RESPIRATORY SYSTEM NON-MODIFIABLE

 Comprised of the upper airway and lower airway A- age

structures.
 UPPER RESPIRATORY SYSTEM H- history/hereditary/genetics
- Filters, moistens and warms air during R- race
inspiration.
1. NOSE MODIFIABLE
2. PHARYNX
C- chemicals
3. LARYNX
4. TRACHEA L- lifestyle
 LOWER RESPIRATORY SYSTEM
- Enables the exchange of gases to regulate DISORDERS OF THE UPPER RESPIRATORY SYSTEM
serum PaO2, PaCO2 and Ph
1. LARYNGEAL CANCER
1. BRONCHI
2. BRONCHIOLES Risk Factors
3. LUNGS
4. ALVEOLI S- Smoking- damages mucous membrane
5. PLEURA H- HPV
CANCER (in general) A- Alcohol/Acid reflux- bulimia, anorexia, GERD, rumination

 Cellular Aberration, abnormal healing process L- Low immunity- taking corticosteroids, undergone organ
 CURABLE. If there’s early diagnosis and prompt transplant, chronic illnesses (e.g. malnutrition)
treatment
E- Exposure to substances- occupational work (people working in
 NEOPLASM= new substance/growth cold mines, coal dust, fumes, dust)= (Miners, Carpenters, Factory
 METASTASIS= affectation of other organs workers)
Cause: Idiopathic *ASBESTOS- natural mineral and carcinogen that causes
mesothelioma, present in walls of structures, fire proof RISK
2 TYPES: FOR LUNG CANCER
1. BENIGN S- Straining of voice
W-well differentiated
E- encapsulated Signs and symptoms
L- localized
H- Hoarseness- presence of voice change
D- does not metastasized
S- slow growing - Halitosis- presence of necrosis on larynx area
2. MALIGNANT
P- pleomorphism= abnormally large nuclei E- Ear pain
M- metastasis A- A lump on the throat
C- cytokines
- A weight loss
Risk Factors
D- Dysphagia
A- A virus – Human Papilloma Virus (HPV)
S- Shortness of breath
B- Bacteria – Mycobacterium Tuberculosis
Confirmatory tests:
C- Chemicals (BAN)
 BIOPSY
a. BENZOPYRENE- present in burnt foods  ENDOSCOPY
b. AFLATOXIN- present in repeatedly boiled
peanuts=molds of it
c. NITROSAMINES- present in processed foods
(noodles)

*SMOKING/ALCOHOL- 4,000 chemicals are present, 43 Treatment

are carcinogenic C- Chemotherapy- kills fast growing cells, kills only
D- Diet/lifestyle- fatty foods= fecalith = colorectal cancer rapidly dividing cells

E- Estrogen/Hormone- estrogen is a food for breast cancer Expect: ALOPECIA

ADVERSE EFFECTS:
G- Genetics/Hereditary- the P- pancytopenia
development of cancer A-anemia
N- neutropenia
T-thrombocytopenia  Production of thick, gelatinous sputum; greater
R- Radiation- radiation (brachytherapy, teletherapy) amounts produced during superimposed infections
 Wheezing and dyspnea as disease progresses
S- Surgery

1) LASER SURGERY THROUGH THE MOUTH 2) EMPHYSEMA

- Is a complex lung disease characterized by
(ENDOSCOPIC RESECTION) destruction of the alveoli, enlargement of
 TLM- Transoral Laser Microsurgery distal airspaces, and a breakdown of alveolar
 TORL- Transoral Resection of the Larynx walls. There is a slowly progressive
deterioration of lung function for many years
2) PARTIAL LARYNGECTOMY- removal of part of before the development of illness
the larynx - Causes RESPIRATORY ALKALOSIS
3) TOTAL LARYNGECTOMY- total removal of Alveoli is damaged
larynx permanent loss of voice
4) NECK DISSECTION- utilizes tracheostomy,
No exchange of O2 and CO2
utilize Penrose drain

POST-SURGERY
Accumulates O2, no exchange of CO2
 SPEAKING- give alternatives for communication
(pen and paper)
Pressure of chest
- assess for robotic voice
 TUBES AND DRAINS- press Penrose then cover
- serosanguinous fluid – must Increase diameter of chest (BARREL CHEST)
be present 2 types:
- If bleeding- presence of a) Panlobular Emphysema
bright red fluid - destruction of respiratory bronchiole, alveolar
 STOMA CARE duct and alveolus

DISORDERS OF THE LOWER RESPIRATORY SYSTEM b) Centrilobular (Centroacinar) Emphysema

