Various Respiratory Diseases and Nursing Intervention

Chronic Obstructive pulmonary Disease (COPD )

 

 

–    Disease state characterized by airflow limitation that is not fully reversible; sometimes referred to as chronic airway obstruction.
–    Include (Emphysema, Chronic bronchitis) or combination of these disorder such as brochioectasis, cystic fibrosis.
–    Asthma, previously classifies as COPD, but now is a separated disorder.

Chronic Obstructive pulmonary Disease
Asthma

•    Intermittent and reversible airflow obstruction affects only the airways, not the alveoli.
•    Airway obstruction occurs due to inflammation and airway hyperresponsiveness.

asthma-airways_lg

 

Interventions

 

•    Client education: asthma is often an intermittent disease; with guided self-care, clients can co-manage this disease, increasing symptom-free periods and decreasing the number and severity of attacks.
•    Drug therapy plan is specific.
•    Medication: inhalation “ventolin”, steroid “hydrocortison”, Bronchodilator “Aminophyllin”

Status Asthmaticus

–    Status asthmaticus is a severe, life-threatening acute episode of airway obstruction that intensifies once it begins and often does not respond to common therapy.
–    If the condition is not reversed, the client may develop pneumothorax and cardiac or respiratory arrest.
–    Emergency department treatment is recommended.
–    Status asthmaticus is treated with inhaled and intravenous bronchodilators and oxygen therapy. Endotracheal intubation and mechanical ventilation are sometimes necessary.

Emphysema

–    Emphysema: a disease of the airways characterized by destruction of the walls of over distended alveoli.
–    Pts are often thin and may be observed using accessory muscles of respiration.  Increased anteroposterior diameter of the chest creates a barrel chest.
–    Despite dyspnea at rest,  Pts who have emphysema without chronic bronchitis often have normal ABGs until the disease is very advanced. The skin color may be normal, which explains the term pink puffer, used to describe the pt with emphysema

Emphysema

Chronic Bronchitis

•    Inflammation of the bronchi and bronchioles caused by chronic exposure to irritants, especially tobacco smoke
•    Inflammation, vasodilation, congestion, mucosal edema, and bronchospasm
•    Affects only the airways, not the alveoli
•    Production of large amounts of thick mucusChronic Obstructive pulmonary Disease

 

Brochioectasis

–    Is a chronic, irreversible dilation of the bronchi and bronchioles and destruction of bronchial walls.
–    Because the availability of antibiotics to treat acute respiratory tract infections, the incidence of bronchioectasis has dramatically decreased in the past 20 years.

Cystic Fibrosis

•    Genetic disease affecting many organs, lethally impairing pulmonary function
•    Present from birth, first seen in early childhood.
•    Error of chloride transport, producing mucus with low water content
•    Problems in lungs, pancreas, liver, salivary glands, and testes
•    Mucus in the lungs lead to infections, emphysema and atelectasis

Pneumonia

–     Is an inflammatory response to the uncontrolled multiplication of microorganisms invading the lower respiratory tract.

Pleural Effusion

–    Is an excess of fluid in the pleural space (the thin space between the lung tissue and the membranous sac that protect it).
–    Normally, the pleural space contains a small amount of extracellular fluid that lubricates the pleural surfaces.

Cor pulmonale

–    A chronic heart condition, it is hypertrophy “enlargement” of the heart right ventricle that results from disease affecting the function or the structure of the lung.
–    To compensate for the extra work needed to force blood through the lungs, right ventricle dilates and enlarge.

Asbestosis

–    Is characterized by widespread filling and inflammation of lung spaces with asbestos fibers. Asbestos fibers move in the direction of airflow, and penetrate respiratory bronchioles and alveolar wall, and it increase the risk of lung cancer.

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Posted in Critical Care Nursing, Respiratory

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