Respiratory system Flashcards
What is the anatomical difference of upper airway in an infant?
Head : larger with prominent occiput
Neck : shorter
Tongue : Larger
Larynx : Higher and anterior
Epiglottis : Floppier, narrow and U-shaped
Trachea : shorter, right main bronchus angled less than left
What is the narrowest part of the airway for infants and adults?
Infant : Criocoid cartilage
Adults : glottis
What are the 3 components for work of breathing?
- Compliance work
- Resistance work
- Airway resistance
What is compliance work?
It is required to expand the elastic force of the lungs
What is resistance work?
It is required to overcome the viscosity of the lung and thoracic cage
What is airway resistance?
It is work required to overcome resistance to gas flow
What is the effect of pulmonary disease?
Increase the work of breathing -> Increase the metabolic rate and oxygen demand
-> results in respiratory muscle fatigue
What are the factors that wil affect tissue oxygen consumption?
- Fever
- Shivering
- Working of breathing
- Dressing change
- Bath
- Sepsis
- Agitation
How to assess patients with respiratory conditions?
- General appearance
- Respiratory efforts and patterns ( use of accessory muscle )
- Present of cough or phlegm
- Skin colour and perfusion
- Abdomen distention ( splinting of diaphragm )
- Activity intolerance
- Level of responsiveness - drowsy
- Oxygen profile - saturation, blood gases
What is the assessment of respiratory distress?
- Increase in RR
- Increase in HR
- Decrease in SpO2
- Usage of accessory muscles
- Retractions and/ or nasal flaring ( Suprasternal, Intercostal, Clavicular, Subternal and Subcostal )
- Sweating, clammy skin
- Grunting
- Auscultate breath sounds ( stridor, wheeze etc )
- Head bobbing
- Character of cough ( e.g. Croupy cough )
- Agitation of restlessness
- Cyanosis
- Conscious level : drowsy and hypercapnia
- Position ( assume position to enable ventilation and limit work of breathing e.g. Tripod position, Classic in Epiglottis : drooling and sitting upright )
- Metabolic acidosis
Increase in respiration rate equal
high fever, pain or anxiety
What are the normal readings for neonate?
HR : 120 - 180
RR : 40-60
Systolic BP : 60-80
What are the normal readings for 1 month to 1 year ?
HR : 110 - 160
RR : 30 - 40
Systolic BP : 70 - 90
What are the normal readings for 1 to 2 years ?
HR : 100 -150
RR : 25 - 35
Systolic BP : 80 -95
What are the normal readings for 2 to 7 years ?
HR : 95 -140
RR : 25 - 30
Systolic BP : 90 -110
What are the normal readings for 7 to 12 years ?
HR : 80 -120
RR : 20 - 25
Systolic BP : 100 -120
Bradynpea
Slow for age
- Hypothermia
- Drug-induced
- Increase in ICP ( Increased intracranial pressure )
Tachypnea
Rapid for age
- Pulmonary disease
- Metabolic acidosis
- Increased metabolic need
Hypernea
Deep and rapid
- Diabetic Ketoacidosis
Dyspnea
Difficult of labored breathing - Acute distress pneumothorax - Intermittment distress Asthma - Chronic lung problems
Orthopnea
Intolerant of supine position
- Asthma
- Pulmonary Edema / Disease
What are the nursing problems?
- Ineffective airway clearance Ineffective cough Fatigue, weakness Viscous secretion Pain Aspiration of foreign body
- Inflammatory process
- Impaired gas exchange
- Altered family process
- Imblance Nutrition
What are the nursing management?
- Administer oxygen and humidification
- Suctioning to remove secretion / mouth care
- Adequate oral fluid intake
- Medication : expectorant therapy
- Positioning
- Chest Physiotherapy referral
- Family support to allay anxiety
- Homecare
What is the purpose of oxygen delivery device?
- relieve hypoxemia
- decrease work of breathing
- reduce myocardial stress
What are the diagnostic tests that need to be done?
- Chest x-ray
- Respiratory function studies
- Laboratory tests e.g. blood gas analysis
What is the nursing management ( evaluation )
- Observe child’s respiratory effort and chest movement
- Observe child’s behaviour and activity ( tolerance of physiotherapy )
- Monitor vital signs
- Observe signs of inadequate hydration
- assess complications e.g. dehydration, weight loss or infection
- collaborate with child and family, observing their behaviour