Treatments for Chronic lower respiratory diseases
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Hospital statistics for Chronic lower respiratory diseases:
These medical statistics relate to hospitals, hospitalization and Chronic lower respiratory diseases:
- 1.8% (229,725) of hospital episodes were for chronic lower respiratory diseases in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 72% of hospital consultations for chronic lower respiratory diseases required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 49% of hospital episodes for chronic lower respiratory diseases were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 51% of hospital episodes for chronic lower respiratory diseases were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Book Excerpts: Treatment of Chronic lower respiratory diseases
- Treatment - Cough - Productive
- Treatment - Cough - Nonproductive
- Treatment - Cough – Acute
- Treatment - Cough – Chronic
- Emergency interventions - Cough, barking
- Emergency interventions - Cough, productive
- Treatment - Whooping cough
- Emergency interventions - Cough, barking
- Emergency interventions - Cough, productive
- Patient counseling - Cough, nonproductive
- Nursing considerations - Cough, barking
- Nursing considerations - Cough, productive
- Patient counseling - Cough, barking
- Emergency Actions - Cough, productive
- Patient counseling - Cough, nonproductive
- Nursing considerations - Cough, barking
- Nursing considerations - Cough, productive
- Nursing considerations - Cough, nonproductive
Treatments of Chronic lower respiratory diseases: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the treatments of Chronic lower respiratory diseases.
Cough - Productive:
Treatment
(In a Page: Signs and Symptoms)
-
Cessation of cigarette smoking
-
Administer supplemental O2 if necessary
-
Postnasal drip: Treat underlying etiology (e.g., antibiotics for sinusitis, antihistamines and/or inhaled steroids for allergies)
-
- Acute bronchitis: Inhaled β2 agonists (e.g., albuterol); since most cases are of viral origin, antibiotics are usually not indicated; increased fluid intake; antitussive
-
Pneumonia: Oral (e.g., macrolide, doxycycline, quinolone) or IV antibiotics (third-generation cephalosporin and a macrolide; or a second-generation quinolone)
COPD: Inhaled bronchodilator therapy with β2 agonists (e.g., albuterol) and anticholinergics (e.g., ipratropium); systemic corticosteroids; antibiotics (e.g., azithromycin, doxycycline) should be administered in severe exacerbations or secondary infections; noninvasive mechanical ventilation by CPAP or BiPAP may be necessary
>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Cough - Nonproductive:
Treatment
(In a Page: Signs and Symptoms)
-
Cessation of cigarette smoking and/or ACE inhibitors
-
Postnasal drip: Treat underlying etiology (e.g., antibiotics for sinusitis, antihistamines and/or nasal steroids for allergies)
-
GERD: Lifestyle modifications (e.g., weight loss, dietary changes to eliminate predisposing agents, avoid alcohol and tobacco, avoid food within 4 hours of bedtime, sleep with head of bed elevated), anti-ulcer/antacid medications (H2 blockers, proton pump inhibitors), anti-reflux surgery (fundoplication)
-
Asthma: Avoid triggers; use inhaled β2 agonists (e.g., albuterol) and anticholinergics (e.g., ipratropium), inhaled or oral steroids (delayed onset 2–6 hours), children may benefit from magnesium or cromolyn
-
Acute bronchitis: Inhaled β2 agonists (e.g., albuterol); since most cases are of viral origin, antibiotics are usually not indicated; increased fluid intake; antitussive
-
Pneumonia: Appropriate oral or IV antibiotics
>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Cough – Acute:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment is often empiric and based on history
-
Cough suppression is usually avoided, but may assist with sleep; other OTC therapies of little value
-
An empiric “diagnostic trial” of medication may treat asthma, GER, or bacterial infections
-
Treatment of “habit component” may help with psychogenic cough or other chronic conditions (e.g., postinfectious bronchitis)
-
Speech therapy is very helpful for VCD or habit cough (i.e., using cold water “hard swallow,” benzocaine throat lozenges, breathing exercises)
-
Serious psychiatric disease may be associated with VCD but referral to mental health specialists is rarely needed
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Cough – Chronic:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment is often empiric and based on history
-
An empiric “diagnostic trial” of medication may treat asthma, GER, or bacterial infections. Treatment of “habit component” may help with other chronic conditions (e.g., postinfectious bronchitis)
-
Speech therapy is helpful for VCD or habit cough (i.e., using cold water “hard swallow,” benzocaine throat lozenges, breathing exercises)
-
Serious psychiatric disease may be associated with VCD, but referral to mental health specialist is rarely needed
-
Other treatments first require accurate diagnosis (e.g., TB, CF, FB)
-
-
-
Cough suppression may be of use at night to achieve sleep, but is generally avoided
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Cough, barking:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Quickly evaluate the child's respiratory status, and then take his vital signs. Be particularly alert for tachycardia and signs of hypoxemia. Also, check for a decreased level of consciousness. Try to determine if the child has been playing with any small object that he may have aspirated.
