The role of the respiratory system is simple and crucial at the same time – it delivers oxygen and carbon dioxide to the human body and makes all body functions work. As a rule, any kind of problem that takes place within the respiratory system affects other parts of the body (Kluwer, 2008). Therefore, it is important to know more about the diseases of the respiratory system and the ways how to diagnose, prevent, and treat them. The current paper discusses the peculiarities of tuberculosis, asthma, and chronic obstructive pulmonary disease (COPD).
Tuberculosis (TB) is “an acute or chronic infection characterized by pulmonary infiltrates and formation of granulomas with caseation, fibrosis, and cavitation” (Kluwer, 2008, p. 414). Anyone can get this disease; still, the following factors may considerably increase the risk of developing:
- The immune system is weakened because of young/advanced age, alcohol/tobacco use, or by such diseases as silicosis, leukemia, gastrectomy, diabetes, HIV/AIDS, kidney disease (the end-stage), etc.
- Presence in certain areas (China, Russia, or India);
- Poverty (inability to get medical care or poor living conditions).
As a rule, tuberculosis produces the following signs and symptoms:
- Overall weakness and fatigue;
- Low-grade fever;
- Weight loss;
- No appetite;
- Night sweats.
As soon as some symptoms are noticed, it is necessary to pass through medical diagnoses to be checked for TB:
- Doctors listen to the lung sounds through a stethoscope;
- Chest X-rays (to define some scar tissues, nodular lesions, etc.);
- Skin or blood tests;
- Sputum tests (to check the presence of TB bacteria).
As soon as the tests are taken, it is time to pass through a general assessment for at-risk patients before the test results are ready:
- Is there any contact with a TB-infected person?
- Are there any travels to the countries with a high range of TB disease?
- Is there HIV infection?
- Is a patient a drug/alcohol/tobacco user?
- Are there any diseases associated with risk factors?
- Are there any TB symptoms?
TB complications may vary, but the most possible are:
- Liver/kidney problems;
- Heart disorders;
- Spinal pain;
- Joint problems.
This is why a properly organized treatment is necessary:
- The use of drugs (isoniazid, or pyrazinamide, or rifampin) during the next 6 to 9 months (depending on the patient’s age and overall health);
- Isolation for 2-4 weeks in the beginning.
Potential nursing diagnosis (Nanda):
- Goals: to prevent complications, provide a patient with an adequate respiratory system, change the patient’s lifestyle.
- Interventions: to evaluate abnormal respiratory sounds and chest expansion limitations, check skin, reduce activity/get isolated, and provide oxygen in case of emergency.
- Outcomes: clear sounded lungs, awareness about the main TB risk factors, avoidance of people with TB.
Asthma is “a chronic inflammatory disease of the airways that causes airway hyperresponsiveness, mucosal edema, and mucus production” (Smeltzer, Bare, Hinkle, & Cheever, 2010, p. 620). More than 23 million Americans have asthma (Healthy People, 2015). A person has more chances to get asthma because of the following risk factors:
- Smoking or smoking mother while pregnancy;
- Poor living conditions (dust, kapok pillows, wrong food);
The main signs and symptoms of asthmas are as follows:
- Cough and wheeze;
- Shortness of breath;
- Chest pain;
- Painful breathing.
Asthma is diagnosed with the following steps:
- Doctors use a stethoscope to listen to breathing;
- Skin tests for allergy;
- Arterial blood gas analysis (Kluwer, 2008);
- Chest X-rays (to define hyperinflation);
- Inhalation bronchial challenge test (Kluwer, 2008).
In addition, the evaluation for at-risk patients is necessary:
- Attention to a medical history;
- Allergy threat;
- Living conditions.
People should know about possible complications of asthma:
- Sleeping disorders;
- Worse quality of breathing;
- Hospitalization is necessary to control severe asthma attacks.
Each patient has his/her own treatment because of possible allergies or the presence of some irritants. Usually, asthmatics are treated with:
- Drugs like terbutaline, aminophylline, flunisolide, etc.;
- Inhalers with fluticasone-salmeterol or mometasone-formoterol;
- Use of mucus plug expulsion;
- Control of attacks to take the necessary measures (make a patient sit down, take a rest, and relax).
A part of a potential nursing diagnosis (Nanda) requires the identification of goals, interventions, and outcomes.
Goal: to control the causes of anxiety, maintain the cleanliness of the airways, and promote gas exchange.
Interventions: make a body relax, free and clean the airway by means of drinking warm, and promote oxygen saturation.
Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease (COPD) is usually a combination of the symptoms of such diseases as “emphysema, chronic bronchitis, asthma” (Kluwer, 2008, p. 397). More than 30 million Americans suffer from COPD, and usually, it is caused by the following factors:
- Exposed cigarette smoking;
- Poor environment;
- Genetics (Healthy People, 2015).
If a person observes the following signs or symptoms, it is necessary to address a doctor:
- The reduction of the ability to do strenuous work/lack of energy;
- The presence of productive cough;
- The development of dyspnea even after inconsiderable actions;
- Chest tightness;
- Frequent respiratory infections
Usually, doctors make use of the following methods to diagnose COPD:
- Check patient’s medical history;
- Chest X-rays (to define emphysema);
- Arterial blood analysis;
- CT scan (to detect emphysema and the level of possible surgery effectiveness);
- Spirometry (to identify how much air lungs can hold and how fast the process of lowing air is).
Attention to the following clinical assessments for at-risk patients is necessary:
- Sex of a patient;
- The sphere of occupation;
- Smoking level;
- Presence/absence of a diet.
If something goes wrong, COPD may be characterized by a number of complications such as:
- The development of respiratory infections;
- Constant high blood pressure;
- Problems with heart;
- Numerous depressions;
- Lung cancer (that can lead to death).
As soon as the general evaluation of the situation is over, it is high time to set treatment:
- Smoking cessation is obvious;
- Use of medications like albuterol, levalbuterol, salmeterol, etc.;
- Choice of inhalers like budesonide, salmeterol, fluticasone, etc.;
- Oxygen therapy;
- Pulmonary rehabilitation program;
- Lung transplantation.
An example of a potential nursing diagnosis on Nanda’s basis looks like that:
- Goals: to promote effective airway clearance; gas exchange improvement.
- Interventions: give antibiotics as required; promote aerosol therapy.
- Outcomes: possible allergies; stable breathing.
The analysis of three respiratory system diseases shows that smoking and poor living conditions are usually the most frequent reasons why people get asthma, tuberculosis, or COPD. Hospitalization is a necessary step to be taken in the beginning to provide patients with the necessary portion of medical help.
Healthy People. (2015). Respiratory diseases. Web.
Kluwer, W. (2008). Medical-surgical nursing made it incredibly easy! Ambler, PA: Lippincott Williams & Wilkins.
Smeltzer, S.C.C., Bare, B.G., Hinkle, J.L., & Cheever, K.H. (2010). Brunner and Suddarth’s textbook of medical-surgical nursing. Ambler, PA: Lippincott Williams & Wilkins.