Assessment of Respiration Flashcards
To understand why and how assessment of respiration is taken
What is the function of the respiratory system?
To supple the body’s tissues with sufficient oxygen for effective metabolism, whilst removing carbon dioxide
What two components is respiration divided into?
External and Internal
What is external respiration?
The drawing of air into the lungs
What is internal respiration?
The process whereby gases in the lungs are exchanged with those in the blood and tissues
How can the external respiration be assessed?
by recording the respiration rate, the depth and pattern of breathing and how much effort the patient makes to breathe
What are signs of laboured breathing?
If the patient is finding it has to talk because of laboured breathing or they are using the accessory muscles in their neck to breathe as these assist with deep breathing and shoudn’t normally be used while a person is at rest
What can you consider when assessing internal respiration?
Factors such as skin pallor or cyanosis
What is cyanosis?
This refers to a bluish-purple colour of the skin which is mostly seen where the skin is thin so the lips, mouth, earlobes and fingernails. This could be caused by problems with the lungs or heart.
What can a pulse oximeter be used for?
To assess the oxygen saturation of heamoglobin delivered to the tissues.
What is the recommended target oxygen saturation when an acutely ill patient is admitted to hospital?
95-98 per cent
What is the recommended target oxygen saturation for a patient at risk of hypercapnic respiratory failure?
88-92 per cent
What is hypercapnic respiratory failure?
defined as an increase in arterial carbon dioxide (CO2) (PaCO)> 45 mmHg with a pH < 7.35 due to respiratory pump failure and/or increased CO2 production.
What is the respiratory rate for a newborn?
30-50 breaths per minute
What is the respiratory rate for a 2-12 year old?
20-30 breaths per minute
What is the respiratory rate for a teenager?
12-20 breaths per minute
What is the respiratory rate for an adult?
12-20 breaths per minute
What can finger clubbing be a sign of?
long term cardiac or respiratory disease.
What can a sweet/fruity odour of breath indicate?
Ketoacidosis in diabetic patients
What can a faecal odour of breath indicate?
Intestinal obstruction
What is a barrel chest associated with?
chronic respiratory conditions such as emphysema and it also occurs in some populations who live at altitudes above 15,000 feet
How should a patient normally be breathing when at rest?
Quiet and effortlessly
What are signs of respiratory effort?
- use of accessory muscles
- pursed lips
- nasal flaring
- coughing, wheezing, stridor and stertor
What is stridor?
A high pitched wheezing sound caused by distrupted airflow in the laynx or lower in the bronchial tree.
What can stridor be indicative of?
serious airway obstruction from conditions such as epiglottitis, a foreign body or tumor in the airway.
What is stertor?
A noisy inspiration the resembles snoring which occurs in deep sleep or a coma
What may cause stertor?
accumulation of tracheal secretions or an obstruction of the larynx or upper airway
What is apnoea?
When breathing stops all together
What is Bradypnoea?
Breathing that is slow, regular respiration less than 12 breaths/minute.
What conditions are associated with Bradypnoea?
Alcohol consumption, over-sedated, metabolic and central nervous system disorders (and some healthy individuals in a state of deep relaxation)
What is Tachypneoa?
Rapid, regular respiration over 2- breaths/minute
What conditions are associated with Tachypneoa?
Pneumonia, respiratory insufficiency, lesions in respiratory centre in brain, fever, panic attack (and following exercise and exertion)
What is prolonged expiration?
Expiration that is longer than inspiration in normal breathing but may be further prolonged in certain conditions
What is a condition associated with prolonged expiration?
Chronic obstructive pulmonary disease
What is Cheyne Stokes breathing pattern?
starts with slow, shallow breaths, gradually becomes rapid and deep, then slowly subsides to produce preiods of apnoea lasting between 12 and 2- seconds. A cycle may last 45 seconds to 3 minutes.
What conditions are associated with Cheyne Stokes respiration?
Raised intracranial pressure, cerebral anoxia, drug overdose, meningitis, congestive heart failure, renal failure, terminal stages of disease
What is dyspnoea?
difficult, laboured and uncomfortable breathing
What conditions are associated with Dyspnoea?
Pleurisy, pulmonary embolism, pneumothorax, tumour pericarditis, angina and general sever chest pain of any cause
What is Orthopnoea?
Dyspnoea is experienced in the recumbent position (lying flat)
What conditions are associated with Orthopneoa?
Occurs in a number of caridac and respiratory conditions
What are the steps involved in a respiration assessment?
- Prep patient
- Take their respiratory rate
- General respiratory observations
- Patients breath as a sign of health problems
- Inspection of the chest
- Signs of respiratory effort
- PPE
- Assess coughing
- Effectiveness of cough
- observation of sputum
- obtaining a sputum sample
- Disposal and hygiene
- Reporting and recording observations
What should normal sputum look like?
It should have a thin and watery consistency.
What does frothy sputum indicate?
This can sometimes be pink in coloud and indicates pulmonary oedema
What does mucopurulent sputum indicate (yellowy discolouration)?
This discolouration may be caused by pneumonia or bronchiectasis
What does black contamination sputum indicate?
The patient may have suffered smoke inhilation
What does Mucoid Sputum (white or opalescent) indicate?
This is often seen in asthma or chronic bronchitis but it does not mean that infection is present
What does haemoptysis sputum (blood in the sputum) indicate?
Rusty coloured sputum may indicate bacterial pneumonia, other causes include trauma, pulmonary embolus and carcinoma
What does purulent sputum (thick and viscous) indicate?
This may present in a range of colours from yellow, dark green or brown to redcurrent jelly. A green colour could generally indicate a chest infection.
