2. Respiratory
I. Review of Respiratory System
II. Common Manifestations
III. Diagnostic Tests/ Procedures
IV. Common Pharmacologic Agents
V. Disturbances
a. Restrictive Lung Disease
b. COPD/ CAL
c. Pulmonary Vascular Disease
5. Hematopoietic
I. Review of the Hematopoietic System
II. Disturbances
a. Anemia
b. Polycythemia Vera
c. Bleeding Tendencies
- DIC
- Hemophilia
- Thrombocytopenia
6. Cardiovascular
I. Review of the Cardiovascular System
II. Common Diagnostic Tests/ Procedures
III. Disturbances
a. Infection
- Rheumatic Heart Disease
b. Coronary Artery Disease
- Atherosclerosis
- Arteriosclerosis
7. - Angina Pectoris
- Myocardial Infarction
IV. Congestive Heart Failure
- Right Sided Heart Failure
- Left Sided Heart Failure
V. Congenital Heart Defects
- Cyanotic Heart Defects
- Acyanotic Heart Defects
15. Things to Remember:SUCTIONING
Assess: AUDIBLE SECRETIONS during
respiration
Position:
Conscious: SEMI-FOWLER’s POSITION
Unconscious: LATERAL POSITION
17. Appropriate Size of Catheter:
Adult: Fr. 12-18
Child: Fr. 8-10
Infant: Fr. 5-8
Lubricate Catheter:
Nasopharyngeal: water-soluble lubricant
Oropharyngeal: Sterile water or NSS
18. • Apply suction during withdrawal of the
suction catheter (NEVER during insertion)
• Apply suction for 5 to 10 seconds
(maximum of 15 seconds)
• Allow 20-30 seconds interval between each
suction and limit suction to 5 minutes in
total
• Encourage patient to breathe deeply and to
cough between suctions.
• Assess effectiveness of suctioning
20. 10. Administration of supplemental oxygen
Signs of Hypoxemia
1. Increased pulse rate
2. Rapid, shallow respiration
3. Increased restlessness
4. Flaring of nares
5. Substernal or intercostal retractions
6. Cyanosis
21. OXYGEN SYSTEMS:
1. Low-flow Administration Devices
a. Nasal Cannula (24-45% at 2-6LPM)
b. Simple Face Mask (40-60% at 5-8LPM)
c. Partial Rebreathing Mask
(60-90% at 6-10LPM)
d. Non-rebreathing Mask
(95-100% at 6-15LPM)
e. Oxygen Tent
22. 2. High flow Administration Devices
a. Venturi Mask
b. Oxygen Hood
c. Incubator / Isolette
23. Common Manifestations:
1. Cough
- the cardinal symptom of respiratory
problem
2. Dyspnea
- refers to difficulty on breathing
* EXERTIONAL DYSPNEA
* PAROXYSMAL NOCTURNAL
* ORTHOPNEA
24. 3. Clinical Signs of Hypoxia
EARLY SIGNS LATE SIGNS
Tachycardia Bradycardia
Kussmaul’s Respiration Dyspnea
N/V Decreased Systolic BP
Headache Cough
Irritability Increased RBC
Memory loss Increased Hgb
Dizziness Clubbing of fingers
28. Common Procedures/ Tests
1. Abdominal Thrust (Heimlich Maneuver)
- a short, abrupt pressure against the
abdomen, two fingerbreadths above the
umbilicus, to raise the intrathoracic
pressure.
PARTIAL: Noisy respiration, repeated
coughing
TOTAL: Cessation of breathing, inability to
speak
55. Coronary Artery Diseases (CAD)
1. Atherosclerosis
- an abnormal accumulation of lipid, or
fatty, substances and fibrous tissues in the
vessel wall
2. Arteriosclerosis
- refers to hardening of the vessel walls
57. Risk Factors for CAD
Nonmodifiable Risk Factors
Family History of CAD
Increasing Age
Gender
Race
58. Modifiable Risk Factors
High Blood pressure
Cigarette smoking
High Blood cholesterol levels
Diabetes Mellitus
Lack of estrogen in women
Physical inactivity
Obesity
62. Desired levels of LDL?
< 160mg/dl for patients with one or no risk
factors
<130mg/dl for patients with two or more risk
factors
<100mg/dl for patients with CAD
63. Angina Pectoris
Classifications of Angina
Class Activity Evoking Limits to Activity
I Prolonged exertion None
II Walking >2 blocks Slight
III Walking <2 blocks Marked
IV Minimal or Rest Severe
68. Management:
M - morphine SO4 for pain
O - Oxygen
A – Aspirin/ ACE inhibitors (captopril)
N – Nitroglycerin
S – streptokinase ( thrombolytics )
– should be given in 6 hrs but better
if in 3 hrs
72. CLASSIFICATION II
Slight limitations on ADL’s
Patient reports no symptoms at rest but
increased physical activity will cause
symptoms
PROGNOSIS: Good
73. CLASSIFICATION III
Marked limitation on ADL
Patient feels comfortable at rest but less
than ordinary activity will cause symptoms
PROGNOSIS: Fair
74. CLASSIFICATION IV
Symptoms of Cardiac insufficiency at rest
PROGNOSIS: Poor