Congenital Lobar Emphysema
II. Congenital Lobar Emphysema also known as Congenital Lobar Over-inflation (CLO) and Infantile Lobar Emphysema is a rare congenital respiratory anomaly related to the hyperinflation of one or more of the pulmonary lobes. It is a condition in which the neonate or infant can accumulate more air into the lung than what can be utilized. This condition results in air trapping, and air leakage out into the pleural space and in most cases resulting in respiratory distress. The lobar is over distended and there is displacement of the mediastinum to the opposite side with the other lung undepressed. It is frequently detected weeks after birth or in early infancy. Congenital Lobar Emphysema is more common in boys though
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Echocardiogram: to disclose any congenital cardiac disorders.
The patient is treated based on the diagnosis: if the patient has mild symptoms, monitor for any change; in severe cases patients may need a lobectomy to improve their life expectancy. In this case, the patient is in severe respiratory distress with accompanying tachycardia, on auscultation decreased sounds in the right upper hemithorax, tachypnea, and SpO2 of 80% on room air. The patient had been treated without any improvement, in retrospect the patient is deteriorating. At this time the best procedure to improve patient oxygenation and life expectancy is to perform a right upper lobe lobectomy.
V. The infant was placed on the heating mattress to maintain his body temperature. A pulse oximeter and cardioscope in place to check oxygenation and to monitor the infant’s heart.
NG tube was aspirated with a syringe before apply any anesthesia to prevent any aspiration during and after the surgery; monitor blood pressure, SpO2, rectal temperature, ETCO2, and fluids to maintain vitals in normal ranges. Blood transfusion was placed on hold in case of any
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media,
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
Based on the subjective symptoms, it appears this patient has bronchitis, a type of chronic obstructive pulmonary disease, which is a respiratory disorder. The care plan will focus on intervention to prevent the disease from re-occurring and causing chronic bronchitis. Further assessment will be needed to obtain a baseline, so when the care plan is implemented, then it can be evaluated to measure positive outcome and where alteration will be need in the plan for a great outcome in the patient’s health.
In the case study it is the left lung that is in distress, and as the pressure increases within the left lung it can cause an impaired venus return to the right atrium (Daley, 2014). The increased pressure can eventually affect the right lung as the pressure builds in the left side and causes mediastinal shift which increases pressure on the right lung, which decreases the patients ability to breath, and diffuse the bodies tissues appropriately. The increase in pressure on the left side where the original traum... ... middle of paper ... ... 14, January 29).
Anomalous systemic arterial supply to the lungs has been extensively described in association with other congenital abnormalities such as bronchopulmonary sequestration and hypogenetic lung syndrome (scimitar syndrome). In 1946, Pryce introduced the term ‘sequestration’ to describe congenital abnormalities characterised by an anomalous systemic arterial supply to the lung and atresia or hypoplasia of the pulmonary artery. Sequestration was defined by Pryce as a “disconnected (dislocated, ectopic) bronchopulmonary mass or cyst with an anomalous systemic blood supply”.
Whether lung cancer is operable or not, may well depend upon the circumstances of the patient involved; however, where certain factors do not allow for this option, other treatments may well be offered. Many factors must be taken into consideration before any treatment or operation can take place, as either may have a prominent bearing on the prognosis of the cancer patient.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
...itoring vital signs in infants, children and young people [WWW] RCN . Available from http://www.rcn.org.uk/__data/assets/pdf_file/0004/114484/003196.pdf [Accessed 26/03/2013].
First, you must obtain all of the necessary supplies: gloves, alcohol or Betadine preps, a tourniquet, tape, an appropriately sized IV catheter, a bag of IV solution, the IV tubing, and gauze pads. While obtaining the supplies, you should inform the patient that IV catheter placement is necessary, and why. Do not lie to the patient and tell him or her that it is a painless procedure. Instead, be honest with them and explain that the initial puncture feels like a sharp pinch on the skin and that the pain and discomfort associated with the IV placement is only temporary. You may find it helpful to demonstrate to the patient the amount of pain to expect by pinching the skin on the back of their hand. This is especially helpful for younger patients or patients who are more concrete in their thinking.
Emphysema is a chronic obstructive pulmonary disorder that is characterized by destructive changes in the alveolar walls and irreversible enlargement of alveolar air spaces. This disorder causes loss of elasticity in the walls of the alveolar walls, which results in the walls stretching and after an amount of time eventually breaking. Once damage to the walls occurs, the air spaces are unable to carry out the exchange of oxygen and carbon dioxide. Due to the disruption in the breakage and exchange process and inability to carry out duty, the remaining alveoli that is working correctly becomes overinflated and eventually makes exhaling difficult. Smokers put themselves at risk because they have genetic predisposition along with those that have
Subotic, D. and Lardinois, D. 2013. Chapter 9. Surgical treatment of bronchiectasis. European Respiratory Society Monograph, 61 pp. 90-106.
After almost one hour of “tube procedure connections”, I got up to go to the restroom with an IV pole following my s...
Time out was done by the anesthesiologist, the circulating nurse, the surgeon, and the scrub tech all pausing before the surgery and verifying the patient’s name and date of birth, the procedure being done, the site and location on the body in which the procedure was being done, and documented the count of all the equipment the scrub nurse had before surgery to compare to after surgery. 5. The patient’s privacy was protected and respected throughout the whole surgical procedure. The staff was very professional and I felt I learned a lot from them during my OR experience. 6. A sponge count is when the scrub nurse counts the sponges that are unused before the surgery she relays this to the circulating nurse and it is documented. After the surgery the count is redone to make sure that there are no sponges left in the patient. 7. The circulating nurse documents the information and signs the chart in the operating room. From pre-op to the operating room the nurses in pre-op gave off report to the circulating nurse by SBAR. From the operating room to PACU the anesthesiologist went with the patient and handed off the patient’s condition and information to the nurse in there. 8. There were no ethical or legal issues that were raised during my observation in the whole surgical process. 9. I learned how the whole operating procedure works from start to finish, all the legal paperwork involved, and how the team interacts and helps each other out to give the patient a safe and