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Non Communicable Diseases - Causes, Risk factor, Signs and Symptoms, Diagnosis, Management - Respiratory Disorders | 12th Nursing : Chapter 3 : Non Communicable Diseases

Chapter: 12th Nursing : Chapter 3 : Non Communicable Diseases

Respiratory Disorders

Asthma, COPD (Chronic Obstructive Pulmonary Disease) - Non Communicable Diseases - Respiratory Disorders



·         Asthma

·         COPD (Chronic Obstructive Pulmonary Disease)


1.   Asthma

Asthma is an inflammatory disease of the airway causing mucosal oedema and increased mucous production.


Exposure to indoor and outdoor allergens  Airway irritant

Risk factors

·            Family history of bronchial asthma

·            Exposure to airway irritants (weed, pollens, dust, strong odours, smoke)

·            Signs and Symptoms:

·            Non-Productive cough

·            Dyspnea

·            Diaphoresis

·            Tachycardia

·            Tachypnea

·            Wheezing

·            Cyanosis


·            Family and occupational history  Increased esonophil counts ABG-Analysis

·            Sputum for Culture

·            Pulmonary function test

Medical management

·            Corticosteroids

·            Bronchodilators

·            Oxygen therapy

·            Nebulization

Nursing Mangement

Ineffective air way clearance related to inflammation and increased secretion.

·           Increased fluid intake

·           Coughing and breathing exercise

·           Change of position frequently

·           Administer broncho dilator

·           Chest physiotherapy

·           Suctioning

·           Artificial airway if required

Ineffective breathing pattern related to tachycardia

·            Comfort position to facilitate breathing

·            Administer prescribed cough suppressants and analgesics

·           Monitor ABG

·           Observe signs of hypoxia

Activity intolerance related to decreased energy

·            Schedule the activity after management

·           Use oxygen as needed

·           Avoid smoking, weight gain and stress which increases the oxygen demand

·           Provide psychological support

·           Calm and quiet environment to reduce anxiety


2. COPD (Chronic Obstructive Pulmonary Disease)

This is characterized by progressive airflow limitation that is not fully reversible. It includes chronic bronchitis, pulmonary emphysema and bronchial asthma.

Chronic bronchitis, is a chronic inflammation of the lower respiratory tract characterized by excessive mucous secretion, cough, and dyspnea associated with recurring infections of lower respiratory tract.

Pulmonary emphysema, is a complex lung disease characterized by destruction of the alveoli enlargement of distal air space, and break down of alveolar walls.


·           Cigarette smoking

·           Air pollution

·           Occupational exposure

·           Allergy

·           Autoimmunity

·           Infection

·           Genetic predisposition

·           Aging

Signs & Symptoms

Chronic bronchitis

·            Productive cough

·            Production of thick gelatinous sputum  Wheezing and dyspnea


·            Dyspnea

·            Decreased exercise tolerance

·            Minimal cough with mild expectoration  Barrel chest


·            PFT – Pulmonary function Test

·            ABG levels

·            Chest X ray


·            Cessation of smoking

·            Inhaled bronchodilators

·            Inhaled and or oral corticosteroids

·            Chest physiotherapy

·            Oxygen administration

·            Pulmonary rehabilitation

·            Antimicrobial agents

·            Lung volume reduction surgery

Nursing Management

Improving airway clearance  

·            Eliminate pulmonary irritants  Smoking cessation

·            Administer bronchodilators

·            Assess for adverse effect of medications

·            Auscultate chest before and after aerosol therapy

·            Postural drainage

·            Encourage increased fluid intake  Avoid diary product.

Improving breathing pattern

·            Teach and supervise breathing exercise

·            Teach diaphragmatic, lower costal, abdominal breathing using relaxed breathing pattern

·            Use pursed – lip breathing at intervals and during dyspnea

·            Comfortable position

·            Relief from anxiety

Controlling infection

·            Recognize early sign of infection  Sputum for culture and sensitivity

Improving gas exchange

·            Observe the patient for any disturbance  Monitor ABG, and oxygen saturation  Assist mechanical ventilation

Improving nutrition

·            Collect nutritional history

·            Encourage small and frequent feeds

·            Liquid nutritional supplement  Avoid gas producing food  Encourage oral hygiene

·            Encourage pursed lip breathing in between the meals

·            Monitor body weight


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