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Respiratory care.

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Presentation on theme: "Respiratory care."— Presentation transcript:

1 Respiratory care

2 Nursing diagnosis Activity intolerance Inefective airway clearance
Anxiety Ineffective breathing pattern Fatigue Impaired gas exchange Impaired spontaneous ventilation Ineffective tissue perfusion Deficient knowledge

3 Nursing interventions
Independent Health promotion and prevention behaviors Positioning Coughing techniques Dependent Oxygene therapy Lung inflation techniques Hydration Medication administration Chest physiotherapy

4 Health promotion Vaccination
Annual influenza vaccination for Clients older than 65 years of age Clients of any age with chronic disease of the heart, lungs or kidneys Clients with diabetes Clients with immunosuppression or severe forms of anemia 70% reduction in the number of adults requiring hospitalization for pneumonia 85% reduction of mortality

5 Health promotion Pneumococcal vaccine – recommended for client at increased risk of development pneumonia: With chronic illnesses or immunosuppression Living in special environments (nursing homes, American Indian population) Age over 65

6 Health promotion Healthy lifestyle behavior
Healthy low-fat, high-fiber diet Monitoring cholesterol, trigliceride, HDL&LDL levels Reducing srtess Exercise Maintain normal body weight Elimination of cigarettes Reduction of pollutants Monitoring of air quality

7 Acute care Dyspnea management (drugs, oxygene therapy, physical techniques) Airway maintenance Humidification (adding water to gas): bubbling oxygen trough water, humidity tent Nebulization (adding moisture or medication to inspired air): jet-aerosol nebulizer and ultrasonic nebulizer Chest physiotherapy is recommended for clients who produce more than 30 ml of sputum per day or have evidence of atelectasis (x-ray). Includes percussion, vibration, postural drainage.

8 Acute care Suctioning techniques
Oropharyngeal and nasopharyngeal suctioning Orotracheal and nasotracheal suctioning Suctioning an artificial airways (tracheal) Each type requires the use a rounded-tipped catheter with a number of side holes at the distal end

9 Acute care Oropharyngeal or nasopharyngeal suctioning is used when client is able to cough effectively but is unable to clear secretion by expectorating or swallowing Orotracheal or nasotracheal suctioning is necessary when the client with pulmonary secretions is unable to manage secretion by coughing and does not have an artificial airway present Tracheal suctioning is accomplished through an artificial airway such as an endotrcheal tube or tracheostomy tube

10 Acute care Maintenance and promotiom of lung expansion
Artificial airways are indicated for clients with decreased level of consciousness or airway obstruction and to aide in removal of tracheobronchial secretions. Oral airway Endotracheal and tracheal airway Maintenance and promotiom of lung expansion Positioning The most effective position for client with cardiopulmonary diseases is 45-degree semi-Fowler’s position For the client with unilateral lung disease – position “good lung down” The presence of pulmonary abscess or hemorrhage – “affected lung down’

11 Acute care Incentive spirometry is a method of encouraging voluntary deep breathing by providing visual feedback to clients about inspiratory volume. Flow-oriented Volume-oriented Chest tubes

12 Acute care Maintenance and promotion of oxygenation Oxygen therapy
Nasal cannula – flow rate of up to 6 L/min, has drying effect on the mucosa Transtracheal oxygen No oxygen is lost to the atmosphere Client achieve adequate oxygenation at lower flow rates Oxygen delivery is more efficient and less expensive Fewer side effects Increased mobility, comfort and cosmetic improvement

13 Acute care Oxygene masks
The simple face mask is used for short-term oxygene therapy (30-60 % oxygen) A plastic mask with a reservoir bag A Venturi mask (80-90 % oxygen)


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