Care of Patients with Respiratory System Diseases and Disorders

1
Care of Patients with Respiratory System Diseases
and Disorders

• Acute Care/Hospital Setting

2
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.

3
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.

4
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?

5
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

6
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

7
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.

8
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.)

9
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

10
Respiratory System Overview

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

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Overview of Respiratory System

• Lungs protected by bony framework
• Name the structures of the bony framework using
  the acronym below
• SRV

12
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

13
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

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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.

15
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

16
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

17
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- lt12/min
• Tachypnea-rapid respirations gt24
• Apnea absence of respirations

18
Alterations in Respiratory Function

• 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

• Cheyne-Stokes-Respirations increase in rate and
  depth and then become shallow and slow, periods
  of apnea may occur also
• Kussmauls Respirations-Deep and Rapid

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Alterations in Respiratory Function

• Biots 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

20
Assessment

• Patient Assessment is an important part of
  patient care