Ineffective Airway Clearance Research Articles

Nursing Care for Septic Shock Patients Using Indonesian Nursing Standards: A Case Reports

Aims: This case report aimed to identify gaps in applying the Nursing Standard Guidelines of the Indonesian Association in critical care, specifically focusing on patients with septic shock. Methods: This study used a case report with a nursing care approach that includes an assessment to evaluation. Nursing care was provided to a patient who was experiencing septic shock, was on a ventilator, and had experienced organ failure. Results: A 63-year-old man on mechanical ventilator was diagnosed with septic shock caused by community-acquired pneumonia. The nursing diagnoses for this case included impaired spontaneous ventilation related to respiratory muscle weakness, ineffective airway clearance related to the accumulation of secretions, peripheral tissue perfusion disorders related to changes in fluid regulation, and risk of infection. The study identified inappropriate nursing diagnoses, such as 'impaired spontaneous ventilation for patients on mechanical ventilation. Conclusion: This study concludes that there are still several gaps in diagnosing and managing clinical conditions in critical cases. The nursing problem of impaired spontaneous ventilation should not have been identified as the patient was already on a ventilator. Additionally, there was no actual diagnosis for impaired organ perfusion or infection. This case report recommends further developing the Nursing Standard Guidelines of the Indonesian Nursing Association to optimize coverage of critical care. Recommendations include revising the Indonesian Nursing Diagnosis Standards to align with critical care needs. This enhancement will help nurses and clinicians in critical care not experience confusion when applying the current guidelines.

Effectiveness of Chest Physiotherapy toward Tuberculosis (TBC) Patient to Overcome Ineffective Airway Clearance in Dieng Inpatient Room of dr. Abdoer Rahem Hospital Situbondo: A Case Report

Tuberculosis is an infectious and potentially fatal disease in worldwide, caused by lungs inflammation due to Mycobacterium bacteria infection. Tuberculosis patient experiences coughing with phlegm, shortness of breath or dyspnea, accumulation of exudate or sputum. Excessive of sputum accumulated can lead to obstruction of breath way and increase lungs infection that related to ineffective airway clearance. Chest physiotherapy can be intervention of nursing to overcome ineffective airway clearance that helps in clearing accumulated sputum and improving oxygen saturation. This scientific work uses a case report method that describes the case of Tuberculosis patient with main problem of nursing that was called ineffective airway clearance. The sampling was consecutive sampling but only one patient included in the case. The sample of study was Mrs. M, 32 years old who had Tuberculosis patient with ineffective airway clearance. The research was conducted twice daily for 3 days began from December 21st, 2023, to December 23rd, 2023, in the Dieng Inpatient Room of dr. Abdoer Rahem Hospital Situbondo. Intervention was done in two sessions, that were morning and afternoon. Based on observations, there was no significant difference on blood pressure level, but there were decreasing pulse rate, decreasing respiratory rate, increasing oxygen saturation value, and improving ability of sputum production post intervention Chest Physiotherapy on the third day. The application of Chest Physiotherapy quietly helped in expelling phlegm and improving respiratory status.

Penerapan Kolaborasi Pemberian Inhalasi dengan Close Suction untuk Bersihan Jalan Napas Tidak Efektif pada Pasien Ny. R Terpasang Endotracheal Tube di Ruang ICU RSUD Sidoarjo

Ineffective airway clearance is a condition where the patient is unable to cough effectively, often caused by thick or excessive secretions due to infection. The objective of this intervention is to address ineffective airway clearance in patients with an endotracheal tube in the ICU of RSUD Sidoarjo. After inhalation and close suction procedures, observations showed improvements in vital signs and respiratory rate, along with significant reduction of secretions. This led to an increase in peripheral oxygen saturation (SpO2), improving oxygen supply to the body. Based on the case study, the nursing intervention for ineffective airway clearance conducted over 2 x 8 hours showed partial success in resolving the issue. Following a thorough nursing assessment, the diagnosis for patient Mrs. R was determined as ineffective airway clearance related to airway spasms, evidenced by inability to cough, excessive sputum, and ronchi sounds.

