Respiratory Conditions in Acute Biological Crisis

Ateneo de Davao University
School of Nursing
NCM 4164
Nursing Care for Clients with Life Threatening Conditions Lecture
by: Deanne Joy Tutor
Lower Respiratory Tract

Respiratory Conditions in Acute Biological Crisis
Prepared by: Mr. Michael Francis H. Cahandig, RN, MN
Discussed by Mr. Joel Mikee A. Beldua, Jr. RN, MN
Discussion date: September 1, 2023
Respiratory System
The respiratory system is for
• Gas exchange (oxygenation)
• Defense
• Homeostasis through a balance of acids and bases (removal
of excess CO2)
o If not removed: dissolve to plasma (CO2 +
Plasma), causing or leading to acidosis Note:
• Right lung – 3 lobes • Question: what is the function of the sinuses?
• Left lung – 2 lobes o It keeps head light since ithas air inside to support
o Note: pneumonia is more susceptible to the right the head.
side of the lungs; more vertical bronchi • Question: What is the probable sound of sinuses upon
• Bronchus to bronchi (lower respiratory) percussion?
• Alveolar capillaries – where gas exchange happens o Resonance (both direct and indirect percussion)
(specifically type I) • Question: How many sinuses are in the head?
o 3 types of cells in pneumocytes o 4. Frontal, maxillary, sphenois and ethmoid.
▪ Type I – the lining of alveolar capillaries • Question: Among them all, which cannot be palpated?
▪ Type II – the one who produces o Sphenoid and ethmoid
surfactant to allow lungs to expand
despite the fluid • Diaphragm
• Dexamethasone for pregnant o (inhale) – flat
woman with signs and o Exhale – dome shape
symptoms of premature labor • DIapghragmatic excursion – percussion (3-5 or 3-5.5 cm)
▪ Type III – alveolar macrophage protects o How well diaphgram contracts since lungs won’t
the lungs from foreign bodies; when the expand if diaphragm is weak
1st line of defense cannot tolerate it. o Phrenic nerve – control the diaphragm
• 1st line: ▪ GBS attacks phrenic nerve
o cilia – cannot be ▪ GBS vs MS
seen by naked eye • MG (mind-ground paralysis)
o vibrisae – hair nose • GBS (ground to brain
visible to naked eye paralysis)
o In hypoxemia, type I is affected o Inferior to the lungs
o To assess
Upper Respiratoy Tract ▪ Resonance until hitting the diaphragm
(dull)
▪ Ask to inhale (flat) and hold – resonant
first
▪ When dull is heard, ask to exhale and
mark
▪ Ask to inhale, and do again. Mark the
site.
o Breathing is both a voluntary and an involuntary
movement
• How to assess for respiratory excursion?
o Butterfly hand
o Normal: 3-5 or 3-5.5 cm
o Palpation
o To know which lobes are not expanding; ideally
both should move symetrically.
o It can be measured anteriorly and posteriorly
School of Nursing
NCM 4164
Respiratory System Conditions in ABC Type 3 (Perioperative)

• Acute Respiratory Failure • Subtype of type 1 that results from lung or alveolar
• Acute Severe Asthma (Formerly called Status Asthmaticus) atelectasis
• Anaphylactic Shock o Note: atelectasis (lungs collapse or cannot
• Acute Respiratory Distress Syndrome (ARDS) expand)
• Chronic Obstructive Pulmonary Disease (COPD) • General anesthesia can cause collapse of dependent lung
alveoli
Acute Respiratory Failure (ARF) • Note:
o If CTT is disconnected, kink the tube to prevent
atmospheric air (high pressure) to go inside the
lungs (negative air pressure) causing
pneumothorax which can lead to atelectasis
o Aftercare: just get the output, DO NOT TOUCH!
Type 3 (Perioperative)
• The lungs fail

