What is the purpose of respiration?
The lungs, in conjunction with circulatory system, deliver oxygen to and expel carbon dioxide from the cells of the body.
What is arterial blood gases?
The measurement of arterial oxygen and carbon dioxide levels in arterial circulation.
Used to assess the adequacy of respiration.
There are 2 major types of oxygen delivery devices available for supplemental oxygen. Name them and how much O2 can be given.
- Low flow oxygen system- nasal cannula =1-5L/min, Hudson mask=4-8L/min, non-rebreather=12-15L/min
- High flow oxygen system - venturi mask=4-8L/min
What are the 3 processes of respiration?
- ventilation
- diffusion
- perfusion
What would you teach a pt with respiratory problems about when in comes to nutrition?
- adequate dietary intake promotes gas exchange and increase energy levels
- teach a pt to consume small meals and snacks to avoid pressure on thoracic cavity
- avoid gas-producing foods to prevent gastric distress
- rest before and after meals to conserve energy.
What is the goal of oxygen therapy?
The goal of O2 therapy is to provide adequate transport of 02 in the blood whilst decreasing the work of breathing and reducing stress on the myocardium.
- is usually only given to raise the arterial oxygen pressure (PaO2) back to the pt’s normal baseline.
What is postural drainage?
This uses specific positions that allow the force of gravity to assist in the removal of bronchial secretions from affected bronchial and relieve bronchial obstruction
There are 3 types of Pneumothorax. List and describe them.
- Simple pneumothorax = occurs when air enters the pleural space through a breach of either the parietal or visceral pleura.
- Traumatic pneumothorax = occurs when air escapes from a laceration in the lung and enters the pleural space or from a wound in the chest wall.
- tension pneumothorax - occurs when air is drawn into the pleural space from a lacerated lung or through a small opening or wound in the chest wall.
Chest trauma can be categorised into 2 categories. What are they?
- Blunt trauma = results from sudden compression or positive pressure inflicted to the chest wall. (MVA, falls)
- Penetrating trauma = occurs when a foreign object penetrates the chest. (Stab wound, gunshot)
In the elderly what extra things would you be monitoring for if they had a respiratory infection?
You would be monitoring for:
- any unusual behaviour
- dehydration
- excessive fatigue
- concomitant heart failure
- altered mental status
What would we be monitoring for in a pt with a respiratory infection?
- changes in temp and pulse
- amount, colour and odour of secretions
- frequency and severity of cough
- degree of tachypnoea or SOB
- changes in physical assessment
- changes in X-ray findings
What nursing care would you be doing for a pt with URTI?
- promote comfort
- maintain airways
- promote communication
- monitor and manage potential complications
- encourage fluid intake
- promote home or community care
What is a pneumothorax?
It is when air is in the pleural cavity.
What is haemoptysis?
Blood expectorated (expel matter, such as phlegm) up from the respiratory tract.
What questions should you be asking in a health hx in a respiratory assessment?
- Health hx focuses on physical and functional problems of the pt, including ability to carry out ADL’s.
- reason pt is seeking healthcare
- when did the symptoms start?
- -how long has it lasted?
- any relieving factors?
- duration, severity, associated symptoms?
- any psychosocial factors present? (Anxiety, role change)
What other questions would you be asking with a respiratory assessment? (Think back to 105 clinical assessments)
- how much triggers SOB?
- is there a cough associated with it?
- Dyspnoea(SOB) associated to other symptoms?
- Onset? Sudden or gradual
- occurrence? Day or night?
- is it worse lying down?
- rate the intensity of SOB?
What are we assessing on a physical assessment of a pt with respiratory problems?
-clubbing off fingers= can indicate lung disease ie chronic hypoxic conditions, chronic lung infections
-cyanosis= late indicator of hypoxia
IPPA= Inspection, Palpate, Percussion & auscultation.
what past hx of health, family and social questions might we ask to assist us?
- child hx
- chronic medical conditions?
- immunisations?
- injuries?
- surgeries?
- allergies?
- smoking hx?
- medications?
- hospitalisation that may be related?
What tests may be performed to find a diagnosis?
- Bronchophony
- Egophony
- throat cultures taken
- computed tomography (CT)
- bronchoscopy
- thoracoscopy
What do 90% of URTI stem from?
-viral infections
Can antibiotics be used to treat pneumonia and viral URTI?
No, antibiotics are ineffective
What is the treatment of viral pneumonia?
Treatment of viral pneumonia is primarily supportive.
What are some sever complications of pneumonia?
- hypotension
- respiratory failure
- shock
What is rhinitis?
Inflammation and irritation of the mucous membranes of the nose
