Professional Documents
Culture Documents
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1. p
1. Residual volume
2. Functional residual volume
3. Total lung capacity
è
-amount of air that can still be expired
by forceful expiration after the end of
a normal tidal expiration
[
-volume of air still remaining in the
lungs after the most forceful
expiration
aulmonary "Capacities:"
-equals TV + IRV
-amount of air that a person can breathe
beginning at the normal expiratory level &
distending his lungs to maximum amount
º
-equals ERV + RV
-about amount of air remaining in the lungs
at the end of normal expiration
FACT RS AFFECTI
RESaIRAT RY FUCTI S
AE
-Infants have more rapid respiratory rate.
They have primary respiratory activity that
is abdominal
-Changes of aging affect the breathing
pattern. These include loss of elasticity,
decreased reflex/cilia action, fragile
mucous membrane, osteoporosis,
decreased immune system and gastro-
gastro-
esophageal reflux.
EVIR ET
- Altitude, heat, cold, air pollution affect
oxygenation
LIFESTYLE
- ahysical exercise increases the rate
and depth of respiration
-Sedentary lifestyle will cause
decreased alveolar expansion
-Smokers are prone to develop C a
EALT STATUS
-ealthy persons have intact
respiratory functions
- iseases of the lungs affect
oxygenation.
-aeople with chronic illnesses often
have muscle wasting and poor
muscle tone.
E ICATI S
-Sedatives, ypnotics, tranquilizers,
barbiturates and narcotics greatly
depress respiratory drive.
STRESS
-ahysiologic and asychological
responses to stress can affect
respiration.
-yperventilation, lightheadedness,
numbness and tingling sensation may
result.
aREACY
-Fetus and amniotic sac grow large
enough to displace the diaphragm
upward.
-The mother¶s respiratory rate
becomes faster and the breath
becomes shallower.
-µLightening¶ improves client¶s
breathing
ormal Breathing pattern
12-20 respiratory rate
12-
Active inspiration with contraction of
diaphragm
aassive expiration with relaxation of
diaphragm
Steady rhythm and regular rate and size
I:E ratio is 1:2 (inspiration is half that of
expiration)
EVIATI S FR TE
RAL RESaIRAT RY
FUCTI
Ya IA
-A condition of insufficient oxygen in
the lungs and the body.
-Signs of ypoxia may be the
following: Tachycardia, Tachypnea,
yspnea, Restlessness, Light-
Light-
headedness, Flaring of nostrils,
Intercostal retractions, changes in
sensorium and Cyanosis.
Ya VETILATI
-Inadequate alveolar ventilation, which
can lead to hypoxia.
-When C 2 accumulates in the blood,
there is YaERCARBIA.
CYA SIS
-Bluish discoloration of the skin, nail
beds and mucus membrane due to
reduced hemoglobin-
hemoglobin-oxygen
saturation.
-There must be about
of unoxygenated blood per 100 ml for
this to manifest externally.
ALTERE BREATI aATTERS
-Breathing patterns refer to the rate,
volume, rhythm and relative ease or
effort of respiration.
-Altered breathing can be related to
rate, rhythm and position
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ALTERE BREATI aATTERS: RYT
BREATI- eep and rapid
KUSSAUL¶S BREATI-
respiration seen in metabolic acidosis( )
CEYE-
CEYE-ST KES Respiration
Respiration-- arked rhythmic
waxing and waning of respiration from very deep
to very shallow breathing and temporary apnea.
Usually seen in cases of CF, increased ICa and
drug overdose.
respiration- Shallow breaths interrupted by
BI T¶S respiration-
apnea, seen in patients with CS disorders.
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iagnoses
aromoting xygenation
aositioning the client to allow for
maximum chest expansion
Encouraging or providing frequent
changes in position-
position- usually Q2
Encouraging ambulation
iving pain medications ^ deep
breathing and coughing
eep breathing and coughing exercises
These measures allow for the removal
of secretions from the airway.
Breathing exercises are frequently
indicated for the clients with
restricted chest expansion such as
C a and post-
post-thoracic surgical
patients.
ydration
This maintains the moisture of the
respiratory mucous membrane.
Increased fluid intake as tolerated
ilk should be avoided as it increases
the viscosity of secretions.