• Airway is the problem than circulation
• It won’t be able to provide good oxygenation and ventilation
o Ventilation – movement of air in and out of the
lungs.
o Respiration
▪ exchange of gases from the human
body and outside of the human body
(atmosphere)
▪ exchange of atmospheric air in and out
of the body
• Causes of respiratory failure
o Decrease O2 or increase CO2 (hypercapnia)
o Note: ABG is obtained
• Another term for COPD is CAL (Chronic Airflow Limitation)
• Hypoxemia can be measured thru
o Pulse oximeter (95-100)
o ABG (80-100)
Types of Respiratory Failure

Type 1 (Hypoxemic)
• Failure to exchange oxygen in the lungs
• Note: oxygen and hypoxemia
Type 2 (Hypercapnic)
• Failure to exchange or remove carbon dioxide in the lungs
• Note: hypercapnic
Note:
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NCM 4164
• The patient will be intubated and attacked to a

mechanical ventilator
• High V/Q – more movement, less perfusion
• Low V/Q – less movement, more perfusion
o Note: both can be mismatched
Pathophysiology of ARF
Note:
• Impaired CNS function – medulla, brainstem and pons
• Musculoskeletal dysfunction – won’t be able to use ICS
muscle to breathe
• Pulmonary dysfunction – atelectasis
Causes of Respiratory Failure
Clinical Manifestations
Early Signs
• Dyspnea
• Air Hunger
• Restlessness
o Brain receives low oxygen
o Neurological manifestation
• Fatigue
• Headache
• Airway obstruction – affects ventilation • Tachycardia - compensation
• Head injury • Increased Blood Pressure – to supply oxygen
o Brain has a respiratory center
o Medulla oblongata, brain stem and pons As Hypoxemia progresses
• Pneumonia – severe pneumonia can lead to septic shock • Confusion
• Asthma • Lethargy
o Broncho/bronchioles affectation o Confusion and lethargy are both neurological
o Lower manifestation
o bronchoconstriction o LOC is affected
• COPD o In NVS, how to know if the patient is confused?
o 3 types: ▪ Ask name and place where he is
▪ Emphysema o Sleepy and laziness
▪ Chronic bronchitis • Tachypnea
▪ Asthmaticus • Central Cyanosis – diaphragm
• Severe obesity – pushes diaphgram • Diaphoresis – expected cardiac manifestations
• Stroke – it affects the 3 respiratory centers • Respiratory Arrest – patient is intubated
• PE – formation of floating clots
o Ischemia and infarction if there is emboli in the DIagnostics
alveolar capillaries • Chest X-ray (CXR)
• Chest CT Scan
• Arterial Blood Gas (ABG)
Note: what structure do X-ray cannot see? Tissues

• Air in xray is hazy (blackish), while fluid is white
Medical Management
• Bronchodilators (Salbutamol inhalation)
Pathophysiology o Monitor HR
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NCM 4164
• Steroids (Hydrocortisone)
o Monitor sugar, salt and sex hormone (SSS)
o It can increase blood glucose and sodium which
can cause hypernatremia
▪ Normal CBG: 80-120 or 70-120 mg/dl
• If patient’s CBG is >120, do
not give steroids as it can
increase its levels
▪ Normal Na: 135-145 mEqs/L
(extracellular)
• If Na is elevated, do not give
steroids
Note:
▪ Normal K: 3.5-4.5 mEqs/L
• NPPV – non invasive positive pressure ventilation
(intraceullular)
• PAV – machine and patient do the inspiration and
o Alteration of sex hormone – androgen
expiration
▪ Increase muscle mass
o Mechvent only assists in the delivery of O2
▪ Gynecomastia in males
o Patient’s effort
• Antibiotics (Treat underlying infection)
• BiPAP – inspiration and expiratiion, or both
o pneumonia
• Non-invasive Positive Pressure Ventilation (CPAP or BiPAP)
o Mechvent modes
Nursing Interventions
• Oxygen Therapy
• Intubation and mechanical ventilation
o During arrest
Note:
• COPD: salbutamol
• Bronchoconstriction: steroids
Continuous Positive Airway Pressure (CPAP)
Note:
• Pulse oximeter is sensitive to light, cover with blanket
when obtaining.
o 1 full minute
mottled skin
• It prevents alveoli to collapse

