Medical-surgical Nursing Demystified

CHAPTER 2 Respiratory System^109

• Administer expectorant—to loosen secretions:
  
  
  • guaifenesin
  
  
  
  


• Administer diuretics to decrease fluid retention in patients that are develop-
  ing right-sided heart failure secondary to lung disease:
  
  
  • furosemide, bumetanide
  
  
  
  


• Administer vaccines—to prevent respiratory infections:
  
  
  • influenza
  
  
  • pneumonia
  
  
  
  


• Administer antibiotics:
  
  
  • selected based on results of culture and sensitivity study or given empirically
  
  
  
  


• Administer alpha 1 -antitrypsin therapy for patients with deficiency.


• Administer oxygen, 2 liters per minute, to help meet body’s oxygen needs
  while avoiding CO 2 retention.


• Give patient 3 liters of fluids per day to help liquefy secretions.


• Nocturnal negative pressure ventilation for hypercapnic (elevated CO 2 levels)
  patients.


• Teach patient how to use:
  
  
  • the incentive spirometer to encourage deep breathing and enhance cough-
    ing and expelling of mucous.
  
  
  • the flutter valve to increase expiration force.
  
  
  
  

NURSING DIAGNOSES

• Impaired gas exchange


• Fatigue


• Risk for infection

NURSING INTERVENTION

• Monitor the patient’s sputum for color, amount, or changes in characteristics,
  which may indicate infection.


• Place patient in high Fowler’s position, which eases respiratory effort.


• Administer low-flow oxygen, which increases oxygen delivered to patient
  without compromising respiratory drive.