ANEXO 2. PARTITURAS DE A-RONNE
A- RONNE- Pieza radiofónica de Luciano Berio- 1984
A. Predisposing Factors 1. Tricuspid valve stenosis 1. Tricuspid valve stenosis 2. Pulmonary embolism 2. Pulmonary embolism 3. Related to COPD 3. Related to COPD
4. Pulmonic valve stenosis 4. Pulmonic valve stenosis 5. Left sided heart
5. Left sided heart failurefailure
B. Signs and Symptoms (venous congestion) B. Signs and Symptoms (venous congestion) 1. Neck/jugular vein distension
1. Neck/jugular vein distension 2. Pitting edema
2. Pitting edema 3. Ascites
3. Ascites 4. Weight gain 4. Weight gain
5. Hepatosplenomegaly 5. Hepatosplenomegaly 6. Jaundice
6. Jaundice 7. Pruritus 7. Pruritus 8. Anorexia 8. Anorexia
9. Esophageal varices 9. Esophageal varices C. Diagnostic Procedures C. Diagnostic Procedures
1. Chest x-ray – reveals cardiomegaly 1. Chest x-ray – reveals cardiomegaly 2. Central venous pressure (CVP) 2. Central venous pressure (CVP)
- Measure pressure in right atrium (4 – 10 cm
- Measure pressure in right atrium (4 – 10 cm of water)of water) - CVP fluid status measure
- CVP fluid status measure
- If CVP is less than 4 cm of water
- If CVP is less than 4 cm of water hypovolemic shockhypovolemic shock - Do the fluid challenge (increase IV flow rate)
- Do the fluid challenge (increase IV flow rate) - If CVP is more than 10 cm of
- If CVP is more than 10 cm of water hypervolemic shockwater hypervolemic shock - Administer loop diuretics as ordered
- Administer loop diuretics as ordered
- When reading CVP patient should be flat on bed - When reading CVP patient should be flat on bed
- Upon insertion place client in trendelendberg position to promote ventricular filling and prevent - Upon insertion place client in trendelendberg position to promote ventricular filling and prevent pulmonary embolism
pulmonary embolism
3. Ecocardiography – reveals enlarged
3. Ecocardiography – reveals enlarged heart chambers (cardiomyopathyheart chambers (cardiomyopathy 4. Liver enzymes –
4. Liver enzymes – SGPT and SGOT is increasedSGPT and SGOT is increased D. Nursing Management
D. Nursing Management Goal:
Goal: increase cardiac contractility thereby increasing cardiac output (3 increase cardiac contractility thereby increasing cardiac output (3 – 6 L/min)– 6 L/min) 1. Enforce CBR
1. Enforce CBR
2. Administer medications as ordered 2. Administer medications as ordered
48 48 a.
a. Cardiac glycosidesCardiac glycosides - Digoxin (Lanoxin) - Digoxin (Lanoxin)
- Increase force of cardiac contraction - Increase force of cardiac contraction - If heart rate is decreased do not - If heart rate is decreased do not givegive b.
b. Loop DiureticsLoop Diuretics - Lasix (Furosemide) - Lasix (Furosemide) c.
c. BronchodilatorsBronchodilators d.
d. Narcotic analgesicsNarcotic analgesics - Morphine Sulfate - Morphine Sulfate e.
e. VasodilatorsVasodilators - Nitroglycerine - Nitroglycerine f.
f. Anti ArrhythmicAnti Arrhythmic - Lidocaine (Xylocane) - Lidocaine (Xylocane)
3. Administer oxygen inhalation with high inflow, 3 – 4 L/min, delivered via nasal cannula 3. Administer oxygen inhalation with high inflow, 3 – 4 L/min, delivered via nasal cannula 4. High fowlers position
4. High fowlers position
5. Monitor strictly vital signs, intake and
5. Monitor strictly vital signs, intake and output and ECG tracingoutput and ECG tracing 6. Measure abdominal girth daily and
6. Measure abdominal girth daily and notify physiciannotify physician 7. Provide a dietary intake of
7. Provide a dietary intake of low sodium, cholesterol and caffeinelow sodium, cholesterol and caffeine 8. Provide meticulous skin care