• In respiratory failure, alveoli does not expand. Hence, CPAP
continuously expands the alveoli
• Cold and clammy

• In pedia patients, mottling is present but it should not be to
webby
• S/Sx of hypoxemia
Acute Severe Asthma
CPAP vs BiPAP
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NCM 4164
Formerly known as status asthmaticus, is defined as • panic or confusion – sensation of doom

severe asthma unresponsive to repeated courses of beta-agonist • blue-tinted lips or skin – cyanosis (decreased O2)
therapy such as inhaled Albuterol, Levalbuterol, or Subcutaneous • loss of consciousness – decreased O2
Epinephrine.
• It falls under COPD of CAL Pathology of Asthma
• Asthmaticus
• Asthma cannot be relieved by bronchodilators
• Due to triggers
o Exposure to allergens
o Stress
o Food
o etc.
Note:
• no muxus, relaxed airway
• chemical mediators
o histamine
o leukotrine
o cytokine
o note: these can cause dilation of the blood vessel
Causes causing edema
• thickening of walls plus fluid = wheezing
• Upper respiratory tract infections
• Insufficient use of inhaled or oral corticosteroids. • narrowing of bronchioles plus presence of musucs
o When taking steroids, immune system is o during inhalation, air can go in but only a few can
depressed get out
▪ Isolate patient • The alveoli will over inflate (overinflation)
▪ Wear mask o Q: what will be the percussion note?
▪ Avoid crowd Hyperresonance due to too much air in the
• Allergen Exposure (Pets, drugs, dust, pollen, etc.) alveoli (COPD, empyema)
o Animal dander
Diagnostics
• Irritant Inhalation (tobacco smoke, paint, etc.),
• CHEST X-RAY
• Exercise or Physical Exhaustion
o rule out pneumonia
Signs and Symptoms • ECG
o To rule out heart condition
• difficulty breathing - constriction
o Note: it can be considered pulmonary edema
• heavy sweating
• ABG
• coughing, wheezing
• Sputum culture
o Coughing – bronchoconstriction (productive
o early in the morning, do not gargle
cough)
o inhale, exhale, inhale and cough out
o Wheezing – mucus
o mucus ciliary plug is increased when sleeping,
▪ Heard thru auscultation.
hence it should be taken in the morning
▪ High pitch sound during expiration
▪ Note:
Treatment
• Stridor – inspiration
• Parenteral corticosteroids
▪ No breath sounds and wheezing is
o Decreased leukotriene, cytokine and histamine
dangerous as it is an indication of apnea
• Nebulization (Ipratropium Bromide)
• fatigue and weakness
• Epinephrine
• abdominal, back, or neck muscle pain
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NCM 4164
• Breathing and Oxygenation Assistance

