Lung exercise – This course is designed to understand the concept of community health nursing: nurses’ roles and interventions in family health, school health, occupational health, environmental health, elderly health care, gender issues, disaster management and principles and terminology of epidemiology. The aim of the course is to acquire knowledge and skills in community health nursing.
Lung exercise
Lung exercise that enhances the respiratory system by improving ventilation, strengthening respiratory muscles, and increasing endurance. It is used in pulmonary rehabilitation
Or,
Any exercise used to control one’s breathing as a strategy to reduce stress.
Purposes of lung exercise:
- It helps to enhance the respiratory system by improving ventilation,
- It helps to strengthening respiratory muscles, and increasing endurance
- It helps to control one’s breathing as a strategy to reduce stress
Benefits of Lung Exercise:
- Lower anxiety
- It helps to maintain nervous system and heart balance.
- It helps to release toxins.
- Helps to healthier body.
- Heightened focus: Increased oxygen flow to the brain allows it to function at its optimal levels, which in turn aids decision making and ability to focus on tasks. Studies have shown that breathing exercises have beneficial impacts on the brain’s state of awareness-increasing retention and concentration.
- Calmer Mind: Deep breathing triggers the release of pleasure-inducing neurochemicals in the brain, simultaneously improving feelings of well-being while also providing pain-relief.
- A Healthy Pattern: Establishing healthy patterns and rhythms to our daily lives is important for creating a sense of balance and harmony. Oftentimes, healthy decisions lead to further healthy decisions.
Routine for Lung Exercise:
You may want to try several different relaxation techniques to see which one works best for you. And if your favorite approach fails to engage you, or you want some variety, you’ll have alternatives. You may also find the following tips helpful:
- Choose a special place where you can sit (or lie down) comfortably and quietly.
- Don’t try too hard. That may just cause you to tense up.
- Don’t be too passive, either. The key to eliciting the relaxation response lies in shifting your focus from stressors to deeper, calmer rhythms and having a focal point is essential.
- Try to practice once or twice a day, always at the same time, in order to enhance the sense of ritual and establish a habit.
- Try to practice at least 10-20 minutes each day.
Postoperative Management and Care of a Patient with Thoracic Surgery:
According to World Health Organization. (WHO):
Postoperative care
A. Post-operative note and orders: The patient should be discharged to the ward with comprehensive orders for the following:
- Vital signs
- Pain control
- Rate and type of intravenous fluid
- Urine and gastrointestinal fluid output
- Other medications
- Laboratory investigations
The patient’s progress should be monitored and should include at least:
- A comment on medical and nursing observations
- A specific comment on the wound or operation site
- Any complications
- Any changes made in treatment
B. Aftercare: Prevention of complications
Encourage early mobilization:
✔ Deep breathing and coughing
✔ Active daily exercise
✔ Joint range of motion
✔ Muscular strengthening
✔ Make walking aids such as canes, crutches and walkers available and provide instructions for their use
- Ensure adequate nutrition
- Prevent skin breakdown and pressure sores:
✔ Turn the patient frequently
✔ Keep urine and faeces off skin
- Provide adequate pain control
C. Discharge note: On discharging the patient from the ward, record in the notes:
- Diagnosis on admission and discharge
- Summary of course in hospital
- Instructions about further management, including drugs prescribed.
Ensure that a copy of this information is given to the patient, together with details of any follow-up appointment
Postoperative Management
If the patient is restless, something is wrong.
Look out for the following in recovery:
- Airway obstruction
- Hypoxia
- Haemorrhage: internal or extemal
- Hypotension and/or hypertension
- Postoperative pain
- Shivering, hypothermia
- Vomiting, aspiration
- Falling on the floor
- Residual narcosis
The recovering patient is fit for the ward when:
- Awake, opens eyes
- Extubated
- Blood pressure and pulse are satisfactory
- Can lift head on command
- Not hypoxic
- Breathing quietly and comfortably
- Appropriate analgesia has been prescribed and is safely established
Nursing Responsibilities:
- The patient should be kept on nothing by mouth according to doctor’s order.
- IV fluid should be given according to doctor’s order.
- Maintain input and output chart.
- Maintain patency of NG tube. Notify physician if tube becomes dislodged
- Note character and amount of surgical drainage.
- Provide oral hygiene on a regular, frequent basis, including petroleum jelly for lips.
- Auscultate for resumption of bowel sounds and note passage of flatus.
- Monitor tolerance to fluid and food intake, noting abdominal distension, reports of increased pain, cramping, nausea and vomiting.
- Avoid milk and high-carbohydrate foods in the diet
- Note admission weight and compare with subsequent readings.
- Administer IV fluids, TPN, and lipids as indicated.
- Monitor laboratory studies (Hb. and Hct, electrolytes, and total protein, prealbumin).
- Progress diet as tolerated, advancing from clear liquid to bland diet with several small feedings.
- Administer medications as indicated:
✔ Anticholinergics: atropine, propantheline bromide (Pro-Banthine)
✔ Fat-soluble vitamin supplements, including vitamin B12, calcium
✔ Iron preparations
✔ Protein supplements
✔ Medium-chain triglycerides (MCT)
- Care of the surgical area
- Care of IV cannel
- Care of the bowel and bladder
- Patient and their family members assured and informed about patient condition.
Pneumothorax
Pneumothorax:
Accumulation of air in the pleural space is called pneumothorax. It can either occur spontaneously or results from iatrogenic injury or trauma to the lung or chest wall.
Classification:
A. Spontaneous pneumothorax:
1. Primary
- Closed type
- Open type
- Valvular type or tension pneumothorax
2. Secondary to COPD and tuberculosis
B. Iatrogenic pneumothorax:
- During aspiration of pleural fluid
- Thoracic surgery
C. Traumatic pneumothorax:
- Penetrating injury
- Rib fracture
[Reference: Davidsons 19 edition)
Treatment:
A. Conservative treatment:
- Bed rest in propped up position
- Easy diet
- O inhalation
- Easy bowel clearance
- Antibiotics
B. Rx of underlying cause:
- Water seal drainage
- Radiological observation
C. Specific treatment of the cause.
Thoracic surgery:
Cardiothoracic surgery (also known as thoracic surgery) is the field of medicine involved in surgical treatment of organs inside the thorax (the chest)-generally treatment of conditions of the heart (heart disease) and lungs (lung disease).
Or,
Thoracic surgery focuses on the chest organs, including the heart, lungs, esophagus, and trachea. Technological advances have increased the safety and availability of these complex surgical procedures. Lung cancer surgeries, heart transplants, and anti-reflux surgeries save and improve lives around the world.
Complications of Thoracic Surgery:
Potential complications of pneumonectomy and extrapleural pneumonectomy include the following:
- Atrial fibrillation
- Cardiac herniation
- Tamponade
- Diaphragmatic/pericardial patch dehiscence
- Bronchopleural fistula
- Deep venous thrombosis
- Pulmonary embolism
- Pneumonia
- Pulmonary edema
- Respiratory insufficiency
- Myocardial infarction
- Bleeding
- Wound infection
- Urinary tract infection
- Sepsis
- Post pneumonectomy syndrome
- Empyema
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