstructive Pulmonary Disease
Broad classifications of disease
COPD
• Characterized by
– airflow limitation
– Irreversible
– Dyspnea on exertion
– Progressive
– Abn. inflammatory response of the lungs to
noxious particles or gases
Pathophysiology
• Noxious particles of gas 
• Inflammatory response 
• Narrowing of airway
Pathophysiology
• Inflammation 
• Thickening of the wall of the pulmonary
capillaries
• (Smoke damage & inflammatory process)
COPD
• Includes
– Emphysema
– Chronic bronchitis
• Does not include
– Asthma
COPD - FYI
• COPD 4th leading cause of death in the US
• 12th leading cause of disability
• Death from COPD is on the rise while death
from heart disease is going down
COPD
Risk Factors for COPD
• Exposure to tobacco smoke
–
•
•
•
80-90% of COPD
Passive smoking
Occupational exposure
Air pollution
COPD risk factors
• #1
– Smoking
• Why is smoking so bad??
– ↓ phagocytes
– ↓ cilia function
– ↑ mucus production
Chronic Bronchitis
• Disease of the airway
• Definition:
– cough + sputum production
– > 3 months
Chronic Bronchitis
Pathophysiology
• Pollutant irritates airway 
• Inflammation
• h secretion of mucus
Chronic Bronchitis
• Plugs become areas for bacteria to grow and
chronic infections which increases mucus
secretions and eventually, areas of focal
necrosis and fibrosis
Chronic Bronchitis
• Bronchial walls thicken
– Bronchial Lumen narrows
– Mucus plugs airway
• Alveoli/bronchioles become damaged
• ↑ susceptibility to LRI
What do you think?
Exacerbation of Chronic bronchitis is most likely
to occur during?
A. Fall
B. Spring
C. Summer
D. Winter
Emphysema
Pathophysiology
• Affects alveolar membrane
– Destruction of alveolar wall
– Loss of elastic recoil
– Over distended alveoli
Emphysema
Pathophysiology
• Over distended alveoli
– Damage to adjacent pulmonary capillaries
– h dead space
– Impaired passive expiration
•  Impaired gas exchange
Emphysema
• Impaired gas exchange
– impaired expiration
• Hypoxemia
• h CO2
Emphysema
• Damaged pulmonary capillary bed
– h pulmonary pressure 
– h work load for right ventricle 
– Right side heart failure
COPD
Compare and contrast
• Chronic Bronchitis is a disease of the
___________?
– Airway
• Emphysema is a disease affecting the
___________?
– Alveoli
C.O.P.D.
• Risk factors, S&S, treatment, Dx, Rx
- same for Chronic Bronchitis & Emphysema
C.O.P.D.
Clinical Manifestation (primary)
1. Cough
2. Sputum production
3. Dyspnea on exertion
(Secondary)
•
•
•
Wt. loss
Resp. infections
Barrel chest
C.O.P.D.
Nrs. Assessment
•
•
•
•
•
•
Risk factors
Past Hx / Family Hx
Pattern of development
Presence of comobidities
Current Tx
Impact
• ABG’s
– Baseline PaO2
• Rule out other diseases
– CT scan
– X-ray
C.O.P.D.
Medical Management
• Risk reduction
– Smoking cessation!
• (The only thing that slows down the progression of the
disease!)
C.O.P.D.
Rx. therapy
Primary
• Bronchodilators
• Corticosteriods
Secondary
• Antibiotics
• Mucolytic agents
• Anti-tussive agents
Bronchodilators
• Action:
– Relieve bronchospasms
– Reduce airway obstruction
– ↑ ventilation
Bronchodilators
• Examples
– Albuterol (Proventil, Ventolin, Volmax)
– Metaproterenol (Alupent)
– Ipratropium bromide (Atrovent)
– Theophylline (Theo-Dur)*
* Oral
Glucocorticoids
• Action
– Potent anti-inflammatory agent
Corticsteriods
• S/E
– Cushing
• Moon face
• Na+ & H20 retention
– Never discontinue abruptly
• What affect do corticosteroids have of
blood sugar levels?
Glucocorticoids
• Examples
– Prednisone
– Methyprednisone
– Beclovent
C.O.P.D.
Medical Management
• Treatment
– O2
• When PaO2 < 60 mm Hg
– Pulmonary rehab
• Breathing exercises
• Pulmonary hygiene
Nursing Management
•
•
•
•
•
•
Impaired gas exchange
Ineffective airway clearance
Ineffective breathing patterns
Activity intolerance
Deficient knowledge about self-care
Ineffective coping
Exercise has which of the following
effects on clients with asthma,
chronic bronchitis and emphysema?
A.
B.
C.
D.
It enhances cardiovascular fitness
It improves respiratory muscle strength
It reduces the number of acute attacks
It worsens respiratory function and is
discouraged