ventilation
air moves to alveoli
diffusion
02 diffuses into the blood stream
transport
binds to hemoglobin
perfusion
oxygen rich blood reaches cells
breathing definiton
the automatic act of ventilation, usually
unnoticed until it’s hard to do (Automatic Act)
Hypoxemia
A decreased level of oxygen in the arterial blood (↓ PaO₂ or ↓ SpO₂)
Hypoxia
A deficiency of oxygen at the tissue level, which may result from hypoxemia or other causes (e.g., poor perfusion)
Early Signs of hypoxia
Restlessness
* Anxiety
* Tachypnea
* Tachycardia
* Diaphoresis
* Mild desaturation
Late Signs of hypoxia
Cyanosis
* Confusion
* Bradypnea
* Decreased LOC
* Lethargy
* Use of accessory muscles
medical conditions that put people at risk for respiratory issues
❤️ CHF and cardiac disorders →
* ↓ perfusionᾩAnemia →
* ↓ O₂-carrying capacity
* ᾩObesity, scoliosis → ↓ chest expansion
* ᾩOpioid/sedative use → respiratory depression
* ᾩInfections (COVID, PNA, RSV) → inflammation, fluid, impaired
exchange
respiratory diagnostic tools
Pulse Oximetry (SpO2)
XRAY
Sputum culture
pulmonary function tests
inspection cues
resp. rate
skin color
chest symmetry
barrel shaped
palpation
symmetrical chest expansion
Tactile fremitus
Tracheal alignment
chest tenderness
percussion cues
resonant vs dullness
focus on abnormal findings
auscultation cues
lung sounds (crackles, wheeze, etc.)
adventitious sounds
oxygenation solutions
oxygenation:
Sit upright (high Fowler’s)
Administer O₂ as ordered
Encourage deep
breathing & coughing
Reassess lung sounds
tissue:
Monitor color/temp
Conserve energy
Bundle care
Promote circulation
immunity:
Hydration
Administer antipyretics
Encourage coughing &
expectoration
Monitor for fever trends
