Inhaled beta-adrenergic agents

Inhaled beta-adrenergic agents help promote bronchodilation, which improves oxygenation. I.V. beta-adrenergic agents can be used but have to be monitored because of their greater systemic effects. They’re typically used when the inhaled beta-adrenergic agents don’t work. Corticosteroids are slow-acting, so their use won’t reduce hypoxia in the acute phase.

Use of an incentive spirometer

Using an incentive spirometer requires the client to take deep breaths and promotes lung expansion. Chest physiotherapy helps mobilize secretions but won’t prevent atelectasis. Reducing oxygen requirements or placing someone on mechanical ventilation doesn’t affect the development of atelectasis.

Atelectasis

Atelectasis develops when there’s interference with the normal negative pressure that promotes lung expansion. Clients in the postoperative phase often splint their breathing because of pain and positioning, which causes hypoxia. It’s uncommon for any of the other respiratory disorders to develop.

How to recognize the signs of an impending respiratory infection.

Respiratory infection in clients with a respiratory disorder can be fatal. It’s important that the client understands how to recognize the signs and symptoms of an impending respiratory infection. It isn’t appropriate for the wife to listen to his lung sounds, besides, you can’t purchase stethoscopes from Wal-Mart. If the client has signs and symptoms of an infection, he should contact his physician at once.

The client breathes only when his oxygen levels dip below a certain point.

Clients with emphysema breathe when their oxygen levels drop to a certain level; this is known as the hypoxic drive. They don’t take a breath when their levels of carbon dioxide are higher than normal, as do those with healthy respiratory physiology. If too much oxygen is given, the client has little stimulus to take another breath. In the meantime, his carbon dioxide levels continue to climb, and the client will pass out, leading to a respiratory arrest.

Emphysema

In emphysema, the wall integrity of the individual air sacs is damaged, reducing the surface area available for gas exchange. Very little air movement occurs in the lungs because of bronchial collapse, as well. In ARDS, the client’s condition is more acute and typically requires mechanical ventilation. In asthma and bronchitis, wheezing is prevalent.

Reducing fluid volume reduces oxygen demand.

Reducing fluid volume reduces the workload of the heart, which reduces oxygen demand and, in turn, reduces the respiratory rate. It may also reduce edema and improve mobility a little, but exercise tolerance will still be harder to clear airways. Reducing fluid volume won’t improve respiratory function, but may improve oxygenation.

It enhances cardiovascular fitness.

Exercise can improve cardiovascular fitness and help the client tolerate periods of hypoxia better, perhaps reducing the risk of heart attack. Most exercise has little effect on respiratory muscle strength, and these clients can’t tolerate the type of exercise necessary to do this. Exercise won’t reduce the number of acute attacks. In some instances, exercise may be contraindicated, and the client should check with his physician before starting any exercise program.

Respiratory infections can cause severe hypoxia and possibly death in these clients.

It’s highly recommended that clients with respiratory disorders be given vaccines to protect against respiratory infection. Infections can cause these clients to need intubation and mechanical ventilation, and it may be difficult to wean these clients from the ventilator. The vaccines have no effect on bronchodilation or respiratory care.

Emphysema

These are classic signs and symptoms of a client with emphysema. Clients with ARDS are acutely short of breath and require emergency care; those with asthma are also acutely short of breath during an attack and appear very frightened. Clients with chronic obstructive bronchitis are bloated and cyanotic in appearance.