o High dose of O2 cannot be given because it will Causes
retain and cause overinflation. • The most common are food allergies (nuts, fish, shellfish).
o The brain has respiratory center that stimulates • Certain medications: Antibiotics, Aspirin and other over-the-
lungs to breathe when there is a decrease in RR counter Pain Relievers, and the intravenous (IV) contrast used
and O2. But with too much O2, brain won’t react. in some imaging tests.
o Too much O2 can decrease hypoxic drive • Stings from bees, yellow jackets, wasps, hornets and fire ants
o Nasal cannula – low dose (2LPM) • Latex
o Face mask – 5-10 LPM high or low
o Note: in COPD, venturi mask is used as it should Diagnosis
be controlled and filtered History of Hypersensitivity to:
▪ Also for status asthmaticus and • Particular Foods
empyema • Medications
• Latex
Nursing Interventions • Insect Stings
• Oxygen therapy; Monitor oxygen saturation
o Normal O2 saturation for asthma (COPD): 90- To help confirm the diagnosis:
100% • Blood test to measure the amount of a certain enzyme
• Administer bronchodilators (Salbutamol) (tryptase) that can be elevated up to three hours after
• Administer pressurized metered dose inhaler as ordered anaphylaxis
• Corticosteroid therapy (Hydrocortisone, Terbutaline) • Skin tests
• Monitor vital signs including the O2 saturation
Treatment
MDI Spacer During an anaphylactic attack, you might receive cardiopulmonary
resuscitation (CPR) if you stop breathing or your heart stops beating.
You might also be given medications, including:
• Epinephrine
• Oxygen
• Intravenous (IV) Antihistamines and Cortisone
• A Beta-Agonist (such as Albuterol)
• Long term: Desensitization
• Maintain patent airway
• Assist in intubation as indicated
• Suction secretions as needed
• Administer medications as ordered
Anaphylactic Shock • WOF: Signs of respiratory distress
Anaphylaxis
• A severe, potentially life-threatening allergic reaction.
• It can occur within seconds or minutes of exposure to
something you're allergic to, such as peanuts or bee stings.
• Anaphylaxis causes your immune system to release a flood
of chemicals that can cause you to go into shock — your
blood pressure drops suddenly and your airways narrow,
blocking breathing.
Signs and Symptoms

• Skin reactions, including hives and itching and flushed or pale
skin
• Low blood pressure (hypotension)
• Constriction of your airways and a swollen tongue or throat,
which can cause wheezing and trouble breathing
• A weak and rapid pulse
• Nausea, vomiting or diarrhea
Anaphylaxis vs Severe Acute Asthma
• Dizziness or fainting
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NCM 4164
Uses of PEEP
• Improves arterial oxygenation by alleviating pulmonary
shunting
• Helps the respiratory muscles to decrease the work of breathing
• Decreases the rate of infiltrated and atelectatic tissues
Acute Respiratory Distress Syndrome (ARDS) • Increases functional residual capacity
• Severe form of acute lung injury
• Characterized by:
o A sudden and progressive pulmonary edema
o Increasing bilateral infiltrates on chest x-ray
o Hypoxemia unresponsive to oxygen
supplementation regardless of the amount of
PEEP
o Absence of an elevated left atrial pressure.
Note:
• There is too much fluid in CXR, also a manifestaion of PE
Positive End Expiratory Pressure (PEEP)

• PEEP is a pressure applied by the ventilator at the end of each
breath to ensure that the alveoli are not so prone to collapse.
• The goal of PEEP in patients with ARDS is to maximize and
maintain alveolar recruitment, thereby improving oxygenation
and limiting oxygen toxicity.
Normal CXR vs CXR with Infiltrates
Note:
• It is an umbrella to CPAP
• It allows lungs to inflate, preventing collapse
• But not too much O2
• PE in lungs and blood goes to left atrium
• Too much o2 in babies = blindness
• Too much o2 in adults = free radicals (can damage
surrounding of the lungs)
ARDS
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NCM 4164
• Mortality rate of 25-58% • Low blood pressure (hypotension)

