respiratory
[res´pir-ah-tor″e] pertaining to respiration.
acute respiratory distress syndrome (
adult respiratory distress syndrome) a group of symptoms accompanying fulminant pulmonary edema and resulting in acute respiratory failure; see also
acute respiratory distress syndrome.
respiratory care 1. the health care profession providing, under qualified supervision, diagnostic evaluation, therapy, monitoring, and rehabilitation of patients with cardiopulmonary disorders; it also employs educational activities to support patients and their families and to promote cardiovascular health among the general public.
2. the care provided by members of this profession.
3. the diagnostic and therapeutic use of medical gases and their administering apparatus, environmental control systems, humidification, aerosols, medications, ventilatory support, bronchopulmonary drainage, pulmonary rehabilitation, cardiopulmonary resuscitation, and airway management.
respiratory distress syndrome, neonatal (
respiratory distress syndrome of the newborn (RDS)) a condition of the newborn marked by dyspnea with cyanosis, heralded by such prodromal signs as dilatation of the nares, grunting on exhalation, and retraction of the suprasternal notch or costal margins. It usually occurs in newborns who are preterm, have diabetic mothers, or were delivered by cesarean section; sometimes there is no apparent predisposing cause.
This is the major cause of death in neonates and survivors have a high risk for chronic neurologic complications. No one factor is known to cause the condition; however, prematurity and interrupted development of the
surfactant system is thought to be the major causative factor. Surfactant is secreted by the epithelial cells of the alveoli. It acts as a detergent, decreasing the surface tension of fluids that line the alveoli and bronchioles and allowing for uniform expansion of the lung and maintenance of lung expansion. When there is an inadequate amount of surfactant, a great deal of effort is required to re-expand the alveoli with air; thus the newborn must struggle for each breath. Insufficient expansion of the alveoli results in partial or complete collapse of the lung (
atelectasis). This in turn produces hypoxemia and elevated serum carbon dioxide levels.
The hypoxemia causes metabolic acidosis from increased production of lactic acid and respiratory acidosis due to the hypercapnia. The lowered pH constricts pulmonary blood vessels and inhibits intake of oxygen, thus producing more hypoxemia and interfering with the transport of substances necessary for the production of the sorely needed surfactant.
Patient Care. In order to minimize the hazards of oxygen toxicity and
retinopathy of prematurity, the blood gases of the newborn with respiratory distress syndrome must be carefully monitored to assess response to therapy. The goal is to administer only as much oxygen as is necessary to maintain an optimal level of oxygenation.
To improve respiratory function, intubation, suctioning of the air passages, and
continuous positive airway pressure via nasal prongs are commonly used, as well as instillation of artificial
surfactant. Monitoring is conducted using
transcutaneous oxygen monitoring or a
pulse oximeter. To optimize breathing effort and facilitate air exchange, the newborn is positioned on the back with a shoulder support to keep the neck slightly extended, or on the side with the head supported. Because of the drying effect of oxygen therapy and the prohibition of oral fluids, mouth care must be given frequently to prevent drying and cracking of the lips and oral mucosa.
respiratory failure a life-threatening condition in which respiratory function is inadequate to maintain the body's need for oxygen supply and carbon dioxide removal while at rest; it usually occurs when a patient with
chronic airflow limitation develops an infection or otherwise suffers an additional strain on already seriously impaired respiratory functions. Inadequate or unsuccessful treatment of
respiratory insufficiency from a variety of causes can lead to respiratory failure. Called also
ventilatory failure.
Early symptoms include dyspnea, wheezing, and apprehension; cyanosis is rarely present. As the condition worsens the patient becomes drowsy and mentally confused and may slip into a coma.
blood gas analysis is an important tool in diagnosing respiratory failure and assessing effectiveness of treatment. The condition is a medical emergency that can rapidly progress to irreversible cardiopulmonary failure and death. Treatment is concerned with improving ventilation and oxygenation of tissues, restoring and maintaining
fluid balance and
acid-base balance, and stabilizing cardiac function.
respiratory insufficiency a condition in which respiratory function is inadequate to meet the body's needs when increased physical activity places extra demands on it. Insufficiency occurs as a result of progressive degenerative changes in the alveolar structure and the capillary tissues in the pulmonary bed, as, for example, in
chronic airflow limitation and
pulmonary fibrosis. Treatment is essentially supportive and symptomatic. If the condition is not successfully managed it may progress to
respiratory failure.
