Respiratory System CNA 2 OSBN Curriculum The Respiratory

Respiratory System CNA 2 OSBN Curriculum

◦ The Respiratory System http: //www. medcomrn. com/dev/flash/flvplayer/movie. php? movi e=http: //ss 1. medcomrn. com/flv/78716 r_sec 02_300 k. flv&title= &detectflash=false ◦ Organs of the Respiratory System http: //www. medcomrn. com/dev/flash/flvplayer/movie. php? movi e=http: //ss 1. medcomrn. com/flv/78716 r_sec 03_300 k. flv&title= &detectflash=false

Overview Anatomy & Physiology

Tuberculosis �Bacterium ◦ Kidneys ◦ Bones ◦ Brain � 2 infects lungs forms ◦ Inactive ◦ Active �Annual Screening of Health workers

Observation & Reporting �Weakness �Productive �Fever �Night Cough Sweats �Wt. Loss �Loss of Appetite

CNA 2 Actions �Treatment: RX x 2 mos. �Precautions: ◦ HANDWASHING ◦ Airborne Precautions ◦ Isolation �Negative Flow Room ◦ PPE �N 95 �PAPR Hood

Asthma �Episodic inflammation & narrowing airways �SOB �Chronic

Triggers �Weather �Allergies �Infections �Stress �Smoke �Animals dander �Exercise �May have an inhaler or a nebulizer

Observation & Reporting �Wheezing �SOB �Anxiety �Chest Tightness �Low Energy �Cyanosis

CNA 2 Actions �STAY CALM �Pt. can get worse fast �Report STAT

Bronchitis �Inflammation �Acute ◦ Viral ◦ Bacterial �Chronic ◦ Irritation of the Bronchi

Observation & Reporting �“Bark-Like” cough ◦ Non-productive �Coughing �Fever �Chest Episodes Pain �Restlessness �May Progress

CNA 2 Actions �Report increasing SOB �Adequate PO fluids ◦ Thin secretions

Chronic Obstructive Pulmonary Disease COPD ◦ Emphysema ◦ Chronic Bronchitis ◦ Asthma �Limited Air Flow ◦ Obstructed Airways

Chronic Bronchitis �After Repeated Episodes of Bronchitis �Mucus �Inflamed Bronchus

Observation & Reporting �Smokers morning cough ◦ Starts dry and hacking ◦ Progresses to productive �Difficulty Breathing �Tires Easily

Emphysema �Damaged Airways �Air trapped �O 2 & CO 2 blocked �Less O 2

Observation & Reporting �SOB/Dyspnea �Sputum/Pus �Orthopnea �Wt. Loss �Barrel Chest �Inactivity �Skin Breakdown �Difficult w/ ADLs

CNA 2 Actions: COPD �Report Increasing SOB STAT �Upright Positions �Hydrate �Emotional Support �Reduce Fatigue ◦ Cluster ADL’s ◦ Plan Rest Periods

Influenza �“The Flu” �Acute Infection �At Risk for Complications ◦ Young ◦ Elderly �A Virus �Easily Spread

Treatment �PREVENTION!!!!! ◦ HANDWASHING!!!!! �Alcohol-based sanitizer ◦ Cross Contamination Handwashing �Don’t touch your face �Medications ◦ Decongestants ◦ Antipyretic ◦ Analgesic Alcohol Based

Observation & Reporting

CNA 2 Actions �HANDWASHING ◦ Pt. s should also ◦ So should visitors ◦ So should Doctors ◦ ETC…. . �Standard Precautions �Report Changes

Pneumonia �Lung Infection ◦ Tissue inflamed ◦ Fluid in alveoli ◦ Poor gas exchange �Causes: ◦ Bacteria ◦ Virus ◦ Aspiration

Treatment �Based on Presentation �Antibiotics �Supplemental O 2 �Fluids

Observation & Reporting

CNA 2 Actions �HANDWASHING �Tissue for sputum �Report: SOB/Dyspnea �O 2 as directed ◦ DO NOT ADJUST �Increase Fluids �Cluster Activities

Atelectasis �Collapsed Lung �Small or Large �Causes ◦ Hypoventilation ◦ Airway Obstruction ◦ Lung Compression ◦ Post Surgery ◦ Severe Pneumonia

Observation & Reporting �S/S may not be present �Dyspnea �Breathing difficulty �Chest Pain �Cough

CNA 2 Actions �C & DB Post-op �TCDB ALL Patients �Ambulate �IS every hour ◦ https: //www. youtube. com/watch? v=-O-Zawtb 32 o �Pulse Oximetry �Report abnormals

Pneumothorax �Air in Pleural Space �Lung Collapse �Trauma �Spontaneous �Treatment ◦ Chest Tubes

Chest tubes Lewis, Figs. 28 -7 & 28 -8, pg. 589

Observation & Reporting �Sudden onset Sharp Severe Pain �Pain may radiate �SOB �Dyspnea �Cyanosis �Unequal Chest Movement

CNA 2 Actions �Report SOB/Dyspnea STAT �Reassure �Observe ◦ Dressing ◦ Crepitus ◦ Drainage �Closed Container �Amount �Color Change

Pulmonary Embolism: PE �Thrombus to the Lung: Bld/Air/Fat �Risk Factors ◦ Immobilization ◦ Surgery ◦ Obesity ◦ HF ◦ Pregnancy ◦ Advancing Age ◦ Prior Hx ◦ Major Trauma

Observation & Reporting �Increased �SOB �S&S Effort Hypoxia ◦ Confusion/restlessness �Productive Cough �Engorged Neck Veins

CNA 2 Actions �Prevention: ◦ Passive/Active ROM ◦ Ambulation ◦ TED Hose ◦ SCDs ◦ Decrease Popliteal Space Pressure ◦ Adequate Fluids �Report Sudden Changes STAT

Technical Skills � Adjust O 2 https: //www. youtube. com/watch? v=Riols. Hu. B_GA Apply and remove delivery device and turn on and off continuous positive airway pressure (CPAP) or bilevel positive airway (Bi. PAP) device https: //www. youtube. com/watch? v=5 g. H 5 a. IMs. Q 40 � Suction nose Suction oral pharynx http: //www. medcomrn. com/dev/flash/flvplayer/movie. php? movie=h ttp: //ss 1. medcomrn. com/flv/m 234 tb_sec 03_300 k. flv&title=&detec tflash=false � Suctioning (Infant Nose) https: //www. youtube. com/watch? v=h. FZ 15 PSd. OSw