ASSOCIATE DEGREE NURSING PROGRAM
NURS 201: NURSING CARE OF ADULTS II
Methodical Instruction N 4
7 hours
Theme: Assessment of the respiratory system. Interventions for clients requiring oxygen therapy or tracheostomy.
Theme1: ASSESSMENT OF THE RESPIRATORY SYSTEM
Instructor:
Place of training: educational rooms, hospital wards.
Aim: Students must be able to use the basic nursing skills in the assessment of the clients with respiratory problems
Professional orientation of students:
After completing this theme, you should be able to:
- Know the anatomy and physiology of the respiratory system.
- Describe changes associated with aging.
- Identify factors that place clients at risk for respiratory problems.
- Perform appropriate assessments for clients with these problems.
- Interpret diagnostic test findings for clients with suspected or actual respiratory disease.
6. Explain the purpose of frequent monitoring.
Program of self training:
Interpret different types of tests to assess the client’s respiratory status.
Chapter outline:
- Compare and contrast the structures and functions of the upper airways to those of the lower airways.
- Distinguish betweeormal and abnormal (adventitious) breath sounds.
- Describe the respiratory changes associated with aging.
- Calculate the pack-year smoking history for the client who smokes or who has ever smoked cigarettes.
- Demonstrate the proper technique when using observation and auscultation to assess the respiratory system.
- Demonstrate proper technique when using palpation and percussion to assess the respiratory system.
- Interpret arterial blood gas values to assess the client’s respiratory status.
- Prioritize educational needs for the client undergoing pulmonary function tests.
- Prioritize nursing care needs for the client after bronchoscopy or open lung biopsy.
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Lecture Outline |
Assignments |
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1. |
Anatomy and Physiology Review 1. Upper Respiratory Tract 2. Lower Respiratory Tract 3. Respiratory Changes associated with Aging 4. Accessory Muscles of Respiration
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Text: Chapter 27 pp. 467-488
Study Guide:
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2. |
Assessment Techniques 1. History 2. Physical Assessment 3. Psychosocial Assessment
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Text: Chapter 27 pp. 467-488
Study Guide: |
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3. |
Diagnostic Assessment 1. Laboratory Tests 2. Radiographic Examinations 3. Noninvasive Diagnostic Tests 4. Invasive Diagnostic Tests
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Text: Chapter 27 pp. 467-488
Study Guide: |
Theme 2. Interventions for clients requiring oxygen therapy or tracheostomy.
Instructor:
Place of training: educational rooms, hospital wards.
Aim: Students must be able to use the basic nursing skills in the assessment of the clients with respiratory problems
Professional orientation of students:
After completing this theme, you should be able to:
1. Compare and contrast the uses and nursing care issues of oxygen delivery by nasal cannula and oxygen delivery by mask.
2. Explain the problems associated with oxygen therapy for those clients whose respiratory efforts are controlled by the hypoxic drive.
3. Analyze changes in clinical manifestations to determine the effectiveness of therapy for the client receiving oxygen.
4. Use laboratory data and clinical manifestations to determine the presence of hypoxemia or hypercarbia.
5. Prioritize educational needs for the client receiving supportive oxygen therapy at home.
6. Prioritize nursing care needs for the client with a new tracheostomy.
7. Identify techniques to minimize the risk for aspiration when helping the client with a tracheostomy to eat.
Program of self training:
Interpret different types of tests to assess the client’s respiratory status.
Chapter outline:
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Oxygen Therapy
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Text: Chapter 28 pp. 489-507
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Tracheostomy
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Text: Chapter 28 pp. 489-507
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TESTS AND TASKS:
1.What problem would result from a swollen epiglottis?
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a. |
The airway would be unprotected during swallowing, increasing the risk for aspiration. |
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b. |
The vocal cords would be stretched, causing the voice to be deeper. |
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c. |
The airway would be obstructed, causing a decrease in ventilation. |
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d. |
Swallowing would be impossible. |
____ 2. 2.For what problem is the client who cannot breathe through the nose because of a congenital bone obstruction at greater risk?
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a. |
Dry respiratory tract membranes |
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b. |
Frequent episodes of tonsillitis |
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c. |
Development of nasal polyps |
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d. |
Difficulty swallowing |
____ 3. 3.The client is taking enalapril (Vasotec), an angiotensin-converting enzyme (ACE) inhibitor, for hypertension. Which respiratory side effect should you teach the client to expect?
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a. |
Wheezing on exhalation |
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b. |
Increased nasal stuffiness |
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c. |
Chest pressure or pain |
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d. |
Persistent dry cough |
____ 4. 4.What is the priority nursing diagnosis for the client receiving nonhumidified oxygen therapy of 40% (6 L/min) by simple mask?
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a. |
Risk for Injury |
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b. |
Impaired Oral Mucous Membranes |
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c. |
Risk for Infection |
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d. |
Impaired Gas Exchange |
____ 5. 5.While suctioning the client who had a tracheostomy placed 4 days ago, you note particles of food in the tracheal secretions. What is your best first action?
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a. |
Increase the inflation pressure in the tracheostomy cuff. |
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b. |
Document the finding. |
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c. |
Make the client NPO. |
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d. |
Notify the physician. |
Answers:
1.C. 2. A.3.D. 4.A. 5.D.
lITERATURE:
Ignatavicius, D. & Workman, L. (2006). Medical-surgical nursing: Critical thinking for collaborative care (5th ed.). Volume I & II.