Asuhan Keperawatan Pada An.K Dengan Gangguan Sistem Pernapasan: Bronkopneumonia di Ruang Anggrek 2 RSUD Dr. Soeselo Kabupaten Tegal

Bronchopneumoia is type of pneumonia, namely inflammation of the lungs due to viral, bacterial and fungal infection (Damayanti & Nurhayati, 2019). The purpose of this writing is to find out and provide nursing care to An.K with respiratory system disorders: bronchopneumonia in the anggrek ward 2 RSUD dr.Soeselo Kabupaten Tegall in accordance with nursing standards. The method used is data collection methods in the form of interviews, observation, consultation, examination. From the case review, it was found that An.H’s mother’s main complaint was that An.K was experiencing shortness of breath. Three diagnoses were found, namely ineffective airway clearance, anxiety and knowledge deficit about bronchopneumonia. Interventions are prepared based on the theory of SDK, SLKI and SIKI as well as on the client’s condition and can be implemented.

Asuhan Keperawatan pada Ny. S dengan Gangguan Sistem Pernapasan : Bronkopneumonia di Ruang Dahlia Rsud Dr. Soeselo Kabupaten Tegal

Bronchopneumonia is an inflammation of the lung parenchyma that extends to the bronchioles, which can be understood as inflammation of the lung tissue with direct spread through the respiratory tract to the bronchi (Hapsari et al., 2022). The purpose of this writing is to understand the nursing care process for Mrs. S with respiratory system disorders: bronchopneumonia in Dahlia Ward, RSUD dr. Soeselo Tegal Regency. This writing method uses a descriptive approach with a nursing process approach. The results of the nursing care found that the patient had shortness of breath, productive cough, and ronchi sounds; the patient and family were unaware of the disease. The nursing diagnoses identified were ineffective airway clearance and knowledge deficit. Interventions were carried out based on SIKI (Indonesian Standard for Nursing Care) and implementation was based on the designed interventions. Evaluation of the two diagnoses revealed that one diagnosis, the knowledge deficit, was resolved, while the issue of ineffective airway clearance was partially resolved. The results of the nursing care were consistent with the theory. This writing is expected to improve skills in providing nursing care.

Addressing the Challenge of Ineffective Airway Clearance in Toddler-Aged Children: The Role of Chest Physiotherapy in Arjawinangun Hospital

Addressing the Challenge of Ineffective Airway Clearance in Toddler-Aged Children: The Role of Chest Physiotherapy in Arjawinangun Hospital

Nursing Care in the Case of Infants with Acute Respiratory Infections with Ineffective Airway Nursing Problems: A Case Study

Acute respiratory infections that attack the upper and lower tract in a stimulant or sequential manner that lasts up to 14 days This can certainly result in the risk of inability to clear secretions or even obstruction of the airway. The purpose of the study was to provide nursing care to overcome patient problems. This research is a case study of 1 infant who experienced acute respiratory infection with the nursing problem of ineffective airway clearance for 3 days on May 15-18, 2023. The subject in this study was Baby. A who was male and 35 days old who was admitted to the pediatric ward (Melati) of Dr. H. Koesnadi Bondowoso Hospital with the main complaint of shortness of breath who met the inclusion criteria with data collection techniques of interviews, observation, physical examination and documentation studies. The instrument used is the pediatric nursing assessment form and the SOP for action according to applicable regulations. The results of this study were obtained from the assessment, namely ineffective airway clearance in accordance with the theory, and diagnoses in accordance with the client's condition. In implementation refers to nursing interventions using SIKI which are tailored to the client's condition as well as evaluation refers to the overview, goals and specific objectives that have been set. The evaluation results obtained complaints of tightness and reduced secretion production, RR: 46 x/min, SpO2: 98%.

