Respiratory Disorders

CHAPTER 2 Respiratory Disorders

Section One Acute Respiratory Disorders

Acute respiratory disorders are short-term diseases or acute complications of chronic conditions. They can occur once and respond to treatment or recur to further complicate an underlying disease process.

imageAtelectasis

Nursing Diagnoses and Interventions

For Patients at Risk for Atelectasis

Nursing Interventions

Deep breathing expands the alveoli and aids in mobilizing secretions to the airways, and coughing further mobilizes and clears the secretions. Monitor patient’s progress and document in nurses’ notes.

imagePneumonia

Overview/Pathophysiology

Pneumonia is an acute bacterial or viral infection that causes inflammation of the lung parenchyma (alveolar spaces and interstitial tissue). As a result of the inflammation, involved lung tissue becomes edematous and air spaces fill with exudate (consolidation), gas exchange cannot occur, and nonoxygenated blood is shunted into the vascular system, with resulting hypoxemia. Bacterial pneumonias involve all or part of a lobe, whereas viral pneumonias appear diffusely throughout the lungs.

Influenza, which can cause pneumonia, is the most serious viral airway infection for adults. Patients more than 65 yr old, residents of extended care facilities, and individuals with chronic health conditions have the highest mortality from influenza.

Pneumonias usually are classified into two general types: community acquired and hospital associated (nosocomial). A third type now recognized is pneumonia in the immunocompromised individual.

Assessment

Findings are influenced by patient’s age, extent of the disease process, underlying medical condition, and pathogen involved. Generally, any factor that alters integrity of the lower airways, thereby inhibiting ciliary activity, increases the likelihood of developing pneumonia (TABLE 2-1).

Diagnostic Tests

Collaborative Management

Nursing Diagnoses and Interventions

For Patients with Pneumonia

Nursing Interventions

Nursing Interventions

Nursing Interventions

Recognize risk factors for patients with tracheostomy: presence of underlying lung disease or other serious illness, increased colonization of oropharynx or trachea by aerobic gram-negative bacteria, greater access of bacteria to lower respiratory tract, and cross-contamination caused by manipulation of tracheostomy tube.

imagePatient-Family Teaching and Discharge Planning

Provide verbal and written information about the following:

imagePleural Effusion

Nursing Diagnoses and Interventions

Ineffective breathing pattern

related to decreased lung expansion secondary to fluid accumulation in the pleural space

imagePulmonary Embolism

Assessment

Diagnostic Tests

Collaborative Management

The three goals of therapy are (1) prophylaxis for individuals at risk for development of PE, (2) treatment during acute embolic event, and (3) prevention of future embolic events in individuals who have experienced PE.

Anticoagulation

Low molecular weight heparin (LMWH) or unfractionated heparin (UFH) therapy

Started immediately in patients without bleeding or clotting disorders and in whom PE is strongly suspected with the aim of inhibiting further thrombus growth, promoting resolution of the formed thrombus, and preventing further embolus formation. Continued for at least 5 days to allow for depletion of thrombin.

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Sep 1, 2016 | Posted by in NURSING | Comments Off on Respiratory Disorders

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