CHAPTER 2 Respiratory System^91
- Explain to the patient:
- The importance of doing coughing and deep-breathing exercises—after
coming off the ventilator the patient needs to move adequate air in and out
of the lungs. Coughing helps to rid the lungs of any remaining fluid. - How to identify the signs of respiratory distress, any sign that symptoms
may be returning: shortness of breath, coughing, wheezing, rapid breath-
ing, cyanosis, restlessness, or anxiety.
- The importance of doing coughing and deep-breathing exercises—after
Asbestosis
WHAT WENT WRONG?
Asbestos fibers enter the lungs, causing inflammation in the bronchioles and in the
walls of the alveoli. After inhalation, the fibers settle into the lung tissue. Fibrosis
develops and ultimately pleural plaques form. The changes within the lung result
in a restrictive lung disease. The damage to the lung causes impairment in breath-
ing and air exchange.
PROGNOSIS
It may take a decade or longer from the time of exposure before symptoms begin
to develop. Some patients have worked in occupations known for asbestosis ex-
posure (mining, shipyards, fireproofing, and construction before the mid-1970s),
for 10 or 15 years prior to symptom development. There is an increased risk of
lung cancer (mesothelioma) in patients with history of asbestosis exposure, espe-
cially if the patient has also smoked. Mesothelioma may develop 2 to 4 decades
postexposure.
HALLMARK SIGNS AND SYMPTOMS
- Difficulty breathing (dyspnea) on exertion and at rest due to changes in the
lung tissue - Chest pain or tightness due to changes within the lung tissue and restrictive
air movement
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