respiratory therapist a health care professional skilled in the treatment and management of patients with respiratory problems, who administers
respiratory care. The minimum educational requirement is an associate degree, providing knowledge of anatomy, physiology, pharmacology, and medicine sufficient to serve as a supervisor and consultant. Those registered by the National Board for Respiratory Therapy are designated Registered Respiratory Therapist (RRT).
respiratory therapy technician a health care professional who has completed a specialized one- or two-year educational program and who performs routine care, management, and treatment of patients with respiratory problems under the supervision of a
respiratory therapist. Such programs are usually found in community colleges and are accredited by the Joint Review Committee for Respiratory Therapy Education.
therapy
[ther´ah-pe] activity therapy in the
nursing interventions classification, a
nursing intervention defined as the prescription of and assistance with specific physical, cognitive, social, and spiritual activities to increase the range, frequency, or duration of an individual's (or group's) activity.
animal-assisted therapy in the
nursing interventions classification, a
nursing intervention defined as the purposeful use of animals to provide affection, attention, diversion, and relaxation.
art therapy in the
nursing interventions classification, a
nursing intervention defined as facilitation of communication through drawings or other art forms.
aversion therapy (
aversive therapy) a form of
behavior therapy that uses aversive conditioning, pairing undesirable behavior or symptoms with unpleasant stimulation in order to reduce or eliminate the behavior of symptoms. The term is sometimes used synonymously with
aversive conditioning.
client-centered therapy a form of psychotherapy in which the emphasis is on the patient's self-discovery, interpretation, conflict resolution, and reorganization of values and life approach, which are enabled by the warm, nondirective, unconditionally accepting support of the therapist, who reflects and clarifies the patient's discoveries.
cognitive therapy (cognitive-behavioral therapy) a directive form of psychotherapy based on the theory that emotional problems result from distorted attitudes and ways of thinking that can be corrected. Using techniques drawn in part from behavior therapy, the therapist actively seeks to guide the patient in altering or revising negative or erroneous perceptions and attitudes.
collapse therapy a formerly common treatment for pulmonary
tuberculosis in which the diseased lung was collapsed in order to immobilize it and allow it to rest.
pneumonolysis and
thoracoplasty are methods still sometimes used to collapse a lung and allow access during thoracic surgery.
continuous renal replacement therapy hemodialysis or
hemofiltration done 24 hours a day for an extended period, usually in a critically ill patient.
convulsive therapy treatment of mental disorders, primarily depression, by induction of
convulsions. The type almost universally used now is
electroconvulsive therapy (ECT), in which the convulsions are induced by electric current. In the past, drugs were sometimes used.
diet therapy treatment of disease by regulation of the
diet.
estrogen replacement therapy administration of an
estrogen to treat estrogen deficiency, such as that occurring after menopause; there are a number of indications, including the prevention of postmenopausal osteoporosis and coronary artery disease, and the prevention and treatment of vasomotor symptoms such as hot flashes and of thinning of the skin and vaginal epithelium, atrophic vaginitis, and vulvar atrophy. In women with a uterus, a progestational agent is usually included to prevent endometrial hyperplasia. Called also
hormone replacement therapy.
exercise therapy: ambulation in the
nursing interventions classification, a
nursing intervention defined as promotion of and assistance with walking to maintain or restore autonomic and voluntary body functions during treatment and recovery from illness or injury.
exercise therapy: balance in the
nursing interventions classification, a
nursing intervention defined as use of specific activities, postures, and movements to maintain, enhance, or restore
balance.
exercise therapy: joint mobility in the
nursing interventions classification, a
nursing intervention defined as the use of active or passive body movement to maintain or restore joint flexibility.
exercise therapy: muscle control in the
nursing interventions classification, a
nursing intervention defined as the use of specific activity or exercise protocols to enhance or restore controlled body movement.
family therapy 1. group therapy of the members of a family, exploring and improving family relationships and processes, understanding and modifying home influences that contribute to mental disorder in one or more family members, and improving communication and collective, constructive methods of problem-solving.
