1. What is an obstructive lung disorder?
COPD- preventable and treatable disease state characterized by chronic airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking.
2. What should the nurse consider when giving oxygen to the patient with an
obstructive lung disorder and why?
-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.
- Periodic reevaluations are necessary for the patient who using chronic supplemental O2
-Most patients with COPD can tolerate 2 L/min via cannula
-Access patients nares and ears for skin breakdown and may need to pad cannula where its sits on the ears
-Watch for complications
-Periodically check o2 delivery device to ensure that the prescribed concentration is being delivered
-Monitor the effectives of 02 therapy( pulse ox, ABG’s) to evaluate patient response to therapy
-Observe for signs of o2-induced hypoventilation because this occurs with carbon dioxide nacrosis
-Position to minimize respirator efforts ( HOB elevate and provide overbed table for patient to lean on)
-The person with COPD who retains CO2 should be treated with low rates of 02 with careful monitoring of ABG’s to avoid hypercarbia.
3. What are nursing management issues related to obstructive disorders?
Assessment- Subjective health information past health history and medications, functional health patterns, general objective data with integumentary, respiratory, cardiovascular, gastrointestinal, musculoskeletal and diagnostic findings.
* Objective- Debilitation, restlessness, assumption of upright position, cyanosis, pallor, poor skin turger, thin skin, digital clubbing, easy bruising, peripheral edema, rapid, shallow breathing, inability to speak, prolonged expiratory phase, pursed-lip breathing, wheezing, rhonchi, crackles, diminished breath sounds, use of accessory muscles
Goals- 1. prevention of disease progression. 2. ability to perform ADLs and improved exercise tolerance. 3. relief of symptoms. 4. no complications related to COPD. 5. knowledge and ability to implement a long-term treatment regimen, and 6. overall improved quality of life.
Teaching- Overall guide, what is COPD, breathing and airway clearance exercises, energy conservation techniques, medications, correct use of medications, psychosocial/emotional issues, management plan, health nutrition.
4. How does a nurse know when a person is experiencing respiratory failure?
Fever, increased cough and dyspnea, or other symptoms suggestive of exacerbation
-Use of B-adrenergic blocker may also exacerbate respiratory failure
-Use of indiscriminate sedatives, benzos, and opioid’s, especially in post-op patient who retains Co2, may suppress the ventilator drive ...