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Pnuemonia & O2 Tx
Pneumonia PPT Goodcare LPN April 2019
| Question | Answer |
|---|---|
| Gas exchange | The process by which oxygen is transported to cells and carbon dioxide is transported from cells |
| Nose | External nose The part that is seen on the face Made of bones and cartilage covered with skin Lining: thick mucous membranes and small hairs Nasal cavity Lies over the roof of the mouth Lined with mucous membranes along with the cilia (small hairli |
| Pharynx | A 5-inch tube extending from the back of the mouth to the esophagus A passage for the respiratory and digestive systems |
| Pharynx | Nasopharynx lies behind the nose Oropharynx lies behind the mouth Laryngopharynx lies behind the larynx |
| Pharynx | Functions in the formation of sounds, especially vowel sounds Tonsils located in the pharynx; may interfere with breathing, particularly nasal breathing, if they become enlarged |
| Larynx | The air passage between the pharynx and the trachea |
| Larynx | Contains vocal cords and several types of cartilage, including the thyroid cartilage and the epiglottis During swallowing, the epiglottis acts like a lid to help prevent aspiration of food into the trachea |
| Larynx | Vocal cords: folds of mucous membranes attached to cartilage; extend from the front to the back |
| Larynx | Sounds produced when air from the lungs causes a rapid, repeated opening and closing of the glottis Sounds transformed into speech by lips, jaws, and tongue |
| Trachea | A 4- to 5-inch tube descending from the larynx into the bronchi Made of cartilage, smooth muscle, and connective tissue lined by a layer of mucous membrane A passageway for air to reach the lungs |
| Bronchi | Passageway for air to and from the lungs Two primary bronchi split to the right and left from the trachea Right bronchus is shorter and wider and runs straighter up and down than the left bronchus |
| Large Bronchi | Divided into smaller, or secondary, bronchi; divide again into smaller tertiary bronchi |
| Tertiary ronchi | Divided into smaller bronchioles, which lead into tiny air sacs called alveoli in the lungs Through the walls of the alveoli, exchange of oxygen and carbon dioxide takes place |
| Lungs | Located in right and left sides of the thoracic cavity within the chest wall |
| Thoracic cavity | separated from the abdominal cavity by the diaphragm, a large sheet of muscle |
| Lungs | Three lobes on the right and two on the left |
| Each lung covered by membrane: the pleura | A sac containing a small amount of fluid that acts as a lubricant for the lungs when they expand and contract |
| Alveoli-lined with mucous membranes | functional units of gas exchange (also contain macrophages) |
| Cilia lining mucous membranes | trap and remove foreign particles |
| Physiology of the Respiratory System | Mechanism of breathing Inspiration: air entering the lungs Active contraction of the muscles and diaphragm and can be noted by an enlargement of the chest cavity Expiration: air leaving the lungs Muscles relax and the chest returns to normal size |
| Respiratory center | Located in medulla; controls breathing Stimulated by changing levels of carbon dioxide and oxygen in arterial blood Chemoreceptors in the aorta and carotid artery monitor the pH and amount of carbon dioxide and oxygen in the bloodstream Changes in th |
| When gas exchange is compromised, the availability of oxygen is affected | Mild impairment Moderate impairment Severe Complete cessation |
| Hypoxemia | Decreased amount of oxygen in the blood Results in decreased oxygen at the cellular level (called hypoxia) Also results in increased levels of carbon dioxide (called hypercapnia) Onset may be rapid and obvious or insidious and gradual |
| Obstruction of the airway | Occlusion by the tongue or mucous secretions Inflammation from croup, asthma, tracheobronchitis, or laryngitis Occlusion by foreign body Chemical and heat burns with inflammation COPD causing airway collapse Near drowning: occlusion by water |
| Restriction of the thoracic cage | Abdominal injuries Chest injuries, flail chest Pneumothorax Extreme obesity, diseases |
| Hypoxia | Decreased neuromuscular function Depressed central nervous system: drugs including sedatives, anesthetic agents, and analgesics, brain trauma; CVA Coma (diabetic, uremic, brain injuries) Diseases (multiple sclerosis, myasthenia gravis, poliomyelitis, G |
| Hypoxia | Disturbances in diffusion of gases Diseases (pulmonary fibrosis, emphysema) Trauma (contusion) Emboli (fat embolus, pulmonary embolus) Tumors, benign and malignant Respiratory distress syndrome |
| Hypoxia | Environmental causes High altitude |
| Signs of Hypoxia | Restlessness, irritability, confusion Difficulty in breathing (dyspnea) Rapid breathing (tachypnea, stridor) Abnormal lung sounds Cyanosis, retractions, dysrhythmias Acid-base imbalance Decreased oxygen saturation |
| Risk Factors Hypoxia | Populations at greatest risk Infants Children Older adults |
| Risk Factors Hypoxia | Individual risk factors Age Smoking Presence of chronic medical conditions, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), heart failure (HF) Immunosuppression Reduced state of cognition Brain injury Prolonged immobilit |