Check for cyanosis in the lips and nail beds. Observe the patient for sternal or intercostal retractions or nasal flaring. Next, note the depth and rate of his respirations; they may become increasingly shallow as respiratory distress increases. Observe the child's body position. Is he sitting up, leaning forward, and struggling to breathe? Observe his activity level and facial expression. As respiratory distress increases from airway edema, the child will become restless and have a frightened, wide-eyed expression. As air hunger continues, the child will become lethargic and difficult to arouse.
If the child shows signs of severe respiratory distress, try to calm him, maintain airway patency, and provide oxygen. Endotracheal intubation or a tracheotomy may be necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Cough, productive:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
A patient with a productive cough can develop acute respiratory distress from thick or excessive secretions, bronchospasm, or fatigue, so examine him before you take his history. Take his vital signs and check the rate, depth, and rhythm of respirations. Keep his airway patent, and be prepared to provide supplemental oxygen if he becomes restless or confused or if his respirations become shallow, irregular, rapid, or slow. Look for stridor, wheezing, choking, or gurgling. Be alert for nasal flaring and cyanosis.
A productive cough may signal a severe life-threatening disorder. For example, coughing due to pulmonary edema produces thin, frothy, pink sputum, and coughing due to an asthma attack produces thick, mucoid sputum. Assist the patient to clear excess mucous with tracheal suctioning if necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Whooping cough:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Vigorous supportive therapy requires hospitalization of infants (commonly in the intensive care unit) and fluid and electrolyte replacement. Other measures include adequate nutrition; codeine and mild sedation to decrease coughing; oxygen therapy in apnea; and antibiotics, such as erythromycin and, possibly, ampicillin, to shorten the period of communicability and prevent secondary infections.
Because very young infants (younger than age 1) are particularly susceptible to whooping cough, immunization — most commonly with the diphtheria-tetanus acellular-pertussis vaccine — begins at ages 2, 4, and 6 months. Boosters follow at age 18 months and at ages 4 to 6. The risk of pertussis is greater than the risk of vaccine complications such as neurologic damage. However, seizures or unusual and persistent crying may be a sign of a severe neurologic reaction, and the physician may not order the other doses. The vaccine is contraindicated in children older than age 6 because it can cause a severe fever.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cough, barking:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Quickly evaluate the child’s respiratory status. Then take his vital signs. Be particularly alert for tachycardia and signs of hypoxemia. Also, check for a decreased level of consciousness. Try to determine if the child was playing with a small object that he may have aspirated.
Check for cyanosis in the lips and nail beds. Observe the patient for sternal or intercostal retractions or nasal flaring. Next, note the depth and rate of his respirations; they may become increasingly shallow as respiratory distress increases. Observe the child’s body position. Is he sitting up, leaning forward, and struggling to breathe? Observe his activity level and facial expression. As respiratory distress increases from airway edema, the child will become restless and have a frightened, wide-eyed expression. As air hunger continues, the child will become lethargic and difficult to arouse.
