case 3 Flashcards
(25 cards)
management of possible pnuemonia
management of respiratory failure
management of airway secretions
reduction of increase work of breathing
management of co morbilidites
recovery of illness
what would you hear on ascultation if the patient has pnemonia or pulmonary odema
coarse crackles- sound of walking on snow
what would fine crackles on ascultation indicate
pulmonary fibrosis - rubbing fingers along a balloon
postural management of breathlessness
forward kneeing - children, lying on pillows
relxed standing
forward leaning standing on window seal
high side lying
breathing control in sitting
what is the term given to low heart rate
bradycardia
normal heart rate 60-100 bpm
major cause of desaturation
loss of lung volume
confirmed with cardio resp assessment
ascultation and palpation
outcome measures
ascultation
dysponea rating score
palpation
functional test, time up and go
6 min walk test
Lars quesitonnaire score
What is COPD
chronic obstructive pulmonary disorder
chronic inflammatory lung disease - causes obstructive airflow from the lungs
symptoms of COPD
breathing difficulties
shortness of breath during physical activities
cough
mucus production
wheezing
chest tightness
frequent respiratory infections- case
lack of energy- difficulty coping at home, using Zimmer frame , is she leaning over the zimmer frame
unintended weight loss
swelling in ankles and feet
common conditions that contribute to COPD
emphysema
chronic bronchitis
what is chronic bronchitis
inflammation of the lining of bronchial tubes
test for COPD diagnosis
spirometry
treatment for infection in COPD
emphysema during an infection episode
bronchitis - always do postural drainage
outcome measures for COPD
lung volumes and exercise capacity
cardiopulmonary exercise testing
bleep test
6- minute walk test
purpose of inhalers in COPD
relaxing the muscles in the airway
reducing swelling
benefit of NIV
reduces the work of breathing
improving gas exchange
how does NIV work
create a positive airway pressure - make the pressure outside the lung greater than the pressure inside the lungs
Boyles law- gas will move from a place of high concentration to low concentration, hence air rushes inside the lungs and keeps the airway open for longer. - Air Force into the lung down the pressure gradient
keeps the chest and lungs expanding by increasing the residual capacity
types of NIV
non invasive positive pressure
negative pressure ventilation
what is non NIPP
non invasive positive pressure breathing
delivery of oxygen at either constant or variable pressure
two types of pressures in non invasive positive pressure
Bi-level positive pressure breathing
constant positive pressure CPAP
what is CPAP
a type of NIV but a non invasive positive pressure breathing non rebreathing mask
provides constant fixed pressure throughout expiration and inspiration - constant C
causes the airway to remain open - results in a higher degree of inspired oxygen
usually for patients with sleep apnea
eg type 1 respiratory failure , acute pulmonary oedema - by recruiting collapse alveoli
how does CPAP work with pulmonary oedema
recruits collapse alveoli
indications for CPAP
patient remains hypoxic after intervention
atlectesis complete or partial collapse of the lung
rib fractures
type 1 respiratory failure
congestive heart failure
cardio pulmonary oedema
obstructive sleep apnea
pneumonia
which respiratory failure would you use CPAP
type 1
