MECHANICS OF RESPIRATION AND O2 THERAPY Flashcards
MECHANICS OF RESPIRATION
*TAKES PLACE AS A RESULT OF PRESSURE GRADIENTS BETWEEN:
A. ALVEOLI
B. INTRAPLEURAL
C. ATMOSPHERIC AIR
*INTRA-PULMONARY PLEURAL PRESSURE IS GREATER THAT ATMOSPHERIC AIR
*CHANGES IN CHEST CAVITY SIZE AND PRESSURE ALLOWS FOR INSPIRATION AND EXPIRATION
*INSPIRATION IS ACTIVE
*EXPIRATION IS PASSIVE 1:2 RATIO
INSPIRATION
- DIAPHRAGM CONTRACTS(SMALLER), FLATTENS
- THORACIC CAGE EXPANDS
- CHEST VOLUME INCREASES (AIR COMES INTO CHEST)
- INTRAPULMONARY PRESSURE DECREASES (ALLOWS MORE AIR TO COME IN)
- AIR MOVES INTO THE LUNGS AS AIRWAY PRESSURE DECREASES
EXPIRATION
- INSPIRATORY MUSCLES RELAX
- DIAPHRAGM RISES, RIBS DESCEND
- LUNGS RECOIL
- INTRAPULMONARY PRESSURE INCREASES (PUSHES AIR OUT) AIR FLOWS OUT OF LUNGS
FACTORFFECTING RESPIRATIONS
- RATE AND DEPTH CONTROLLED BY CNS (BRAIN STEM; MEDULLA)
- LUNG COMPLIANCE
- LUNG ELASTICITY/ RECOIL
- ALVEOLAR SURFACTANT
- CHEMORECEPTORS RESPOND TO CHANGE IN O2 & CO2
- TUMORS CAN AFFECT RESPIRATIONS
CHEYNE-STOKES
- PERIODS OF HYPERVENTILATION AND THEN PERIODS OF APNEA
* PRECLUDE TO RESPIRATORY DISTRESS
SIGNS AND SYMPTOMS OF RESPIRATORY DISORDERS
- DYSPNEA (SOB)
- TACHYPNEA (INCREASE RESPIRATORY RATE
- INCREASE IN SPUTUM PRODUCTION (COUGH)
- HEMOPTYSIS (BLOOD STREAKED SPUTUM
- WHEEZING/STRIDOR/HYPOXIA
- CHEST PAIN
- CLUBBING
WHEEZE
- AIRWAYS GETTING TIGHTER (ASTHMA)
* MUSICAL SOUND
STRIDOR
- UPPER AIRWAY
- CROWING SOUND
- INFLAMMATION, EDEMA (SWOLLEN AIRWAY)
ASSESSMENT OF RESPIRATORY STATUS
*HEALTH ASSESSMENT INTERVIEW
*PHYSICAL EXAM THORAX & LUNGS
INSPECTION
PALPATION
PERCUSSION
AUSCULTATION (PRIORITY IN NCP)
INTERVENTIONS TO IMPROVE RESPIRATION
- POSITIONING/POSTURE
- ENVIRONMENTAL CONTROL (SMOKING)
- DECREASE IN ACTIVITY/REST/ANXIETY
- HYDRATION - VERY IMPORTANT
- INFECTION PREVENTION
- NUTRITION
- O2/VENTILATION
OXYGEN THERAPY PURPOSE
*TO PREVENT HYPOXIA AND PROVIDE TISSUE OXYGENATION
PATIENT O2 NEED ASSESSMENT
- ABG LOWER O2 SATURATION
- VS/LUNG SOUNDS
- MEDICAL HISTORY
- EKG CHANGES
- RESTLESSNESS/CONFUSTION
TYPES OF OXYGEN DELIVERY SYSTEMS
- O2 DELIVERED VIA LITERS & %
- N/C: NASAL CANALA: LEAST OCCLUSIVE-USE WATER SOLUABLE GEL FOR DRYNESS
- O2 MASK
- VENTURI MASK (MOST PRECISE AMT)
- PARTIAL REBREATHER MASK BAG MUST BE INFLATED)
- VENTILATORS
- NURSES ARE RESPONSIBLE-NEEDS TO BE ORDERED BY DR.-CHECK LEVEL OF BALL AND IF TUBING IS CONNECTED IF PT. HAS PROBLEM BREATHING
- NURSE ALWAYS HAS TO CHECK MODE
LOW FLOW O2
- GIVEN OF COP PTS BECAUSE OF CO2 RETENTION
- IN PTS. W/COPD THEIR BREATHING MECHANISM IS A LOW LEVEL O2
- CO2 IS STIMULANT FOR BREATHING
- LOW LEVEL O2 IS BREATHING STIMULANT FOR COPD PATIENTS BECAUSE OF CO2 RETENTION
INTERVENTIONS FOR PATIENTS ON O2
- MAINTAIN PATENT AIRWAY
- RESPIRATORY SYSTEM ASSESSMENT
- O2 DELIVERY SYSTEM ASSESSMENT
- O2 HUMIDIFICATION
- MOUTH/NOSE CARE
- PSYCHOSOCIAL SUPPORT
- PATIENT/FAMILY EDUCATION
CHEST PHYSIOTHERAPY AND INTERVENTIONS
*VIBRATION/CLAPPING SUCTIONING
*POSTURAL DRAINAGE
*AEROSOL NEBULIZER & IPPB
*INCENTIVE SPIROMETER
*BREATHING EXERCISES
DIAPHRAGMATIC
PURSE LIP:EXPIR WHISTLE COPD PTS.
EXERCISE CONDITIONING
FLUTTER VALVE DEVICE (UPPER AIRWAY
INFECTION
DIAGNOSTIC PROCEDURES TESTS FOR FUNCTION
- ABG (HOW PATIENT IS VENTILATING) PH, O2, CO2 & BICARB (DETERMINES MODE FOR O2 ADMINISTRATION
- PULMONARY FUNCTION TEST (PFT) LUNG VOLUME, AIR FLOW
- V/Q SCAN: PE
- D-DIMER TEST: PE
TEST TO EVALUATE ANATOMY
*CHEST RADIOGRAPHY ( XRAY)
*COMPUTED TOMOGRAPHY (CAT SCAN)
*BRONCHOSCOPY
*MAGNETIC RESONANCE IMAGING (MRI)
PULMONARY ANGIOGRAM (DYE INJECTION)
PULMONARY SPECIMEN COLLECTION
- THORACENTESIS
- BIOPSY
- SPUTUM COLLECTION: 3 TIMES
- NOSE AND THROAD CULTURES
BROCHOSCOPY
- INVASIVE
- SIGNED CONSENT
- FLEXIBLE SCOPE TO BRONCHI
- ANESTHETIZE THROAT
- TAKE BIOPSY
- VISUALIZATION PURPOSES
THORACENTHESIS
- SYMPTOM: PLEURAL INFUSION
- SIGNED CONSENT
- AREA LOCALIZED
- RELIEVES PAIN
- USED DIAGNOSTICALLY
- COLLAPSED LUNG CAN HAPPEN (PNEUMOTHORAX)
POLYCYTHEMIA
- EXCESS # OF RBC
- BECOME THICK AND GLUEY (BLOOD CLOTS)
- LONG STANDING CHRONIC HYPOXIA MIGHT DEVELOP THIS