8. Provide meticulous skin care 9.
9. AssiAssist st in bloodless phlebotin bloodless phlebotomy – omy – rotatrotating tourniquing tourniquet, rotated clockwiet, rotated clockwise se every 15 every 15 minutminutes es to to promopromotete decrease venous return
decrease venous return
10. Provide client health teaching and
10. Provide client health teaching and discharge planningdischarge planning a. Prevent complications
a. Prevent complications - Arrythmia - Arrythmia - Shock - Shock
- Right ventricular hypertrophy - Right ventricular hypertrophy - MI
- MI
- Thrombophlebitis - Thrombophlebitis b. Dietary modification b. Dietary modification
c. Strict compliance to medications c. Strict compliance to medications Arterial Ulcer
Arterial Ulcer
I. Thrombo Angitis Obliterans I. Thrombo Angitis Obliterans
Burger’s DiseaseBurger’s Disease
Reynaud’s DiseaseReynaud’s Disease Venous Ulcer
Venous Ulcer 1. Varicose Veins 1. Varicose Veins
2. Thrombophlebitis (deep vein thrombosis) 2. Thrombophlebitis (deep vein thrombosis) THROMBOANGITIS OBLITERANS
THROMBOANGITIS OBLITERANS Acu
Acute te infinflamlammatmatory ory disdisordorder er usuusuallally y affaffectecting ing the the smasmall ll memediudium m sizsized ed artarterieries es and and veiveins ns of of the the lowlower er extremities
extremities
A. Predisposing Factors A. Predisposing Factors
1. High risk groups – men 30 years
1. High risk groups – men 30 years old and aboveold and above 2. Smoking
2. Smoking
B. Signs and Symptoms B. Signs and Symptoms
1. Intermittent claudication – leg pain upon
1. Intermittent claudication – leg pain upon walkingwalking
2. Cold sensitivity and changes in skin color (pallor, cyanosis then rubor) 2. Cold sensitivity and changes in skin color (pallor, cyanosis then rubor) 3. Decreased peripheral pulses
3. Decreased peripheral pulses 4. Trophic changes
4. Trophic changes 5. Ulceration
5. Ulceration
6. Gangrene formation 6. Gangrene formation C. Diagnostic Procedures C. Diagnostic Procedures 1.
1. OscillometryOscillometry – decrease in peripheral pulses– decrease in peripheral pulses
48 48 2.
2. Doppler UTZDoppler UTZ – decrease blood flow to the affected extremity – decrease blood flow to the affected extremity 3.
3. AngiographyAngiography – reveals site and extent of malocclusion– reveals site and extent of malocclusion D. Nursing Management
D. Nursing Management 1. Encourage a slow
1. Encourage a slow progressive physical activityprogressive physical activity a. walking 3 – 4 times a
a. walking 3 – 4 times a dayday b. out of bed 3 – 4 times a day b. out of bed 3 – 4 times a day 2. Administer medications as ordered 2. Administer medications as ordered
a. Analgesics a. Analgesics b. Vasodilators b. Vasodilators c. Anti coagulants c. Anti coagulants
3. Institute foot care management 3. Institute foot care management
4. Instruct client to avoid smoking and exposure to cold environment 4. Instruct client to avoid smoking and exposure to cold environment 5. Assist in surgical procedure
5. Assist in surgical procedure – bellow knee amputation– bellow knee amputation REYNAUD’S DISEASE
REYNAUD’S DISEASE
Disorder characterized by acute episodes of arterial spasm involving the fingers or digits of the hands Disorder characterized by acute episodes of arterial spasm involving the fingers or digits of the hands PREDISPOSING FACTOR
PREDISPOSING FACTOR
1. High risk group – female 40 years old
1. High risk group – female 40 years old and aboveand above 2. Smoking
2. Smoking
3. Collagen diseases 3. Collagen diseases
a. SLE (butterfly rash) a. SLE (butterfly rash) b. Rheumatoid Arthritis b. Rheumatoid Arthritis 4. Direct hand trauma
4. Direct hand trauma a. Piano playing a. Piano playing b. Excessive typing b. Excessive typing c. Operating chainsaw c. Operating chainsaw B. Signs and Symptoms B. Signs and Symptoms
1. Intermittent claudication – leg pain upon
1. Intermittent claudication – leg pain upon walkingwalking
2. Cold sensitivity and changes in skin color (pallor, cyanosis then rubor) 2. Cold sensitivity and changes in skin color (pallor, cyanosis then rubor) 3. Trophic changes
3. Trophic changes 4. Ulceration
4. Ulceration
5. Gangrene formation 5. Gangrene formation C. Diagnostic Procedures C. Diagnostic Procedures 1.
1. Doppler UTZDoppler UTZ – decrease blood flow to the affected extremity – decrease blood flow to the affected extremity 2.
