Oxford Handbook of Respiratory Nursing

685 Pages·2009·2.944 MB·English

by  Terry Robinson, Jane Scullion

Oxford Handbook of
Respiratory
Nursing
Published and forthcoming
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Edited by Beverley Tabernacle, Marie Honey, and Annette Jinks
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Edited by Vari Drennan and Claire Goodman
Oxford Handbook of Respiratory Medicine
Edited by Terry Robinson and Jane Scullion
Oxford Handbook of
Respiratory
Nursing
Edited by
Terry Robinson
Specialist Respiratory Nurse, Harrogate and District NHS
Foundation Trust
Jane E. Scullion
Respiratory Nurse Consultant, University Hospitals of
Leicester
1
1
Great Clarendon Street, Oxford OX2 6DP
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v
Foreword
The practice of modern medicine is changing rapidly and nursing roles
have developed to meet this challenge. Whilst much of the world is still
affected by acute or infectious illnesses, there has been an increasing focus
on chronic diseases that are now prevalent even in developing countries.
Chronic respiratory disease continues to make a prominent contribution
to global ill health and cannot be ignored. Most major respiratory dis-
eases cannot be cured but have to be managed to limit their impact on
the patient and their families. This approach requires the collaboration
of several healthcare disciplines as well as the active involvement of the
patient and their relatives. The emphasis on moving healthcare closer to
the patient’s home will inevitably mean that nurses in particular will have
greater involvement in routine and unscheduled care.
In this book on the nursing of respiratory disorders it is evident that
the reader is invited to acquire knowledge and skills specifi c to acute and
chronic respiratory diseases that will help them understand and manage
the patient effectively. This book seeks to provide the common knowl-
edge base for the nurse professional who is developing an enthusiasm for
the provision of fi rst-class respiratory care. The chapter authors in this
welcome book have all demonstrated their commitment and enthusiasm
to the care of people with lung disease. They have also all contributed
to the practical development of innovative respiratory services and aim
to share that experience with the reader. They are justly proud of their
achievements but understand that they must spread the word to be even
more effective.
Mike Morgan
Consultant Respiratory Physician
Chairman of the British Thoracic Society
July 2008
vi
Acknowledgements
We would like to offer our grateful thanks to the following relatives,
friends and colleagues for their support, advice and guidance on various
sections of the book.
Mrs Sharon Haggerty, Mr John Robinson, Dr Tony Fennerty, Dr Claire
Taylor, Mrs Shona Shires, Ms Sarah Howard.
And to all our contributors for their patience and hard work.
vii
Preface
The multitude of respiratory diseases present a considerable burden on
healthcare resources, the economy, and particularly on individual patients
and their carers. In the United Kingdom (UK) one in fi ve deaths occur as
the result of respiratory disease with more deaths occurring from this
group of disease than from coronary heart disease or the non-respira-
tory cancers. The UK death rate from respiratory disease is also one of
the highest in Europe, estimated to be around twice the European (EU)
average, and it appears that this burden is increasing, which contrasts
sharply to coronary heart disease where the overall relative burden falls
year on year. Around one in eight admissions to the acute sector are as
a consequence of respiratory disease. It also places a heavy burden on
primary care, with many consultations both at the surgery and in the
patient’s home.
This handbook was put together to give a practical, reliable and useful
guide to practitioners interested in some of the more common respiratory
conditions affecting adults, recognizing that respiratory patients present in
all specialties and in a variety of settings. This is therefore a useful book for
anyone from the interested novice to the experienced practitioner. It can
give quick facts or can be read in a more in-depth style
Written in the style of previous Oxford Handbooks, the book appears
in topics which are also cross-referenced to other relevant sections within
the book. It is up-to-date and written by experienced practitioners within
the specialty, directly involved in patient care. A glossary at the end pro-
vides a useful adjunct to the topics. Given the breadth and range of respi-
ratory conditions it is not an exhaustive guide, but it does look at the
more common presenting problems with their care, management and
treatment. Each chapter is useful as a stand-alone text and is presented
with further reading rather than being referenced throughout.
Terry Robinson and Jane Scullion
July 2008
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ix
Contents
1 Introduction 1
2 Why work in respiratory nursing? 7
3 Anatomy and physiology 13
4 Respiratory assessment 31
5 Respiratory investigations 75
6 Acute respiratory distress syndrome 137
7 Asthma and allergies 145
8 Bronchiectasis 231
9 Chronic obstructive pulmonary disease 249
10 Cystic fi brosis 297
11 Diffuse parenchymal lung disease (interstitial
lung disease) 311
12 Lung cancer 323
13 Obstructive sleep apnoea 349
14 Oxygen therapy 359
15 Pharmacology 391
16 Pleural effusion 447
17 Pneumonia 455
18 Pneumothorax 465
19 Pulmonary embolism 471
20 Pulmonary hypertension 481
21 Non-invasive positive pressure ventilation 493
22 Tuberculosis 507
23 Palliative care 521
24 Pulmonary rehabilitation 531
25 Public health 541
26 Sex, sexuality and breathlessness 571