Nursing Assessment: Respiratory System Exam 2 Flashcards
Functions of
Respiratory System
Gas Exchange
What are the parts of the respiratory system?
Upper respiratory tract
Lower respiratory tract
What is included in the upper respiratory tract?
Nose
Mouth
Pharynx
Epiglottis
Larynx
Trachea
What is the signifigance of the Carina and mainstem bronchus?
It is very sensitive. It will initiate an extreme cough when deep sunctioning
What is included in the lower respiratory tract?
Bronchi
Bronchioles
Alveolar ducts
Alveoli
Lung lobes
Parts of the airway conducting and respiratory
Pulmonary Functional Unit
Pulmonary blood supply includes…..
Pulmonary
Bronchial-
Bronchial circulation is where oxygen is givent ot the bronchi and other pulmonary tissue
Whats included in the chest wall?
Ribs
Pleura
Diaphragm
Where does gas exchange occur?
The Alveoli
What is considered “dead space” and why
The trachea and Bronchi because ther is no gas exchange
What is the purpose of an incentive spirometer?
Alveolar cells secrete surfactant when stretched. The purpose of IS is to stretch the aveoli and increase lung capacity decreasing chances of a collasped lung and infection
What are the 3 parts of the physiology of respiration?
Ventilation
Compliance
Diffusion
What occurs in ventilation?
Inspiration
Expiration
What is compliance?
How much your langs can expand
What occurs in diffusion?
CO2 and O2 go back and forth
until equilibrium is achieved
What are ways to check Blood oxygen levels?
Arterial blood gases
Mixed venous blood gases
Oximetry
PaO2 And SpO2 critical levels
What does SpO2 and PaO2 Messure?
SpO2= Tissue perfusion
PaO2= partial pressure of oxygen in the blood
What is included in the objective data in assessment of the upper respiratory tact?
Nose
Mouth and pharynx
Neck
Steps to assess the thorax and lungs
Inspection
Palpation
Percussion
Ausculation
Whats involved in Insepction?
- any evidence of respiratory distress, such as tachypnea or use of accessory muscles.
- the shape and symmetry of the chest. Chest movement should be equal on both sides
- pectus carinatum [a prominent protrusion of the sternum
- pectus excavatum [an indentation of the lower sternum above the xiphoid process]
- respiratory rate, depth, and rhythm.
Whats involved in palpation?
- Palpation-Normal Expansion is 1 inch-2.54 cm-feel for tactile fremitus
- used to determine tracheal position
How should percussion and asculation of the chest be done?
Percussion and auscultation of the chest should be performed in a planned sequence from top to bottom. It is important to compare sounds side to side
How do you percuss the lungs?
tap over lung tissue
How to asculate breath sounds
instruct the patient to breathe slowly and a little deeper than normal through the mouth. Auscultation should proceed from the lung apices to the bases, comparing opposite areas of the chest, unless the patient is in respiratory distress or will tire easily; if so, start at the bases.
What is another word for abnormal breath sounds?
Adventitious Sounds
Examples of Adventitious breath sounds
Fine crackles-Sounds like rubbing your hair together
Coarse crackles-bubbling
Rhonchi-rumbling/snoring sound
Wheezes-high pitch and squeaky
Stridor-obstruction of larynx&trachea-Sounds like a crow
Pleural friction rub-Grating/creaking sound. If you hear it while holding your breath its cardiac*********
What are normal breath sounds?
vesicular
bronchovesicular
bronchial
What is vesicular breath sounds?
sounds that are relatively soft, low-pitched, gentle, rustling sounds. They are heard over all lung areas except the major bronchi. Vesicular sounds have a 3:1 ratio, with inspiration 3 times longer than expiration
What are Bronchovesicular sounds
They have a medium pitch and intensity and are heard anteriorly over the mainstem bronchi on either side of the sternum and posteriorly between the scapulae. Bronchovesicular sounds have a 1:1 ratio, with inspiration equal to expiration
What are Bronchial Sounds?
Bronchial sounds are louder and higher pitched and resemble air blowing through a hollow pipe. Bronchial sounds have a 2:3 ratio with a gap between inspiration and expiration. This reflects the short pause between the respiratory cycles. To hear the likeness of bronchial breath sounds, place the stethoscope alongside the trachea in the neck.
What are some Diagnostic Studies
of Respiratory System?
Sputum Studies:
Spontaneous
Induced Sputum with hypertonic saline solution
Skin Tests
Allergies
TB
Bronchoscopy-
Deeper sunctioning
What is bronchoscopy?
- Bronchoscopy is a procedure in which the bronchi are visualized through a fiberoptic tube.
- Bronchoscopy may be used for diagnostic purposes to obtain biopsy specimens and assess changes resulting from treatment. Small amounts (30 mL) of sterile saline may be injected through the scope and withdrawn and examined for cells, a technique termed bronchoalveolar lavage (BAL).
- Bronchoscopy is also used for treatment. For example, mucous plugs or foreign bodies can be removed. Laser therapy, electrocautery, cryotherapy, and stents may be placed through a bronchoscope to achieve patency of an airway that has been completely or partially obstructed by tumors.
Bronchoscopy can be performed in an outpatient procedure room, in a surgical suite, or at the bedside in the intensive care unit or on a medical-surgical unit, with the patient lying down or seated. After the nasal pharynx and oral pharynx are anesthetized with local anesthetic, the bronchoscope is coated with lidocaine (Xylocaine) and inserted, usually through the nose, and threaded down into the airways.
Bronchoscopy can be done on mechanically ventilated patients through the endotracheal tube
Other Diagnostic Studies
of Respiratory System
Lung Biopsy
Transbronchial
Percutaneous/transthoracic needle aspiration (TTNA)
Video-assisted thoracic surgery (VATS)
Open biopsy
Transbronchial Biopsy
Thoracentesis
What isThoracentesis?
Aspiration of pleural fluid or air from pleural space
Stinging sensation and feeling of pressure
Correct position
Motionless patient
Follow-up assessment for
complications
Hold anticoagulants
