Care of Patients with Respiratory System Diseases and Disorders Acute Care/Hospital Setting

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.

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.

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?

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

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

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.

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.)

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

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

Overview of Respiratory System Lungs protected by bony framework Name the structures of the bony framework using the acronym below SRV

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

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

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.

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

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

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- <12/min Tachypnea-rapid respirations >24 Apnea –absence of respirations

Alterations in Respiratory Function Cheyne-Stokes- Respirations increase in rate and depth and then become shallow and slow, periods of apnea may occur also Kussmaul’s Respirations- Deep and Rapid 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

Alterations in Respiratory Function Biot’s Respirations- Rapid and deep respirations followed by seconds of apnea Dyspnea- difficulty breathing-may be labored or painful Orthopnea - breathe normally when in sitting position

Assessment Patient Assessment is an important part of patient care