Please enable JavaScript.
Coggle requires JavaScript to display documents.
Occupational lung disease & respi failure & other respi failure
Occupational lung disease & respi failure & other respi failure
pneumonconiosis
fine particles and gaseous agent entering the lung -> once inhaled particulate matters are deposited on various areas of the respiratory tract
3 major types
silicosis
caused by inhalation and pulmonary deposition of crystalline silicon dioxide dust -> deposited in alveoli
nodular lesion-> often progress to fibrosis; show no symptoms
asbestosis
Deposition of small asbestos particles on bronchioles/ alveolar walls -> non nodular lesion, involving usually the lower lungs & often has pleural thickening, plaque formation, pleural calcification
coal workers' pneumoconiosis
chronic pathologic condition due to prolonged exposure to coal dust
phagocytosis move them to the terminal bronchioles; involve the upper lobe
S/S (along the progression of disease)
sob
loss of appetite
chest pain
severe scarring of lung
management
screening and monitoring of individual at risk (assessing history of exposure to environmental agents; make referrals to assess pulmonary function
promote measure to reduce exposure of hazards (use protective devices: facemask. hoods, industrial respirators)
education: pursed-lip breathing, abdominal breathing exercise; signs of complication of pneumoconiosis such as dyspnoea, cough....
provide supportive therapy aiming to prevent infections and managing complication
Respiratory failure
sudden & life-threatening deterioration of gas exchange function of lung -> lung failed to provide adequate oxygen for blood
causes
drug overdose, head trauma, infection, sleep apnea -> impaired CNS
,COPD, asthma -> pulmonary dysfunction
myasthenia gravis (cause weakness in skeletal muscle, such as breathing)/ spinal cord trauma -> neuromuscular dysfunction
chronic respiratory failure
(deterioration in the gas exchange that has developed insidiously/ has persisted for a long period after an episode of acute respiratory failure
indicated by the presence of a chronic respiratory acidosis, absence of acute symptoms. gradual worsening hypoxemia & hypercapnia
acute respiratory failure
decrease in arterial oxygen tension(PaO2) to <50mmhg (hypoxemia) & increase in PaCo2 (>50mmhg) (hypercapnia), eith arterial pH <7,35
S/S
early signs
restlessness, fatigue, headache, tachycardia, bp rise
when hypoxemia progresses
confusion, tachycardia, decrease in breathing sound, cyanosis
management
restore adequate gas exchange in lungs (endotracheal intubation & mechanical ventilation)
treat the underlying cause (drug overdose...)
nursing intervention
(if patient is undergoing mechanical ventilation) -> provide related nursing management
monitoring indications of altered tissue perfusion (ABG, Spo2, vital signs...)
monitoring & promote effective breathing pattern
prevent complication of immobility
promote comfort & self care
SARS (severe acute respiratory syndrome)
a viral respiratory infection caused by coronavirus (SARS-CoV)
Transmission route: close person-to-person contact, via respiratory droplets (coronavirus is stable in environment for upto 2 days at rm temp.)
diagnostic & lab test
can be detected in bld, respi secretion, urine & stool
serological test detect antibodies to SARS-CoV, which are produced from ard 10 days after onset of illness
S/S
high fever, associated with chills, rigors, headache, muscle pain, non productive cough & sob -> may progress to respi failure
later stage:CXR shows area of consolidation
management
limit transmission
use negative-pressure isolation rm, PPE, maintain hand hygiene,
nursing care & interventions (similar to that of pneumonia)
improving airway patency
promote rest
promote fluid intake & maintain nutrition
Monitor pt's s/s, pao2 and other lab result
pleural effusion
collection of fluid in the pleural space, usually secondary to other disease (tb, pneumonia...)
fluid can be divided into transudate & exudate
transudate: pleural membrane are not diseased and it is commonly due to heart failure
exudate: usually resulted from inflammation of bacterial products/ tumors involving the pleural surface
could be clear fluid. blood stained fluid/ purulent
S/S (depending the underlying cause & severity)
pneumonia cause: fever, chills, pleuitic chest pain
malignant effusion causes: dyspnea (sob), coughing
dyspnea possibly absent for small effusion
decrease/ absent of breathing sound
dull. flat sound on percussion
tracheal deviation
assessment & diagnostic investigation
physical exam
CXR
chest ct scan
thoracetesis (chest tap)
pleural biopsy
management
perform thoracentesis (remove fluid + collect some for analysis)
chest tube placement & connect to water-seal drainage
pleurodesis to obliterate the pleural space and prevent further accumulation
nursing management
thoracentesis: prepare and position the patient, ensure adequate analgesia prior procedure
monitor chest drain
monitor respiration function
evaluate pain level & administer analgesic to relieve pain
atelectasis
due to reduction of ventilation/ airway obstruction -> no additional air can enter alveoli -> collapse of alveoli
S/S: dyspnea, cough, sputum production
acute atelectasis-> tachycardia, tachypnea, central cyanosis
chronic atelectasis: s/s of pulmonary infection may also present
diagnostic & assessment
CXR -> patchy infiltrate/ consolidated areas
spo2 <90%
decrease in breathing sound
management
frequent turning, early mobilization to promote ventilation
voluntary deep breathing maneuvers
use of incentive spirometry enhance lung expansion, decrease potential for airway closure
secretion management
directed cough, suctioning, aerosol nebulizer treatment followed by chest physiotherapy & bronchoscopy
pulmonary embolism (obstruction of pulmonary artery by a thrombus)
thrombus -> blood clot, air, fat
cause: trauma, surgery, prolonged immobility
prevention: active leg exercise, use of elastic pressure stocking, low dose of heparin used after surgery
dyspnea, tachypnea
assessment: clinical history, s/s, CXR, ECG, pulse oximetry, ABG, pulmonary angiogram
management
general: o2 therapy, elastic stocking, elevating legs
anticoagulation therapy: heparin, warfarin
thrombolytic therapy: therapy that resolve the thrombus(e.g. by streptokinase)/ surgical embolectomy
semi fowler for breathing