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Kimberly Ambruso
NU 102- Fall 2012
Respiratory Disorders I
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Pertussis (whooping cough)
Bordetella Pertussis
Incubation: 7-21 days
Unimmunized children
Low grade fever and resp
symptoms
Paroxysmal cough
Apneic episodes
Prevention
vaccination
Treatment
Erythromycin,
azithromycin (Z-pack)
Droplet precautionsfor 5 days after abx start
Humidification
Suctioning
Fluids Cardio-resp monitoring
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Acute Tracheobronchitis
Preceeds URIs pneumonia
Causes
bacterial or fungal
microorganisms Ingestion of irritants or
fumes
Manifestations Dry, irritating cough
Scant sputum
Inspiratory stridor,expiratory wheeze
purulent sputum
Treatment
Fluids
humidification
Suctioning PRN
Avoid antihistamines
May use expectorants
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Asthma
Increased airway responsiveness to astimuli
, causinginflammation of the airways
Inflammation causes the normal protective
mechanisms to react excessively in
response to the
stimulus, and
cause obstruction
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Reactive Airway Disease (RAD)
History of wheezing, coughing, or shortness of
breath due to undetermined cause
Generally used as a diagnosis for children < 4-5
yrs old
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Asthma Manifestations
Wheezing
Coughing
Tachypnea, orthopnea
Recurrent difficulty breathing
Recurrent tightness in chest
Retractions
Stridor
Nasal flaring
Restlessness
Tripod positioning
Fatigue Worsening of
symptoms at night
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Tripod position
Retractions
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Severe Respiratory Distress
In severe respiratory distress the patient may notwheeze because of decreased air movement
With treatment, increased wheezing may actually
signal an improvement
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Asthma Diagnostic Studies
History and Physical
Environmental
assessment
Pulmonary Function tests Peak expiratory flow
monitoring
Chest X-Ray
CBC
Allergy skin testing
Serum IgE levels
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Peak Flow Meter
Device used to monitorbreathing capacity
Measures the flow
of air in a forced
exhalation in liters/minute Accurate indicator of
impending asthma attack
Higher numbers = less risk for
attack
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Asthma Medications
Long term
Oral
Inhaled
Nebulizer
Quick relief
Oral
Inhaled
Nebulizer
Intravenous Combination
inhaled
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Nursing CareAssessment
Precipitating factors Environment
Changes in activity
Recent stressors/illness
Current medication regimen
History of acute episodes,attacks
Physical exam Appearance
Mental status
Vital signs
Respiratory assessment
Effort, quality ofrespirations
Color
Moving air?
Interventions
Monitor respiratory status Pulse oximeter, ABGs
Medications. Respiratorytreatments
Supplemental 02
Chest Physiotherapy
Peak expiratory flowmonitoring
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Patient/family education
Signs and symptoms of attack
Keep a symptom diary
Compliance with meds
Carrying PRN meds
Conditions in which meds are increased
Use of equipment
Smoking cessation
Influenza vaccination
Exercise