module 10: respiration Flashcards
pulse oximetry
measures SpO2 (peripheral arterial oxyhemoglobin saturation)
this affects accuracy of reading
low hemoglobin; if SpO2 < 80%
ideal oxygen saturation
98-100%
normal oxygen saturation
95-100%
giving O2 in an emergency:
can administer when there is a clear clinical indication and then get order later; up to 2L nasal cannula or venturi mask
start O2 therapy is SpO2 is below
92%
humidified oxygen
used for high-flow O2 rates (>6L/min); uses distilled or sterile water to liquify secretions and hydrate mucous
venturi mask
delivers the most precise concentration of O2
oxygen delivery for very sick patients
non-rebreather and high-flow nasal cannula
nebulizer
disperses fine particles of liquid medication into respiratory tract; delver inhaled medications; continue until all of medication has been aerosolized
metered dose inhalers
deliver a controlled dose of medication with each compression; bronchodilators, mucolytic agents, corticosteroids
dry powder inhalers
small capsule or disk is inserted into dry powder inhaler and made into a powder; flow of med is activated by patient breath (powerful inspiration)
deep breathing
in through nose and out through mouth; used to overcome hyperventilation; exhale longer than inhale
pursed lip breathing
prolong exhalation by creating a smaller opening for air movement; can help feelings of dyspnea or panic
diaphragmatic breathing
breathe in letting abdomen protrude; breathe out through pursed lips while contracting abdomen muscles; reduces RR, increases alveolar ventilation, promotes effective expiration; kids are normally abdomen breathers; singers and sports; can help COPD
incentive spirometry
provides visual reinforcement for deep breathing; promotes optimal gas exchange and secretion expectoration; measures max inhalation in mL; inhale as much as possible, hold for 3 secs, exhale as much as possible
splinting
placing a pillow on abdomen over sutures during deep breathing or productive coughing post surgery
chest physiotherapy (CPT)
mobilizes/loosens secretions to increase mucus clearance; includes percussion, vibration, and postural drainage; not recommended for pneumonia, COPT or post-op
sputum culture
can be suctioned or coughed up
ventilation
moving air in/out of lungs
respiration
gas exchange between atmospheric air and alveoli
normal respiratory system requires:
integrity of airway system, functioning alveolar system, functioning cardiovascular system for perfusion
upper respiratory tract
nasal cavity, pharynx, larynx
lower respiratory tract
trachea, bronchi, lungs
active phase of ventillation
inspiration; requires muscles to bring air into lungs
passive phase of ventillation
expiration
cigarette smoking impacts:
internal cilia of lungs
anteroposterior diameter
diameter from posterior to anterior
older adults have higher risk for pneumonia due to:
less effective airway clearance, hold onto secretions; less gas exchange due to dec. lung elasticity
wheeze caused by
restricted airways; typically on expiration
clear sputum
allergies
green/yellow sputum
infection
bloody sputum
lung cancer
normal anteroposterior to transverse diameter
1:2
barrel chest AP:transverse ratio
1:1, normal in infants
pectus excavatum
congenital indent in chest
pectus carinatum
congenital protruding of chest
cheyne-stokes respirations
alternating periods of deep, rapid breathing followed by periods of apnea; regular right before death
biot’s respirations
varying depth and rate of breathing followed by periods of apnea; irregular
kussmaul’s respirations
hyperventilation caused by ketoacidosis; could be diabetes or for dying pt.
point of maximal impulse (PMI)
location where the cardiac impulse can be best palpated on the chest; often the left 5th intercostal space at the midclavicular line
adventitious
unexpected/abnormal
bronchial breath sound
high pitched; inspiration shorter than expiration; heard over trachea
bronchovesicular breath sound
medium pitch; inspiration same length as expiration; heard over main bronchi
vesicular breath sound
low pitched inspiration longer than expiration; heard over peripheral lung fields
often first respiratory sign of disease
decrease in rate and depth of breathing
vesicular breath sounds become bronchial when:
there is fluid/mucus in areas that normally have vesicular sounds
crackles
high pitched, discontinuous popping sound; fluid in the lungs; usually during inspiration; usually does not clear with coughing; associated w/ pneumonia and congestive HF; can be fine or coarse
fine crackles
brief sounds, like hair rubbing together between fingers
course crackles
louder, moist bubbling sounds
crackle intervention
fluid restriction, diuretics; get extra fluid out of lungs
wheeze
high pitched, continuous on inspiration or expiration, ex is more typical; musical/squeaking; caused by swelling of airway; heard in lower lungs; associated w/ asthma
wheeze cause
air passing through narrow airways constricted by swelling, narrowing, secretions, or tumors
sonorous wheeze
course wheeze that may clear with coughing
wheeze intervention
bronchodilators, hydration, coughing
stridor
high pitched, crowing sound typically on inspiration; associated with upper airway obstruction; associated with croup
rhonchi
low pitched, continuous snoring or rumbling; usually inspiration and expiration; may clear with coughing; caused by secretions in the large bronchial airways
rhonchi interventions
cough and deep breathing, hydration, humidified air, mobilization
