NUR 3050 Pharmacology for Clinical Practice

NUR 3050 Pharmacology for Clinical Practice

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Management of Patients With chest and Lower Respiratory Tract Disorders Atelectasis Definition: Closure or collapse of the alveoli Most commonly encountered abnormality seen on the chest x-ray Maybe acute or chronic Most commonly acute Often occurs in Post operative setting or in people who are immobilized and have a shallow breathing pattern Excessive secretions or mucous plug may cause obstruction that blocks the flow of air Pathophysiology: May occur in adults as a result of reduced ventilation or any blockage that abstracts passage of air to and from the alveoli Obstructive atelectasis is the most common type and the results from reabsorption of gas-Gas is reabsorbed into the blood and because of the obstruction no more air can flow back and the lungs becomes airless and alveoli collapse. Causes: Foreign body, Tumor growth in an airway altered breathing patterns, retain secretions, pain, alterations in small air way function, prolong supine positioning increased abdominal pressure, reduced lung volumes Due to musculoskeletal or neurological disorders, Restrictive defects, and specific surgical procedures Patients are high risk for atelectasis postoperatively because of several factors that cause low tidal breathing pattern and may cause airway closure and Alveolar collapse. Anesthesia, analgesic, supine positioning Bronchial obstruction by secretions May also occur in patients with impaired Cough mechanisms. Atelectasis may develop because of excessive pressure on lung tissue which restrict normal lung expansion on inspiration Such pressure can be produced by fluid accumulating in the plural space, Pleural effusion, Pneumothorax, And hemothorax. Clinical manifestation Signs and symptoms include increasing dyspnea cough and sputum production. Acute atelectasis- Involve a large amount of tissue and marked respiratory distress. Symptoms include tachycardia tachypnea, central cyanosis and plural pain. Patients have difficulty breathing Chronic- Signs and symptoms are similar to acute. The chronic nature of the collapse in chronic atelectasis predisposes patience to infection distal to the obstruction Assessment and diagnostic findings Clinically significant atelectasis is characterized by increased work of breathing and hypoxemia decreased breath sounds and crackles are heard. Chest x-ray may suggest a diagnosis. Low saturation of hemoglobin with oxygen less than 90% or Lower than normal normal partial pressure of arterial oxygen. Prevention: Frequent turning, early mobilization, strategies to expand the lungs and to manage secretions, volunteer deep breathing assist in preventing and treating atelectasis. Patient education, incentives spirometer, voluntary deep breathing enhances law expansion decrease the potential for airway closure and may generate a cough Secretion management techniques include directed cost suctioning nebulizer and bronchoscopy Management Goal of treatment is to improve ventilation a

NUR 3050 Pharmacology for Clinical Practice