RespiratorySystem分析.pptVIP

* * * * * ASK the learners. Go back to the breath through the closed hand exercise to discuss s/s. * Discuss briefly * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Review. Ask them to describe someone they’ve worked with who had COPD and determine at what level that person might have been. * * * * * * * * * * 26/10/2009 * Nursing diagnosis Ineffective airway clearance r/t secretions Impaired gas exchange r/t altered supply O2 Altered health maintenance r/t ineffective individual coping Risk for infection r/t inadequate defense system Knowledge deficit of COPD Altered role performance r/t changes in role 26/10/2009 * Nursing DX Ineffective breathing pattern r/t musculoskeletal impairment , decreased energy Inability to sustain spontaneous ventilation r/t muscle fatigue Activity intolerance r/t imbalance of O2 supply 26/10/2009 * Clinical Features of COPD Patients Mild COPD: no abnormal signs, smokers cough, little or no breathlessness Moderate COPD: breathlessness with/without wheezing, cough with/without sputum Severe COPD: breathlessness on any exertion/at rest, wheeze and cough prominent, lung inflation usual, cyanosis, peripheral edema, and polycythemia in advanced disease 26/10/2009 * Diagnosis Spirometry Breathing test which measures the amount and rate at which air can pass through the airways Bronchodilator Reversibility Testing Relaxing tightened muscles around the airways and opening up airways quickly to ease breathing Other pulmonary function testing Diffusion capacity Chest X-ray Arterial Blood Gas Shows oxygen level in blood 26/10/2009 * Medical Management of COPD Patient Smoking cessation and elimination of environmental pollutants Palliative measure such as regular exercise, good nutrition, flu and pneumonia vaccines Bronchodilators, corticosteroids, anticholinergics, and NSAIDs 26/10/2009 * Management of COPD Patient Review history for concurrent heart disease Avoid treatment if upper respiratory tract infection is present Treat in up