• Patients with ARDS usually require mechanical ventilator with a • Confusion and extreme tiredness
higher-than-normal airway pressure
• 2 major factors associated with the development of ARDS: Pathophysiology
o Direct injury: cigarette smoking
o Indirect insult: shock, trauma
• Major cause of death in ARDS: non-pulmonary multiple-system
organ failure, often with sepsis.
Etiology
• Aspiration
• Drug ingestion and overdose
• Hematologic disorders
o Leukemia
o Sickle cell anemia
o Aplastic anemia
o etc.
• Prolonged inhalation of high concentrations of oxygen, smoke,
or corrosive substances
• Localized infection
• Metabolic disorders
o Pancreatitis
o Opiates (morphine)
• Shock (any cause)
• Trauma Note:
• Major surgery • Damaged type II alveolar cell
• Fat or air embolism o Decrease surfactant production
o Obtained from IV o Decrease surface tension
• Systemic sepsis o Decrease alveoli compliance
• Imapired gas exchance
Clinical Manifestations o Type I
• Rapid onset of dyspnea
• Arterial hypoxemia Diagnostics
• Bilateral infiltrates that quickly worsen • No specific test to identify ARDS
• Alveolitis w/ persistent, severe hypoxemia o Know the root cause of ARDS
• Increased alveolar dead space • Diagnosis is based on the physical exam, chest X-ray and oxygen
• Decreased pulmonary compliance levels.
• Imaging
Signs and Symptoms o Chest X-ray
• Severe shortness of breath (sob) o Chest CT Scan
• Labored and unusually rapid breathing • ABG
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NCM 4164
• CBC • Scarring (Pulmonary fibrosis)

o Increase WBC o alveoli manifesting ischemia
▪ Neutrophil – bacterial • Breathing problems
▪ Basophil/eosinophil – anaphylactic • Depression
shock
▪ Eosinophil – parasitic infection Note:
▪ Basophil – alltergic reactions • Chest tapping – if mucus is in the left side, turn to side
• Also eosinophil (right); if at bottom, tendelenburg.
o Immunoglobulin • Pressure ulcers – 2 hours frequent position change
▪ IgG – passive immunity o Calamine lotion is the safest
▪ IgA – fluid (mnemonics: lAwAy) o Egg mattress
▪ IgM – blood (mnemonics: mmmm • TPN – monitor signs and symptoms of hypoglycemia and
dinuguan) infection
▪ IgE – allergic reaction (mnemonics: Ew)
▪ IgD – function is unknown (mnemonics: Nursing Interventions (5Ps)
di ko alam) • Perfusion
• 2D Echo o ARDS patients is to maximize perfusion in the
pulmonary capillary system by increasing oxygen
There's no specific test to identify ARDS. The diagnosis is based on the transport between the alveoli and pulmonary
physical exam, chest X-ray and oxygen levels. It's also important to capillaries.
rule out other diseases and conditions — for example, certain heart o Increase fluid volume without overloading the
problems — that can produce similar symptoms. patient
o Oxygen therapy
IMAGING o Administer Inotropes/Vasodilators as ordered
• Chest X-ray. A chest X-ray can reveal which parts of your o Strict monitoring of vital signs including central
lungs and how much of the lungs have fluid in them and venous pressure (CVP) and left atrial pressure
whether your heart is enlarged. • Positioning
• Computerized tomography (CT). A CT scan combines X-ray o Proper positioning of the patient aids in drainage
images taken from many different directions into cross- of lung secretions
sectional views of internal organs. CT scans can provide o Promotes mobility to improve blood perfusion
detailed information about the structures within the heart o Turning to sides every 1-2 hours
and lungs. • Protective Lung Ventilation
o Primary goal of ventilation is to support organ
Assessment and Diagnostic Findings function by providing adequate ventilation and
• Plasma brain natriuretic peptide (BNP) levels oxygenation while decreasing the patient’s work
• Transthoracic echocardiography of breathing
• Pulmonary artery catheterization o Assist in intubation and mechanical ventilation
o Suction secretions per ET and per mouth
Medical Management o Monitor tidal volume (VT) and positive end
• Supplemental oxygen expiratory pressure (PEEP) of the ventilator
• Endotracheal Intubation o Prevention of Ventilator-Induced Lung Injury
• Mechanical ventilation (with PEEP) (VILI)
• Arterial blood gas analysis o BiPAP / CPAP
• Pulse oximetry • Protocol Weaning
• Bedside pulmonary function testing o Carry out weaning orders as ordered by the
o Incentive spirometry Pulmonologist
• Pharmacologic therapy (Treat symptoms) o Monitor and assess patient’s response to weaning
o Weaning precautions (WOF: respiratory distress,
Complications untoward vitals signs)
• ARDS • Preventing Complications
o due to ventilation associated infection o Deep Vein Thrombosis (DVT): Passive ROM
o nosocomial infection (hospital acquired exercises, Frequent position changes,
pneumonia) Anticoagulant prophylaxis, Anti-embolic
• Blood clots (DVT) stockings
• Collapsed lung o Pressure Ulcers: Frequent position changes,
• Infections Promoting adequate nutrition, Frequent skin
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NCM 4164
assessment and proper skin care, Implementing Emphysema

