Nursing Tips: Respiratory

A patient with a tension pneumothorax is likely to have tracheal deviation towards the unaffected side. Assess respiratory status in any patient with this finding!

A patient with asthma who is experiencing airway obstruction unresponsive to usual therapy is experiencing status asthmaticus. Administer oxygen and prepare for emergency intubation!

Because ipratropium is an anticholinergic medication, educate patients that they should increase their fluid intake and suck on candy for dry mouth.

Acetylcysteine is a mucolytic used to treat pulmonary disorders with thick mucous secretions (e.g., cystic fibrosis). It is expected that this medication smells like rotten eggs; this is not an indication it has expired!

Acetylcysteine, a respiratory medication, is also used as an antidote for acetaminophen toxicity!

A patient with Chronic Obstructive Pulmonary Disease (COPD) is likely to have a "barrel chest" appearance, use accessory muscles to breathe, have clubbing of the fingernails, and exhibit hyperresonance upon percussion.

A high pressure alarm from a ventilator could indicate Pulmonary edema, Pneumothorax, Bronchospasm, Biting of the tube, Secretion excess, Coughing, or a Kink in the tubing.

Following a bronchoscopy (visualization of the structures of the airway with sedation), ensure the patient's gag reflex has returned prior to allowing the patient to eat or drink.

ABCD = Antitussives include Benzonatate, Codeine, 
Dextromethorphan.

Chest physiotherapy treatments should be included 1 hour before or 2 hours after meals to avoid vomiting.

Beta 2 adrenergic agonists: Albuterol is SHORT-acting (for acute episodes) and Salmeterol is LONG-acting.

Patients with asthma should monitor their airway with a peak flow meter. 

After a tonsillectomy, monitor for frequent swallowing or clearing of the throat. This can indicate bleeding at the incision site!

Fetal lung maturity is determined by the L/S ratio.

Guaifenesin is an expectorant. "Gauif" sounds like "Cough". It reduces the viscosity of secretions, making coughs more productive.

If you suspect that a patient has epiglottitis, DO NOT take a throat culture or place a tongue blade in the patient's mouth!

Good way to remember anticholinergic side effects: Can't see, can't pee, can't spit, can't s**t.