Lungs Thorax Flashcards
Respiratory system functions
a) Supplies oxygen to the body for energy production.
b) Removes carbon dioxide as waste product of energy reactions.
c) Maintains homeostasis (acid-base balance).
d) Maintains heat exchange.
DC: pregnant women
Enlarging uterus elevates diaphragm
decreased vertical chest diameter, and compensatory increase in the horizontal diameter
Increased estrogen—relaxes the chest cage ligaments.
Increased total chest circumference
Increased tidal volume to meet oxygen demands of fetus (deeper breathing); little change in RR)
Physiologic dyspnea—from increased awareness of need to breathe
DC: Aging Adult
more rigid structure that is harder to inflate.
Costal cartilages become calcified—thorax less mobile
Respiratory muscle strength decreases.
Decreased elastic properties within lungs; lungs have less tendency to collapse and recoil.
Decreased vital capacity (max amount air that client can expel after first filling lungs to the max).
Increased residual volume (amount of air remaining in the lungs after forceful expiration).
decreased number of aveoli; lung bases less ventilated; increased risk for DOE.
Elderly have increased risk for postoperative pulmonary complications because:
Decreased ability to cough
Loss of protective airway reflexes
Increased secretions
What are the two major pulmonary diseases in which there are greater risks for races other than Whites?
Asthma TB
SD: Cough
ask about onset, frequency, duration, productivity, self-care
Timing will indicate what you should be thinking about in terms of causes
SD: SOB
onset, precipitating factors; ask about exposure to pets, pollen, food , exercise
affected by activity or position
Are there any alleviating factors?
SD: SOB associated factors
sweats, wheezing
Orthopena
Difficulty breathing when laying flat
Person has to sleep sitting up to properly breath
Paroxysmal nocturnal dyspnea (PND)?
SOB that occurs at night, can awaken person from sleep with coughing and difficulty breathing
SD: pain with breathing
Ask about coughing, recent respiratory infection, fever, chills
SD: Infants and children
Ask about frequency of URIs, allergies, noisy breathing.
Assess risk for FB aspiration, toxic ingestions. Ask about exposure to secondhand smoke.
SD: Aging adult
Ask about any new SOB or fatigue, reduced activity level, new immobility, weight change, falls, chest pain while breathing.
OD: Inspection
Assess facial expression to determine comfort of breathing.
Assess LOC, color and skin condition, quality of respirations, respiratory rate.
What position has client taken to breathe.
Look for symmetrical chest expansion.
What should be the relationship between the AP diameter and the transverse diameter?
OD: Palpation
for symmetric expansion, tactile fremitus.
Symmetric expansion—unequal with atelectasis, pneumonia, pleural effusion, fractured ribs, pneumothorax
Tactile fremitus—palpable vibration; “ninety-nine” side to side should be symmetrical (if not, investigate further).
Crepitus—palpate to determine if present
OD: Percussion
resonance—low-pitched, clear hollow sound over healthy lung tissue
Check for symmetry
Lower-pitched indicates more air (emphysema, pneumothorax)
Higher-pitched indicates increase in density (pneumonia)