pressure-relieving devices (air mattress)
o Poor Nutrition: Monitor nutritional status,
Administer parenteral nutrition as ordered
o Ventilator Acquired Pneumonia (VAP):
Compliance to Infection Control Protocols,
Oral/Mouth care
Chronic Obstructive Pulmonary Disease (COPD)
Chronic Bronchitis
• A chronic inflammatory lung disease that causes obstructed

airflow from the lungs.
• It's caused by long-term exposure to irritating gases or
particulate matter, most often from cigarette smoke.
• People with COPD are at increased risk of developing heart
disease, lung cancer and a variety of other conditions.
• Emphysema and chronic bronchitis are the two most common

conditions that contribute to COPD.
• Chronic bronchitis is the inflammation of the lining of the
bronchial tubes, which carry air to and from the air sacs (alveoli)
of the lungs. It's characterized by daily cough and mucus
(sputum) production.
• Emphysema is a condition in which the alveoli at the end of the
smallest air passages (bronchioles) of the lungs are destroyed as
a result of damaging exposure to cigarette smoke and other
irritating gases and particulate matter.
• COPD is treatable. With proper management, most people with
COPD can achieve good symptom control and quality of life, as
well as reduced risk of other associated conditions.
Causes of Airway Obstruction

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NCM 4164
• Emphysema causes destruction of the fragile o The uncommon genetic disorder alpha-1-
walls and elastic fibers of the alveoli. Small airways collapse antitrypsin deficiency is the cause of some cases
when you exhale, impairing airflow out of your lungs. of COPD. Other genetic factors likely make certain
• Chronic bronchitis causes the bronchial tubes to become smokers more susceptible to the disease.
narrow and inflamed. Lungs may also produce more mucus
which can further block the narrowed tubes. Pathogenesis of COPD
Signs and Symptoms

