List the factors that affect airway efficiency below, any changes in these factors will affect the ease with which air passes through the air passages or the ability of a patient to clear mucous.
- Shape and size of each segment of the respiratory tract
- Ciliated mucos-secreting, epithelial lining throughout most of the respiratory tract
- Character and thickness of the respiratory tract secretions
- Compliance of the cartlaginous and bony supports
- Pressure gradients of gases
- Traction on airway walls
- Contraction and relaxtion of smooth muscle
- Absence of foreign substances in the lumen of the respiratory tract
The size and number of droplets suspended in an inhaled aerosol can affect the effectiveness of the medication. Complete the table below describing droplet size, area of effect and possible uses.
Large droplets
While oxygen is essential for life there can be significant problems that arise from prolonged exposure to oxygen at high concentrations. This is a condition known as oxygen toxicity. What causes this condition and what are the signs and symptoms?
Exposure to oxygen 80% to 100% for a prolonged period of time causes oxygen toxicity.
Signs and symptoms include: Substernal distress(ache or burning sensation behind the sternum) respiratory distress with decreased vital capacity, nausea, vomiting, restlessness, tremors,twitching, paraesthesias, convulsions and a dry hacking cough.
Patient education is an important aspect of nursing care across the lifespan. This is particularly relevant with patients who will be required to administer respiratory medication via an inhaler. In the space below outline the instructions and important points you would give a patient when teaching them to use an inhaler.
- Take the cap off the puffers mouthpiece.
- Hold the puffer upright and shake it well.
- Breathe out slowly and gently without emptying the lungs
- Put the mouthpiece between the teeth and close the lips around it without biting.
- Tilt head back slightly, while breathing in slowly, press down on the top of the aerosol canister and breathe in deeply.
- Take puffer away from mouth and hold the breath or as long as possible and breathe out gently.
- Put cap back on puffer
- Clean the plastic casing at least once a week.
For many people with coughs and colds medication prescribed is to relieve symptoms rather than cure. Discuss the clinical use of expectorants, mucolytics and cough suppressants.
Expectorants- Drugs that aid in the removal of the sputum from the bronchial passages.
Mucolytics- Drugs that help breakdown mucus which is then removed by postural drainage.
Cough suppressants- Drugs that supress or stop coughing.
The adrenal glands are responsible for synthesising three important classes of hormones. List the three classes below as well as their primary functions.
Th three classes are Glucocorticosteriods, Mineralocorticoids & Androgens
Glucocorticosteriods have anti-inflammatory & immunosuppressant effects.
Mineralocorticoids help maintain blood volume, promote retention of the sodium/water and increase urinary output of Potassium(K) and Mercury(Hg)
Androgens are the metabolic precursors to sex hormones
Describe the mechanism of the anti-inflammatory and immunosuppressant actions of glucocorticoids.
Glucocorticosteriods have an anti-inflammatory action that works by supressing vascular and cellular events in the inflammatory response. Neutraphils etc
The Immunosupressant action of glucocorticosteriods work by decreasing the number of lymphocytes, plasma cells and eosinophils in the blood. Interferes with the T and B lymphocytes
Explain the advantages of local administration of glucocorticoids and describe four specialised agents, formulations and uses.
Local administration allows lower doses to be uses, fewer systemic adverse effects and a more rapid and direct action occurs.
Topical, inhaled, injected,oral uses
Betamethasone, Desonide, Triamcinolone & methylprednisolone.
Dexamethasone, fluorometholone, prednisolone & hydrocortisone
