Exam 2; respiratory Flashcards
fxn of upper respiratory tract
warm, filter, humidify inspired air
nose, pharynx, larynx, epiglottis, trachea
fxn of lower respiratory tract
conduction of air, mucocillary clearance, production of pulmonary surfactant
bronchi, bronchioles, alveolar ducts and alveoli
inspiration
the active phase of ventilation
-involves the mvmt of mm and the thorax to bring air into the lungs
expiration
the passive phase of ventilation
-mvmt of air out of the lungs
hypoventilation
occurs when a reduced amount of air enters the alveoli in the lungs, resulting in decreased lvls of oxygen and increased lvls of co2 in the blood
hyperventilation
overbreathing, ventilation exceeds the metabolic demand causing abnormally low levels of co2 in the blood
dyspnea
difficulty breathing, shortness of breath
hypoxia
inadequate amount of oxygen available to the cells in your tissues
hypoxemia
below normal level of oxygen in your blood (arteries)
hypercapnia
greater than normal amounts of co2 in the blood; result of hypoventilation
bronchoconstriction
constriction of the airways in the lungs due to the tightening of surrounding smooth mm, with consequent coughing, wheezing and shortness of breath
bronchodilation
an expansion of the air passages through the bronchi of the lungs.
hemoptysis
coughing up of blood-stained mucus from the bronchi, larynx, trachea, or lungs
atelectasis
collapsed alveoli
assessment of respiratory system subjective data
past health history-respiratory, allergies or other body systems
-meds
-surgery or other systems
-smoking
-avtivity tolerance
-sleep issues
-work or hobbies (dust, asbestos)
assessment of respiratory system (objective data)
normal breath sounds
vesicular- low-pitched soft sound during expiration heard over most of the lungs
bronchial- high pitched and longer; heard over the trachea
bronchovesicular- med pitch and sound during expiration, heard over the upper anterior chest and intercostal area
abnormal/adventitious breath sounds
crackles: intermittent sounds occurs when air moves through the airways that contain fluid– fine, med or course
wheezes: continuous sounds heard on expiration and sometimes on inspiration as air passes through airways constricted by swelling, secretions or tumors
respiratory system (objective data)
pulse oximetry= 94-99%
Radiology—no metal; check pregnancy
Chest x-ray—most common
Computed tomography (CT)
Nursing: check allergy to contrast/iodine; renal function; encourage hydration before and after; feel warm and flushed with injection
Magnetic resonance imaging (MRI)
Nursing: screen for/remove all metal; check implantable devices; address claustrophobia (sedation)
Ventilation-perfusion (V/Q) scan
Pulmonary angiogram
Nursing: contrast media precautions, pressure dressing to injection site; monitor distal circulation
Positron emission tomography (PET)
Nursing: NPO prior; monitor glucose levels; encourage fluids
sputum studies
expectoration, suctioning or bronchoscopy for sample
skin tests-intradermal injection
-allergies, TB
pulmonary fxn test
-measures lung volumes and airflow
-spirometer and computer calculate values
respiratory fxn INFANT
normal: lungs are transformed from fluid-filled structures to air-filled organs
small chest, short airways and aspiration is a potential problem
rapid respiratory rate and respiratory activity is abnormal
crackles heard at the end of deep respiration are normal
abnormal respiratory in INFANTS
apnea of prematurly
respiratory distress syndrome
patent ductus arteriosus
respiratory fxn TODDLER
abnormal respiratory
upper respiratory infections
-nasopharyngitis
-pharyngitis
-tonsilitis
-airways obstruction
-asthma
-chocking episodes
-accidental suffocation
-accidental aspiration
-accidental poisoning
respiratory fxn CHILD
some subcutaneous fat on the chest wall
-eustachian tubes, bronchi, and bronchioles are elongated and less angular
-the average number of routine colds and infections decrease until children enter daycare/ school
-good hygiene and tissue etiquette are encouraged
