Nursing 211

N211: Health Differences Across the Lifespan I

2.21 Diaphragmatic Paralysis Diaphragmatic Paralysis is a result of damage to the phrenic nerve. Intercostal and accessory muscles take over the role of breathing and can quickly lead to fatigue and respiratory failure. The treatment is having the client in an upright position and frequent use of mechanical ventilation especially at night. 2.22 Inhalation Injury Inhalation Injury is the inhalation of hot air, chemicals, or smoke that can cause injuries to the respiratory tissue. Inhalation injuries account for a significant amount of injuries in burn patients. Inhalation injuries occur from the inspiration of thermal or chemical substances into the upper or lower airways. Injury to the respiratory tract may result in loss of ciliary action, hypersecretion, severe mucosal edema and bronchospasm. Pulmonary surfactant is reduced, which results in atelectasis. Inhalation injury interferes with oxygen supply and absorption, resulting in severe or fatal hypoxia. There are three forms of inhalation injury: carbon monoxide poisoning, inhalation injury above the glottis and inhalation injury below the glottis. 2.23 Carbon Monoxide Poisoning Carbon Monoxide Poisoning is when carbon monoxide (produced by combustion of burning materials) is inhaled; it replaces oxygen on the hemoglobin molecule, causing hypoxia, carboxyhemoglobinemia, and ultimately death when levels are high. The patient should be treated with 100% humidified oxygen. Client will have headache, visual changes, confusion, irritability, nausea and ataxia. 2.24 Inhalation Injury Above the Glottis Inhalation Injury above the glottis is the result of inhalation of hot air, steam or smoke. Nursing Assessment Includes singed nasal hairs, circumoral burns, conjunctivitis, sooty or bloody sputum, hoarseness. Asymmetry of chest movements with respirations and use of accessory muscles is indicative of pneumonia. Rales, wheezing, and rhonchi denote smoke inhalation. Obstruction of the airway can


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