Impaired Lung Compliance Notes

Unit 6 Impaired Lung Compliance  Inability of the lungs to fully inflate Pulmonary Ventilation – Breathing in and breathing out     Lung compliance o The ability of the lungs to fully inflate during inspiration Respiration o The diffusion of gas between alveoli and blood capillaries Airway resistance o The size of the diameter of the airway, can affect the flow of air into the lungs Perfusion o The process which oxygenated blood passes through to body tissues Educate to thin Pulmonary secretions    Increase fluid intake, will thin secretions, which become easier for the client to remove from the airway Exercise will help with improving compliance of lung tissue Avoid OTC decongestants Smoking and Therapeutic communication     Lifestyle considerations “Can you tell me more about how you are feeling?” The nurse should allow the client to express their feelings The nurse should avoid pressuring the client or using threatening communication, which could make the client avoid the topic and are considered barriers to communication Focused assessment of the respiratory system    The nurse should assess for factors that affect oxygenation o Level of health o Developmental considerations o Medication considerations o Lifestyle considerations o Environmental considerations o Psychological health considerations When a client reports a recent fever, the nurse should assess for signs of infection or exposure to tuberculosis The nurse should assess if the client has any other manifestations, such as night sweats or cough Sputum cytology      Why o To detect cells that may be malignant, determine organisms causing infection, and identify blood or pus in the sputum When o Clinical signs of infection including a productive cough and purulent sputum o Signs of systemic infection o Pyrexia of unknown origin What to avoid o Do not eat, smoke, or use toothpaste/mouthwash before collection Cough-times o Take deep breath, slowly breathe out. Take another deep breath then cough until some sputum comes up How often o Usually, a specimen is taken three days in a row Pulmonary Studies     Vital capacity o Measures the maximum amount of air exhaled after maximum inspiration Tidal Volume o Measures the total amount of air inhaled and exhaled in one breath Residual Volume o Measures the amount of air left in the lungs at expiration Forced Vital Capacity o Measures the maximum amount of air that can be forcefully exhaled Incentive spirometer teaching     Instruct the client to sit in upright with back straight The exhale normally through the nose, then place the mouthpiece between lips and inhale slowly Remove the mouthpiece and exhale normally If the patient gets lightheaded or can no longer inhale, the client should hold their breath and count to three, then resume normal breathing Prone position in Acute Respiratory Distress Syndrome (ARDS)   Can assist a client with breathing and improve oxygenation Promotes oxygenation by ventilating and perfusing the posterior dependent secretions Metered Dose Inhaler Teaching (MDI)        Often prescribed to reduce inflammation, loosen secretions, or dilate narrow airways Instruct the client to shake the canister before use, hold the canister upright and create a seal with lips The client should then depress the MDI taking a slow, deep breath Tell the client to keep inhaling when they feel the cold propellant against the back of the throat After inhalation, the client should hold their breath, then slowly exhale The client should only use one spray from each breath Rinse mouth out especially for steroids Oxygen Delivery Systems          Nasal cannula – Most common, low or high flow of oxygen that is not in a precise concentration o Flow: 1-6 L/min High flow nasal cannula o Up to 60 L/min o 21-100% Nasopharyngeal catheter Transtracheal catheter Simple mask o 5-10 L/min Partial rebreather mask – Provides a conservation of oxygen by mixing exhaled air and 100% oxypgne3 mixed in a bag Nonrebreather mask – Provides the highest concentration, not precise amount, of oxygen o 10-15 L/min o 80-95% Venturi mask – Provides the most precise amount of oxygen o 2-15 L/min o 24-60% Tent o 10-15 L/min o 40% Pleural Tube Disconnection Steps  If the chest tube comes disconnected from the drainage system, the nurse should place the end of the chest tube in a bottle of sterile saline or water. This will create a water seal Tracheostomy Suction Steps       Set up equipment, adjust the wall suction, check the function of the suction catheter Open the supplies, don sterile gloves Hyperventilate the client Insert the catheter without suction Apply suction while rotating the catheter in circular motion Assess for secretion clearance (O2 saturation and respiratory rate)