Slide 1 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing Assistants Chapter 26 - The Respiratory System

Slide 2 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Structure of the Respiratory System

Slide 3 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The respiratory system consists of: The lungs A series of passages referred to as the ‘airway’ The lower respiratory tract consists of the:  Trachea  Bronchi  Bronchioles  Lungs Structure of the Respiratory System

Slide 4 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The upper respiratory tract consists of the:  Nasal cavity  Pharynx  Larynx Structure of the Respiratory System

Slide 5 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Main organs for respiration Process of gas exchange involves: Bronchioles Alveoli Lungs are divided into sections called lobes The lungs are housed in the chest cavity Pleura – a membrane that lines the chest cavity Lungs

Slide 6 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Function of the Respiratory System

Slide 7 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The main purpose of the respiratory system is respiration Respiration is accomplished through the processes of Ventilation Gas exchange Function of the Respiratory System

Slide 8 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Ventilation: the mechanical process of moving air in and out of the lungs The two phases are: Inhalation Exhalation Diaphragm and intercostal muscles assist with ventilation Ventilation

Slide 9 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Gas exchange: the transfer of oxygen into the blood, and carbon dioxide out of it Occurs in the alveoli Gas Exchange

Slide 10 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The Effects of Aging on the Respiratory System

Slide 11 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Factors that speed up the aging process: Chronic illness Immobility A lifelong exposure to toxic chemicals Smoking Effects of Aging

Slide 12 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Changes that occur even in healthy people Less efficient ventilation  Loss of tissue elasticity and loss of muscle mass An increased risk for respiratory tract infections  Less efficient immune system  Immobility Effects of Aging

Slide 13 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Disorders of the Respiratory System

Slide 14 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Infections like: Pneumonia Bronchitis Influenza Asthma Chronic obstructive pulmonary disease (COPD) Emphysema Chronic bronchitis Cancer Pneumothorax and hemothorax Types of Disorders

Slide 15 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Pneumonia Caused by infection with a virus or a bacterium Symptoms include:  Fever  Pain when breathing  Cyanosis (bluish skin as a result of decreased oxygen levels in the blood)  Productive cough Usually diagnosed with a chest x-ray and treated with antibiotics Pleurisy: inflammation of the pleura that often accompanies pneumonia Infections

Slide 16 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A productive cough is one in which a person coughs up sputum Productive cough is a symptom of pneumonia Sputum consists of mucus and other respiratory secretions that are coughed up from the lungs, bronchi, and trachea Guidelines for collecting sputum sample include: Explain to the person the right method of coughing up sputum Provide privacy and have the person rinse her mouth with water, and not mouthwash, before coughing up the specimen Have the person spit the specimen directly into a sterile specimen container and close the lid Make sure that the specimen container is labeled properly and that the information is correct Take the specimen container to the laboratory immediately or ask the nurse how to store it Sputum Collection: Guidelines

Slide 17 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Bronchitis Inflammation of the bronchi Can be caused by a viral or bacterial infection Usually treated with antibiotics Can turn into pneumonia if not treated promptly Infections

Slide 18 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Influenza Commonly referred to as “the flu” Caused by the influenza virus Symptoms include:  Sore throat and dry cough  Stuffy nose and headache  Body aches, weakness, and fever Very contagious and can cause serious complications in chronically ill or elderly people An annual “flu shot” for both staff members and residents is recommended Infections

Slide 19 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Causes the bronchi and bronchioles to constrict, making breathing difficult Can be a frightening experience An acute asthma attack is treated with inhaled drugs called bronchodilators Call the nurse immediately if one of your patients or residents is: Having trouble breathing Making wheezing sounds Asthma

Slide 20 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A general term to describe two lung disorders: Emphysema: involves damage to the alveoli Chronic bronchitis: caused by long-term irritation of the bronchi and bronchioles Emphysema and chronic bronchitis often occur together in the same person Leading cause – smoking Chronic Obstructive Pulmonary Disease

Slide 21 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Cancers involving the lungs and airway: the most common cause of cancer-related death in both men and women Ways of diagnosing cancer: Radiologic studies Bronchoscopy Surgery Cancer

Slide 22 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The nursing assistant cares for people who are: Waiting for the results of diagnostic tests Receiving treatment for cancer Coping with physical disfigurement due to surgery Coping with the diagnosis of cancer Cancer

Slide 23 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Complications of chest trauma Pneumothorax Occurs when air builds up in the space between the lungs and the chest wall Insertion of a chest tube to remove the air is usually necessary Hemothorax Occurs when blood builds up in the space between the lungs and the chest wall Sometimes surgery is needed to stop the bleeding A chest tube is inserted to remove the blood Pneumothorax and hemothorax

Slide 24 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Respiratory Therapy

Slide 25 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Any treatment that is used to help a person achieve satisfactory respiration Respiratory therapists: specially trained to evaluate and treat problems of the respiratory system Nursing assistants: Watch the therapist Ask questions about the types of treatments he is using on the person Ask about specific signs or symptoms that should be reported to the nurse immediately Respiratory Therapy

Slide 26 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Types of treatments Oxygen therapy Mechanical ventilation Suctioning Respiratory Therapy

Slide 27 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Given to people with reduced lung function These people have trouble getting the oxygen their bodies need from inhaled air alone Sources of supplemental oxygen Wall-mounted delivery system A pressurized tank An oxygen concentrator Delivery of supplemental oxygen Nasal cannulas Facemasks Accessory devices Oxygen Therapy

Slide 28 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Conditions under which mechanical ventilation can be used A serious head injury Stroke Drug overdose Spinal cord injury A neurologic disorder Mechanical Ventilation

Slide 29 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Delivery of mechanical ventilation  An endotracheal tube is inserted into the person’s nose or mouth  A tracheostomy is a surgically created opening in the neck that opens into the trachea Mechanical Ventilation

Slide 30 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Delivery of mechanical ventilation Mechanical Ventilation

Slide 31 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Suctioning is the process of removing fluid and mucus from a person’s airway Conditions under which suctioning is used Pneumonia Chronic bronchitis A person who is in a coma A person who is heavily sedated Suctioning

Slide 32 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Person can become hypoxic (deficient of oxygen) Nursing assistants are not responsible for suctioning patients and residents, but they are responsible for: Letting the nurse know that suctioning may be needed Assisting during the procedure Suctioning

Slide 33 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. General Care Measures

Slide 34 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Responsibilities of the nursing assistant: Observe for signs that a person may be having problems with ventilation or gas exchange Promote comfort Provide holistic care Observation

Slide 35 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Measures that promote comfort Positioning the person in the Fowler’s or semi-Fowler’s position Assisting the person to assume a forward- leaning position using pillows on the over-bed table Encouraging the person to drink plenty of fluids (if no restrictions) Providing frequent oral care Promoting Comfort

Slide 36 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Holistic care involves meeting a person’s emotional and physical needs Holistic care: Being patient and understanding of the underlying fears the person may have Spending more time with the person Keeping in mind the stages of grief Not being judgmental about the role the person’s actions may have had in causing her disease Accepting decisions the person makes concerning her own quality of life Providing Holistic Care

Slide 37 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. End of Presentation