If the child shows signs of severe respiratory distress, try to calm him, maintain airway patency, and provide oxygen. Endotracheal intubation or a tracheotomy may be necessary.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Cough, productive:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
A patient with a productive cough can develop acute respiratory distress from thick or excessive secretions, bronchospasm, or fatigue, so examine him before you take his history. Take vital signs and check the rate, depth, and rhythm of respirations. Keep his airway patent, and be prepared to provide supplemental oxygen if he becomes restless or confused, or if his respirations become shallow, irregular, rapid, or slow. Look for stridor, wheezing, choking, or gurgling. Be alert for nasal flaring and cyanosis.
A productive cough may signal a life-threatening disorder. For example, coughing due to pulmonary edema produces thin, frothy, pink sputum, and coughing due to an asthma attack produces thick, mucoid sputum.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Cough, nonproductive:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Explain to the patient why nonproductive coughs should be suppressed and productive coughs encouraged. Encourage the patient to use a respirator in the presence of airway irritants such as paint fumes and dust.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Cough, barking:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Don’t attempt to inspect the throat of a child with a barking cough unless intubation equipment is available. If the child isn’t in severe respiratory distress, a lateral neck X-ray may be done to visualize epiglottal edema; a negative X-ray doesn’t completely rule out epiglottal edema. A chest X-ray may also be done to rule out lower respiratory tract infection. Depending on the child’s age and degree of respiratory distress, oxygen may be administered. Rapid-acting epinephrine (racemic epinephrine) and a steroid should be considered.
Be sure to observe the child frequently, and monitor the oxygen level if used. Provide the child with periods of rest with minimal interruptions. Maintain a calm, quiet environment and offer reassurance. Encourage the parents to stay with the child to help alleviate stress.
Patient teaching
Teach the parents how to evaluate and treat recurrent episodes of croup syndrome. For example, creating steam by running hot water in a sink or shower and sitting with the child in the closed bathroom may help relieve subsequent attacks. The child may also benefit from being brought outdoors (properly dressed) to breathe cold night air.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Cough, productive:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Obtain the patient’s vital signs and note signs of infection. Assess the respiratory system frequently, noting signs of respiratory distress. Avoid taking measures to suppress a productive cough because retention of sputum may interfere with alveolar aeration or impair pulmonary resistance to infection. Expect to give a mucolytic and an expectorant, and increase the patient’s intake of oral fluids to thin his secretions and increase their flow. In addition, you may give a bronchodilator to relieve bronchospasms and open airways. An antibiotic may be ordered to treat underlying infection.
Humidify the air around the patient; this will relieve mucous membrane inflammation and also help loosen dried secretions. Provide pulmonary physiotherapy, such as postural drainage with vibration and percussion, to loosen secretions. Aerosol therapy may be necessary.
Provide the patient with uninterrupted rest periods. If bed rest is ordered, change the position often to promote the drainage of secretions.
Prepare the patient for diagnostic tests, such as chest X-ray, bronchoscopy, lung scan, and pulmonary function tests. Collect sputum samples for culture and sensitivity testing.
Patient teaching
Encourage the patient not to smoke because doing so can aggravate his condition. Explain that quitting even after decades of use is helpful. Teach the patient how to breathe deeply, to cough effectively and, if appropriate, to splint his incision when he coughs. Teach the patient and his family how to use chest percussion to loosen secretions.
Tell the patient to cover his mouth and nose with a tissue when he coughs and to dispose of contaminated tissues properly, to protect himself and others from the cough and secretions. Be sure to provide a container for tissues and sputum.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Cough, barking:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the parents how to evaluate and treat recurrent episodes of croup syndrome. For example, creating steam by running hot water in a sink or shower and sitting with the child in the closed bathroom may help relieve subsequent attacks. The child may also benefit from being brought outside (properly dressed) to breathe cold night air.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Cough, productive:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
A patient with a productive cough can develop acute respiratory distress from thick or excessive secretions, bronchospasm, or fatigue, so examine him before you take his history. Take vital signs and check the rate, depth, and rhythm of respirations. Keep his airway patent, and be prepared to provide supplemental oxygen if he becomes restless or confused, or if his respirations become shallow, irregular, rapid, or slow. Look for stridor, wheezing, choking, or gurgling. Be alert for nasal flaring and cyanosis.
