Care of the Adultwith aBreathing Problem

(General instructions, Pneumonia, Bronchitis, Asthma, COPD)

□General Instructions

  1. If you smoke, stop. Smoking makes you more likely to get lung infections, and makes them last longer when they do occur. Do not let anyone else smoke near you.
  2. You should take any medication as it was prescribed until all of it is gone, even if you are feeling better.
  3. You may take acetaminophen (Tylenol, Tempra) or ibuprofen (Motrin, Advil) for fever or body aches, unless you have been told not to (e.g. if you have stomach ulcers or liver problems, or if you have asthma and these medicines aggravate your symptoms).
  4. acetaminophen ______mg every 4 hours
  5. ibuprofen ______mg every 8 hours
  6. Drink plenty of fluids. This helps to loosen secretions in the throat and lungs and makes them easier to cough out.
  7. Return to the ER immediately (call 911) if:
  8. You develop severe difficulty breathing or severe chest pain
  9. You have difficulty swallowing or experience swelling of the mouth or tongue
  10. You or someone else notices bluish discoloration of your lips or tongue
  11. See your primary care provider or return to the ED if:
  12. Your cough is becoming worse
  13. You develop a new fever, or if you already had one, it is not going away
  14. You are not feeling better after 2-3 days
  15. You are unable to take your medication due to nausea or vomiting

□Pneumonia

  1. Read the instructions above under “General Instructions”.
  2. Some pneumonias are caused by viruses, and some are caused by bacteria. Since we can’t tell these apart by looking at you or the X-ray, most patients will be given an antibiotic.
  3. You should take your antibiotic as it was prescribed until all of it is gone, even if you are feeling better.
  4. Try to avoid the use of cough suppressants (e.g. DM, dextromethorphan). Coughing is your body’s way of clearing the secretions and infection.
  5. Usually you will begin to feel better after 2 to 3 days of antibiotics. If you are an otherwise healthy person, you should feel close to normal after about one week. You should get extra rest until you are feeling better.

□Bronchitis

  1. Read the instructions above under “General Instructions”.
  2. Most cases of bronchitis are caused by viral infection, and so do not respond to antibiotics.
  3. Under certain circumstances, your doctor may prescribe you with an antibiotic. If so, you should take your antibiotic as it was prescribed until all of it is gone, even if you are feeling better.
  4. You may try over-the-counter cough medication, but should be aware of the fact that they do not make your cough go away faster, and can cause drowsiness and other side effects. Make sure you check with the pharmacist if you take any other medicines or have other medical problems (e.g. high blood pressure).

□Asthma

  1. Read the instructions above under “General Instructions”.
  2. Most asthma exacerbations are caused by viral infection or allergies, and so do not respond to antibiotics. You may get antibiotics if your doctor thinks they would be helpful for you.
  3. Your doctor may prescribe a steroid medication (prednisone) to help reduce the inflammation in your lungs. There are many side effects associated with steroid use, but most of them only occur if steroids are taken for a long time. If you develop sudden pain in your hips or legs while on your steroid pills, stop taking them and see your doctor.
  4. You should take your puffers as directed by your doctor, or according to your Asthma Action Plan. In general, there are two kinds of puffers: relievers (e.g. Ventolin, salbutamol, Bricanyl, which are usually blue in colour) and preventers (e.g. QVAR, Flovent, Advair).
  5. If you are short of breath, wheezing, or coughing, you should use the reliever puffer.
  6. The preventer puffers should only be used regularly as prescribed, and not taken extra times if you are not feeling well.
  7. All patients should take their puffers using an Aerochamber or other spacer device. These are not just for kids; they help get more of the puff into your lungs where it can do its job.
  8. You should make an appointment to see your regular doctor to review your overall asthma management plan. If you don’t have a family doctor, any other doctor (e.g. ER or walk-in clinic) can refer you to the Asthma Clinic at RVH.

□Exacerbation of COPD (emphysema, chronic bronchitis)

  1. Read the instructions above under “General Instructions”.
  2. In addition to antibiotics, your doctor may prescribe a steroid medication (prednisone) and some inhaled medications (puffers). These should all be taken as directed until they are all finished, even if you are feeling better.
  3. COPD is caused by permanent damage to your lungs, usually related to smoking. Even though the damage is permanent, if you are still smoking you should stop. This will minimize any future damage and improve your ability to fight lung infections.

These instructions are not intended to be all-inclusive, and may not cover all possibilities. If a new problem develops, or if you have any further concerns or questions please contact your primary care provider, Telehealth Ontario at (866) 797-0000, or return to the ER.

RoyalVictoriaHospital of Barrie, 201 Georgian Drive, Barrie, OntarioL4M 6M2 (705)728-9802

Rev 10/07 P:\My Documents\Discharge instructions\Formatted and Revised\Care of adult with breathing problem.doc