Recording-2025-03-12T18:07:21.755Z

Respiratory Patterns

• Respiratory Rate: Important measurement in respiratory health; varies in conditions like obesity and alcoholism.

  • Elevated respiratory rate (tachypnea): greater than 20 breaths per minute.

Biot's Breathing Pattern

• Definition: Characterized by periods of apnea followed by rapid breathing.

• Causes: Often results from brain insult, such as strokes or encephalitis.

• Pathophysiology:

  • Normal control of breathing is disrupted by brain injury.

  • Breathing center can only activate in response to strong stimuli, primarily high carbon dioxide levels in the blood.

Cheyne-Stokes Breathing Pattern

• Definition: Similar to Biot's but involves a gradual increase in breathing depth followed by a gradual decrease.

• Associated Conditions: Indicative of cardiac damage.

• Characteristic: Often seen as a precursor in near-death scenarios.

Kussmaul's Breathing Pattern (Hyperventilation)

• Context: Observed during acidosis, particularly in diabetic ketoacidosis (DKA).

• Mechanism: Fast and deep breathing to blow off carbon dioxide, reducing acidity in the blood.

• Characteristics: Maximum inhalation followed by maximum exhalation at a rapid rate.

Terminology Review

• Eupnea: Normal breathing rate and pattern.

• Respiratory Conditions:

  • Tachypnea: Increased respiratory rate (>20 breaths/min).

  • Bradypnea: Decreased respiratory rate (<20 breaths/min).

  • Apnea: Periods of no breathing.

Assessments in Clinical Practice

• Normal Pulse Oximetry Reading: Generally between 95-100%.

• Locations to Measure Oxygen Saturation:

  • Fingertips, earlobes, toes, forehead.

• Factors Affecting Readings: Nail polish, cold extremities, poor perfusion, anemia, and artificial nails.

Initial Actions in Assessment

• Patient with Dyspnea:

  • First, elevate the head of the bed to relieve pressure on lungs.

  • Assess the patient's work of breathing following position change.

  • Determine oxygen saturation as a priority vital sign (lower oxygen takes precedence over low blood pressure).

Nursing Diagnoses Related to Respiratory Function

• Activity Intolerance: Patient experiences shortness of breath upon exertion.

  • Example: Difficulty climbing stairs.

• Hyperventilation could lead to hypoventilation or impaired gas exchange.

Patient Scenarios and Assessments

• Case 1: 60-year-old with hypertension

  • Vital Signs: 170/92 BP, HR 70, RR 16.

  • Focus on assessing symptoms of dyspnea due to possible hypertension complications.

• Case 2: Patient with vomiting and diarrhea

  • Vital Signs: BP 85/40, HR 104, RR 20.

  • Assess blood pressure first; low blood pressure with high heart rate indicates compensatory mechanism from volume loss.

Key Questions for Patients

• Questions to assess potential dyspnea history and fluid loss:

  • When did symptoms start?

  • Has the patient had adequate hydration or changes in diet?

  • Are there signs of dizziness or lightheadedness indicating possible fluid volume deficit?

Understanding Activity and Mobility

• Immobility: Inability to move or decreased activity; key area of assessment in nursing.

  • Assessment Factors:

    • Gait and balance.

    • Muscle strength and range of motion.

    • Body alignment and exercise patterns.

Factors Influencing Activity Levels

• Patient's physical activity level impacts mobility and overall health.