2. AngiographyAngiography – reveals site and extent of malocclusion– reveals site and extent of malocclusion D. Nursing Management
D. Nursing Management
1. Administer medications as ordered 1. Administer medications as ordered
a. Analgesics a. Analgesics b. Vasodilators b. Vasodilators 2. Encourage to wear gloves 2. Encourage to wear gloves
3. Instruct client on importance of cessation of smoking and exposure to cold environment 3. Instruct client on importance of cessation of smoking and exposure to cold environment VARICOSITIES
VARICOSITIES
Abnormal dilation of veins of lower
Abnormal dilation of veins of lower extremities and trunks due toextremities and trunks due to Incompetent valve
Incompetent valve resulting toresulting to Increased venous pooling
Increased venous pooling resulting toresulting to Venous stasis
Venous stasis causingcausing Decrease venous return Decrease venous return A. Predisposing Factors
A. Predisposing Factors 1. Hereditary
1. Hereditary
2. Congenital weakness of veins 2. Congenital weakness of veins 3. Thrombophlebitis
3. Thrombophlebitis 4. Cardiac disorder 4. Cardiac disorder 5. Pregnancy
5. Pregnancy
48 48 6. Obesity
6. Obesity
7. Prolonged standing or sitting 7. Prolonged standing or sitting B. Signs and Symptoms B. Signs and Symptoms
1. Pain after prolonged standing 1. Pain after prolonged standing 2. Dilated tortuous skin veins 2. Dilated tortuous skin veins 3. Warm to touch
3. Warm to touch 4. Heaviness in legs 4. Heaviness in legs C. Diagnostic Procedure C. Diagnostic Procedure 1. Venography
1. Venography
2. Trendelenburg’s T
2. Trendelenburg’s Test est - veins distends qui- veins distends quickly in less than 35 sckly in less than 35 secondseconds D. Nursing Management
D. Nursing Management
1. Elevate legs above heart level to promote increased venous return by placing 2
1. Elevate legs above heart level to promote increased venous return by placing 2 – 3 pillows under the legs– 3 pillows under the legs 2. Measure the circumference of
2. Measure the circumference of leg muscle to determine if swollenleg muscle to determine if swollen 3. Wear anti embolic stockings
3. Wear anti embolic stockings
4. Administer medications as ordered 4. Administer medications as ordered
a. Analgesics a. Analgesics
5. Assist in surgical procedure 5. Assist in surgical procedure
a. Vein stripping and ligation (most
a. Vein stripping and ligation (most effective)effective)
b. Sclerotherapy – can recur and only done in spider web varicosities and danger of thrombosis (2 – 3 b. Sclerotherapy – can recur and only done in spider web varicosities and danger of thrombosis (2 – 3 years for embolism)
years for embolism) THROMBOPHLEBITIS THROMBOPHLEBITIS Deep vein thrombosis Deep vein thrombosis
Inflammation of the veins with thrombus formation Inflammation of the veins with thrombus formation A. Predisposing Factors
A. Predisposing Factors 1. Obesity
1. Obesity 2. Smoking 2. Smoking
3. Related to pregnancy 3. Related to pregnancy 4. Chronic anemia 4. Chronic anemia 5. Prolong use of
5. Prolong use of oral contraceptives – promotes lipolysisoral contraceptives – promotes lipolysis 6. Diabetes mellitus
6. Diabetes mellitus
7. Congestive heart failure 7. Congestive heart failure 8. Myocardial infarction 8. Myocardial infarction 9. Post op complication 9. Post op complication
10. Post cannulation – insertion of various cardiac catheter 10. Post cannulation – insertion of various cardiac catheter 11. Increase in saturated fats in the diet.
