Ch. 10 - Respiration & Artificial Ventilation

what is ventilation?

moving air into and out of the lungs

in inhalation active or passive?

active

what happens during inhalation?

chest expands, diaphragm contracts, negative pressure pulls air in

is exhalation active or passive?

usually passive

what happens during exhalation?

chest and diaphragm relax, chest size decreases, positive pressure pushes air out

what is tidal volume?

amount of air moved in one min

what is minute volume?

amount of air moved in and out of the lungs per min

what is alveolar ventilation?

amount of air that reaches alveoli for gas exchange

why doesn’t all inhaled air reach the alveoli?

some stays in dead space

what happen at the alveoli?

O² moves into blood and CO₂ moves from blood into alveoli

what is diffusion?

movement from high concentration to low concentration

what is pulmonary respiration?

gas exchange between blood and body cells

what is a V/Q match?

ventilation and perfusion working together properly

what can mechanically interfere with ventilation?

chest injury, loss of nerve control, pain, or bronchoconstriction

what is hypoxia?

not enough oxygen reaching body tissues

what is hypercapnia?

too much carbon dioxide

how does the body initially compensate for hypoxia/hypercapnia?

faster breathing, faster heart rate, vasoconstriction

respiratory distress vs respiratory failure?

distress = compensation still working

failure = compensation is failing and breathing is inadequate

what can respiratory failure progress to?

respiratory arrest

first two questions when assessing breathing?

is the patient breathing?
is the breathing aqequate?

signs of adequate breathing?

equal chest rise, normal air movement, normal skin color, and appropriate rate/depth

signs of inadequate breathing?

altered mental status, uneven/minimal chest rise, abnormal rate/depth, poor air movement, abnormal sounds, cyanosis

important pediatric sign of inadequate breathing?

retractions, nasal flaring, or a slow pulse

what oxygen saturation does the slideshow call low?

95%

what do you do for a patient who is not breathing or breathing inadequately?

provide artificial ventilation

what do you do for a patient who is breathing but needs more oxygen?

supplemental oxygen

what is positive pressure ventilation?

forcing air/oxygen into the lungs

when is positive pressure ventilation used?

respiratory arrest or inadequate ventilation

why is positive pressure ventilation different from normal breathing?

normal inhalation uses negative pressure; PPV forces air in with positive pressure

major side effects of positive pressure ventilation?

decreased cardiac output/BP, gastric distention, and hyperventilation

why can PPV lower blood pressure?

it can reduce how well the heart refills

why is hyperventilating a patient harmful?

too much CO₂ is blown off, causing vasoconstriction

what should you watch for with every ventilation?

visible chest rise

what is a BVM used for?

ventilating nonbreathing or assisting patients in respiratory failure

what oxygen flow is attached to a BVM in the slideshow?

15 L/min

what do you do if the chest does not rise with BVM mask?

reposition the head, fix the mask seal, check for obstruction, and resuction if needed

adult ventilation rate from this chapter?

10-12 breaths/min

child ventilation rate from this chapter?

12-20 breaths/min

how long should each ventilation be delivered?

about 1 sec

how much volume should you give?

only enough to make the chest begin to rise

why is too much ventilation volume harmful?

can cause gastric distention and lung injury

what is a nonrebreather mask used for?

high concentration oxygen in a breathing patient

nonrebreather flow rate?

15 L/min

approx. oxygen concentration from a nonrebreather?

80-90%

what must you do before placing a nonrebreather on the patient?

inflate the reservoir bag

how full should the nonbreather reservoir stay?

it should not deflate by more than about 1/3

what is a nasal cannula used for?

low concentration supplemental oxygen

nasal cannula flow rate?

up to 4/6 L/min

approx. oxygen concentration from nasal cannula?

22-44%

when might nasal cannula be useful instead of a mask?

mild distress or if the patient refuses a mask

what is a Venturi mask useful for?

delivering a specific oxygen concentration; commonly used with COPD patients

what is a tracheostomy mask?

oxygen mask placed over a stoma/tracheostomy

tracheostomy mask flow rate?

8-10 L/min

what is blow by oxygen?

holding oxygen tubing/mask near an infant or child’s face so oxygen flows past them

how close is blow by held?

about 2 inches from the face

why must oxygen cylinders be handled carefully?

pressurized tanks can become dangerous projectiles and oxygen makes fire burn faster

what should never be used around oxygen equipment?

oil, grease, smoking, or open flames

should an unsecured oxygen cylinder be left standing upright?

no

why is oxygen considered a drug?

too much or too little can be harmful

how does the slideshow suggest supplemental oxygen?

hypoxia, low O² saturation, shortness of breath, or decompensation

important pediatric ventilation rule?

avoid excessive pressure and volume

why are children more vulnerable during respiratory problems?

their anatomy is smaller and their oxygen use is higher

what does the chapter say about respiratory assessment?

keep reassessing because respiratory status can change quickly