Respiratory disorders

Asthma

Main Problem: Abnormal bronchial hyperactivity to certain substances and conditions

Clinical manifestation:
Dyspnea
Wheezing
Diagnostic test:
PFT’s during attacks show decreased forced expiratory volumes, elevated immunoglobulin E
ABG
Nursing diagnosis: Ineffective breathing pattern
Nursing Interventions:
Assess precipitating factor and eradicate these sources
Instruct patient to avoid 3 E’s (exercise specially in cold weather, environmental factors like
dust, emotional factors)
Place patient in orthopneic position and encourage patient to do pursed lip breathing
Administer medications - bronchodilators and corticosteroids usually via nebulization
(aerosol)
Liberal fluid intake
✔ A - minophylline
✔ S - teroid
✔ T - heophylline
✔ H - istamine antagonist
✔ M - ucolytics
✔ A - ntibiotics

✔ B - ronchodilators
✔ R - est
✔ O - xygen
✔ C - hest physiotherapy
✔ H - igh fowler’s position
✔ I - ntermittent positive pressure breathing
✔ A - erosol
✔ L -iberal fluid intake
Bronchiectasis

Main Problem: Chronic abnormal dilation of bronchi and destruction of bronchial walls leading to
multiple respiratory complications
Clinical manifestation:
Chronic cough that produces copious, foul smelling, mucupurulent secretions, possibly
totaling several cupfuls daily
Diagnostic test:
Bronchoscopy help identify source
Chest x-ray shows peribronchial thickening, areas of atelectasis and scattered cystic
changes
Pulmonary funtion test detect decreased volumes
Nursing diagnosis:
Ineffective airway clearance
Impaired gas exchange
Nursing Interventions:
Assess respiratory status and level of consciousness to detect early signs of hypoxia and
decompensation
Administer antibiotics as necessary
Teach and perform respiratory physiotherapy, deep breathing and coughing, postural
drainage and chest percussion
Teach importance of quitting smoking and avoidance of milk products
Bronchiolitis/respiratory synctial virus (RSV)

Main Problem: Inflammation of the bronchioles, production of mucus that occludes bronchiole
tubes and small bronchi, RSV - highly communicable usually transferred by hands
Clinical manifestation:
Upper respiratory infection
Lethargy
Poor feeding
Tachypnea
Expiratory wheezes and grunting respirations
Diminished breath sounds
Diagnostic test:
Mucus sample test
Urine or blood test
Pulse oximeter test
Nursing diagnosis: Ineffective airway clearance
Nursing Interventions:
Isolate in a single room or place with same patient
Good handwashing
Nurses caring for these children do not care for other high risk children
Wear gowns when soiling may occur
Ribavirin - may be aerosol
Nurses wearing contact lenses must wear goggles - rivavirin may dissolve contact lenses
Bronchitis

Main Problem: Infection of the major bronchi, inflammation of the airways that lead to the
windpipe
Clinical manifestation:
Cough, worse at night, becomes productive in 2-3 days
Diagnostic test:
Chest x-ray
Blood test
Nursing diagnosis: Ineffective airway clearance
Nursing Interventions:
Monitor for respiratory
Increased fluid intake
Acetaminophen
Chronic bronchitis (Blue bloater)

Main Problem: Excessive mucus secretion with and recurrent cough usually related pollutionand
infection
Clinical manifestation:
Cough with copious sputum
Diagnostic test:
ABG
Nursing diagnosis: Impaired breathing pattern
Nursing Interventions:
Increase humidity
Provide postural drainage before meals
Relieve bronchospasm
Teach the patient about breathing techniques like: blowing bubbles, blowing a trumpet,
blowing a feather in the air