RESPIRATORY

Med-Surg 1: Respiratory Notes

Chapter Reference

  • Text: Rosdahl
  • Chapters: 15, 17-23 (Med Surg ATI)

Anatomy & Physiology Review

  • Normal Respiration Rate for Adult:
    • Normal Range: 12 to 20 breaths per minute.
    • Action: Notify the physician if the respiratory rate is below 10 or above 24, unless it is established as normal for the patient.
    • Definitions:
    • Inspiration: Breathing in.
    • Expiration: Breathing out.

Key Processes in Respiratory Function

  • Movement of Air: Involves three interrelated processes:
    • Ventilation: Mechanical movement of air in and out of the lungs.
    • Diffusion: Movement of respiratory gases between the alveoli and blood.
    • Perfusion: Distribution of blood through pulmonary capillaries.

Respiratory Assessment

  • Evaluation Indicators:

    • Observe respiratory status through:
    • Retraction of intercostal spaces on inspiration, indicating possible respiratory distress.

  • Dyspnea:

    • Definition: Shortness of breath or difficulty breathing.
    • Causes: Can be due to a variety of conditions, including asthma, COPD, heart failure, etc.
    • Treatment Options: Oxygen therapy, bronchodilators, anti-anxiety medications, etc.

  • Related Terms: Definitions:

    • Orthopnea: Shortness of breath when lying flat, relieved when sitting up.
    • Wheezing: Common in asthma and bronchospasm conditions.
    • Apnea: Temporary cessation of breathing.
    • Cheyne-Stokes Respiration: Cyclic pattern of breathing with periods of hyperventilation followed by apnea.
    • Asphyxia: Lack of oxygen supply leading to unconsciousness or death.
    • Cyanosis: Bluish discoloration of the skin due to insufficient oxygenation.
    • Hyperventilation: Abnormally rapid breathing.
    • Hypoventilation: Inadequate ventilation to perform needed gas exchange.
    • Tachypnea: Abnormally rapid breathing.
    • Hyperpnea: Increased depth of breathing.
    • Bradypnea: Abnormally slow breathing.
    • Kussmaul’s Respirations: Deep and labored breathing pattern often associated with metabolic acidosis.
    • Eupnea: Normal, good, unlabored respiration.

Lung Sounds Assessment

Conduct when:

  • Patient complains of:
    • Excessive secretions.
    • Chest pain.
    • Dyspnea.
    • History of chest trauma.

Detailed Respiratory History Assessment

  • Key History Points:
    • Cough (productive vs. nonproductive).
    • Sputum characteristics (color, quality).
    • Hemoptysis (coughing up blood).
    • Cyanosis presence.
    • Note any abnormal respiratory patterns or sounds.
    • Assess exercise tolerance, allergies, medications, recent infections, smoking habits, occupational hazards, and family health history.

Physical Assessment Techniques

  1. Inspection: Observe for signs of respiratory distress, effort, and cyanosis.
  2. Palpation: Assess the trachea’s position.
  3. Percussion: Identify areas of abnormal density.
  4. Auscultation: Listen for abnormal lung sounds.

Clinical Manifestations of Oxygen Deprivation

  • Signs include:
    • Restlessness
    • Yawning
    • Anxiety
    • Drowsiness
    • Confusion
    • Disorientation
    • Flaring nostrils
    • Retractions of the intercostal muscles.

Importance of the Respiratory System

  • Role: Vital for sustaining life by ensuring the body receives oxygen and eliminates carbon dioxide.
    • Partnership: Works closely with the cardiovascular system.

Specialized Respiratory Care Professionals

  • Pulmonologist: A physician specializing in the diagnosis and treatment of lung disorders.
  • Pulmonology: The medical field focusing on respiratory diseases.

Upper Respiratory System Components

  • Key Structures:
    • Nose
    • Sinuses
    • Pharynx
    • Larynx
    • Trachea
    • Nasal and oral cavities

Lower Respiratory System Components

  • Key Structures:
    • Lower trachea
    • Bronchi
    • Lungs

Diagnostic Tests for Respiratory Function

  • Common Tests Include:
    • Sputum specimen
    • Lavage specimen
    • Throat cultures
    • Arterial blood gases (ABGs)
    • Chest X-ray (CXR)
    • CT scan
    • Lung scan and perfusion scan
    • Pulmonary angiography
    • MRI
    • Pulmonary function tests (PFT)
    • Bronchoscopy testing
    • Skin tests (PPD/Tine test)
    • Blood tests (CBC/RBC)

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