Active Cycle Breathing Technique on Airway Clearance in Pulmonary TB Patients

Abstract Introduction: Gorontalo City has 643 cases of tuberculosis in 2022, with the problem of ineffective airway clearance which causes airway obstruction which is often characterized by symptoms of ineffective cough, excess sputum, wheezing and rhonchi. Objective: To determine the effect of active cycle breathing technique on airway clearance in pulmonary TB patients. Method: The type of research used is quantitative. The research design uses a Quasi Experiment One Group Pre test- Post test design, namely a research design that only uses one group of subjects and takes measurements before and after giving treatment to the subjects being studied. The sampling technique was carried out using the Accidental Sampling technique with a sample size of 10 respondents. Data analysis uses univariate and bivariate analysis and the instrument used is a questionnaire. Results: The results of the study showed that the patient's clinical results from ineffective airway clearance problems, after being given the active cycle breathing technique, resulted in effective airway clearance. The statistical test results obtained p-Value = 0.004, which means less than (α = 0.05), indicating that there is an influence of active cycle breathing technique on airway clearance in pulmonary TB patients. Conclusion: The active cycle breathing technique can be a recommended nursing intervention in overcoming the problem of airway clearance in pulmonary TB patients.

Management of Airway Clearance is Ineffective in Patients with Tuberculosis & Mediastinal Tumors

Ineffective airway clearance is a common problem in pulmonary tuberculosis patients. This condition occurs due to an infectious process that causes an inflammatory response and excessive secretion production. The mediastinal tumor experienced by the patient resulted in the patient's condition getting worse because the lump in the mediastinal area pressed on the airway so that phlegm/secretions were difficult to expel. This study aimed to describe the ineffective management of airway clearance in patients with pulmonary tuberculosis, pleural effusion, and mediastinal tumors. This study uses a descriptive observational research design in the form of a case report using a nursing care approach. The subject of this study was a 34 year old woman with a medical diagnosis of pulmonary tuberculosis, pleural effusion, and mediastinal tumor. The intervention carried out, namely managing airway clearance, was not effective. Some of the actions carried out include semi-fowler position, collaborative administration of 3 lpm oxygen, combivent and pulmicort nebulization 3 times/day, and suctioning. After carrying out nursing procedures for 3 x 24 hours, the patient said he felt more comfortable in the semi-Fowler's position, she felt the shortness of breath was reduced after nebulization but the shortness of breath became worse again sometime later, the patient said he had difficulty expelling phlegm so his shortness of breath did not improve, SaO2 100%, RR 18 times/minute, and wheezing (-). It can be concluded that the interventions can reduce symptoms but cannot solve the problem. Management of ineffective airway clearance in this case cannot be done independently by the nurse. Collaboration is needed by considering the need for surgery and pharmacological therapy.

Pursed-Lips Breathing and High Fowler Position in Pleural Effusion Patient: Case Report

Pleural effusion is a collection of fluid in the pleura caused by the impact of another disease. Treatment for pleural effusion can be provided through the nursing care process with airway management interventions to help minimize shortness of breath in patients. There are nursing actions that can be carried out independently by nurses, namely the semi-fowler or fowler position, administering additional oxygen, and other therapies such as pursed lips breathing. The aim of this research is to determine the effectiveness of the combination of pursed lips breathing and high fowler position in the nursing care process for patients with ineffective airway clearance nursing problems in patients with pleural effusion using the case report method and nursing care approach. The results of the study showed that the combination of pursed lips breathing and the use of the selected high fowler position as high as 90 degrees for 3 days provided comfort and reduced shortness of breath with pleural effusion while being balanced by the provision of pharmacological therapy. Providing pursed lips breathing therapy and high fowler position has the potential to reduce shortness of breath in patients with pleural effusion

Accuracy of the defining characteristics of respiratory nursing diagnoses in patients with COVID-19.