2. in the
nursing interventions classification, a
nursing intervention defined as assisting family members to move their family toward a more productive way of living.
hemofiltration therapy in the
nursing interventions classification, a
nursing intervention defined as cleansing of acutely ill patient's blood via a hemofilter controlled by the patient's hydrostatic pressure. See also
hemofiltration.
hormone replacement therapy the administration of hormones to correct a deficiency; usually used to denote
estrogen replacement therapy occurring after menopause.
host modulating therapy efforts to control
periodontal disease by directly targeting the host response; an example is the use of drugs that do this, such as sub-antimicrobial doses of
doxycycline,
nonsteroidal antiinflammatory drugs, or
bisphosphonates.
humidification therapy (
humidity therapy) the therapeutic use of air supersaturated with water to prevent or correct a moisture deficit in the respiratory tract; see also
humidity therapy.
leech therapy in the
nursing interventions classification, a
nursing intervention defined as the application of medicinal
leeches to help drain replanted or transplanted tissue engorged with venous blood.
marital therapy a type of
family therapy aimed at understanding and treating one or both members of a couple in the context of a distressed relationship, but not necessarily addressing the discordant relationship itself. In the past, the term has also been used in a narrower sense to mean what is defined as
marriage therapy, but that is increasingly considered a subset of marital therapy. Called also
couples therapy.
marriage therapy a subset of
marital therapy that focuses specifically on the bond of marriage between two people, enhancing and preserving it.
milieu therapy 1. treatment, usually in a psychiatric treatment center, that emphasizes the provision of an environment and activities appropriate to the patient's emotional and interpersonal needs.
2. in the
nursing interventions classification, a
nursing intervention defined as the use of people, resources, and events in the patient's immediate environment to promote optimal psychosocial functioning.
music therapy 1. the use of music to effect positive changes in the psychological, physical, cognitive, or social functioning of individuals with health or educational problems. Music therapy is used for a wide variety of conditions, including mental disorders, developmental and learning disabilities, Alzheimer's disease and other conditions related to aging, brain injury, substance abuse, and physical disability. It is also used for the management of acute and chronic pain and for the reduction of stress.
2. in the
nursing interventions classification, a
nursing intervention defined as using music to help achieve a specific change in behavior or feeling.
nutrition therapy in the
nursing interventions classification, a
nursing intervention defined as administration of food and fluids to support metabolic processes of a patient who is malnourished or at high risk for becoming malnourished. See also
nutrition.
optometric vision therapy a treatment plan prescribed to correct or improve specific dysfunctions of the vision system; it includes, but is not limited to, the treatment of
strabismus (turned eye), other dysfunctions of
binocularity (eye teaming),
amblyopia (lazy eye),
accommodation (eye focusing), ocular motor function (general eye movement ability), and visual-motor and visual-perceptual abilities.
oral rehydration therapy (ORT) oral administration of a solution of electrolytes and carbohydrates in the treatment of
dehydration.
peritoneal dialysis therapy in the
nursing interventions classification, a
nursing intervention defined as administration and monitoring of dialysis solution into and out of the peritoneal cavity. See also
peritoneal dialysis.
recreation therapy in the
nursing interventions classification, a
nursing intervention defined as the purposeful use of recreation to promote relaxation and enhancement of social skills.
reminiscence therapy in the
nursing interventions classification, a
nursing intervention defined as using the recall of past events, feelings, and thoughts to facilitate pleasure, quality of life, or adaptation to present circumstances.
replacement therapy treatment to replace deficient formation or loss of body products by administration of the natural body products or synthetic substitutes. See also
replacement. Called also
substitution therapy.
root canal therapy that aspect of
endodontics dealing with the treatment of diseases of the dental pulp, consisting of partial (
pulpotomy) or complete (
pulpectomy) extirpation of the diseased pulp, cleaning and sterilization of the empty
root canal, enlarging and shaping the canal to receive sealing material, and obturation of the canal with a nonirritating hermetic sealing agent. Called also
pulp canal therapy. simple relaxation therapy in the
nursing interventions classification, a
nursing intervention defined as the use of techniques to encourage and elicit relaxation for the purpose of decreasing undesirable signs and symptoms such as pain, muscle tension, or anxiety.
speech therapy the use of special techniques for correction of
speech disorders.
swallowing therapy in the
nursing interventions classification, a
nursing intervention defined as facilitating
swallowing and preventing complications of impaired swallowing.
thrombolytic therapy the administration of drugs for
thrombolysis (dissolution of a thrombus in an artery), to reduce the size of occlusion and thereby reduce damage to muscular tissue; the coronary artery is a commonly used site. Agents commonly used are
streptokinase and
tissue plasminogen activator (t-PA).
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.