Question

I. Read Chapters 25 to 28 for Quiz # 7 ( Next Week)

II. Read and write about the following subjects:

A) Asthma and COPD. Description. Etiology. Clinical Manifestations. Nursing Assessment, diagnosis and management.

B) Methods of Oxygen Administration.

Answer 1

Answer :

II) A

ASTHMA

COPD (Chronic Obstructive pulmonary disease)

Description : Asthma is a medical condition that affects the lungs. In asthmatic condition lungs become narrow, swellon and inflammed and produce extra mucus. So breathing difficulty, wheezing, triggor coughing can occur. In some person's it can be a major problem that interferes with daily activities and may lead to life threatening asthma attack. Asthma cannot be cured, but can controll some symptoms. Etiology : combination of environmental and genetic factors, airborne allergens such as dust, mites, mold spores, pollen etc. wheather respiratory infections such as common cold Air pollutantants stress certain medication including beta blockers, aspirin nonsteroidal inflammatory drugs, etc. Clinical manifestations : breathing difficulty chest tightness or pain wheezing tiredness sleeplessness common cold productive cough Anxiety Nursing assessment : Take vital signs : temparature, pulse, respiration, BP, SPO2 General condition for audiable wheezing,body build,pallor, ictres, clubbing, cyanosis,lymph adenopathy,edema ect Inspection : bilateral chest movement, breathing difficulty, accessory muscle usage, nose, throat, upper airways Ausculation : wheezing sound may present , high pitched whistling sound chest X-ray findings may including bronchial wall thickening Nursing Diagnosis : Ineffective breathing pattern related to increased of secretions Impaired gas exchange related to altered delivery of inspired SPO2 Productive cough related to excessive secretion in the airway pathway Anxiety related to perceived threat of death Sleeplessness related to difficult to breathing while sleeping Management : Maintain oxygen saturation by oxygen administration Broncho dialators like salbutamol and ipratropium bromide, steroids like budesonide Injection hydrocortizone, inje. deriphilline. Maintained semi fowler's position administer steam inhalaton with salbutamol eat healthy food exercise like walking cover nose and mouth mainatain healthy weight

Description : It is a group of disease include emphysema and chronic bronchitis that obstructbthe airway pathway. Emphysema : slowly destroys air sacs in lungs. Bronchitis : inflammation and narrowing of the bronchial tubes. There is no cure, symptomatic treatment can control the disease. Etiology : smoking Long term exposure to lung irritants such as air pollutions, chemical fumes etc. genetic condition called alpha 1 antitrypsin defficiency Asthma can lead to COPD Clinical manifestaions : productive cough shortness of breath wheezing chest tightness fatigue weight loss Sleeplessness Nursing assessment : Vital signs : temparature, pulse, respiration, BP, SPO2 Genaral condition of the patient including wheezing, body build, pallor, ictres, clubbing, cyanosis, lymph adenopathy, edema, etc Inspection : An expanded chest is present in COPD, Wheezing during normal breathing, Taking longer to exhale fully, decreased breath sound Auscultaion : Coarse crackles sound may present in auscultation X-ray may show the enlarged lungs Nursing diagnosis : Ineffective airway clearance related to increased production of secretion as evidenced by difficulty to breath Impaired gas exchange related to bronchospasmb as evidenced by breathing difficulty ineffective breathing pattern related to increased production of secretion Risk for infection related to allergic airways as evidensed by cough Activity intolerance related to breathing difficulty as evidenced by fatigue Management : stop smoking Short acting broncho dilators like albuterol, ipratropium Long acting bronchodilators such as salmetarol, tiotropium etc. inhaled steroid such as fluticasone to reduce airway inflammation oral steroids lung therapies eat halthy food maintain positions while sitting and sleeping Surgical management : lung transplant Bullectomy

B. Methods of oxygen administration :

Oxygen administration is the key treatment in respiratory care. Oxygen administration is the procedure that provide at concentration of pressure greater than that found in the environemental atmosphere.

The purpose of oxygen therapy is to increase oxygen saturation in tissues where the saturation levels are too low due to illness or injury.

Oxygen can administer through :

• Nasal cannula : It is a disposable , plastic device with two protruding prongs for insertion to the nostrils. Oxygen can be given 24 % to 44 %
• simple mask : It is made of clear flexible plastic or rubber that can be molded to fit the face. It deliverse 35 to 60 % oxygen
• Partial re-breather mask :The mask is with a reservoir bag that must remain inflatted during both inspiration and expiration concentration upto 80 %
• Non-re breather mask (NRBM) : This mask provided the highest concentration of oxygen 95 to 100 %
• venturi mask : It is high flow oxygen delivery device from 40 to 50 %
• oxygen hood : An oxygen hood is used for babies whocan breath on their own but still need extra oxygen
• oxygen tent :It is consist of a cannopy placed over the head and shoulder or over the entire body
• ambu bag : Artificial manual breathing unit , is a hand held device commonly used to provide positive pressure ventilation
• tracheostomy collar : inserted direct into trachea is indicated for chronic oxygen therapy neede
• T-piece : used on end of ET tube when weaning from ventilator