• For chronic bronchitis, the main symptom is a daily cough and
sputum production.
• Shortness of breath, especially during physical activities
• Wheezing
• Chest tightness
• Excessive mucus in your lungs
• Cyanosis
• Frequent respiratory infections
• Lack of energy
• Unintended weight loss (in later stages)
• Swelling in ankles, feet or legs
• Episodes of exacerbations, during which their symptoms
become worse than usual day-to-day variation and persist for at
least several days.
Complications of COPD
Causes
• Respiratory Infections
• The main cause of COPD in developed countries is tobacco o People with COPD are more likely to catch colds,
smoking. the flu and pneumonia. Any respiratory infection
• In the developing world, COPD often occurs in people exposed can make it much more difficult to breathe and
to fumes from burning fuel for cooking and heating in poorly could cause further damage to lung tissue. An
ventilated homes. annual flu vaccination and regular vaccination
against pneumococcal pneumonia can prevent
Risk Factors of COPD some infections.
• Exposure to tobacco smoke • Heart problems
o The most significant risk factor for COPD is long- o For reasons that aren't fully understood, COPD
term cigarette smoking. The more years you can increase your risk of heart disease, including
smoke and the more packs you smoke, the heart attack. Quitting smoking may reduce this
greater your risk. Pipe smokers, cigar smokers and risk.
marijuana smokers also may be at risk, as well as • Lung Cancer
people exposed to large amounts of second-hand o People with COPD have a higher risk of
smoke developing lung cancer. Quitting smoking may
• People with asthma who smoke reduce this risk.
o The combination of asthma, a chronic • High blood pressure in lung arteries
inflammatory airway disease, and smoking o COPD may cause high blood pressure in the
increases the risk of COPD even more. arteries that bring blood to your lungs (pulmonary
• Occupational exposure to dust and chemicals hypertension).
o Long-term exposure to chemical fumes, vapors • Depression
and dusts in the workplace can irritate and o Difficulty breathing can keep you from doing
inflame your lungs. activities that you enjoy. And dealing with serious
• Exposure to fumes from burning fuels illness can contribute to development of
o In the developing world, people exposed to fumes depression. Talk to your doctor if you feel sad or
from burning fuel for cooking and heating in helpless or think that you may be experiencing
poorly ventilated homes are at higher risk of depression.
developing COPD.
• Age
o COPD develops slowly over years, so most people
are at least 40 years old when symptoms begin.
• Genetics Diagnosis
c
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NCM 4164
COPD is commonly misdiagnosed — former • If patient is intubated, suction oral and endotracheal secretions
smokers may sometimes be told they have COPD, when in reality they as needed
may have simple deconditioning or another less common lung • Proper assessment of VS especially RR and O2 sat
condition. Likewise, many people who have COPD may not be
diagnosed until the disease is advanced and interventions are less
effective.
• SPIROMETRY is the most common lung function test. It can
detect COPD even before you have symptoms of the disease. It
can also be used to track the progression of disease and to
monitor how well treatment is working.
• CHEST X-RAY can show emphysema. Helps rule out other lung
problems or heart failure.
• CT SCAN helps detect emphysema and help determine if you
can be a candidate for surgery. CT scans can also be used to
screen for lung cancer.
• ARTERIAL BLOOD GAS ANALYSIS to check your bloods
oxygenation.
• LABORATORY TEST to check genetic disorder alpha-1-
antitrypsin (AAt) deficiency, which may be the cause of some
cases of COPD
Treatment
• Smoking Cessation
c
• Medications
o Bronchodilators (Salbutamol, Ipratropium)
o Inhaled steroids (Fluticasone, Mometasone)
o Combination inhalers (Symbicort, Combivent,
Respimat)
o Oral steroids (Prednisone, Prednisolone)
o Phosphodiesterase-4 inhibitors (PDE4):
Roflumilast and Cilomilast
o Theophylline
o Antibiotics
• Lung therapies
o Oxygen therapy
o Pulmonary rehabilitation program
• Surgery
o Lung volume reduction surgery
o Lung transplant
o Bullectomy
•
c
Provide oxygen (goal is to achieve O2 sat of 90% or higher)
• Administer medications as ordered (bronchodilators,
corticosteroids, antibiotics)
• Proper patient positioning (moderate to high back rest)

Respiratory Conditions in Acute Biological Crisis

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Respiratory Conditions in Acute Biological Crisis

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Ateneo de Davao University

Lower Respiratory Tract

Respiratory System Conditions in ABC Type 3 (Perioperative)

• The lungs fail

Types of Respiratory Failure

• The patient will be intubated and attacked to a

Note: what structure do X-ray cannot see? Tissues

Continuous Positive Airway Pressure (CPAP)

• It prevents alveoli to collapse

• Cold and clammy

Formerly known as status asthmaticus, is defined as • panic or confusion – sensation of doom

• Breathing and Oxygenation Assistance

Signs and Symptoms

Positive End Expiratory Pressure (PEEP)

• Mortality rate of 25-58% • Low blood pressure (hypotension)

• CBC • Scarring (Pulmonary fibrosis)

assessment and proper skin care, Implementing Emphysema

Chronic Obstructive Pulmonary Disease (COPD)

• A chronic inflammatory lung disease that causes obstructed

• Emphysema and chronic bronchitis are the two most common

Causes of Airway Obstruction

Signs and Symptoms

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