11. Increase in saturated fats in the diet.
B. Signs and Symptoms B. Signs and Symptoms 1. Pain at affected extremity 1. Pain at affected extremity 2. Warm to touch
2. Warm to touch
3. Dilated tortuous skin veins 3. Dilated tortuous skin veins
4. Positive Hpman’s Signs – pain at the calf or leg muscle upon dorsi flexion of the 4. Positive Hpman’s Signs – pain at the calf or leg muscle upon dorsi flexion of the footfoot C. Diagnostic Procedure
C. Diagnostic Procedure 1. Venography
1. Venography 2. Angiography 2. Angiography
D. Nursing Management D. Nursing Management
1. Elevate legs above heart level to promote increase venous return 1. Elevate legs above heart level to promote increase venous return 2. Apply warm moist pack – to reduce lymphatic congestion
2. Apply warm moist pack – to reduce lymphatic congestion 3. Measure circumference of leg
3. Measure circumference of leg muscle to determine if swollenmuscle to determine if swollen 4. Encourage to wear anti embolic stockings or knee elastic stockings 4. Encourage to wear anti embolic stockings or knee elastic stockings 5. Administer medications as ordered
5. Administer medications as ordered a. Analgesics
a. Analgesics b. Anti Coagulant b. Anti Coagulant - Heparin - Heparin
48 48 6. Monitor for signs of
6. Monitor for signs of complicationscomplications Embolism
Embolism a.
a. PulmonaryPulmonary
- Sudden sharp chest pain - Sudden sharp chest pain - Unexplained dyspnea - Unexplained dyspnea - Tachycardia
- Tachycardia - Palpitations - Palpitations - Diaphoresis - Diaphoresis - Restlessness - Restlessness b.
b. CerebralCerebral - Headache - Headache - Dizziness - Dizziness - Decrease LOC - Decrease LOC
MURPHY’S SIGN is seen in clients
MURPHY’S SIGN is seen in clients with cholelithiwith cholelithiasis, cholecystitis characterized by pain at asis, cholecystitis characterized by pain at thethe 1. PTB/Pulmonary Tuberculosis (Koch’s Disease)
1. PTB/Pulmonary Tuberculosis (Koch’s Disease) - Infection of lung
- Infection of lung tissue caused by invasion tissue caused by invasion of mycobacterium tuberculosis or tubercle bacilliof mycobacterium tuberculosis or tubercle bacilli - An acid fast, gram negative, aerobic and easily destroyed by heat or
- An acid fast, gram negative, aerobic and easily destroyed by heat or sunlightsunlight A. Precipitating Factors
A. Precipitating Factors 1. Malnutrition
1. Malnutrition
2. Overcrowded places 2. Overcrowded places 3. Alcoholism
3. Alcoholism 4. Over fatigue 4. Over fatigue 5. Ingestion of an
5. Ingestion of an infected cattle with mycobacterium bovisinfected cattle with mycobacterium bovis 6. Virulence (degree of pathogenecity) of
6. Virulence (degree of pathogenecity) of microorganismmicroorganism B. Mode of Transmission
B. Mode of Transmission
1. Airborne transmission via droplet nuclei 1. Airborne transmission via droplet nuclei C. Signs and Symptoms
C. Signs and Symptoms
1. Low grade afternoon fever, night sweats 1. Low grade afternoon fever, night sweats 2. Productive cough (yellowish sputum) 2. Productive cough (yellowish sputum) 3. Anorexia, generalized body malaise 3. Anorexia, generalized body malaise 4. Weight loss
4. Weight loss 5. Dyspnea 5. Dyspnea 6. Chest pain 6. Chest pain
7. Hemoptysis (chronic) 7. Hemoptysis (chronic) D. Diagnostic Procedure D. Diagnostic Procedure 1.
1. Mantoux Test (skin test)Mantoux Test (skin test) - Purified protein derivative - Purified protein derivative
- DOH 8 – 10 mm induration, 48 –
- DOH 8 – 10 mm induration, 48 – 72 hours72 hours - WHO 10 – 14 mm induration, 48 –
- WHO 10 – 14 mm induration, 48 – 72 hours72 hours - Positive Mantoux test (previous exposure
- Positive Mantoux test (previous exposure to tubercle bacilli but without active TB)to tubercle bacilli but without active TB) 2.
