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What are the three parts to “breathing''?
Pulmonary ventilation, inspiration and exhalation
What are the methods of respiratory assessment? What does each one do?
Inspection (watching chest rise+falls)
Palpation (structure damage…like broken ribs)
Percussion (hollow sound on skin… indication of mass) (not often performed)
Auscultation (stethoscope…hearing for abnormal lung sounds)
Why do some patients use their accessory muscle? What is the type of position they are in called?
Is an attempt to get more air. Tripod position
Tripod=Leaning forward with arms braced against their knees, chair, or bed. This gives them leverage so that their rectus abdominis, intercostal, and accessory neck muscles all can aid in expiration. Trying to open airway
What is Incentive Spirometry & Acapella? how many times an hour should our patient be using one?
Incentive spirometry is a device used for encouragement of voluntary deep breathing by providing visual feedback to clients regarding inspiratory volume. Incentive spirometry promotes deep breathing and prevents or treats atelectasis in the postoperative client.
10 times an hour to open airway
What is a negative effect of bed rest?
slows metabolism down
What is internal respiration?
Exchange of gasses between blood and body
What does Pulse Oximetry measure?
measurement of % of RBC that have oxygen
What does bronchial, vesicular, bronco-vesicular, crackles and diminished breathe sounds mean?
Bronchial- higher pitched because its higher in the lungs
Vesicular lung sound= bases… deeper
Broncho-Vesicular- Middle of our lobe
crackles- mean that there is fluid or atelectasis
Diminished breath sounds- inflammation, not as much air getting into the alveoli within each breath. Indicates there is some type of blockage or inflammation (sounds like normal sounds just quiet)
What is barotrauma? Another complication
It is damage to the body tissue caused by a difference in pressure between an air space inside or beside the body and surrounding fluid.
What do we watch for with patients who have nasal canal? Why are they one this? Normal O2 range? What is a complication of nasal canal?
- skin breakdown and nose bleeds
- maintains good oxygen 92%-100%
- ends up with respiratory infection it not properly sterile
What will the lungs try to do?
Take in O2 by altering ventilation rate
What is hypoxemia and hypoxia? What are the signs of them?
Hypoxia- deficiency in the amount of oxygen reaching the tissues. when we obtain ABGs (arterial blood gasses) that tell us how much oxygen is on our red blood cells in a measurement of pressure
Hypoxemia- see with ABC tell us how much oxygen is on how RBC is measurement of pressure
Clubbing= hypoxemia; Cyanosis= hypoxia
What is expiratory wheezing, pleural rub, bronchi, stridor?
Expiratory wheezing- constriction of the airway. When you hear wheezing patients think constricted.
Pleural Rub- Indicates that there's inflammation of lung sac (lung rubbing against pleural space.
Ronchi- Mucus build up in the lungs(junk in the lungs), associated with crackles you'll have a couple different sound
Stidor= upper airway restriction
What is the benefit of mobility and exercise?
Musculoskeletal, cardiovascular, gastrointestinal, nutritional, sleep & rest, metabolic, skin and physical.
Nursing Assessment includes
listening to lung sounds, rhythm, rate, obtaining health history, identifying impacts of patients.
Normal Values oh pH, CO2, HCO3 (bicarbonate), and O2 are?
pH- 7.35-7.45
CO2- 35-45
HCO3- 22-26
O2- 80-100
What is Biot’s? What is Kussmaul? What is a Cheyne Stroke? Why are we breathing like this?
Boots- injury to brain…periods of apnea so it’s building up…fast breathing trying to get rid of CO2)(impacts drive to breath)
Kussmaul- very very high levels of CO2 in our body… buildup of acid in our body)
Cheyne-Stokes- periods of deep breathing that alternate with periods of apnea. cardiac damage…drive to breath is superpress. Inability blood flow to lungs
What is cilia?
Tiny hairlike structures that propel substances along the surface of the tissue. Along the airway that allows filtration (filter) by moving anything bad out of the airway. If we inhale smoke it's going to try and push it out of our airway. Over time the mobility of the cilia is going to slow down.
What hospital acquired a decline?
a patient comes into the hospital with their baseline and now their condition has declined. ← We need to determined what the patient can do when they get admitted so that they don't decline.
What is clubbing? What does cyanosis cause?
Clubbing- they aren't getting profusion so they're going dilate, this vasodilation causes Overtime chronic inflammation.
cyanosis- decrease oxygen flow (prob have purple lips or pale
What is tachypnea and bradypnea? Bonus what is apnea and eupnea?
Tachypnea- Respiration rate greater than 20
Bradypnea? Respiration rate lower breathing rate less than 12
Apnea= no breathing
eupnea= normal breathing
What is dyspnea? What is orthopnea?
dyspnea= difficulty breathing at rest
Orthopnea- difficulty breathing while moving
What is our response to PaO2?
partial pressure of oxygen in arterial blood 80-100 mm/Hg. Response to PaO2- as we age it may influence how our body responds to oxygen we may need a higher level of oxygen. Measured through Arterial Blood Gasses. SP02 measured through pulse oximetry.
What does aerobic mean? What does anaerobic mean?
aerobic- with oxygen
anaerobic- without oxygen
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I don't know what to put here bc I got all the question ummmmmm. Tell me what stridor is again