Arf Aspiration

-02 has an irritating effect in mucous membranes and dries secretions, therefore it is important that a high liter of flow of 02 delivering 35-50% be humidified when administered.

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

Mr. Magnuson has had slow decline in his functional status over many years, which is consistent with his progressive chronic obstructive pulmonary disease and chronic respiratory failure. At this time, I have ordered a six-minute walk test as well as arterial blood gas to document the need for supplemental oxygen on a continuous basis. Provided that there is sufficient evidence for him to qualify for oxygen, we will work with his durable medical equipment company and order an oxygen concentrator as well as portable oxygen

An important nursing intervention for a patient with COPD is to improve functional capacity of the lungs with oxygen use (ANA, 2012). An oxygen saturation value of 90% or higher is the optimal goal for the patient (ANT, 2012). Patients should be instructed on how to use oxygen properly and safely,

Mr. Joseph is a 56-year-old has 30 smoking pack years. He was diagnosed 10 years ago with asthma/chronic bronchitis, arthritis of the knees, and congestive heart failure (CHF). Mr. Joseph weighs 350 pounds with a height of 6 feet, making his body mass index (BMI) of 47.5, much more than the recommended 25, and in fact his BMI places him in the morbid obesity classification. He takes medicines for his pulmonary conditions, along with a diuretic.

However one would be lax if they didn’t take this as a serious situation. A patient with a partial airway obstruction can be presenting in a couple different ways. In the stable patient the signs may be mild and mostly just worrisome and irritating to the patient. In these cases even thou there is a need to obtain definitive care in is imperative to remain calm so as not to worry the patient. One should consider immediate administration of oxygen by non rebreather to make sure the patient remains stable along with encouraging the patient to cough if the feel the need. However in an unstable patient you would expect to hear noisy respirations, coughing and gagging. As the patient continues to deteriorate the coughing will become feeble and signs of respiratory distress such as anxiety, lethargy and even cyanosis will become apparent.[Joynt 2015] In these cases it is imperative to initiate aggressive oxygen therapy immediately. In cases such as these a paramedic could employ several different methods to ensure the patient doesn’t progress to a complete obstruction. First would be to visualize as much of the airway as possible with the naked eye and remove any obstruction visible. However this is not too be confused with the blind figure sweep of the past. One should never attempt to remove an object that they can not see. Another

In the health care setting the measurement of everything in regards to patient care must be closely monitored. In respiratory care we have many important diagnostic data that we must monitor to keep our patients safety. We deal closely with the lungs and monitor pressures, sounds, and x-rays, that we can see their performance and characteristics. Precise measurements are critical to patient care because they can determine the patient’s condition. The outcome of not getting measurements could lead to patients becoming critical or worse death. Respiratory closely monitors mechanical ventilation pressures, MetaNeb pressures, vital signs, breath sounds, BiPAP, medications, and other related items. Certain protocols are in place for the respiratory practitioner

1.16. Explain the standard set of nursing observations that are completed on an individual who is in respiratory distress? Blood pressure, L&S manual or machine, SPo2 used on finger, ear or nose, Respirations for full minute, HR manual or through machine, neurovascular observation and capillary refill, pain scale, alert scale (Chrisp & Taylor, 2011)

A simultaneously published trial called Oscar did not seem to have the same outcomes for patients receiving HFOV. There were multiple differences between Oscillate and Oscar, the most obvious being the use of the Novalung R100 in the Oscar trial. This was a new ventilator to the clinicians and hospitals participating in Oscar therefore, all clinicians participating in the study were required to go through 198 training classes to learn the specifics of the Novalung R100 ventilator. The outcome of the Oscar trial was only a 2 percent difference in mortality between conventional ventilation using a lung protective mode versus HFOV. This trial also had a similar outcome with vasoactive and neuromuscular blocking medications, Young et al states that this increase is due to the Novalung R100 not allowing for a patient to spontaneously breath on top of the oscillatory mode, therefore these medications were required to aide in patient- ventilator synchrony (Young,

Insufficient respiratory drive is common for post anesthesia patients. Patients are often given narcotics for pain which is a central nervous system depressant. The patient’s tongue may also fall to the back of their throat. There is also a risk for aspiration as secretions or vomit may be present in the airway and the patient will likely have a weak cough following sedation and intubation. The third major risk of respiratory compromise is atelectasis. This is caused by alveolar collapse. The alveoli are held open by surfactant and pressure in the form

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity

There are many diseases all around the world that affect our loved ones. One in particular that is common among many hospitals is Acute Respiratory Distress Syndrome, also known as ARDS. Originally it was called Adult Respiratory Distress Syndrome but realized that was not accurate because it not only affects adults but children also. ARDS is defined as "the acute onset of respiratory failure, bilateral infiltrates on chest radiograph, hypoxemia as defined by a PaO2/FiO2 ratio ≤200 mmHg, and no evidence of left atrial hypertension or a pulmonary capillary pressure (Fanelli et al., 2013) It can also include cyanosis, tachypnea, dyspnea, reduced respiratory compliance and an arterial blood gas showing respiratory alkalosis with evidence of hypoxemia. Out of the many pulmonary disorders out there, ARDS is one of the most difficult diseases to manage and has a high mortality rate that comes with it.

In order to improve the amount of oxygen and to reduce the burden to the lungs, most ARDS patients will be monitored on a ventilator to support them for breathing, while the lungs goes through process of healing. If the inflammation and fluids still persist in the lungs some patients may develop into scarring of the lung tissue, which is known as fibrotic stages of ARDS. During this stage the lungs will be able to inflate and deflate and all of sudden it may stop, which may cause the lungs to collapse and also a condition known as pneumothorax. Neutrophils are enlisted to the lungs by cytokines, become activated and releases toxic mediators, such as reactive oxygen species and proteases. Extensive free radical productions defeats endogenous anti-oxidant and will cause oxidative cell damages. And “according to C.Melissa Pharm D, C. Michelle, Pharm D, R. Mark, MD in Drug Update journal pathophysiology of ARDS is characterized by 3 progressive clinical stages, the exudative, proliferative, and fibrotic

Nurses are a vital component in patient care. The importance of conducting efficient nursing assessments is critical in order to provide both patient-centered care and safe, effective patient healing. Nurses are often responsible for taking care of patients with very complex disease processes. They frequently provide care to patients with illnesses such as Chronic Obstructive Pulmonary Disease (COPD). According to the Centers for Disease Control and Prevention, in 2014, approximately 6.8 million adults were diagnosed with COPD within the Unites States. The completion of proper assessments and initiation of interventions for these patients are crucial in order to prevent further complications of the illness.

Throughout the 1940’s in America the use of Mechanical Ventilation known as a “Vent Machine” has been used to sustain life. There is evidence that suggests millions are put on a ventilator each year. A Mechanical Ventilator is a method to mechanically assist or replace spontaneous breathing. Also, it delivers a positive or negative pressure directly to the lungs. In addition, breathing may be assisted by a respiratory therapist, registered nurse, physician, physician assistant, paramedic, or other suitable person compressing a bag or set of bellows. Benefits of mechanical ventilation is to sustain or improve ventilation, maintain tissue oxygenation, and decrease the patient work of breathing. However, numerous complications may transpire