The Effects Of Deep Breathing Exercises On The Prevention Of Pulmonary Complications

INDICATIONS FOR SURGERY: The patient is a 62-year-old Caucasian male who has pneumonia. The patient has been on a ventilator for over 2 weeks and appears to require long-term ventilator. The patient is undergoing tracheostomy for this purpose.

Patient outcome consisted of performing 10 deep breaths per hour. We have reviewed details that were difficult for the patient to remember, such as breathing out before placing the lips on the mouthpiece, and holding breath for 3 to 5 seconds at the top of each inhalation. With empathy, I provided understanding that being hospitalized is never easy due to sensory overload, pain and lack of privacy. Additionally, we have discussed the basic pathophysiology of lung inflammation and what it can do to a person. So overall, the outcome included enhanced disease knowledge with effective use of incentive spirometer.

Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.

-Use of indiscriminate sedatives, benzos, and opioid’s, especially in post-op patient who retains Co2, may suppress the ventilator drive and lead to respiratory failure

Patients had to measure their IC by using an incentive spirometer to measure static lung values. They performed this test for 20 minutes after inhaling 400 mg of salbutamol via a nebulizer. The patients were asked to use the FVC spirometer and told to take a deep breath and then to let the breath out passively. They were then asked to do the same maneuver 2 more times, but the closeness made the study choose the first attempt.

Use of daily spontaneous breathing trials to assess the patient’s ability to sustain ventilation, oxygenation, and breathing.

1. Dependent Variable. respiratory volumes 2. Independent Variable. level of physical activity [resting or exercising] 3. Controlled Variables. height; age; sex 4. Which respiratory volume was calculated? Breating rate, TV, ERV, and IRV. 5. What was the purpose of the nose clip? the nose clip was used for the lung function testing to prevent leakage with

When the organs fail the only option is a transplant. With lungs there is only a 50% rate of a five year survival rate after a lung transplantation involving the end-stage respiratory disease. With such a drastic survival rate a study was completed to determine if patients could have a better outcome. This study was done to help determine effective methods to enhance lung transplants before surgery; the Doctors placed the recipients on bi-level positive airway pressure ventilation (BIPAP.) “BIPAP is a noninvasive mode of ventilation administered through a tight-fitting mask to assist spontaneously breathing patients”

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

From investigation in health practices, ventilator associated pneumonia caught my attention. “Ventilator Associated Pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care units. Most episodes of VAP are thought to develop from the aspiration of oropharyngeal secretions containing potentially pathogenic organisms. Aspiration of gastric secretions may also contribute, though likely a lesser degree. Tracheal intubation interrupts the body’s anatomic and physiologic defenses against aspiration, making mechanical ventilation a major risk for Ventilator Associated Pneumonia. Semi-recumbent positioning of mechanically ventilated patients may help reduce the incidence of gastroesophageal reflux and lead to a decreased incidence of VAP. The one randomized trial to date of semi- recumbent positioning shows it to be an effective method of reducing VAP. Immobility in critically ill patients leads to atelectasis and decreased clearance of bronchopulmonary secretions. The accumulation of contaminated oropharyngeal secretions above the endotracheal tube cuff may contribute to the risk of aspiration. Removing these

After being reminded by the instructor, I was aware of my mistakes and noticed that I failed to maintain patient’s safety. An oxygen below 90% can be very dangerous for the patient, especially for a post-op day #1 patient, because prolonged hypoxemia can cause fatigue, headache, acute respiratory failure, cardiac problems (increased heart rate,

Respiratory therapy refers to both a subject area within clinical medicine and to a distinct health care profession. During the 20th century, there were many health care fundamental transformations. Here are 10 possible predictions of what may occur in the future of respiratory care: (1) Less focus on raising PaO2 as a primary goal in managing patients with acute hypoxemic respiratory failure. (2) More attention to

Therefore, the overall prognosis is guarded in view of the underlying pathology, its extent and the post-operative respiratory insufficiency. The life expectancy is difficult to anticipate but the

A systematic review undertaken by Smetana (2009) identifies postoperative respiratory failure as an example of cascade iatrogenesis i.e. serial development of multiple medical complications that can be set in motion by a seemingly innocuous first event. In this case, Mrs Hilton’s open cholecystectomy is that first event. Smetana (2009) points out that: when an older patient with postoperative pain is over-sedated, a decline in respiratory function occurs, that if not recognized, can result in respiratory failure that requires mechanical ventilation, that again, if not managed properly can culminate in ventilator-associated pneumonia and even sepsis and death (p.1529). After her upper abdominal surgery Mrs Hilton may have difficulty with deep breathing and coughing due to pain however both are essential interventions for prevention and treatment of respiratory infections and complications. Brown et al. (2008) recommend that when Mrs Hilton is awake, turning, coughing and deep breathing should be encouraged every one to two hours as this aids in the removal of secretions and prevents mucous plugs. They also encourage mobility when possible to increase respiratory excursion. Moreover, as Mrs Hilton

Spirometry is the most popular lung function test. The patient performs a maximal inhalation and then forcefully exhales as quickly and as long as they are able. The spirometer measures the volume of the air exhaled by patients. These measurements are taken at two intervals. The first measurement is the forced expiratory volume in one second (FEV1), records the volume of air exhaled after one second. The second measurement is taken at the point where the patient has fully exhaled the volume of inhaled air; this measurement is the forced vital capacity (FVC) (Harpreet Ranu et al.,