Oxygenation

What influences blood flow and oxygenation in the body?

The heart's pumping ability.

What condition results in lower red blood cells and can impair oxygenation?

Anemia.

Which part of the brain controls breathing?

The respiratory center, medulla

Name a type of medication that can affect the respiratory center.

Opiates.

What factor can reduce the strength of breathing due to muscle condition?

Weak muscles.

Which disease can reduce lung compliance by decreasing elasticity?

Emphysema.

What factors can obstruct airflow and lead to respiratory issues?

Inflammation and diseases like asthma.

What respiratory challenges do infants and older adults face?

Developmental factors.

What environmental factors can contribute to respiratory issues?

Pollution and secondhand smoke.

How can psychological factors like anxiety affect breathing?

They can lead to hyperventilation.

What should be included in a nursing history assessment for respiratory function?

Evaluate breathing difficulties, previous conditions, immunizations, and exposure to pollutants.

What physical signs should be checked in a respiratory assessment?

Signs of distress, skin color, lung sounds, and heart function.

What diagnostic studies are used to assess respiratory health?

ABGs, CBC, X-rays, and pulmonary function tests.

List some priority problems in respiratory assessment.

Ineffective airway clearance, impaired gas exchange, ineffective breathing pattern, anxiety, activity intolerance.

Name a goal in the nursing process for respiratory care.

Maintaining airway.

What is one technique to improve respiratory function?

Oxygen therapy.

What should be monitored to evaluate improvement in respiratory function?

Lung sounds, respiratory rates, and chest x-ray results.

How can anemia affect respiration

Anemia can affect respiration by reducing the amount of oxygen carried to the tissues.

What things influence the actual transport of gases during respiration

Diffusion, perfusion, and RBC count.

Describe age related changes that may affect respiration/ventilation

Newborns/small children: lungs are not developed enough, higher respirations

Older Adults: decrease in the elasticity of lung tissue. Doesn’t allow lungs to fully expand.

Hypoxia vs. Hypoxemia

Hypoxia is the lack of oxygen in the tissues. Hypoxemia is the decrease of oxygen in the blood.

Why is hydration important with the patient with respiratory conditions

helps thin respiratory secretions

Where is the respiratory control center

Medulla

Where does gas exchange occur in the lungs

Alveoli

What is nail clubbing and what patients are at risk for developing it

Late sign of hypxia. COPD patients are at risk for developing it, or chronically hypoxic.

What complications might occur during or after a thoracentesis? How are they assessed?

Risk of puncturing the lung. Pain, bleeding, or a pneumothorax may happen. This can be x-rayed or just monitored. (higher HR)

What is the carina and what is important about it?

Point at which the trachea bifurcates (splits). Important because the right bronchus extends more vertically than the left, so aspirated fluids may go in the right bronchus.

Do’s of sputum sample

Collect in the AM before breakfast

Take a deep breath and cough up sputum

Don’ts of getting a sputum sample

Get saliva only

Contaminate it

What gas changes stimulate the respiratory muscles to change

The drive for CO2. Increased hydrogen ions and lesser degree decreased oxygen levels

How does atmospheric and pleural pressure changes affect ventilation?

Boyles law. When the temperature is consistant, pressure is inversely proportional to volume. When the volume of space decreases, pressure within that space increases and when the volume increases, the pressure decreases.

Why is the lack of a gag reflux a safety concern

A chance of fluid getting into the lungs

List the post bronchoscopy nursing care

Ensuring gag and swallow reflex is working to keep the airway clear, monitoring and oral care to prevent mucus from collecting in the mouth.

What interventions should follow the drawing of ABG’s

document if patient is on supplemental oxygen, apply pressure, let patient know that it is painful before

How is hypoxemia prevented during suctioning

Preoxygenating the patient, limiting suction time, avoid suction on insertion, appropriate catheter size, appropriate vacuum pressure, hydration and aerosolization, assess effectiveness, document, recognize indication

Do’s of suctioning

Hydrate

limit suction to less than 15 seconds

Keep vacuum pressure from 80-120 mmHG

Document

Don’ts of suctioning

suction for more than 15 seconds

apply suction during insertion

What S/S lead you to believe that the patient has ineffective airway clearance

Coughing when breathing in

Dyspnea

Restlessness

Changes in HR

Adventitious breath sounds

Ineffective cough

S/S of impaired gas exchange

Cyanosis, hypoxia, rapid pulse, flaring nares, clubbing, confusion

S/S of ineffective breathing pattern

labored breathing, use of accessory muscles, tachypnea, alkalosis, orthopnea, paraoxysmal noctural dyspnea

What is respiratory position?

High fowlers position, proning. Gravity helps diaphragm descend easier

What patients are at a high risk for developing hypoventilation due to hypoxia

COPD, CNS issues, anxiety, post op patients

What patients are more likely to develop hyperventilation due to body processes

Patients with anxiety, metabolic acidosis, head injuries, severe hypoxemia

What positive respiratory changes can occur when you ambulate a supine patient?

This will improve airflow, enchances perfusion, prevents atelectasis, strengthens respiratory and abdominal muscles

What interventions prevent atelectasis

ambulation, incentive spirometers, deep breathing, positive expiratory pressure, coughing, hydration, respiratory positions

Describe pursed lip breathing and how it helps

Sit patient up in high fowlers, teach patient to inhale slowly through nose for a count of three, patient will exhale slowly through pursed lips for seven seconds. This helps control breathing, decreases panic and anxiety, increases alveolar respiration, and helps with full expiration

Describe tripod position and how it helps

Helps patients diaphragm downward to increase the volume in the chest cavity

If your patient is hypoxic, what medications should you question

opiates, beta blockers, and anticoagulants

Normal atmospheric concentration of oxygen

21%

Three types of chest physiotherapy

Percussion, vibration, postural drainage

What does intermittent bubbling in the water seal chamber of the chest tub collection container indicate? What interventions are required?

Air is leaving the chest and entering the chest tube system. Monitor the water seal chamber, document any changes, make sure dressing is occlusive and drive, no kinks, if bubbling continues, let physician know.