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CNA Training & Classes | December 17, 2017

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Respiratory Problems

The respiratory system involves the function of the lungs and its transport of oxygen in and carbon dioxide out of the body. Diseases that affect respiratory problems may be acute such as dyspnea and respiratory arrest or reactions to various causes like allergic response to food or drugs etc.

Complications in the respiratory system lead to the lack of nutrients and oxygen in the body tissues which can damage the cells as well as organs like brain, lungs and others. Being in the state of respiratory distress, residents will struggle to breath for air.

This can be seen by various signs like bluish skin color (cyanosis), the rise of heart rate (tachyradia) and a dramatic decrease in the blood pressure. As they gasp for air, residents can become confused and combative thus this is a sign of shock which needs emergency intervention. If not intervened as early as possible, resident might go into respiratory arrest which can lead to death if not intervened.

Heimlich Maneuver

Resuscitation is the key to saving a resident’s life when the individual is in the state of arrest. It involves a procedure called Heimlich maneuver. Heimlich maneuver is used for residents who are choking in order to expel food or other objects that might be blocking the air passageway.

A person is clearly in the state of choking when he cannot speak and his hands begins to clutch his throat. In this state, the individual is still conscious but tries to gasp for air. It is important how to do the procedure in order to perform it correctly especially in emergency cases like this.

Heimlich maneuver is succesful if the person has expelled the object that caused the choking and the person shows no sign of choking and breathing returns to normal. In instances where the maneuver is not effective and the person begins to stop breathing,you should immediately call for help and start mouth to mouth or mask to mouth resucitation.

Check the mouth for signs of object blockage. If the object can be seen, use a finger in a sweep motion to remove the object. If the person is still not breathing, give a set of at least 12 continuous breaths per minute then again check if object can be seen. Continue this step until the resident is breathing again or until help arrives.

Oxygen Therapy

Breathing problems caused by severe allergic reactions may require administration of medications, which is the role of the nurse. Diseases that are considered chronic such as bronchitis, emphysema and congestive obstructive pulmonary disorder may need oxygen therapy since these conditions can be irreparable.

When a resident is using oxygen therapy, be sure to put signs up to warn other people not to smoke near that room. For residents who already have AIDS, a type of pneumonia PCP can become life threatening because of a weakened immune system.

Considerations regarding the use of oxygen should involve proper positioning, changing positions with intervals, doing mouth care , promote rest periods, standard precautionary measures in suctioning sputum, proper disposal of wastes and others.

During each procedure, always make sure that the standards of safety are followed. For people who can swallow and have hard sputums, encourage them to drink water unless contraindicated. Also give careful skin care in the nose area, especially if residents have oxygen therapy via nasal cannula.

Keep oxygen mask in place in order to provide the required delivery of oxygen. Air moisture is required for the oxygen delivery that is why make sure to regularly check the oxygen reservoir and maintain the required water level. Follow the facility’s protocol regarding the changing of water of oxygen reservoir.

If oxygen is received from a tank, check the tank for leakages and make sure that they are functioning properly are not damaged. Report any problems to the nurse (like if the tank needs to be replaced).

A resident may react agressively to situation when they are no able to breathe normally. That is why it is important to calm them down and explain the situation to them. Devices such as call light should be within reach of the resident so that they can used if needed.

Changes in the breathing pattern and the condition of the resident should be noted and reported immediately to the nurse. The amount of oxygen that is prescribed should be followed. Do not attempt to adjust it nor discontinue it without an order from the doctor!

Respiratory problems which are chronic may require the use of mechanical ventilators. In order for the resident to be connected to a mechanical ventilator, it needs to have tubing or an air passage which connects to the lungs. Tracheostomy or the surgical opening of the trachea is needed for connecting the mechanical ventilator. Residents who must have ventilators are usually dependent for the day to day care and it is the role of the health caregiver to provide that care.

Always be remembered that you are caring for a human being and treat them with dignity and respect, even if they are in a state of unconsciousness.

Explain each procedure to them as if they could hear you. Comatose residents can actually hear you and their surroundings, but they cannot communicate. That’s why you need to be careful in what you say in front of the person.

Frequent positioning and ambulating prevents residents from acquiring pressure ulcers that can add up to the present health problems of the resident.