To analyze the accuracy of the defining characteristics of four respiratory nursing diagnoses (ND) in patients with COVID-19 and on oxygen therapy. This is a cross-sectional study conducted in four Brazilian public hospitals in two regions of the country. A total of 474 patients with COVID-19 receiving oxygen therapy were assessed. Latent-adjusted class analysis with random effects was used to establish the sensitivity (Se) and specificity (Sp) of the defining characteristics evaluated for each ND. Among the ND that constituted the study (impaired spontaneous ventilatory, impaired gas exchange, ineffective airway clearance, and dysfunctional ventilatory weaning response), the following defining characteristics had the highest simultaneous Se and Sp (>0.8): decrease in tidal volume, confusion, irritability, dyspnea, decreased breath sounds, orthopnea, impaired ability to cooperate and respond to coaching, and decrease in the level of consciousness. Recognizing the clinical signs that predict respiratory ND in patients affected by COVID-19 can contribute to the nurse's accurate diagnostic inference and designate the appropriate nursing interventions to achieve the desired results and avoid complications.

Nursing Care for Oxygenation Needs Disorder in Patients Diagnosed with Bronchitis in the Jimbaran Lama Ward

Ineffective airway clearance is one of the oxygenation disorders in patients with respiratory disorders (bronchitis). One of the practical nursing actions is to cough effectively to remove mucus in the respiratory tract. This study aimed to determine and analyze nursing care for impaired oxygenation needs in patients with a medical diagnosis of bronchitis in the old Jimbaran room. This research method uses a descriptive design as a nursing practice case study approach. The case study examines the respiratory rate (RR) of patients with respiratory disorders (bronchitis) after giving effective coughing measures for 3x24 hours. The results showed that the patient's RR before implementation was 24 x/min. In comparison, after being given an effective cough implementation for 3x24 hours, the RR was 20 x/min. In conclusion, nursing actions that need to be taken in patients with respiratory disorders (bronchitis) include assessing sputum production, effective coughing techniques, counseling regarding positioning, and collaborative oxygen or nebulizer administration. The implication of this study is the importance of effective coughing measures in managing bronchitis patients, including evaluation of sputum production, training in proper coughing techniques, education on proper positioning, and collaboration with oxygen or nebulizer administration as needed. Synchronization between research objectives and research conclusions. Present the research subject, research criteria, data collection methods, and data analysis.

NURSING CARE ANALYSIS OF ARTIFICIAL RESPIRATORY MANAGEMENT IN STROKE-ASSOCIATED PNEUMONIA (SAP) PATIENTS: A CASE STUDY FROM ICU RSPAL DR. RAMELAN SURABAYA

Introduction: Stroke-associated pneumonia (SAP) is a common complication of stroke, leading to ineffective airway clearance and potentially severe outcomes such as respiratory failure and death. Objective: This case study analyzes the nursing care provided to a SAP patient in the ICU of RSPAL Dr. Ramelan Surabaya, focusing on the application of artificial respiratory management to improve airway clearance Methods: Over five days, the nursing team implemented interventions, including Endotracheal Tube (ETT) care, which partially resolved the ineffective airway clearance. Results: This improvement was evident in the enhanced respiratory parameters and reduced secretion accumulation. Conclusions: The findings highlight the importance of diligent airway management in preventing respiratory complications in SAP patients.

Penerapan Terapi Inhalasi Nebulizer pada Pasein dengan Bersihan Jalan Napas Tidak Efektif Akibat Community-Acquired Pneumonia

Community acquired Pneumonia is a type of Pneumonia that is acquired in the community. The incidence of Pneumonia in Indonesia in 2013 ranged from 23%-27% and mortality was 1.19%. From 2015-2018 confirmed cases of Pneumonia in children under 5 years were recorded at 505,331 patients with 425 patients dying. The prevalence of Pneumonia in Bali Province in 2018 there were 20,560 cases found based on a history of diagnosis by health workers and / or symptoms that had been felt by respondents / patients. Analyze the effect of the application of Nebulizer inhalation therapy in patients with ineffective airway clearance problems due to Community acquired Pneumonia (CAP). Using case study design with the implementation of nursing care from assessment, diagnosis, intervention, implementation, and evaluation. This study was conducted at RSUP Prof. Dr. I.G.N.G NGOERAH, Denpasar Bali, in July 2023. The results of the analysis showed changes in the patient's respiratory status after administration of Nebulizer inhalation therapy. The result is clear white mucus discharge and not viscous; respiratory rate decreased, ronchi sounds decreased, and SPO2 status: 98%, patients appeared calmer. Nebulizer inhalation therapy is effective in overcoming airway clearance problems is not effective in Pneumonia patients, especially CAP.

