Care of Patients with Respiratory System

Diseases and DisordersAcute Care/Hospital Setting

GPS Standard HS-TGM-12. Students will demonstrate understanding of

advanced technical skills in respiratory care – Respiratory Therapy.

a. Identify normal and abnormal respiratory effort. b. Demonstrate correct placement of cannula and mask for oxygen

therapy. c. Describe croup tent usage and maintenance. d. Correctly apply pulse oximeter for measurement of oxygen saturation

and recognize the difference between normal and abnormal readings. e. Assist clients with respiratory management devices. f. Demonstrate techniques for suctioning based on facility protocol. g. Describe and demonstrate care for a tracheostomy based on facility

guidelines within their scope of practice.

Enduring Understandings Management of patients with respiratory diseases and

disorders may require a variety of devices and equipment.

It is important for healthcare workers involved in caring for patients with respiratory disorders to understand how to monitor, recognize and report problems in respiratory effort.

Additionally, the healthcare worker must be able to recognize types of respiratory care devices and understand the use of and how to safely manage devices.

Essential Questions How do body systems and structures operate to maintain

normal functioning of the respiratory system? How are patients with disorders or diseases of the

respiratory system managed to meet their respiratory care needs?

What is the role of respiratory therapists, nurses and patient care technicians in providing care for patients with respiratory diseases or disorders?

How is oxygen therapy provided in a safe and therapeutic manners?

Knowledge from this Unit

Students should know:

The differences between normal and abnormal respiratory effort

Croup tent usage and maintenance Types, use and care of various respiratory devices Safety issues related to respiratory therapy How to monitor and provide care for patients with

respiratory system diseases or disorders

Skills from this Unit

Students should be able to demonstrate:

Setting up for oxygen administration via nasal cannula Setting up for oxygen administration via mask Pulse oximetry measurement Suctioning the airway using a Yankauer catheter Assisting with artificial airway care

Respiratory Activity Have students describe their

breathing in terms of work of breathing (how easy/hard is it) on a sheet of paper.

Pass out drinking straws to each student in class. Instruct them that they are going to be involved in an activity to simulate breathing difficulties. Tell them that they will be breathing through the straw while pinching their nose closed. Students should be sitting down at this time.

Begin the timer and time them for one minute.

Ask students to describe their breathing and how they felt during this exercise.

Now ask them to do the same exercise while jogging in place. Time them for a minute.

Now describe in writing how their breathing felt during this part of the exercise.

Respiratory System Care

Think about what it might be like to fight for every breath you take. How would having breathing problems affect everyday living (sleep, eating, activities, going to the bathroom, mowing the grass, washing clothes, working, etc.)

Respiratory Structures Overview Use the following

acronym and recall the structures through which air passes during inhalation

NPLTBBrA

What gas is inhaled? What gas is exhaled? The right lung has ____

lobes The left lung has ____

lobes

Respiratory System Overview

Accessory Muscle which separates the thoracic and abdominal cavities and flattens during inspiration is called ___________________.

Overview of Respiratory System Lungs protected by bony framework Name the structures of the bony framework using the

acronym below SRV

Factors affecting Oxygen Needs Important for respiratory

and cardiovascular systems to work together to meet the oxygen needs of the body

In the respiratory system, structures must function properly to allow exchange of O2 and CO2

What is the role of the cardiovascular system?

Blood must circulate to and from the heart

Exchange of O2 and CO2 must be able to take place between capillaries and cells

Factors affecting Oxygen Needs Nervous System plays an

important role Diseases of and injury to

can affect respiratory muscles

Breathing may be difficult Brain damage can affect

respiratory rate

Respirations increase when oxygen level is low

Factors Affecting Oxygen Needs Aging- decreased

function because of weaker muscles, lung tissue loses elasticity

Exercise- increases need Pain- increases need

Drugs- some may depress the respiratory center in brain and cause respiratory depression which can lead to respiratory arrest; examples-narcotics like Morphine, Demerol.

Factors Affecting Oxygen Needs

Smoking-causes lung cancer and COPD & risk factor for Disease of Coronary Arteries

Allergies-Sensitivity to substances in which the body reacts when exposed- runny nose, itchy eyes, wheezing, congestion and swelling in the airway which can become severe

Exposure to Pollutants-harmful substances in air or water like asbestos, toxic fumes which can be at work, school, or home

Factors Affecting Oxygen Needs Nutrition – needs to be

good for red blood cells which carry O2 to be produced, vitamins are important to produce the cells such as vitamin C, B12, Folic Acid

Alcohol-Depresses brain and can depress cough reflex in excess

Alterations in Respiratory Function

Hypoxia-Cells do not have enough oxygen

Brain reacts to low oxygen person may become restless, disoriented and dizzy drowsy, personality change. Increased pulse rate

Should be reported to nurse to supervisor

Patients can have abnormal respirations

Bradypnea-slow breathing- <12/min

Tachypnea-rapid respirations >24

Apnea –absence of respirations

Alterations in Respiratory Function Cheyne-Stokes-

Respirations increase in rate and depth and then become shallow and slow, periods of apnea may occur also

Kussmaul’s Respirations-Deep and Rapid

Hypoventilation-slow, shallow, & sometimes irregular –pneumonia, disease of alveoli. Nervous system disorder affecting respiratory system

Hyperventilation-rapid and deeper than normal respirations-can be caused by Asthma

Alterations in Respiratory Function Biot’s Respirations- Rapid and deep respirations

followed by 10-30 seconds of apnea Dyspnea- difficulty breathing-may be labored or painful Orthopnea - breathe normally when in sitting position

Assessment

Patient Assessment is an important part of patient care