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Respiratory Presentation

Transcript: Assessment: Observe childs physical appearance noting lethargy, general malaise, objective information such as body language, facial grimmacing and complaining of pain or discomfort. Obtain vitals and get general information regardomg onset of symptoms and recent activites that may have exposed child. Nursing Diagnoses: Primary: Pain related to viral infection secondary to destruction of epithelial cells as manifested by body aches and general malaise Risk for Knowledge deficit. Children may not know any preventative measures such as washing hands and covering their mouths when they cough, so teaching is essential Risk for fluid volume deficit Risk for developing Pneumonia Interventions 1.Administer analgesics and anitipyretics 2. Follow Droplet and standard precautions 3. Provide cool humidified air 4. Encourage pt to get plenty of rest and drink ample amounts of fluids (IV fluids if needed) 5. Regular monitoring of Vitals, esp. Temperature 6. Monitor I/O's for signs of dehydration 7. Watch for signs and symptoms of developing Pneumonia 8 Provide warm heating pads to relieve myalgia 9. Review prevention of future episodes with pt Influenza is an acute, highly contagious viral respiratory infection caused by one of three types of Influenzae. It occurs globally, with peak incidences occuring during the winter months Transmission: Spread from person to person with direct contact by large droplet infection Pathophysiology: Virus has an affinity for epithelial cells of the respiratory tract mucosa, where it destroys ciliated epithelium with metaplastic hyperplasia of the trachial and blochial epithelium with associated edema Influenza Sarah Gustason Kate Haynes Rachel Leary Types of Viruses 3 types: A Virus: -Most infective of the three. Affecting a wide variety of warm blooded-mammals such as: *Horses, birds, pigs, and humans among others Avian Flu: Derived from acquatic birds and serves as the natural reservoir for all subtypes of Influenza A B virus: -Isolated from Seals C Virus: -Isolated from pigs and dogs References Hockenberry, M., & Wilson, D. (2013). The Child with Respiratory Dysfunction. In Wong's Essentials of Pediatric Nursing (Ninth ed., pp. 716-717). St. Louis: Mosby Nursing Interventions for Influenza. (2010, November 3). Retrieved February 24, 2015, from http://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-influenza.html Patient Education: Influenza. (2008, December 1). Retrieved February 24, 2015, from http://www.nursingcenter.com/lnc/journalarticle?Article_ID=834515 Symptoms & Risk Factors Symptoms of the Flu: 1.Fever of 100.4ºF -104ºF 2. Body aches and muscle pain -Often Sever. Occuring mostly in back arms and legs 3. Headache 4. Occulomotor pain 5. Fatigue and loss of appetite 6. Dry cough, runny nose and sore throat Risk Factors: * Exposure to the virus * Young children and older adults (65+) * Women who are Pregnant * Individuals with COPD * Those who are immunocompromised such as people with AIDS or people going through chemotherapy Nursing Process What is the Flu?? Teaching & Education *Inform Parents and Pts of available flu vaccines and provide detailed hard copy of information. *Inform parents of children who are immunocompromised to protect their immune system by avoiding large crowds or to wear a mask if crowds are inevitable to prevent infection during flu season *Teach children proper handwashing techniques as well as other family members *Teach child and family the importance of covering their mouths when sneezing or coughing as the virus is spread by droplet contact *Staying home when sick *Keeping rubbing or touching of eyes nose or mouth to a minimum prior to washing hands *Stress importance of establishing good health habits such as getting plenty of sleep, staying well hydrated, and eating healthy foods