Combination of Chest Physiotherapy and Postural Drainage for Airway Clearance in Bronchopneumonia: A Case Study

Background: Respiratory diseases such as bronchopneumonia contribute to the highest cause of death in children aged less than two years. Airway clearance becomes a problem due to the accumulation of secretions, resulting in airway obstruction. Independent nursing interventions such as chest physiotherapy can be carried out to free the airway and reduce the burden of breathing. Objective: This study aimed to analyze the application of chest physiotherapy intervention in bronchopneumonia children with airway clearance problems. Method: The research design uses a case study with a nursing process approach. The sample for this study was one child patient aged nine months with bronchopneumonia who was taken using a convenience sampling technique. Data was collected using interviews, observation, and documentation studies using pediatric nursing care format instruments. Chest physiotherapy intervention was carried out three times with a duration of 10-15 minutes with a combination of postural drainage, which was then evaluated before and after the procedure. Results: Chest physiotherapy intervention in patients can improve coughing ability, increase sputum production and respiratory rate 40 times per minute, and decrease rhonchi and oxygen saturation by 96%. Conclusion: Chest physiotherapy can be an effective independent nursing intervention to overcome the problem of ineffective airway clearance nursing in children with bronchopneumonia.

Asuhan Keperawatan pada An. R dengan Bronkopneumonia di Ruang Perawatan Anak Rumah Sakit Hermina Bekasi

Bronchopneumonia or also known as Lobar Pneumonia is an inflammation of the lungs that extends to the lung parenchyma which is characterized by the presence of infiltrated patches caused by infectious agents such as bacteria, viruses, fungi or foreign bodies. In the world, as many as 740,180 children under the age of 5 years died from pneumonia in 2019. The purpose of writing is to describe nursing care for children with bronchopneumonia in the Pediatric Care Room at Hermina Bekasi Hospital. The writing method used is a case study to explore a problem by collecting in-depth data. Data collection techniques that the authors do are interviews, observation, physical examination and documentation study. The nursing diagnoses raised were ineffective airway clearance b.d airway hypersecretion, risk of infection b.d suppression of inflammatory response and risk of nutritional deficit b.d reluctance to eat. After nursing actions for 3x24 hours, all problems were resolved. Patients and families are expected to be able to prevent recurring Bronchopneumonia by keeping the environment clean and consuming healthy food and nurses are expected to have broad insight and be able to apply their knowledge to the implementation of nursing care in Children with Bronchopneumonia.

Efektivitas Minum Air Hangat dan Batuk Efektif terhadap Bersihan Jalan Napas Pasien Tuberkulosis Paru

Pulmonary Tuberculosis is a disease caused by the bacterium Mycobacterium tuberculosis. The main problem that is often experienced by pulmonary tuberculosis patients is the accumulation of sputum which results in ineffective airway clearance. To overcome the ineffectiveness of airway clearance, it can be done by providing therapy with drinking warm water and effective coughing. This study aims to determine the comparison between drinking warm therapy and coughing effectively on airway clearance of pulmonary tuberculosis patients at the Bontomarannu Health Center. This research is a quantitative study using a quasi-experimental design where the researcher uses a two group pretest-posttest design. The determination of the sample is done by simple random sampling technique with a sample size of 42 respondents. This study used the Mann Withney test and the Wilcoxon test. From the results of research that has been carried out, it was found that drinking warm water therapy was effective on airway clearance (p=0.027) and cough therapy was effective on ineffective airway clearance (p=0.003). Based on the results of the study, it was shown that cough therapy was more effective in clearing the airway than drinking warm water therapy. It is suggested that this research can be used as a reference to develop knowledge regarding the handling of clearing the airway using the therapy of drinking warm water and coughing effectively

