NAME 

           : Bamey Ganado

SEMESTER   : 2nd SEMESTER,2023
COURSE        : HUMAN BIOLOGY BL133
 

Respiratory Monitoring in Medical-Surgical Nursing

I. Introduction

Respiratory monitoring is an important component of medical-surgical nursing care since the

respiratory system is responsible for the body's adequate oxygenation and carbon dioxide
removal. To properly evaluate and manage respiratory status in their patients, nurses must be
aware with respiratory monitoring methods and therapies. The goal of this lecture is to provide
an overview of respiratory monitoring in medical-surgical nursing, such as the anatomy and
physiology of the respiratory system, respiratory status assessment, monitoring techniques,
interventions to improve breathing ability, complications and nursing interventions, and future
directions in respiratory monitoring. Students will have a greater grasp of the relevance of
breathing monitoring in medicine-surgical nursing, as well as the tools and methods required for
good respiratory care, by the conclusion of this presentation.

II. Anatomy and Physiology of the Respiratory System

The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi, bronchioles,
alveoli, and lungs. Its main functions are to deliver oxygen to the body and remove carbon
dioxide. 

Air enters the respiratory system through the nose, where it is filtered, warmed, and moistened
before passing through the pharynx and larynx. The trachea, or windpipe, is a tube lined with
cilia and mucus that leads to the bronchi, which divide into smaller bronchioles. The bronchioles
terminate in the alveoli, which are small sacs surrounded by capillaries where gas exchange
occurs.

The mechanics of respiration involve two processes: inspiration and expiration. Inspiration is the
process of air flowing into the lungs, while expiration is the process of air flowing out of the
lungs. The diaphragm and intercostal muscles play a crucial role in the mechanics of respiration,
as they contract during inspiration and relax during expiration. 

Understanding the physiology and anatomy of the respiratory system is critical for nurses to
evaluate and monitor respiratory status in their patients and detect possible concerns.

III. Assessment of Respiratory Status

Assessment of respiratory status involves a thorough patient history, physical examination, and
diagnostic tests. 
NAME            : Bamey Ganado
SEMESTER   : 2nd SEMESTER,2023
COURSE        : HUMAN BIOLOGY BL133
 

A. Patient history: 
The nurse should obtain a detailed patient history to identify any risk factors for respiratory
problems, such as smoking, occupational exposure to respiratory irritants, or a history of lung
disease. The nurse should also ask about the patient's current respiratory symptoms, such as
cough, dyspnea, or chest pain.

B. Physical examination:
The nurse should conduct a comprehensive physical examination, paying close attention to the
patient's respiratory rate, rhythm, depth, and effort. The nurse should also assess for the presence
of abnormal breath sounds, such as wheezes, crackles, or stridor, and inspect for any signs of
respiratory distress, such as nasal flaring, use of accessory muscles, or cyanosis.

C. Diagnostic tests:
Diagnostic tests may include pulse oximetry, arterial blood gases, chest x-ray, or pulmonary
function tests. Pulse oximetry measures the patient's oxygen saturation level, while arterial blood
gases assess the patient's acid-base balance and oxygenation status. Chest x-ray and pulmonary
function tests can provide more detailed information about the patient's respiratory function and
anatomy.

Overall, a comprehensive assessment of respiratory status is essential for nurses to identify any
potential issues and develop an appropriate plan of care.

IV. Monitoring Respiratory Function

Monitoring respiratory function involves using various techniques and tools to assess the
patient's breathing and oxygenation status. The following are some common respiratory
monitoring techniques:

A. Vital signs:
The nurse should monitor the patient's respiratory rate, heart rate, blood pressure, and
temperature to assess respiratory function and identify any signs of respiratory distress.

B. Oxygen saturation:
Pulse oximetry is a noninvasive method of measuring the patient's oxygen saturation level. The
nurse should monitor the patient's oxygen saturation continuously and adjust oxygen therapy as
needed to maintain optimal levels.

C. End-tidal CO2 monitoring:

End-tidal CO2 monitoring measures the amount of carbon dioxide the patient exhales. It is useful
NAME            : Bamey Ganado
SEMESTER   : 2nd SEMESTER,2023
COURSE        : HUMAN BIOLOGY BL133
 

in assessing the patient's ventilation status and detecting any potential issues, such as
hypoventilation.

D. Peak expiratory flow rate:

Peak expiratory flow rate is a measure of the patient's ability to exhale forcefully. It is commonly
used in patients with asthma or other respiratory conditions to monitor lung function.