respiratory fxxn child and adolescents
-exposure to second hand smoke
-smoking at an early age
using dangerous inhalants
respiratory fxn older adult
kyphosis
-barrel chest
-increased risk for disease
-reduced immune system
upper respiratory disorders symptoms
-cough
-nasal discharge
-conjuctivites
-layngitis
-low grade temp
-rhinitis
-sore throat
-watery eyes
upper respiratory infection management
increase fluid intake
-frequent rest periods
-cough expectorants:guaifenesin
-cough suppressants:dextromethorphan
allergic rhinitis
inflammation of nasal mucosa
cause:seasonal (pollen) or environmental allergen
sneezing, watery itchy eyes and nose, congestion, decreased smell, thin nasal drainage
episodic-sporadic exposure
intermittent-less than 4days/week
persistant-greater than 4 days/week
acute viral rhinopharyngitis
common cold
transmission:airborne droplets that transmit the virus
beings with burning sensation @ the back of the nose followed by nasal stuffiness, rhinorrhea and sneezing
chills, low grad fever & headache are symptoms
watery & profuse nasal discharge
acute viral Rhinopharyngitis
symptom relief: rest, fluids, proper diet, decongestants
vitamin C, zinc report worsening symptoms
influenza
highly contagious; increased morbidity and mortality
peak season- December- February
influenza A—most common & virulent
mutated viruses– no immunity
pandemics=world wide spread
epidemic=localized outbreaks
transmitted by infected droplets
@risk population= children under 2, adults over 65, ppl living in institutional settings, ppl with chronic diseases, pregnant women, immunocompromised, healthcare personnel
influenza
abrupt onset about 7 days: chills, fever, myalgia, headache, cough, sore throat, fatigue
can cause: pneumonia, ear/sinus infection
viral cultures & rapid influenza diagnosis tests (RIDTs) can test for influenza
influenza management
flu shot, takes 2 weeks for antibody production
advocate vax for those 6 months and older
flu treatment must be started within 48 hr of initial flu symptoms
acute pharyngitis
inflammation of pharyngeal wall; tonsils, palate & uvula
viral, bacterial (strep-throat), fungal (candidiasis)
sore throat, red, swollen pharynx, absent cough, neck, head and mm pain, white patches, rash may be present
rapid antigen test/ throat culture (diagnosis)
acute pharyngitis
oral penicillin- response within 24 hr. take full course of antibiotics to avoid adverse affects
candida; antifungal- swig and swallow
Implementation: warm salt water gargle, avoid irritating foods (carbonated drinks, lonzenges, humidifier, soft food diet, drink warm liquids
nursing diagnosis for pt with upper respiratory disorders
risk for aspiration- inability to coordinate breathing, coughing or swallowing
difficulty swallowing or discomfort// sore throat
-fatigue// increased energy requirements and metabolic demands
-insomnia// difficulty breathing, positioning required for effective breathing
ineffective airway clearance
–increased production of sputum
–stridor, wet respiration, audible wheezing
–inability to cough
sputum abnormalities:
–quantity
–consistency
–color
–odor
coughing
–absent
–ineffective
hemoptysis (coughing up blood)
–fatigue
–altered lvl of consciousness
–pain
ineffective airway clearance outcome identication
demonstrate effective coughing and clear breath sounds
maintain patent airways at all times
explain methods useful to enhance secretion removal
ineffective airway clearance implementation
-help the client take deep breaths and perform controlled coughing to expectorate secretions
–encourage fluid intake to thin secretions
–administer meds as ordered
– teach the client the importance of taking antibiotics as prescribed
– teach the client the important of not smoking
defining characterisitics
hypoventilation
hyperventilation
dyspnea
irregular patterns
RELATED FACTORS
hypoventilation
immobility
pain
meds
mm or nerve dysfunction
loss of fxn’l lung tissue
restriction of expansion
inability to deep breathe in position
fatigue
hyperventilation
acidosis
dyspnea