APPLICATION OF SIMPLE INHALATION THERAPY IN PULMONARY TB PATIENTS TO OVERCOME THE INEFECTIVENESS OF BREATH WAY CLEANING

Background: Inadequate airway clearance is one of the nursing issues that arises during the pulmonary tuberculosis disease process. If untreated, ineffective airway clearance can result in hypoxemia, decreased consciousness, and even cell death. Objective: The purpose of this study is to see that simple inhalation therapy can help pulmonary tuberculosis patients at the Banyu Urip Community Health Center to overcome ineffective airway clearance. Methods: The research methodology combines a case study approach with a family nursing process approach, with one case as the unit of analysis, Mrs. K, a pulmonary tuberculosis patient who get treatment at the Banyu Urip Community Health Center working area. Data was gathered through interviews, physical examinations, supporting examinations, and a literature review. In the study, 350 ml of hot water steam and 5 drops of eucalyptus oil were applied twice a day for three days, for 10-15 minutes. Result: The research results of simple inhalation therapy proved to have a positive effect on Mrs. K, as evidenced by a reduction in verbal complaints, including ease in driving out secretions, respiratory frequency was within normal limits, and breathing became easier, because the cineol content of eucalyptus oil has mucolytic, bronchodilator, and anti-inflammatory functions. Conclusion: To overcome airway ineffectiveness and improve health status, simple inhalation therapy combined with eucalyptus oil can be used as an alternative. Non-pharmacological techniques that are simple, easy to use but provide numerous benefits in health care facilities, such as simple inhalation therapy, are expected of health care workers.

Penerapan Fisioterapi Dada Efektif Untuk Bersihan Jalan Nafas Pada Anak Usia 6-12 Tahun

Background: The age of children who have infections in the respiratory tract causes excess secret production. With this condition causing the patient to experience shortness of breath, so as not to get to complications, treatment is needed, one of which is removing phlegm by means of chest physiotherapy. Objective: This study was to determine the effect of chest physiotherapy on airway clearance. Methods: This study used 2 child respondents who were conducted from 21-25 August 2023 in Dayu Hamlet RT 02 RW 03 Tawang Village, Weru District, Sukoharjo Regency with each respondent being given an intervention for 5 consecutive days with the type of One Group Pretest Post test design. Results : Statistics obtained respiration rate before chest physiotherapy was carried out with the 1st respondent, namely 38 to 25 and the 2nd respondent, namely 35 to 28, which means that there is an effect of chest physiotherapy on a decrease in respiratory frequency and there is no intercostal retraction in the two respondents, which means there is a difference in the results airway clearance before and after chest physiotherapy. Conclusions : After chest physiotherapy can be useful for removing phlegm in children who are experiencing ineffective airway clearance

Pengembangan Clinical Pathway Stroke Hemoragik Berbasis 3S (SDKI, SLKI, SIKI)

This study aims to develop a clinical pathway for hemorrhagic stroke patients based on the 3S (SDKI, SLKI, SIKI). The method used is Research and Development with stages including literature study, observation evaluation, validity and reliability testing, and Focus Group Discussion (FGD). The research results show that developing a 3S-based hemorrhagic stroke clinical pathway is by clinical practice guidelines and service quality. The results of Pearson's product-moment correlation test are <0.514, and the reliability of the Cronbach alpha test is 0.906. Conclusion: The development of a 3S-based hemorrhagic stroke clinical pathway was prepared with nursing diagnoses, including ineffective airway clearance, decreased intracranial adaptive capacity, acute pain, impaired physical mobility, and risk of fluid imbalance. The development of a 3S-based hemorrhagic stroke clinical pathway is generally in good categories in terms of Functionality, Efficiency, and Usability so that it can be recommended for use by nurses and can improve the quality of hospital services.
 Keywords: Clinical Pathway, SDKI, SIKI, SLKI, Hemorrhagic Stroke