2. Sputum Acid Fast BacillusSputum Acid Fast Bacillus - Positive to cultured microorganism - Positive to cultured microorganism 3.
3. Chest X-rayChest X-ray - Reveals pulmonary
- Reveals pulmonary infiltratesinfiltrates 4.
4. CBCCBC
- Reveals increase WBC - Reveals increase WBC E. Nursing Management E. Nursing Management 1. Enforce CBR
1. Enforce CBR
2. Institute strict respiratory isolation 2. Institute strict respiratory isolation 3. Administer oxygen inhalation 3. Administer oxygen inhalation 4. Force fluids to liquefy
4. Force fluids to liquefy secretionssecretions
5. Place client on semi fowlers position to promote expansion of lungs 5. Place client on semi fowlers position to promote expansion of lungs
48 48 6. Encourage deep breathing and coughing exercise
6. Encourage deep breathing and coughing exercise 7. Nebulize and suction when needed
7. Nebulize and suction when needed 8. Comfortable and humid environment 8. Comfortable and humid environment 9. Institute short course chemotherapy 9. Institute short course chemotherapy
a.
a. Intensive phaseIntensive phase - INH (Isonicotinic Acid
- INH (Isonicotinic Acid Hydrazide)Hydrazide) - Rifampicin (Rifampin)
- Rifampicin (Rifampin) - PZA (Pyrazinamide) - PZA (Pyrazinamide)
- Given everyday simultaneously to p
- Given everyday simultaneously to p revent resistancerevent resistance
- INH and Rifampicin is given for 4 months, taken before meals to facilitate absorption - INH and Rifampicin is given for 4 months, taken before meals to facilitate absorption - PZA is given for
- PZA is given for 2 months, taken after meals 2 months, taken after meals to facilitate absorptionto facilitate absorption
-- Side Effect INH:Side Effect INH: peripheral neuritis/neuropathy (increase intake of Vitamin Bperipheral neuritis/neuropathy (increase intake of Vitamin B66/Pyridoxine)/Pyridoxine) -- Side Effect Side Effect RifampicinRifampicin:: all bodily secretions turn to red orange color all bodily secretions turn to red orange color
-- Side Effect PZA:Side Effect PZA: allergic reaction, hepatotoxicity, nephrotoxicityallergic reaction, hepatotoxicity, nephrotoxicity - PZA can be replaced by Ethambutol
- PZA can be replaced by Ethambutol -- Side Effect Ethambutol:Side Effect Ethambutol: optic neuritisoptic neuritis b.
b. Standard phaseStandard phase
- Injection of streptomycin (aminoglycoside) - Injection of streptomycin (aminoglycoside) - Kanamycin
- Kanamycin - Amikacin - Amikacin - Neomycin - Neomycin - Gentamycin - Gentamycin -- Side Effect:Side Effect:
-- OtotoxicityOtotoxicity damage to the 8damage to the 8ththcranial nerve resulting to tinnitus leading to cranial nerve resulting to tinnitus leading to hearing losshearing loss -- NephrotoxicityNephrotoxicity check for BUN and Creatininecheck for BUN and Creatinine
- Give aspirin if there is fever - Give aspirin if there is fever
-- Side Effect:Side Effect: tinnitus, dyspepsia, heartburntinnitus, dyspepsia, heartburn
10. Provide increase carbohydrates, protein, vitamin C and
10. Provide increase carbohydrates, protein, vitamin C and caloriescalories 11. Provide client health teaching and
11. Provide client health teaching and discharge planningdischarge planning a. Avoidance of precipitating factors
a. Avoidance of precipitating factors
b. Prevent complications (atelectasis, military tuberculosis) b. Prevent complications (atelectasis, military tuberculosis) PTB
PTB
- Bones (potts) - Bones (potts) - Meninges - Meninges - Eyes - Eyes - Skin - Skin
- Adrenal gland - Adrenal gland
c. Strict compliance to medications c. Strict compliance to medications d. Importance of follow up care d. Importance of follow up care PNEUMONIA
PNEUMONIA
Inflammation of the lung parenchyma leading
Inflammation of the lung parenchyma leading to pulmonary consolidation as the to pulmonary consolidation as the alveoli is filled with exudatesalveoli is filled with exudates