A productive cough may signal a severe life-threatening disorder. For example, coughing due to pulmonary edema produces thin, frothy, pink sputum, and coughing due to an asthma attack produces thick, mucoid sputum.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Cough, nonproductive:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Explain to the patient why nonproductive coughs should be suppressed and productive coughs encouraged. Encourage the patient to use a respirator (protective mask) in the presence of airway irritants such as paint fumes and dust. Instruct him to use a humidifier at home. Tell him to avoid using aerosols, powders, or other respiratory irritants — especially cigarettes. Make sure that the patient receives adequate fluids and nutrition.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Cough, barking:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Don't attempt to inspect the throat of a child with a barking cough unless intubation equipment is available. (See Managing the patient with epiglottiditis.)
▪ If the child isn't in severe respiratory distress, a lateral neck X-ray may be done to visualize epiglottal edema.
▪ A chest X-ray may be done to rule out lower respiratory tract infection.
▪ Depending on the child's age and degree of respiratory distress, oxygen may be administered.
▪ Rapid-acting epinephrine and a steroid may be administered.
▪ Observe the child frequently, and monitor pulse oximetry.
▪ Provide the child with periods of rest with minimal interruptions.
▪ Maintain a calm, quiet environment and offer reassurance.
▪ Encourage the parents to stay with the child to help alleviate stress.
Patient teaching
▪ Teach the parents how to evaluate and treat recurrent episodes of croup syndrome.
▪ Teach parents how to administer prescribed medications.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Cough, productive:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Avoid taking measures to suppress a productive cough because retention of sputum may interfere with alveolar aeration or impair pulmonary resistance to infection.
▪ Expect to give a mucolytic and an expectorant.
▪ Increase the patient's intake of oral fluids to thin his secretions and increase their flow.
▪ Give a bronchodilator to relieve bronchospasms and open airways.
▪ Administer an antibiotic to treat any underlying infection.
▪ Humidify the air around the patient to relieve mucous membrane inflammation and help loosen dried secretions.
▪ Provide pulmonary physiotherapy, such as postural drainage with vibration and percussion, to loosen secretions.
▪ Administer aerosol therapy if necessary.
▪ Provide the patient with uninterrupted rest periods.
▪ If the patient is on bed rest, change his position often to promote the drainage of secretions.
▪ Prepare the patient for diagnostic tests, such as chest X-ray, imaging studies, bronchoscopy, a lung scan, and PFTs.
▪ Collect sputum samples for culture and sensitivity testing.
Patient teaching
▪ Encourage the patient to stop smoking and provide him with written resources and contact information for support groups.
▪ Teach him how to perform cough and deep-breathing exercises.
▪ Discuss ways to avoid respiratory irritants.
▪ Explain infection control techniques.
▪ Teach the patient and family how to use chest percussion to loosen secretions.
▪ Explain to the patient his diagnosis and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Cough, nonproductive:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ A nonproductive, paroxysmal cough may induce life-threatening bronchospasm; the patient may need a bronchodilator to relieve his bronchospasm and open his airways.
▪ Unless he has chronic obstructive pulmonary disease, you may have to give the patient an antitussive and a sedative to suppress the cough.
▪ To relieve mucous membrane inflammation and dryness, humidify the air in the patient's room.
▪ Prepare the patient for diagnostic tests, such as X-rays, a lung scan, bronchoscopy, and PFTs.
Patient teaching
▪ Teach the patient to use a humidifier if his home is dry.
▪ Tell him to avoid using aerosols, powders, or other respiratory irritants—especially cigarettes.
▪ If the patient smokes, stress the importance of smoking cessation, and refer him to appropriate resources, support groups, and information to help him quit smoking.
▪ Explain the importance of adequate fluids and nutrition.
▪ Explain to the patient the cause of his cough and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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