Presentación: Pulmonary Nursing: Key Topics

Creada por

Zoey Brar-Avelar

Estados Unidos


Pulmonary Nursing: Key TopicsVersión en línea Pulmonary Nursing Overview por Zoey Brar-Avelar 1 III. Sarcoidosis Definition: An inflammatory, multisystem, granulomatous interstitial lung disease of unknown origin . Patient Demographics: Most common in African American women between ages 30 and 50 . Clinical Manifestations: Insidious onset; symptoms include dyspnea, cough, fatigue, anorexia, and weight loss . Assessment: Requires biopsy for definitive diagnosis (showing noncaseating granulomas) . Nursing Priorities: Medication Education: Educate on corticosteroids (tapering doses over 12 months) and monitoring for side effects like hypercalcemia . Symptom Reporting: Instruct the patient to notify the provider if respiratory symptoms worsen 2 IV. Chest Tumors & Lung Cancer Epidemiology: Leading cause of cancer death; >85% caused by cigarette smoke . Classifications: Small Cell Lung Cancer (SCLC) is very aggressive and fast-growing; Non-Small Cell Lung Cancer (NSCLC) is more common (84%) . Clinical Manifestations: Red Flag: A new cough or a change in a chronic cough character . Dyspnea, hemoptysis, chest pain, and late-stage symptoms like bone pain or weight loss . Screening: USPSTF recommends annual Low-Dose CT (LDCT) for adults 50–80 with a 20 pack-year history who currently smoke or quit within 15 years . Nursing Management: Airway Clearance: Implement deep-breathing exercises, CPT, and directed coughing . Symptom Management: Strategies to manage dyspnea, fatigue, and nausea . Psychosocial Support: Coordinate with nurse navigators and community programs for end-of-life care 3 V. Chest Trauma Nursing Assessment Priority: Assess Airway, Breathing, and Circulation (ABCs) immediately; look for symmetric chest movement and signs of shock 1. Sternal/Rib Fractures & Flail Chest Rib Fractures: Lead to shallow breathing to avoid pain, which increases risk for atelectasis and pneumonia . Flail Chest: Occurs when 3+ adjacent ribs are fractured in 2+ places, causing paradoxical chest movement (inward on inspiration, outward on expiration) . Priority Intervention: Management ranges from clearing secretions to mechanical ventilation (internal pneumatic stabilization) for severe flail chest . 2. Pneumothorax (Simple vs. Tension) Simple: Air enters the pleural space; trachea remains midline . Tension Pneumothorax (Medical Emergency): Air is trapped in the pleural space, increasing pressure and causing mediastinal shift . Critical Signs: Tracheal deviation to the unaffected side, JVD, hypotension, and tachycardia . Immediate Action: Emergency decompression with a large-bore needle at the 2nd intercostal space followed by chest tube insertion 4 VI. Chest Tube Management Purpose: To remove air/fluid from the pleural space and restore negative pressure to re-expand the lung . Monitoring Chambers: Water Seal Chamber: Should show tidaling (fluctuation with breathing); continuous bubbling indicates an air leak . Collection Chamber: Notify the provider if drainage is >100–150 mL/hr or changes suddenly . Nursing Care & Safety: Emergency Kit: Always keep sterile water and Vaseline gauze at the bedside . Disconnection: If the tube becomes disconnected from the system, submerge the end in sterile water to create a temporary water seal . Insertion Site: Monitor for crepitus (subcutaneous emphysema), which feels like "Rice Krispies" under the skin . Do Not Clamp or hemostat a chest tube unless specifically ordered or during system changes

Pulmonary Nursing: Key TopicsVersión en línea

Pulmonary Nursing Overview

por Zoey Brar-Avelar

III. Sarcoidosis

Definition: An inflammatory, multisystem, granulomatous interstitial lung disease of unknown origin

Patient Demographics: Most common in African American women between ages 30 and 50

Clinical Manifestations: Insidious onset; symptoms include dyspnea, cough, fatigue, anorexia, and weight loss

Assessment: Requires biopsy for definitive diagnosis (showing noncaseating granulomas)

Nursing Priorities:

Medication Education: Educate on corticosteroids (tapering doses over 12 months) and monitoring for side effects like hypercalcemia

Symptom Reporting: Instruct the patient to notify the provider if respiratory symptoms worsen

IV. Chest Tumors & Lung Cancer

Epidemiology: Leading cause of cancer death; >85% caused by cigarette smoke

Classifications: Small Cell Lung Cancer (SCLC) is very aggressive and fast-growing; Non-Small Cell Lung Cancer (NSCLC) is more common (84%)

Clinical Manifestations:

Red Flag: A new cough or a change in a chronic cough character

Dyspnea, hemoptysis, chest pain, and late-stage symptoms like bone pain or weight loss

Screening: USPSTF recommends annual Low-Dose CT (LDCT) for adults 50–80 with a 20 pack-year history who currently smoke or quit within 15 years

Nursing Management:

Airway Clearance: Implement deep-breathing exercises, CPT, and directed coughing

Symptom Management: Strategies to manage dyspnea, fatigue, and nausea

Psychosocial Support: Coordinate with nurse navigators and community programs for end-of-life care

V. Chest Trauma

Nursing Assessment Priority: Assess Airway, Breathing, and Circulation (ABCs) immediately; look for symmetric chest movement and signs of shock

1. Sternal/Rib Fractures & Flail Chest

Rib Fractures: Lead to shallow breathing to avoid pain, which increases risk for atelectasis and pneumonia

Flail Chest: Occurs when 3+ adjacent ribs are fractured in 2+ places, causing paradoxical chest movement (inward on inspiration, outward on expiration)

Priority Intervention: Management ranges from clearing secretions to mechanical ventilation (internal pneumatic stabilization) for severe flail chest

2. Pneumothorax (Simple vs. Tension)

Simple: Air enters the pleural space; trachea remains midline

Tension Pneumothorax (Medical Emergency): Air is trapped in the pleural space, increasing pressure and causing mediastinal shift

Critical Signs: Tracheal deviation to the unaffected side, JVD, hypotension, and tachycardia

Immediate Action: Emergency decompression with a large-bore needle at the 2nd intercostal space followed by chest tube insertion

VI. Chest Tube Management

Purpose: To remove air/fluid from the pleural space and restore negative pressure to re-expand the lung

Monitoring Chambers:

Water Seal Chamber: Should show tidaling (fluctuation with breathing); continuous bubbling indicates an air leak

Collection Chamber: Notify the provider if drainage is >100–150 mL/hr or changes suddenly

Nursing Care & Safety:

Emergency Kit: Always keep sterile water and Vaseline gauze at the bedside

Disconnection: If the tube becomes disconnected from the system, submerge the end in sterile water to create a temporary water seal

Insertion Site: Monitor for crepitus (subcutaneous emphysema), which feels like "Rice Krispies" under the skin

Do Not Clamp or hemostat a chest tube unless specifically ordered or during system changes

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Pulmonary Nursing: Key Topics

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