Nursing 211

N211: Health Differences Across the Lifespan I develop due to edema, and intubation should be completed prior to the development of edema. After the airway swells, intubation may not be possible. 2.25 Inhalation Injury Below the Glottis Inhalation Injury below the glottis is an inhalation injury that is chemically induced. Gases are cooled to body temperature before they reach lung tissue. Injury is directly related to the length of exposure. Clinical symptoms may not develop for 12-24 hours after the injury, and once they appear, they may manifest as ARDS. Nursing Assessment Includes inflammation of the bronchioles, hoarseness, crackles, stridor, drooling, ARDS and acute respiratory failure. Nursing Interventions Include assessment of breathing, vital signs and urinary output. Document burns on upper body, assess for hypoxia. Provide supplemental oxygen, use 100% oxygen to remove carbon monoxide from the hemoglobinmolecule. Prepare for and assist with intubation, tracheostomy, and mechanical ventilation. Provide humidification and facilitate the removal of secretions through suctioning or assistance with expectoration. Reduce anxiety by explaining all procedures in clear, simple terms. Assess patient and family understanding of injury and treatment. Administer medications to achieve/maintain pain and anxiety relief. Diagnostics Arterial blood gases, pulse oximetry, carboxyhemoglobin levels, chest x-ray, pulmonary function studies, ventilation perfusion scan and CBC and electrolytes. Nursing Diagnosis • Impaired gas exchange related to inhalation injury, carbon monoxide poisoning, and upper airway obstruction • Ineffective airway clearances related to edema, foreign substance, and increased mucus production • Anxiety related to pain, fear and emotional impact of burn injury 2.26 Coal Worker’s Pneumoconiosis

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