Respiratory Presentation

Transcript: Video Link: Websites: an allergic disorder of respiration, characterized by bronchospasm, wheezing, and difficulty in expiration, often accompanied by coughing and a feeling of constriction in the chest. The diaphragm is a muscle and when it expands, it creates a negative pressure in the lungs, this makes the air outside (which has a relatively positive pressure) want to flow into the lungs and maintain equilibrium. When the diaphragm contracts it creates a positive pressure in the lungs and the air is forced out. Hilus- the tube in humans and other air-breathing vertebrates extending from the larynx to the bronchi, serving as the principal passage for conveying air to and from the lungs; the windpipe. Combination inhalers Alveoli- Past, Present, & Future Surgical & Healing Methods Bronchus- *Herbal Remedies *Vaccines *Mechanical Ventilation on the ends of the bronchioles Vocabulary How the Respiratory system works with the Circulatory and Nervous system to control breathing... Foreign particles in the system... By: Halle Hanks Kathryn Farley Natalie Foster Bibliography The job of the larynx is to produce sound and it is another name for the voice box. Epiglottis plural of bronchus. a muscular and cartilaginous structure lined with mucous membrane at the upper part of the trachea in humans, in which the vocal cords are located. either of the two main branches of the trachea. A Career dealing with the Respiratory System Diaphragm http://www.youtube.com/watch?v=hc1YtXc_84A Trachea Respiratory Therapist In England during the seventeenth century, it was the custom for all those within earshot of someone who sneezed to remove their hats, bow, and shout, "God bless you!" In nineteenth-century England, someone originated a rhyme regarding the consequences of sneezing on certain days of the week: Sneeze on Monday, sneeze for danger. Sneeze on Tuesday, kiss a stranger. Sneeze on Wednesday, sneeze for a letter. Sneeze on Thursday, something better. Sneeze on Friday, sneeze for woe. Sneeze on Saturday, a journey to go. Sneeze on Sunday, your safety seek—for Satan will have you for the rest of the week! 1st Period The air first enters into the nasal cavity then proceeds to the pharynx. Air is warmed by the nasal passages. It passes through the trachea, then to the main bronchi and begins its descent into numerous bronchioles in the lungs. , At the ends of each bronchiole, there are clumps of aveoli. Here, the air we breathe passes into the bloodstream as oxygen. At the same time, carbon dioxide is released from the bloodstream to the aveloi, which expel it into the bronchioles, up through the lungs to the main bronchi, up the trachea, and back up to and out either the nose or the mouth. bronchi: big branch bronchioles: smaller branches Long-acting beta agonists (LABAs) a thin, valvelike, cartilaginous structure that covers the glottis during swallowing, preventing the entrance of food and drink into the larynx. When a foreign particle enters the system, a reflex is triggered. Your body will either cough or sneeze to get rid of the irritants before they reach the alveoli. Steps to expel foreign particles include... 1. Irritation 2. Inhalation 3. Compression 4. Expulsion Diffusion: oxygen enters the alveoli, and from there diffuses into the blood, while carbon dioxide moves out of the alveoli and into the bronchioles, and is exhaled normally. Epiglottis- http://www.lung.org/your-lungs/how-lungs-work/?gclid=CKq6jOeslK8CFWuHtgodnFILzQ a small branch of a bronchus. Leukotriene modifiers Trachea- How the parts of the system work together to get the Body oxygen Asthma: Superstitions!!!!!!!! Intro to Respiratory System the region at which the vessels, nerves, etc., enter or emerge from a part. Larynx- The Respiratory System Required Education: One must have, at least, an associate degree to work as a respiratory therapist, but most programs that train people to work in this field offer bachelor's degrees as well. Respiratory therapy students will take many science-oriented courses including human anatomy and physiology, physics and microbiology. They will also learn about therapeutic and diagnostic procedures, patient assessment and medical recordkeeping and reimbursement. Job Requirements: To work as a respiratory therapist in the U.S. (except in Alaska and Hawaii) one must pass the Certified Respiratory Therapist Exam (CRT) which is administered by the National Board for Respiratory Care. Respiratory therapists must be able to: •pay attention to detail •work on a team •follow instructions •use a computer *Many employers require CPR (cardiopulmonary rescusitation) certification. Nervous: -The Medula, located inside the Brain stem, controls involuntary muscle movement-breathing -The spinal cord delivers the messages from the brain to the rest of the body a thin, valvelike, cartilaginous structure that covers the glottis during swallowing, preventing the entrance of food and drink into the larynx. Bronchi- an air cell of the