A. Etiologic Agents A. Etiologic Agents 1.
1. Streptococcus PneumonaeStreptococcus Pneumonae – causing pneumococal pneumonia– causing pneumococal pneumonia 2.
2. Hemophylus InfluenzaeHemophylus Influenzae – causing broncho pneumonia– causing broncho pneumonia 3.
3. Diplococcus PneumoniaeDiplococcus Pneumoniae 4.
4. Klebsella PneumoniaeKlebsella Pneumoniae 5.
5. Escherichia PneumoniaeEscherichia Pneumoniae 6.
6. PseudomonasPseudomonas B. High Risk Groups B. High Risk Groups
1. Children below 5 years old 1. Children below 5 years old 2. Elderly
2. Elderly
48 48 C. Predisposing Factors
C. Predisposing Factors 1. Smoking
1. Smoking 2. Air pollution 2. Air pollution
3. Immuno compromised 3. Immuno compromised
a.
a. AIDSAIDS
- Pneumocystic carini pneumonia - Pneumocystic carini pneumonia - Drug of choice is
- Drug of choice is Retrovir Retrovir b.
b. Bronchogenic Cancer Bronchogenic Cancer
- Initial sign is non productive cough - Initial sign is non productive cough - Chest x-ray confirms lung cancer - Chest x-ray confirms lung cancer
4. Related to prolonged immobility (CVA clients), causing
4. Related to prolonged immobility (CVA clients), causing hypostatic pneumoniahypostatic pneumonia 5. Aspiration of food causing
5. Aspiration of food causing aspiration pneumoniaaspiration pneumonia D. Signs and Symptoms
D. Signs and Symptoms
1. Productive cough with greenish to rusty sputum 1. Productive cough with greenish to rusty sputum 2. Dyspnea with prolong expiratory grunt
2. Dyspnea with prolong expiratory grunt 3. Fever, chills, anorexia and g
3. Fever, chills, anorexia and g eneral body malaiseeneral body malaise 4. Weight loss
4. Weight loss 5. Rales/crackles 5. Rales/crackles 6. Bronchial wheezing 6. Bronchial wheezing 7. Cyanosis
7. Cyanosis
8. Pleuritic friction rub 8. Pleuritic friction rub 9. Chest pain
9. Chest pain
10. Abdominal distention leading to paralytic ileus (absence
10. Abdominal distention leading to paralytic ileus (absence of peristalsis)of peristalsis) E. Diagnostic Procedure
E. Diagnostic Procedure
1. Sputum Gram Staining and Culture Sensitivity – p
1. Sputum Gram Staining and Culture Sensitivity – p ositive to cultured microorganismsositive to cultured microorganisms 2. Chest x-ray –
2. Chest x-ray – reveals pulmonary consolidationreveals pulmonary consolidation 3. ABG analysis – reveals decrease PO
3. ABG analysis – reveals decrease PO22
4. CBC – reveals
4. CBC – reveals increase WBC, erythrocyte sedimentation rate is increasedincrease WBC, erythrocyte sedimentation rate is increased F. Nursing Management
F. Nursing Management 1. Enforce CBR
1. Enforce CBR
2. Administer oxygen inhalation low inflow 2. Administer oxygen inhalation low inflow 3. Administer medications as ordered 3. Administer medications as ordered Broad Spectrum Antibiotic Broad Spectrum Antibiotic a
a.. PPeenniicciilllliinn b.
b. TTetetrracacycyclliinene c.
