Lesson 7: General Respiratory System Info & Antihistamines

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Fyrcracker
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Lesson 7: General Respiratory System Info & Antihistamines
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2013-10-18 15:45:12
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Respiratory Info
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Power point pgs. 1-3.5
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  1. Name the parts of the upper respiratory system structures.
    • Nose
    • Sinuses
    • Mouth
    • Pharynx
    • Larynx
    • Epiglottis
    • Trachea
  2. Name the respiratory systems lower structures.
    • Bronchi
    • Bronchioles
    • Lungs
    • Alveoli
    • Chest Wall
  3. Where does gas exchange occur?
    Across the alveolar capillary membrane.
  4. What is Surfactant & how does it work in the lungs?
    A lipoprotein in the alveoli that reduces surface tension of pulmonary fluids & keeps alveoli open during expiration.
  5. What are the function of the respiratory system?
    • 1o: Gas exchange
    • Air conduction
    • Protects lungs
    • Warms
    • Filters
    • Humidifies
    • Acid & base balance
  6. What are the defense mechanisms of the Respiratory system?
    • Mucu
    • Bronchospasms
    • Cough
    • Cilia
    • Sneeze reflex
    • Chemical mediators:
    •         Leukotrienes
    •         Macrophages
    •         Mast cells: release histamine
    •         Histamine
  7. What are some of the meds used to Tx respiratory conditions?
    • Decongestants
    • Mucolytics
    • Saline nasal sparys
    • Leukotriene inhibitors
    • Mast cell stabilizers
    • Xanthines
    • Bronchodilators
    • Zinc
    • Antitussives
    • Antihistamines
    • Corticosteroids
  8. What respiratory tract differences do infants have?
    • Obligate nose breathers
    • Sphenoidal sinuses are immature
    • Tonsillar tissue normally enlarged
    • Airways smaller in diameter, easily obstructed by mucus
    • Less muscle mass: ^use of smaller intercostals & diaphragm
    • Less airway cartilage: Trachea softer & can collapse more readily
  9. What are the nursing considerations for Pediatric respiratory conditions?
    • Infections are usually viral w/no need for ABX
    • Tylenol & IBp, NO ASPIRIN
    • Saline nose drops/nasal spray or mist
    • NO oral decongestants
    • Guaifenesin loosens/thins secretions
  10. What are the respiratory tract differences w/Geriatric patients?
    • ^rigidity of thorax
    • <elasticity
    • <cough efficiency
    • < # of functioning alveoli
    • < # of cilia & action
    • < # of macrophages -->ineffective immune response
  11. What forms do respiratory medications come in?
    • Inhalants: MD inhaler
    •                 PD inhaler
    •                 Nebulizer
    • Sprays
    • Oral
    • Injections
    • IV
    • Syrups
    • Lozenges
  12. What position should a patients head be in when administering an inhaled medication like a MD inhaler?
    Head tipped backward to open the airway
  13. What are the nursing interventions/teaching used for Inhaled medications?
    • Hold breath for at least 10 seconds
    • Rinse mouth out after
    • Clean neb tubing & mouthpieces w/soap, water & white vinegar
  14. What types of medications are used for Upper Respiratory disorders?
    • Anti-histamines
    • 1st gen & 2nd gen
    • Decongestants
    • Intranasal Glucocorticoids
    • Expectorants
    • sleeping aids
  15. What is the action of the Antihistamine drugs?
    • Compete w/histamine for receptor sites
    •          *preventing histamine response
    • Reduces nasopharyngeal secretions, itching, sneezing
  16. Antihistamines are used for what conditions?
    • Acute & Allergic Rhinitis
    • & as an atitussive
  17. Antihistamines should be used with caution in patients with what underlying conditions?
    • Sever liver disease
    • Narrow-angle Glaucoma
    • Urinary retention (d/t anticholinergic properties)
  18. How does the Antihistamine H1-blockers (antagonists) work?
    By competing w/histamine for receptor sites, thereby preventing a histamine response.
  19. What is the main difference between 1st Generation & 2nd Generation H1-blockers?
    1st Gen are more effective, but cause sleep
  20. What are the 1st Generation H1-blockers?  (Antihistamines)
    • Diphenhydramine (Benadryl)
    • Clemastine (Tavist)
    • Chlorpheniramine (Chlor-Trimenton)
  21. What are the 2nd Generation H1-blockers? (Antihistamines)
    • Nonsedating antihistamines: little to no effect on sedations
    • ALL OTC now:
    • Cetirizine (Zyrtec)
    • Fexofenadine (Allegra)
    • Loratadine (Claritin)
  22. Diphenhydramine (Benadryl) can be given via what routes?
    • Oral
    • IM
    • IV
  23. What are the interactions that need to be monitored for with Dephenhydramine (Benadryl)?
    • ^CNS depression w/alcohol & other CNS depressants
    • Avoid use of MAOIs
  24. What are the s/e of Diphenhydramine (Benadryl)?
    Drowsiness, dry mouth, dizziness, blurred vision, wheezing, photosensitivity, urinary retention, constipation, GI distress, blood dyscrasias
  25. What is the CAUTION with using Benadryl in elderly clients?
    • Urinary retention
    • Dizziness: leads to falls
  26. Why is Benadryl contraindicated in Asthma, pneumonia & bronchitis patients?
    causes ^dryness and can make it difficult to expectorate mucus in these patients
  27. What are the potential s/e of Antihistamines?
    • Dry mouth: gum, hard candy, ice chips
    • Drowsiness: avoid operating MV
    • photosensitivity: use sun block
    • **do not use if pregnant
    • Give w/food

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