Respiratory Flashcards
Mediastinum
the middle section of thoracic cavity containing esophagus, trachea, heart, and great vessels
How many lobes does the left lung have?
2 lobes
How many lobes does the right lung have?
3 lobes
The key function of the respiratory system
gas exchange. Provide oxygen to the body’s cells and remove carbon dioxide from the body.
Upper Airway
Nose, mouth pharynx, larynx, trachea
Function of upper airway
warm, humidify, and filter air
Lower Airway
bronchi (primary, secondary, tertiary), bronchioles, alveolar ducts, alveoli
Lower airway function
gas exchange. alveoli are the functional units for gas exchange
Pleura
surrounds and cushions the lungs. The space between the two layers is the pleura cavity.
Ventilation
flow of air into and out of the alveoli.
bronchoconstriction causes an increase or decrease in ventilation?
Decrease
Diffusion
exchange of O2 and CO2 between the alveoli and the RBCs in the bloodstream.
Pulmonary fibrosis causes a decrease or increase in diffusion?
Decrease
Perfusion
Exchange of O2 and CO2 between the RBCs and the body tissues
Peripheral Artery Disease causes an increase or decrease in perfusion?
Decrease
Subjective or Objective Data?
Cough
Subjective
Subjective or Objective Data?
Shortness of Breath
Subjective
Preliminary Stats
Observe the client and their position of breathing
level of consciousness
Expected: relaxed and comfortable
unexpected: anxious, agitated, confused, or frequent sighing
Unexpected findings in the fingers and toes
cyanosis
cool, damp skin
clubbing
pallor
Expected respiratory rate
12-20 breaths per minute
Expected finding for pulse oximetry
greater than 95%
Hypoxic SpO2 Range
85-94%
Severely Hypoxic SpO2 Range
< 85%
Normal COPD SpO2 range
88-92%
Hyperventilation Nursing Interventions
Calm Environment
Sitting Position (raise the head of the bed)
Slow breathing
Determine and treat the cause
Notify Provider
Hypoxemia
insufficient oxygen in arterial blood. requires ABG to dx
Hypoxia
insufficient tissue oxygenation
Early signs and symptoms of hypoxia and hypoxemia.
restlessness, irritability, abnormal breathing, tachycardia, tachypnea, HTN, pallor
Late signs and symptoms of hypoxia and hypoxemia
decrease LOC, cyanosis, Increase lactic acid, dysrhythmias, bradycardia, bradypnea, hypotension
Signs and symptoms of oxygen toxicity
non-productive cough, substernal chest pain, nasal stuffiness, nausea and vomiting, fatigue, headache, sore throat
Nasal cannula oxygen rate
1-6 L/mL
Simple face mask oxygen rate
5-10 L/mL
Deep breathing
allows movement in lung bases which prevents collapse
coughing
deep productive coughing clears mucous
positioning
Semi-Fowlers and above lung capacity
incentive spirometer
mechanical device that promotes lung expansion and decrease pulmonary complications. Teach patient proper technique before surgery and reinforce teaching after surgery.
Incentive spirometer use
10 times every hour awake
Arterial Blood Gas (ABG)
An arterial blood sample to assess acid-base balance, ventilation, and oxygenation of critical care patients
Components of ABG
pH, PaO2, PaCO2, HCO3, SaO2
pH expected range and description
7.35 - 7.45
acid-base balance of blood
PaO2 expected range and description
80 - 100 mmHg
Measure of oxygen pressure in arterial blood
PaCO2 expected range and description
35 - 45 mmHg
Measure of carbon dioxide pressure in arterial blood
HCO3 expected range and description
22 - 26 mEq/L
Bicarbonate: important buffer in the blood, regulated by the kidneys
SaO2 expected range and description
95 - 100%
Amount of oxygen bound to the hemoglobin in the arterial blood.
pH below 7.35 indicates
presence of acidosis
pH above 7.45 indicates
presence of alkalosis
PaCO2 above 45 (acid) indicates
respiratory acidosis or compensation for metabolic alkalosis
PaCO2 below 35 (base) indicates
respiratory alkalosis or compensation for metabolic acidosis
HCO3 below 22 (acid) indicates
metabolic acidosis or compensation for respiratory alkalosis
HCO3 above 26 (base) indicates
metabolic alkalosis or compensation for respiratory acidosis
Older adult physiological changes in respiratory system
decrease lung capacity and elasticity
weaker respiratory muscles and increase work of breathing
increase anterior and posterior chest diameter
decrease cough reflex=harder to expel
Expected lung sounds
bronchial, bronchovesicular, vesicular
Lung sounds: crackles (fine)
high-pitched crackling popping sounds
Lung sounds: crackles (coarse)
low-pitched bubbling, gurgling sounds
lung sounds: wheezes
high-pitched, musical, squeaky sounds
lung sounds: pleural friction rub
loud, grating, scratching sounds
lung sounds: rhonchi
low-pitched, coarse, snoring sounds