Respiratory Presentation

Transcript: Self-management techniques (Nottingham University Hospitals, 2012) Patient's ABGs : pH 7.37 7.35-7.45 PCO2 5.7 4.7- 6.0 PO2 10.2 >10 HCO3 25 22-26 BE +1 +/- 2 Nebulisers MOSENIFAR, Zab (2013). MedScape. [online]. Last accessed 17 December 2013 at: http://emedicine.medscape.com/article/297664-treatment#aw2aab6b6b3 NICE (2010). Chronic obstructive Pulmonary Disease. [online]. Last accessed 18 December 2013 at: http://www.nice.org.uk/nicemedia/live/13029/49397/49397.pdf NOTTINGHAM UNIVERSITY TRUST (2012). Active Cycle of Breathing Technique (ACBT) Guideline for Practice. [online]. Last accessed 18 December 2013 at: https://www.nuh.nhs.uk/handlers/downloads.ashx?id=39576 SCHWEIGER, Teresa A. and ZDANOWICZ, Martin (2010). Systemic Corticosteroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease. American Journal of Health-System Pharmacy, 67 (13), 1061-1069. YAMAGUTI, Wellington P, et al. (2012). Diaphragmatic Breathing Training Program Improves Abdominal Motion During Natural Breathing in Patients WithChronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 93 (4), 571-577. Drug History (Schweiger and Zdanowicz 2010) This patient has increased sputum - I'm thinking obstruction/restriction in the airways which is causing the hyperinflation/barrel chest - "What can I do to clear these secretions?" Patient has R lower zone crackles - Fits with the increased sputum - "How can I get the air to the lower zones to help push those secretions up?" Secretions are in the R lower lobe, therefore, I want to get air as low into the lungs as possible to loosen those secretions and push them up Normal SATs for a COPD patient is approx. 88%-92% - this patient has SATs of 93% - quite stable Nil else Contraindications Tightness in chest Increased or thick secretions Pneumonia (congestion) Atelectasis What is Chronic Obstructive Pulmonary Disease? Thanks For Listening Name: Christos Gavras Date of Birth: 01/01/1947 (aged 65) Referral Date: September 2013 Stage 1 (COPD Foundation, 2013) So what am I thinking for this patient.....? NICE (2010) Side effects Used as an umbrella term for a collection of lung diseases including: bronchitis, emphysema and chronic asthma Inflammation of the lungs Common symptoms: Breathlessness, Persistent cough and phlegm, Frequent chest infections, Wheezing Relative to COPD, systemic steroids decrease the inflammation of the airways (reducing swelling and mucus production), making it easier to breath Not suitable for: Patients that cannot walk Unstable angina Recent myocardial infarction Strengthen the diaphragm Decrease the work of breathing by slowing your breathing rate Decrease oxygen demand Use less effort and energy to breathe Apply the most appropriate intervention for 3/7 to ensure his technique is correct. Educate the patient regarding the importance of continuing these interventions until D/C Mobilise patient around the ward to improve exercise tolerance. Advise patient to continue exercise to prevent reversibility Pulmonary Rehabilitation Programmes Plan NICE (2010) Referred to respiratory Physio clinic Increasing sputum production over the last 9/12 2 admissions in last 12 months with chest infection Normally expectorates moderate amount of creamy secretions each morning but has found this increasingly difficult and larger amounts of sputum being produced Patient walks to the pub each evening but is having to stop to "catch his breath" Objective Assessment Pursed Lip Breathing Systemic Steroids Loosen and reduce secretions Reduce breathlessness to increase exercise tolerance Diagnosis - COPD If one or more of the following do not occur, Nebulised therapy should not be continued: a reduction in symptoms an increase in the ability to undertake activities of daily living an increase in exercise capacity an improvement in lung function If however, a nebuliser has been prescribed, the patient should be provided with equipment, servicing, advice and support History of Present Condition Lives with wife in a house with stairs Ex-welder Smoker 30 pack years Alcohol intake > 30 units/week Independent with personal hygiene Patients should be made aware of the benefits and the commitment required to gain these Osteoporosis (bone weakening), which is common Recurrent infections A cloudy area in the lens of the eye (cataracts) Thin, fragile skin that bruises easily Increased risk for sores in the stomach (ulcers) Increased blood pressure (autonomic hyperreflexia) Increased pulse History of adverse reaction to the medication. Due to high efficacy, the use of systemic steroids is widely accepted and recommended Social History Potential Interventions Heart Rate: 78bpm BP: 132/92 Capillary Refill: <2sec Temperature: 36.5 Increased secretions Reduced exercise tolerance/increased breathlessness Aims To remove secretions Atelectasis (Complete/part of the lung collapses) Obtain sputum specimens for analysis Promote

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