Atelectasis
What is it?
o Collapse of the alveoli
Decreased lung volume
Surfactant inactivation
What’s it look like?
o Dyspnea,
... [Show More] cough, decreased breath sounds
o Sputum production
o Leukocytosis/fever
Types
o Compressive – external force compressive lung/cavity; tumor, pleural effusion, abdominal distention, etc.
o Obstructive – secretions, mucous plugs, foreign bodies, hypoventilation
Risk factors
o Post OP patients
Decreased breathing due to pain, mediations/sedation, decreased mobility of secretions
o Chronic lung disease
o Morbid obesity
o Tobacco use
Treatment
o Early ambulation/turning, etc. (mobilization of secretions)
o Incentive spirometer
o Chest physiotherapy/nebulizers
o Hydration
o Various positions – can help promote the evacuation of secretions
Pneumonia
What is it?
o Infection of the lower respiratory tract – inflammation of the lungs
Types
o Bacterial, viral, fungus, aspirations
o CAP (Community acquired), HAP (Hospital acquired), VAP (Ventilator associated)
What’s it look like?
o Inflammation of the lungs that interfere with gas exchange
o Alveolar edema
o Fever
o Cough
o Pleuritic chest pain (pain on inspiration)
o Leukocytosis (increased WBC = infection)
o Sputum (look at color, odor, consistency, amount) – early morning sputum most accurate
o Tachypnea
o Use of accessory muscles
o Crackles
o Fremitus
Risk factors
o Smoking, occupational exposures, malnutrition, elderly (decreased mobility)
o Increased risk of death with: COPD, heart failure, diabetes, CKD or liver failure
Treatments – usual improvement within 24-48 hours
o Improve airway patency – gas exchange – deep breath and cough
o Conserve energy (infection increases metabolic rate)
o Proper hydration (2-3L/day)
o Proper nutrition (high calorie & protein)
o Ambulation
o Vaccination
o Incentive spirometer
Respiratory Delivery Systems
Respiratory infection/Acute respiratory disorders
o Health promotion/prevention
Hand hygiene
Encourage immunizations
Limit exposure to airborne allergens
Encourage quit smoking
o Risk factors
Extremely young or advanced age
Recent illness
Chronic lung disease (asthma, emphysema)
Immunocompromised
Impaired ability to mobilize secretions
Inactive/immobile
Mechanical ventilation
o Rhinitis
Common cold
Spread by droplets
Sneezing, coughing, direct contact
Can coexist with other disorders; asthma, allergies, etc.
Findings include: nasal drainage, congestion, purulent discharge, low-grade fever
Patient care
Encourage rest
2,000mL/day fluids
Home humidifier; steamy air
o Sinusitis
Swelling of mucosa can block drainage of secretions
Often after rhinitis
Viral: Streptococcus
Findings: facial pressure, nasal congestion, headache, etc.
Can be diagnosed with CT
Patient care
Steam humidifier
Sinus irrigation
Saline spray
Hot/wet packs
Increase fluids & rest
Can lead to meningitis/encephalitis if enters the blood stream
o Influenza
Highly contagious
Contagious from 24hrs prior to symptoms to 5 days after
Pandemic influenza – viral infection from animals or birds that mutated to infect humans
Nursing care
Droplet & contact precautions
Monitor hydration, I&O, respiratory
Administer fluids as prescribed
Complications can lead to pneumonia
o Pneumonia
Most common infectious cause of death [Show Less]