Chapter 10-Assess Breathing Flashcards
A patient’s breathing status is directly related to
The adequacy of the patient’s airway
A patient who is breathing without assistance is said to have:
Spontaneous Breathing
As you assess the patients breathing, what three questions should you ask yourself?
Is the patient breathing?
Is the patient breathing adequately ?
Is the patient hypoxic?
________ ventilations should be performed for patients who are not breathing or whose breathing is too slow or shallow
Positive pressure
The goal for oxygenation for most patients is an oxygen saturation of greater than _____
94%
When respirations exceed ___ breaths/min with signs of distress or fewer than ___ breaths/min, or are too shallow for air exchange, what should you do
28 breaths/min
8 breaths/min
provide positive pressure ventilations and an airway adjunct
Remember number of breaths is not the critical issue, but rather______
Air exchange
Normal breathing is an effortless process that does not affect _____, ______, or ______
Speech, posture, positioning
______ is a good indicator of whether a conscious patient is having difficulty breathing
Speech
A patient who can speak normally without unusual extra pauses is breathing normally
True.
What would speech look like in a person who is having difficulty breathing?
Only one word at a time
Must stop every two to three words to catch a breath
Having significant difficulty breathing
Normal respirations are not ____ or excessively _______
shallow
deep
How are shallow respirations identified?
little movement of the chest wall, reduced tidal volume (amount of air in and out the lungs in one breath), or poor chest excursion
Deep respirations, on the other hand, cause ______
significant rise and fall of the chest wall
During retractions, where do indentations occur?
Above the clavicles
In the spaces between the ribs
Use of ________ muscles during during respirations is a sign of inadequate breathing
accessory
Name the accessory muscles
Neck muscles (sternocleidomastoid)
Chest pectoralis major muscles
Abdominal muscles
In pediatric patients, ________ and ________ indicate inadequate breathing
Nasal flaring
Seasaw breathing
A patient who can only speak two or three words without pausing to take a breath has a condition known as:
two-to-three word dyspnea
What are the two common postures that indicate the patient is trying to increase air flow:
Tripod position
Sniffing position
Describe the tripod position.
The patient is sitting and leaning forward on outstretched arms with head and chest thrust slightly forward
Define sniffing position
This is most commonly seen in children
The patient sits upright with head and chin thrust slightly forward , appearing to be sniffing
When you can see the effort in the breathing, the patients breathing is described as:
labored breathing
Labored breathing is characterized by what 3 categories:
The patient’s position
Concentration on breathing
Increased effort and depth of each breath
As breathing becomes more labored, accessory muscles in the _____ and _____ are used and the patient may make ______ sounds
Neck and Chest
Grunting
In infants _______ and _________ and ________ are associated with labored breathing
nasal flaring
supreclavicular and intercoastal retractions
gasping
In infants and small children, ______ is generally caused by respirator arrest
Cardiac arrest
What is respiratory distress?
When a person has difficulty breathing, therefore the work of breathing is increased.
What is respiratory failure and when does it occur?
Occurs when the blood is inadequately oxygenated or ventilation is inadequate to meet the oxygen demand of the body
What is the result of uncorrected respiratory failure?
Respiratory arrest
Signs of respiratory distress
Agitation, Anxiety, Restlessness
Stridor (high-pitched, whistling sound when air flows through an obstructed airway)
Wheezing
Accessory muscles used, intercostal retractions, neck muscle use (sternomastoid)
Tachypnea
Mild tachycardia
Nasal flaring, seasaw breathing, head bobbing
Signs of respiratory failure
Lethargy, difficult to rouse
Tachypnea with periods of bradypnea or agonal respirations
Inadequate chest rise/poor excursion
inadequate respiratory rate and effort
Bradycardia
diminished muscle tone
Typically a person in respiratory distress has an increase in ________
Respiratory effort and rate