c. MiMicrcrololidides es (Z(Zetethrhromomax)ax)
-- Azethromycin (Azethromycin (Side Effect:Side Effect: Ototoxicity)Ototoxicity) -- AntipyreticsAntipyretics
-- Mucolytics/ExpectorantsMucolytics/Expectorants -- AnalgesicsAnalgesics
4. Force fluid 4. Force fluid 5. Place on semi
5. Place on semi fowlers positionfowlers position
6. Institute pulmonary toilet (tends to promote
6. Institute pulmonary toilet (tends to promote expectoration)expectoration) - Deep breathing exercises
- Deep breathing exercises - Coughing exercises - Coughing exercises - Chest physiotherapy - Chest physiotherapy - Turning and reposition - Turning and reposition 7. Nebulize and suction as needed 7. Nebulize and suction as needed 8. Assist in postural drainage 8. Assist in postural drainage
- Drain uppermost area of lungs - Drain uppermost area of lungs - Placed on various position - Placed on various position
Nursing Management for Postural Drainage Nursing Management for Postural Drainage
48 48 a. Best done before meals or 2 –
a. Best done before meals or 2 – 3 hours to prevent gastro esophageal reflux3 hours to prevent gastro esophageal reflux b. Monitor vital signs
b. Monitor vital signs
c. Encourage client deep b
c. Encourage client deep breathing exercisesreathing exercises d. Administer bronchodilators 15 – 30
d. Administer bronchodilators 15 – 30 minutes before procedureminutes before procedure e. Stop if client cannot
e. Stop if client cannot tolerate proceduretolerate procedure f. Provide oral care after
f. Provide oral care after procedureprocedure g. Contraindicated with
g. Contraindicated with - Unstable vital signs - Unstable vital signs - Hemoptysis
- Hemoptysis
- Clients with increase intra ocular pressure (Normal IOP 12 – 21 mmHg) - Clients with increase intra ocular pressure (Normal IOP 12 – 21 mmHg) - Increase ICP
- Increase ICP
9. Provide increase carbohydrates, calories, protein and
9. Provide increase carbohydrates, calories, protein and vitamin Cvitamin C 10. Health teaching and discharge planning
10. Health teaching and discharge planning a. Avoid smoking
a. Avoid smoking
b. Prevent complications b. Prevent complications - Atelectasis
- Atelectasis
- Meningitis (nerve deafness, hydrocephalus) - Meningitis (nerve deafness, hydrocephalus) c. Regular adherence to
c. Regular adherence to medicationsmedications d. Importance of follow up care d. Importance of follow up care
COPD (Chronic Obstructive Pulmonary/Lung Disease) COPD (Chronic Obstructive Pulmonary/Lung Disease) Chronic Bronchitis
Chronic Bronchitis
Inflammation of bronchus resulting to hypertrophy or hyperplasia of goblet mucous producing cells leading to Inflammation of bronchus resulting to hypertrophy or hyperplasia of goblet mucous producing cells leading to narrowing of smaller airways
narrowing of smaller airways A. Predisposing Factors A. Predisposing Factors 1. Smoking
1. Smoking 2. Air pollution 2. Air pollution
B. Signs and Symptoms B. Signs and Symptoms
1. Productive cough (consistent to a
1. Productive cough (consistent to a ll COPD)ll COPD) 2. Dyspnea on exertion
2. Dyspnea on exertion 3. Prolonged expiratory grunt 3. Prolonged expiratory grunt
4. Anorexia and generalized body malaise 4. Anorexia and generalized body malaise 5. Scattered rales/ronchi
5. Scattered rales/ronchi 6. Cyanosis
6. Cyanosis
7. Pulmonary hypertension 7. Pulmonary hypertension
a. Peripheral edema a. Peripheral edema b.
b. Cor PulmonaleCor Pulmonale (right ventricular hypertrophy)(right ventricular hypertrophy) C. Diagnostic Procedure
C. Diagnostic Procedure ABG analysis
ABG analysis – reveals PO– reveals PO22decrease (hypoxemia), PCOdecrease (hypoxemia), PCO22increase, pH decreaseincrease, pH decrease Bronchial Asthma
Bronchial Asthma
Reversible inflammatory lung condition due to hypersensitivity to allergens leading to narrowing of smaller Reversible inflammatory lung condition due to hypersensitivity to allergens leading to narrowing of smaller airways
airways
A. Predisposing Factors (Depending on Types) A. Predisposing Factors (Depending on Types) 1. Extrinsic Asthma (
1. Extrinsic Asthma ( Atopic/ Allergic )Atopic/ Allergic ) Causes
Causes a. Pollen a. Pollen b. Dust b. Dust c. Fumes c. Fumes d. Smoke d. Smoke e. Gases e. Gases f. Danders
Causes a. Pollen a. Pollen b. Dust b. Dust c. Fumes c. Fumes d. Smoke d. Smoke e. Gases e. Gases f. Danders