Laryngeal Obstruction -Obstruction of the larynx Pathophysiology Foreign bodies aspirated into the pharynx and larynx or the

trachea Obstruct air passage

Difficulty in breathing

Asphyxia

Atelectasis -Closure or collapse of alveoli and often is described in relation to x-ray findings and clinical signs and symptoms. Has 2 kinds Acute or Chronic -Acute atelectasis is the most commonly described, occurs frequently in the postoperative setting or in people who are immobilized and have a shallow, monotonous breathing pattern. -Excess secretions or mucus plugs may also cause obstruction of airflow and result in atelectasis in an area of the lung. -also observed in patients with chronic airway obstruction that impedes or blocks air flow to an area of the lung. Pathophysiology -Decreased alveolar ventilation or any type of blockage that impedes passage of air to the alveoli Trapped alveolar air is absorbed into the bloodstream

Affects Bronchi or Bronchial branch Assessment findings -Thorough past medical history -However, emergency measures to secure the patient s airway should not be delayed thus disregarding the mentioned above. -Croupy Cough -Expectoration of blood or mucus -Labored breathing -X-ray findings -Decreased oxygen saturation -Use of accessory muscles during inspiration Nursing Intervention -administer medications prescribed by the doctor such as epinephrine and a corticosteroid -monitor patients respiratory rate and continuous pulse oximetry Medical management for Laryngeal Obstruction -Subdiaphragmatic abdominal thrust maneuver -Immediate Tracheostomy (Worst Case scenario)

Blocks entrance to the alveoli

Alveoli Collapse Assessment Findings -Altered breathing pattern -retained secretions -alterations in small airway function -restrictive defects -surgical procedures (upper abdominal, thoracic or open heart surgery) Nursing Intervention -Frequent turning -Promote early mobilization -promote strategies to expand lungs and to manage secretions -voluntary deep-breathing maneuvers at least 2hrs -Use incentive spirometry or voluntary deep breathing to enhance lung expansion, thus decreasing airway closure.

Pulmonary Edema -An abnormal accumulation of fluid in the lung tissue, the alveolar space, or both. -It is a severe, life threatening condition Pathophysiology Inadequate Left ventricular function Back up of blood into the pulmonary vasculature Abnormal cardiac function Increased microvascular pressure Fluids leak into the interstitial space and the alveoli Pulmonary Edema Assessment and Diagnostic Findings -Crackles upon auscultation in the Lung bases (especially in the posterior bases) -Chest X-ray reveals increased interstitial markings -Pulse Oximetry values begin to fall, and Arterial Blood gas analysis demonstrate worsening hypoxemia. Medical Management -If the pulmonary edema is cardiac in origin, then improvement in the Left ventricular function is the goal. -Vasodilators, inotropic medications, afterload or preload agents, or contractility medications may be administered -Intra-Aortic balloon pump may be indicated if there is no response. -If the problem is fluid overload, diuretics are administered and fluids are restricted.

-Oxygen is administered to correct the hypoxemia and in some circumstances intubation and mechanical ventilation are necessary -Morphine is prescribed to reduce anxiety and to control pain Nursing Management -Assist in administration of oxygen and intubation and mechanical ventilation if respiratory failure occurs -Administer medications as prescribed by the doctor -Monitor patient s responses to the medication regimen -monitor Intake and output -Auscultating lung sounds to detect an increase or decrease in pulmonary crackles