| Age-Related Changes Hypoxia | Muscle atrophy of pharynx and larynx, slackening vocal cords, less elasticity of laryngeal muscles and cartilages May result in a gravelly, softer voice with a rise in pitch Deviation of trachea if scoliosis of upper spinal column Loss of lung elast |
| Assessment Hypoxia | Elements of respiratory assessment History Baseline history Problem-based history Family history Current medications Lifestyle behaviors Occupation Social environment Examination Vital signs Heart rate, respiratory rate, blood pressure, tempera |
| Pulse Oximetry | Used to monitor any patient at risk for hypoxia Measures changes in serum oxygen continuously Sensor attached to fingers, toes, ears, or skin Helps track changes in oxygen therapy |
| Diagnostic Tests and Procedures Hypoxia | Radiologic studies Chest radiography, fluoroscopy, ventilation-perfusion scan Imaging procedures Computed tomography, magnetic resonance imaging, positron emission tomography Pulmonary function tests Spirometry, arterial blood gas analysis Pulse o |
| Clinical Management Hypoxia | Secondary Prevention (Screening) What is the Mantoux skin test? How is it done? Who should be screened? How does this screening test link to gas exchange? |
| Common Therapeutic Measures Hypoxia | Thoracentesis Breathing exercises Deep-breathing and coughing exercises Pursed-lip breathing Sustained maximal inspiration Chest physiotherapy Chest percussion and vibration Postural drainage Suctioning Humidification and aerosol therapy |
| Common Therapeutic Measures Hypoxia | Oxygen therapy Intermittent positive-pressure breathing (IPPB) treatments Artificial airways Oral airway Nasal airway Endotracheal tube Tracheostomy Mechanical ventilation Chest tubes Thoracic surgery |
| Drug Therapy Hypoxia | Decongestants Antitussives Antihistamines Expectorants Antimicrobials Bronchodilators Corticosteroids Mast cell stabilizers Leukotriene inhibitors Mucolytics Thrombolytics |
| Pneumonia Cause and risk factors | Inflammation of certain parts of the lung, such as alveoli and bronchioles Caused by either infectious or noninfectious agents |
| Pathophysiology Pnuemonia | Classified according to the causative organism, usually bacteria or viruses When pathogens invade lungs, inflammation causes fluid accumulation in affected alveoli; capillaries dilate and neutrophils, red blood cells, and fibrin fill alveoli; lung appea |
| Pnemonia Complications | Pleurisy, pleural effusion, and atelectasis Less common: lung abscesses, delayed resolution, and empyema Systemic complications: pericarditis, arthritis, meningitis, and endocarditis |
| Pnuemonia Signs and Sx | Fever, chills, sweats, chest pain, cough, sputum production, hemoptysis, dyspnea, headache, and fatigue |
| Pnuemonia Medical Diagnosis | History and physical examination, sputum culture and gram stain, chest radiograph, complete blood count, and blood culture |
| Medical treatment Pnuemonia | Increased fluid intake (at least 3 L every 24 hours), limited activity or bedrest, antipyretics, analgesics, oxygen, and aerosol intermittent positive-pressure breathing (IPPB) therapy Bacterial pneumonias are treated with appropriate antibacterials |
| Interventions Pnuemonia | Ineffective airway clearance; Impaired gas exchange Activity intolerance Imbalanced nutrition: Less than body requirements Risk for deficient fluid volume Pain Prevention of aspiration pneumonia |
| Oxygen Administration | Oxygen: colorless, tasteless, odorless gas present in the air Considered a medication-requires a physician order Although essential for life, use of oxygen is not without its disadvantages High concentrations cause fires to burn very rapidly –HIGHLY F |
| Oxygen Administration | Used to supplement oxygen in inspired air Inspired air is 21% oxygen Can be delivered by nasal cannula, mask, tent, croupette, or catheter/collar Requires humidification, flow rate prescribed by a physician |
| Oxygen Administration | Common flow rates are 4-6 L/min |
| Oxygen Administration | **COPD patients given only 2 to 3 L/min to prevent causing respiratory arrest (they are used to high levels of CO2 in their blood and do not have the trigger to breathe, if we give too much oxygen, their drive to breathe due to low oxygen decreases and th |
| Oxygen Administration: Cannula | A plastic tube with short, curved prongs that extend into the nostril about ¼ to ½ inch Held in place by looping it over the ears and cinching under the chin; can be easily adjusted for the patient’s comfort Ensure patency of nares prior to application |
| Oxygen Administration: Masks | Simple face mask-Med. Concentrations 35-50%, 6-12L/min (short term) |
| Oxygen concentrations above what percentage are rarely used because of the danger of oxygen toxicity | 60% |
| Oxygen Administration Artificial Airways | Several purposes: Relieve an obstruction, protect the airway, facilitate suctioning, and provide artificial ventilation |
| Oxygen Administration Artificial Airways | Nasopharyngeal and oropharyngeal airways Keep the tongue from falling back into the throat |
| Oxygen Administration Artificial Airways | Endotracheal tubes maintain an airway in those who are unconscious or unable to ventilate on their own |
| Oxygen Administration: Masks | Partial rebreathing-Higher Concentrations 40-60%, 6-10L/min Non-rebreather-High concentrations 60-90% Venturi (Venti) Mask-Consistent FiO2 regardless of breathing pattern (good for COPD) |
Created by:
TutorDavis17
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