HS 4 Respiratory Care

Medicated Aerosol Therapy Bronchodilate= to open the airway Aerosal= does not travel through the body> inhaled in the lungs (do not get systemic effect which can R/I N/V/D and H/A’s) Advantages Smaller doses of drug because inhaled directly into lungs (If oral would travel through stomach/intestines then bloodstream (where it could dilute) and finally act on the lungs) Acts quickly= fast absorption of drug Decreased SE Convenient, easy, painless Can be used at home (reducing hospital admissions)

Disadvantages Difficult to administer correct dosage each time Difficult to teach pt how to use device correctly (ex- Parkinson’s) Healthcare provider may not know how to use themself

Types of drugs given by aerosol 1. Nasal decongestants= contain vasoconstrictors R/I decrease blood flow to vessels of the nose (decreasing blood flow makes vessels shrink R/I nasal passages opening up and allow for air to flow more easily) 2. Bronchodilators= drugs that increase the diameter of airways of lungs 3. Antiasthmatics= reduce the allergic response (b/c allergies often trigger asthma attack) 4. Corticosteriods= used for anti-inflammatory maintenance therapy moderate to severe asthma 5. Mucolytics= breakdown secretions within the lungs; when broken down easier to cough out 6. Antimicrobials= aerosolized antibiotics

Aerosol Delivery System *Must teach pt proper technique for using aerosol device to maximize amount of medication that actually gets into the lungs Several types Available Most frequent used is the metered dose inhaler Contains a canister that has a pressurized gas propellant and medication = = Show you tube video- How to use inhaler

To Evaluate Aerosol Therapy Auscultate before treatment to establish baseline> note any abnormal breaths/lungs sounds Auscultate after treatment> Clear? Ask if pt feels better Can they breathe easier? Speak better? Administer pulmonary function test before and after treatment

Hyperinflation Therapy Involves treatments designed to prevent or treat lung collapse Also called lung expansion therapy *Atelectasis= partial or full lung collapse Lung collapse can develop when a pt consistently breathes small amounts of air and does not fully expand lungs Usually occurs when pt is sedated or in pain Prevention= requires deep breathing or secretion removal to open airways

Indications for Hyperinflation Therapy Anyone who has anything that impairs their ability to take deep breaths and cough EX: surgery of chest/upper abd region Heavily sedated Neuromuscular disease Spinal cord injuries Bedridden Chronic lung disease> excessive mucous production (CF, chronic bronchitis)

Incentive Spirometry *most common hyperinflation therapy Performed using devices that give pt a visual clue by showing the pt numbers signifying volume Pt can see that volume/flow is reached Indications -upper abd surgery -chest surgery -COPD pt undergoing of have undergone surgery -bedridden ** Main reason is to prevent or treat existing atelectasis Contraindications -pt cannot be instructed/supervised on proper use of the device -unconscious pts or unable to speak Show video using IS

Asthma pt would need a ________________ COPD pt undergoing surgery would need ____________________ Lung disease and just had surgery __________ Aerosol therapy (metered dose inhaler), IS, Hyperinflation/IS