E. Arterial blood gases:

Arterial blood gases provide a more detailed assessment of the patient's acid-base balance and
oxygenation status. They are commonly used in patients with severe respiratory distress or those
on mechanical ventilation.

Overall, monitoring respiratory function is essential for nurses to detect any changes in
respiratory status and intervene appropriately to prevent respiratory failure or other
complications.

V. Interventions to Improve Respiratory Function

Nurses play a critical role in implementing interventions to improve respiratory function in their
patients. The following are some common interventions used in medical-surgical nursing:

A. Oxygen therapy:
Oxygen therapy is used to improve oxygenation in patients with respiratory distress. The nurse
should monitor the patient's oxygen saturation continuously and adjust oxygen therapy as needed
to maintain optimal levels.

B. Bronchodilators:
Bronchodilators, such as albuterol or ipratropium, are commonly used in patients with asthma or
chronic obstructive pulmonary disease (COPD) to improve airflow and reduce respiratory
distress.

C. Chest physiotherapy:
Chest physiotherapy involves using techniques, such as percussion, vibration, and postural
drainage, to loosen mucus and improve airway clearance. It is commonly used in patients with
cystic fibrosis, bronchiectasis, or other conditions that cause excessive mucus production.

D. Incentive spirometry:
Incentive spirometry is a breathing technique that involves inhaling deeply through a device to
improve lung function and prevent atelectasis (collapsed lung tissue). It is commonly used in
postoperative patients or those with conditions that limit their ability to take deep breaths.
NAME            : Bamey Ganado
SEMESTER   : 2nd SEMESTER,2023
COURSE        : HUMAN BIOLOGY BL133
 

E. Mechanical ventilation:
Mechanical ventilation is used in patients with severe respiratory distress or respiratory failure
who are unable to breathe adequately on their own. The nurse should closely monitor the
patient's ventilator settings and assess for any signs of complications, such as ventilator-
associated pneumonia or barotrauma.

Overall, interventions to improve respiratory function are tailored to the patient's specific needs
and should be implemented in a timely and appropriate manner to prevent respiratory failure or
other complications.

VI. Complications and Nursing Interventions

Complications related to respiratory monitoring and interventions can arise in medical-surgical

nursing. Nurses should be aware of potential complications and be prepared to intervene
appropriately. The following are some common complications and nursing interventions:

A. Oxygen toxicity:
High quantities of oxygen may be hazardous to the lungs and other organs, causing alveolar
destruction and other tissue damage. To avoid oxygen poisoning, the nurse should regularly
evaluate the patient's oxygen saturation and change oxygen treatment as required.

B. Hypoventilation:
Hypoventilation occurs when a patient does not breathe deeply or regularly enough to maintain
sufficient oxygenation and carbon dioxide removal. The nurse should evaluate the patient's
breathing rate, rhythm, and exertion and act as needed, such as by giving supplementary oxygen,
enhancing ventilation support, or doing chest physiotherapy.

C. Pneumothorax:
Pneumothorax can occur when air leaks into the pleural space, causing the lung to collapse. The
nurse should assess for signs of pneumothorax, such as sudden chest pain, dyspnea, or
respiratory distress, and intervene appropriately, such as applying oxygen and notifying the
healthcare provider.

D. Ventilator-associated pneumonia:
Ventilator-associated pneumonia can occur when bacteria or other microorganisms invade the
lungs through the ventilator. The nurse should assess for signs of ventilator-associated
pneumonia, such as fever, increased sputum production, or worsening respiratory distress, and
intervene appropriately, such as administering antibiotics or performing chest physiotherapy.
NAME            : Bamey Ganado
SEMESTER   : 2nd SEMESTER,2023
COURSE        : HUMAN BIOLOGY BL133
 

Overall, nurses should be vigilant in monitoring for potential complications related to respiratory
monitoring and interventions and be prepared to intervene appropriately to prevent respiratory
failure or other complications.

VII. Conclusion

In conclusion, respiratory monitoring is a critical aspect of medical-surgical nursing. Nurses

must be knowledgeable in assessing respiratory status, monitoring respiratory function, and
implementing interventions to improve respiratory function. Additionally, nurses must be
vigilant in monitoring for potential complications related to respiratory monitoring and
interventions and be prepared to intervene appropriately. With proper respiratory monitoring and
interventions, nurses can help prevent respiratory failure and other complications, ultimately
improving patient outcomes.