Lesson 7: General Respiratory System Info & Antihistamines
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Name the parts of the upper respiratory system structures.
Name the respiratory systems lower structures.
- Chest Wall
Where does gas exchange occur?
Across the alveolar capillary membrane.
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.
What are the function of the respiratory system?
- 1o: Gas exchange
- Air conduction
- Protects lungs
- Acid & base balance
What are the defense mechanisms of the Respiratory system?
- Sneeze reflex
- Chemical mediators:
- Mast cells: release histamine
What are some of the meds used to Tx respiratory conditions?
- Saline nasal sparys
- Leukotriene inhibitors
- Mast cell stabilizers
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
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
What are the respiratory tract differences w/Geriatric patients?
- ^rigidity of thorax
- <cough efficiency
- < # of functioning alveoli
- < # of cilia & action
- < # of macrophages -->ineffective immune response
What forms do respiratory medications come in?
- Inhalants: MD inhaler
- PD inhaler
What position should a patients head be in when administering an inhaled medication like a MD inhaler?
Head tipped backward to open the airway
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
What types of medications are used for Upper Respiratory disorders?
- 1st gen & 2nd gen
- Intranasal Glucocorticoids
- sleeping aids
What is the action of the Antihistamine drugs?
- Compete w/histamine for receptor sites
- *preventing histamine response
- Reduces nasopharyngeal secretions, itching, sneezing
Antihistamines are used for what conditions?
- Acute & Allergic Rhinitis
- & as an atitussive
Antihistamines should be used with caution in patients with what underlying conditions?
- Sever liver disease
- Narrow-angle Glaucoma
- Urinary retention (d/t anticholinergic properties)
How does the Antihistamine H1-blockers (antagonists) work?
By competing w/histamine for receptor sites, thereby preventing a histamine response.
What is the main difference between 1st Generation & 2nd Generation H1-blockers?
1st Gen are more effective, but cause sleep
What are the 1st Generation H1-blockers? (Antihistamines)
- Diphenhydramine (Benadryl)
- Clemastine (Tavist)
- Chlorpheniramine (Chlor-Trimenton)
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)
Diphenhydramine (Benadryl) can be given via what routes?
What are the interactions that need to be monitored for with Dephenhydramine (Benadryl)?
- ^CNS depression w/alcohol & other CNS depressants
- Avoid use of MAOIs
What are the s/e of Diphenhydramine (Benadryl)?
Drowsiness, dry mouth, dizziness, blurred vision, wheezing, photosensitivity, urinary retention, constipation, GI distress, blood dyscrasias
What is the CAUTION with using Benadryl in elderly clients?
- Urinary retention
- Dizziness: leads to falls
Why is Benadryl contraindicated in Asthma, pneumonia & bronchitis patients?
causes ^dryness and can make it difficult to expectorate mucus in these patients
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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