- pathologic changes take place mainly in the
1. CHRONIC OBSTRUCTIVE PULMONARY
DISEASE (COPD) center of the secondary lobule, preserving the
- Refers to a disease characterized by airflow peripheral portions of the acinus
limitation that is not fully reversible.
- Hypoxemia= central cyanosis- circumoral=
- The airflow limitation is generally progressive
and is normally associated with an bluish lips/tongue
inflammatory response of the lungs due to
irritants. Clinical Manifestations
- Causes RESPIRATORY ACIDOSIS
- COPD includes chronic bronchitis and  Pink puffer
pulmonary emphysema  Dyspnea, decreased exercise tolerance.
 Cough may be minimal, except with
1) CHRONIC BRONCHITIS respiratory infection.
- Is a chronic inflammation of the lower  Sputum expectorational mild.
respiratory tract characterized by excessive  Barrel chest
mucous secretion, cough, and dyspnea
associated with recurring infections of the Diagnostic Procedure for COPD
lower respiratory tract
- Causes RESPIRATORY ACIDOSIS 1. Spirometry- determine/detect/evaluate airflow
obstruction
Clinical Manifestations 2. ABG levels- PaO2, PaCO2 and pH
 Blue bloater 3. Chest X-ray- check presence of
 Usually insidious, developing over a period of HYPERINFLATION OF LUNGS
years
 Presence of a productive cough lasting at least 3 Increase pressure
months a year for 2 successive years
  Chronic cough with copious amount of purulent
sputum
Formation of bullae  Hemoptysis
4. Alpha1-antitrypsin assay- genetics  Clubbing of the fingers- seen with decreases CO2,
tetralogy of fallot
Medical Management for COPD  Repeated episodes of pulmonary infection
 Smoking cessation Management
 Bronchodilators- to relieve bronchospasm
 Corticosteroids- (through inhalation)- to slow down  Smoking cessation
inflammation  Chest physiotherapy
 Alpha1-antitrypsin augmentation therapy  Bronchoscopy
 Antibiotic agents, Mucolytic agents, Antitussive  Antimicrobial therapy
agents, vasodilators and narcotics- pt experiences  Influenza and pneumococcal vaccines
pain during expiration, inspiration  Bronchodilators
 Surgical interventions
Surgical Management
Nursing Intervention
1. BULLECTOMY
2. LUNG VOLUME REDUCTION SURGERY –  Assess the patient in alleviating the symptoms and
remove portion of lungs that has been damaged in clearing pulmonary secretions
 Encourage the patient in smoking cessation
NURSING INTERVENTIONS FOR COPD  Educate the patient and his family in performing
 Pulmonary rehabilitation postural drainage
 Pursed-lip breathing  Instruct the patient to avoid exposure to people
 Instruct the patient to coordinate diaphragmatic with upper respiratory or other infection
breathing  Assess nutritional status and ensure adequate diet
 Provide small frequent meals and offer liquid
nutritional supplements 3. PNEUMONIA
 Administer low flow of oxygen (1-2L/min) -Inflammation of the lung parenchyma caused by various
 Administer bronchodilator as prescribed microorganisms, including bacteria, mycobacteria, fungi,
 Adequately hydrate the patient and viruses
 Instruct the patient to avoid bronchial irritants
 If indicated, perform CPT in the morning and at 1. Community-Acquired Pneumonia
night as prescribed 2. Hospital-Acquired Pneumonia
 Encourage alternating activity with rest periods 3. Aspiration Pneumonia
 Teach relaxation technique or provide a relaxation 4. Ventilator associated Pneumonia
tape for patient
 Enrolpatient in pulmonary rehabilitation program Clinical Manifestations
where available  Sudden onset, rapidly rising fever of 38.3°C to
 Monitor respiratory status, including rate and 40.5°C
pattern of respirations, breath sounds, and signs and  Cough productive of purulent sputum
symptoms of acute respiratory distress  Pleuritic chest pain aggravated by deep
respiration/coughing
2. BRONCHIECTASIS  Dyspnea, tachypnea accompanied by respiratory
- A chronic, irreversible dilation of the bronchi grunting, nasal flaring, use of accessory muscles of
and bronchioles respiration, fatigue
- Abnormal dilation of bronchioles  Rapid, bounding pulse
- Production of mucus airway obstruction  Orthopnea
- Associated with CYSTIC FIBROSIS (a  Rusty, blood-tinged sputum
genetic disease)= presence of abnormal  Poor appetite, diaphoresis
enlargement of the lungs, liver, spleen
Diagnostic Procedure
SYMPTOMS:
 Chest X-ray
 Bitter/ very salty sweats
 Gram stain and culture and sensitivity tests of
 Odor-bitter smell sputum
Diagnostic Procedure  Blood culture

CT scan Management

Clinical Manifestations  Administration of the appropriate antibiotic

 Treatment of viral pneumonia
  Oxygen therapy

Complications

1. Shock and Respiratory Failure

2. Pleural Effusion

Nursing Management

 Encourage coughing and deep breathing

 Maintain semi-Fowler’s position
 Monitor pulse oximeter
 Promote hydration (2-3 L/day) to liquefy secretions
 Teach effective coughing techniques; plan rest
periods
 Suction if necessary
 Instruct client to cover nose and mouth when
coughing
 Teach the need to continue entire course of
antimicrobial therapy
 Teach the patient about proper administration of
antibiotics and potential side effects.
 Teach that findings are expected to be less within
48 to 72 hours of initial therapy
 Nutritionally enriched drinks or shakes