Oxygenation Needs Flashcards
What factors affect respiratory functiioning?
Level of health
Developmental considerations
Medications
Lifestyle
Environment
Psychological health
People with renal or cardiac disoriders often have compromised respiratory functioning because of…
Fluid overload and impaired tissue perfusion.
What is a myocardial infarction and what does it cause?
Heart attack
A lack of Blood supply to the heart muscle
Physical changes such as scoliosis influence ______ and may cause _____.
Breathing patterns, air trapping.
How does being obese affect respiratory functioning?
Often short of breath during activity leading to less participation in exercise.
Alveoli at the base of the lungs are rarely stimulated to expand fully.
How do opioids affects respirations?
Decreases the rate and depth
What is an important risk factor for chronic COPD?
Cigarette smoking
What is hyperventilation?
Increase in rate and depth of respirations to eliminate carbon dioxide
Hypoventilation can lead to a lowered level of ___
Arterial carbon dioxide.
What 3 components are part of assessing oxygenation?
Physical assessment
Pulse oxymetry
Diagnostic studies
What is the order of the physcial assessment?
Inspection
Ausculation
Palpation
What does an adult’s normal chest look like?
Slightly convex, with no sternal depression
Anteroposterior diameter should be less than the transverse diameter
What does an infant’s normal chest look like?
Chest wall is so thin and has little musculature that the ribs, sternum, and xiphoid process are easily seen
Rounded chest wall in which the anteroposterior diameter equals the transverse diameter
What is the anteroposterior diameter?
The measurement from the front to back of the thorax
What does a child’s normal chest look like?
Subcutaneous fat is deposited on the chest wall, making some landmarks less prominent
What is Kyphosis and what does it contribute to?
Curvature of the spine
The older person’s apearance of leaning forward
What are the 5 complete components of the physical assessment?
Respiratory rate
Breathing pattern
Inspection of the thorazx
Palpation of the thorax
Ausculation of lung sounds
Tachypnea
Rapid respirations
Respirations > 24
Bradypnea
Abnormally slow breathing rate
Respirations < 12
Narcotics can cause this
Apnea
Cessation of breathing
Kussmaul’s breathing
Very deep gasping respirations
Diabetic kato acidosis usually includes this
Dyspnea
Difficulty breathing
Can benefit from receiving oxygen
Orthopnea
Dyspnea occuring when patient is lying down and improves when patient sits up
Cheyne-Stokes respirations
Deep to shallow with periods of apnea
Periods of apnea could be 10-15 secs
What are situations in which Cheyne-Stokes respirations could occur?
Near death
CHF: Congested Heart Failure
Drug overdose
Biot’s respirations
Shallow breaths interrupted by apnea
Hypoventilation
Slow respirations
Respiratory depressions causing accumulation of carbon dioxide
What should a nurse be inspecting on the thorax?
Color: even and consistent with color of patient’s face
Shape: downward equal slope at the rib cage
Breathing patterns: smooth and even
Muscle development: symmetric with the transverse diameter greater than the anteroposterior diameter
What does it mean to have a barrel chest?
The anteroposterior is increased
What is palpation used to detect?
Areas of sensitivity
Chest expansion during respirations
Vibrations
How do you palpate the anterior and posterior thoracic landmarks?
Use palmar surface of hands to palpate in a sequential pattern for temperature, moisture, muscular development, and any tenderness or masses.
How should anterior and posterior thoracic landmarks be?
Skin should be warm and dry
Symmetric muscular development
No tenderness, masses, and vibrations
How is chest expansion determined?
By placing the hands over the posterior chest wall, with the fingers at the level of T9 or T10
Inspecting cyanosis
Mucous membranes are the best place to look (core of the body)
What are crackles?
wet airways
What is wheezing?
constricted or narrowed airways
What are 3 types of normal lung sounds?
Vesicular
Bronchial
Bronchovesicular
What are vesicular sounds?
low-pitched, soft sounds heard over peripheral lung fields
What are bronchial sounds?
loud, high-pitched sounds heard primarily over the trachea and larynx
What are bronchovesilcular sounds?
medium-pitched blowing sounds heard over the major branch
How should you ausculate the lungs?
Ausculate as the patient breathes through an open mouth.
Breathing through the nose can produce falsely abnormal sounds.
What should you instruct the patient to do if abnormal sounds are detected?
Cough and then ausculate again
What are adventitious breath sounds and how are they categorized?
Abnormal lung sounds.
Discontinuous or continuous.
What is an example of discontinuous sounds?
Crackles
What causes crackles?
Produced by fluid in the airways or alveoli and delayed reopening of collapsed alveoli
Occur due to inflammation or congestion
What are examples of continuous lung sounds?
Wheezing
Pleural friction rub
How are wheezes produced?
Produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors
What is the difference between fine crackles and coarse crackles?
Fine crackles are brief sounds, somewhat like hair rubbing together between fingers.
Coarse sounds are louder, moist, and bubbling.
What is the difference between sibilant wheezes and sonorous wheezes?
Sibilant originate in smaller airways and are high pitched and whistling.
Sonorous can be heard over larger airways and sound like a snore.