1. Nursing Care for patients with Respiratory Disorders

2. Diagnostic Procedures of Respiratory Disorders
Pulmonary Function Tests
Pulmonary function tests (PFTs) are used in patients with chronic respiratory disorders. To assess respiratory function . Such tests include measurements of lung volumes, ventilatory function, and the mechanics of breathing, and gas exchange .

3. 2.Arterial Blood Gases Studies
a. The arterial oxygen tension (PaO2) indicates the degree of oxygenation of the blood,
b. the arterial carbon dioxide tension (PaCO2) indicates the adequacy of alveolar ventilation.
-ABG studies aid in assessing the ability of the lungs to provide adequate oxygen and remove carbon dioxide

4. 3.Pulse Oximetry
Pulse oximetry is a noninvasive method of continuously monitoring the oxygen saturation of hemoglobin (SaO2).
4. Cultures :To identify organisms responsible for respiratory infections

5. 5. Sputum Studies
Sputum is analysis to identify pathogenic organisms and to determine whether malignant cells are present.
6.Imaging Studies
Imaging studies, including x-rays, computed tomography (CT), magnetic resonance imaging (MRI), contrast studies,

6. The purposes of diagnostic bronchoscopy are to:
Bronchoscopy is the direct inspection and examination of the larynx, trachea, and bronchi
The purposes of diagnostic bronchoscopy are to:
A- Examine tissues or collect secretions.
B- Determine the location and extent of the pathologic process and to obtain a tissue sample for diagnosis .
C- Determine whether a tumor can be resected surgically, and ,Diagnose bleeding sites (source of hemoptysis .

7. Therapeutic bronchoscopy is used to :
Remove foreign bodies from the tracheobronchial tree.
Remove secretions obstructing the tracheobronchial tree.
C- Treat postoperative atelectasis.

8. Bronchitis
Bronchitis is a pulmonary disease caused by the inflammation in the bronchial tubes, which are the air passages into the lungs.

9. Types of bronchitis:
Acute bronchitis often occurs after a cold or the flu, as the result of bacterial infection, or from constant irritation of the bronchi by polluted air or chemical fumes in the environment.
It is characterized by : Acute bronchitis, symptoms usually resolve within 7 to 10 days.

10. Chronic bronchitis, also known as chronic obstructive pulmonary disease (COPD). As the condition gets worse, the affected person becomes:
increasingly short of breath.
has difficulty with physical exertion.
and may require supplemental oxygen.

11. Symptoms 1. A cough, which is the main symptom of acute bronchitis
Symptoms 1. A cough, which is the main symptom of acute bronchitis. It may be dry at first (does not produce mucus) and after a few days may bring up mucus from the lungs (productive cough). The mucus may be clear, yellow, or green. Sometimes, small streaks of blood may be present

12. 2A mild fever, usually less than (38.3C) .
3-A general feeling of tiredness..
4- A sensation of tightness, burning pain in the chest under the breast bone that usually is worse when breathing deeply or coughing.
5- Whistling noises (wheezing) when breathing, especially during physical exertion.
6- Hoarseness.

13. Diagnoses
Chest X-ray. The result of a chest X-ray of people who have acute bronchitis is usually normal.
Culture and sensitivity of the mucus from the lungs.
Other tests, including tests to measure blood oxygen levels and sputum's tests

14. Nursing Diagnosis For Bronchitis.
Ineffective airway clearance related to: increased production of secretions.
Acute pain related to: the inflammation of the pleura.
Impaired gas exchange related to: airway obstruction by secretions, spasm of the bronchus.
Ineffective breathing pattern related to: bronchoconstriction, mucus.
Anxiety related to: changes in health status.

16. 6, Administer medications as ordered and note the patient’s response to them.
7, Evaluate sputum quality and quantity, restlessness, increased tachypnea, and altered breath sounds. Report changes immediately.
8, Evaluate the patient’s nutritional status regularly.
9, see the patient for signs and symptoms of respiratory infection, such as fever, increased cough and sputum production, and purulent sputum.
10, Advise the patient to avoid crowds and people with known infections(influenza).

17. Pneumonia
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, mycoplasma, fungi, parasites, and viruses. “Pneumonitis”

18. Pneumonia
is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. 

19. Classification 1. Community-Acquired Pneumonia CAP occurs either in the community setting 2.Hospital-Acquired Pneumonia HAP, also known as nosocomial pneumonia, is defined as the onset of pneumonia symptoms more than 48 hours after admission in patients with no evidence of infection at the time of admission

20. 3.Pneumonia in the Immunocompromised Host includes: Pneumocystis pneumonia (PCP). fungal pneumonias, Mycobacterium tuberculosis. 4.Aspiration Pneumonia Aspiration pneumonia may occur in the community or hospital setting

21. Risk Factor
Conditions that produce mucus or bronchial obstruction and interfere with normal lung drainage (eg, cancer, cigarette smoking, COPD)
Prolonged immobility and shallow breathing pattern
Depressed cough reflex
Alcohol intoxication
Advanced age, because of possible depressed cough

22. Clinical Manifestations 1. sudden onset of chills, 2
Clinical Manifestations 1. sudden onset of chills, 2. rapidly rising fever (38.5° to 40.5°C). 3. Chest pain that is aggravated by deep breathing and coughing. 4. Severely ill, with marked tachypnea (25 to 45 breaths/min), accompanied by other signs of respiratory distress (eg, shortness of breath, use of accessory muscles in respiration). 5. Pulse is rapid . 6. Orthopnea (shortness of breath when sleeping).

23. Assessment and Diagnostic Findings
1.Physical examination.
2. Chest x-ray,
3. Blood culture (bloodstream invasion, called bacteremia, occurs frequently), and sputum examination.

24. The treatment of pneumonia includes:
Medical Management
The treatment of pneumonia includes:
administration of antibiotic.
Antipyretic may be used to treat headache and fever;
antitussive medications may be used for the associated cough.
Warm, moist inhalations are helpful in relieving bronchial irritation.

25. Nursing Interventions
Removing secretions is important, because retained secretions interfere with gas exchange and may slow recovery.
A high-humidity face mask delivers warm, humidified air to the tracheobronchial tree irritation.
Coughing and deep breathing exercises.
semi-Fowler's position to promote rest and breathing and should change positions frequently to enhance secretion.
encourage increased fluid intake (at least 2 L/day),