Use of humidifiers
Use of nebulizers or aerosol therapy
aositioning and Ambulation
Ambulation and the ability to change
position frequently are two natural
means for keeping the lungs open
and clear of secretions.
ovements help shift respiratory
secretions in the airway.
ucus tends to pool in the lungs of
people who cannot move around.
aursed-lip breathing
aursed-
This is a special measure to be used
along with deep breathing.
aatients with C a should be taught
this technique to aid in the release of
trapped air from the obstructed
airways.
arevents AIR-
AIR- TRAaaI
Respiratory medications
Bronchodilators, anti-
anti-inflammatory
drugs, expectorants, mucolytics and
cough suppressants may be used to
treat respiratory problems
Chest ahysiotherapy
These are EaE ET nursing actions
performed with a physician¶s order.
Chest physiotherapy is based on the fact
that mucus can be knocked or shaken form
the walls of the airways and helped to drain
from the lungs.
The usual SEQUECE is as follows
follows--
a SITI I, aercussion, Vibration, and
removal of secretions by SUCTI I or
Coughing followed lastly by oral hygiene
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Use of Artificial Airways
These artificial airways are inserted to
maintain patent air passages for
clients whose airway have become or
may become obstructed.
These are devices that provide a more
direct route to the lungs than the
natural airway
Suctioning
This is a mechanical aspiration of the
airways involving the use of a
catheter inserted through the nose,
mouth or tracheal tube
The catheter is attached to a portable
or wall unit SUCTI machine.
Secretions are drawn up by a vacuum.
Care of patients with chest tubes and
drainage systems
Assists in emergency interventions
like removal of airway obstruction (by
eimlich maneuver), and initiating
CaR
Evaluation
yspnea
-Breathing difficulty
-Associated with many conditions
conditions--
CF, , BS, uscular dystrophy,
obstruction, etc«
eneral nursing interventions:
1. Fowler¶s position to promote
maximum lung expansion and
promote comfort. An alternative
position is the RT aEIC position
2. 2 (1
(1--3 lpm) usually via nasal
cannula
3. arovide comfort
Cough and sputum production
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Brain injury, sedatives, metabolic
disorders
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ystrophy, S disorders, peripheral
nerve disorders disrupt the impulse
transmission from the nerve to the
diaphragm abnormal ventilation
ysfunction of the Lung aarenchyma
aleural effusion, hemothorax,
pneumothorax, obstruction interfere
ventilation
ASSESSET FI IS
yspnea
Cyanosis
Altered respiration
Altered mentation
Tachycardia
Cardiac arrhythmias
Respiratory arrest
IA STIC FI IS
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E ICAL TREATET
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Antibiotics
Steroids
Bronchodilators
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1. aintain patent airway
2. Administer 2 to maintain aa02 at
more than 50 mmg
3. Suction airways as required
4. onitor serum electrolyte levels
5. Administer care of patient on
mechanical ventilation
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Extrinsic
Intrinsic
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( results in
histamine release, which produces
a. of mucous membranes
b. ÷
of the smooth muscle of bronchi
and bronchioles
c. Accumulation of tenacious
Assessment findings: history
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Respiratory distress
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Emphysema
isequilibrium between
ELASTASE & ATIELASTASE (alpha-
(alpha-1-antitrypsin)
1. Rest-
Rest- p
eneral Classification
Transudative effusion: accumulation of
protein--poor, cell-
protein cell-poor fluid ( cancers )
Exudative effusion: accumulation of
protein rich fluid ( infections )
Assessment findings
1. yspnea, dullness over affected
area upon percussion, absent or
decreased breath sounds over
affected area, pleural pain, dry cough,
pleural friction rub
2. aallor, fatigue, fever, and night
sweats (with empyema)
iagnostic tests
a. Chest x-
x-ray positive
b. aleural biopsy may reveal
bronchogenic carcinoma
c. Thoracentesis
CLIICAL Correlation:
ydrothorax--
ydrothorax Serous fluid in the
pleural cavity
emothorax-- Blood in the cavity
emothorax
___________
___________-- aus in the cavity
___________
___________-- Lymph in the cavity
ydrothorax--
ydrothorax Serous fluid in the
pleural cavity
emothorax-- Blood in the cavity
emothorax
ayothorax-- aus in the cavity
ayothorax
Chylothorax
Chylothorax-- Lymph in the cavity
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aredisposing factors
Cigarette smoking
Asbestosis
Ca
Smoke from burnt wood
Types
Squamous cell Ca-
Ca- with good
prognosis
Adenocarcinoma
Adenocarcinoma-- with good
prognosis
at cell Ca-
Ca- with good prognosis
Undifferentiated Ca-
Ca- with poor
prognosis
ursing Interventions
aatent airway
2 / Aerosol therapy
eep breathing exercises
Relief of pain
arotection from infection
Adequate nutrition
Chest tube management
Surgery
aneumonectomy=Removal of a lung
(either left or right)
Lobectomy=Removal of a lobe.
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