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Respiratory Assessment and Acid Base Balance (Unit 5) (Conditions…
Respiratory Assessment and Acid Base Balance
(Unit 5)
Functions of Respiratory System
Pulmonary Ventilation
Respiratory rate and depth
Hyper. vs. Hypo. centilation
Alveolar gas exchange
via
DIFFUSION
O2 vs. CO2
Bronchial tree
Pulmonary capillaries and alveoli
Transport of O2 and CO2
Circulation to all tissues in the body
Systemic diffusion
Movement of CO2 and O2 in body
Conditions Affecting Movement of Air
Eupnea
Normal
Bradypena
Slow
<12
Brain stem trauma
Tachypnea
Fast
20
Fever
Hypoventilation
<12
Surgery pt. after anesthesia
Hyperventilation
20 resp./min.
Fast
Blow off CO2
Kussmaul Resspirations
DKA (Hyperventilation
Cheyne-Stokes
End of life
Deep, apnea, shallow
Drug overdose, CNS disorder
Biots
Shallow with apnea; no cycling
Orthopnea
Propped up breathing
Dyspnea
Difficulty breathing
Conditions Affecting Diffusion
Hypoxia
Decreased O2 levels in
tissues
Confusion
Hypoxemia
Decreased O2 levels in the
blood
Cyanosis
Tissue turns blue d/t hypoxia and hypoxemia
Pneumonia
Acute inflammation of lung tissue
Usually caused from microorganisms
Causation
Aspiration
Inhalation
Hematogenous spread (from another site in the body
Categorized Pneumonia
CAP (Community Acquired)
Not in hosp. or long term care as of 14 days
Treat at home or in hosp.
HAP (Hospital Acquired (Nosocomial))
48h after admission
Not intubated
Aspiration pneumonia
VAP (Ventilator Associated)
48 hours after intubation
Also HAP
Characteristics of Pneumonia
Chronic
Barrel Chest
Cyanosis
Clubbing of nail beds
Prolonged expitory phase
Orthopena
Dyspnea
Tripod
Acute
SOB
Respirations >20
Adventitious Breath Sounds
Fever: 101 or >
Cough (May or may not be productive)
Yellow or green
Infection
Rust, blood, white, or clear
Viral
Pink or frothy
Pulmonary edema
Smelly: abscess or bacterial infection
Pleural chest pain
Cyanosis
Dehydration
Orthopnea, dyspnea, use of accessory muscles, nasal flare, retractions
Anxiety (wide eyed)
BP and HR increases
Excursion (Decreased chest expansion)
BBS (Bilateral Breath Sounds)
Crackles (Rales)
Fluid filled airways
Rhonchi
Wet snore sound
Obstruction r/t mucous, swelling
Usually upper airways
Wheezes
Muscial
Airway narrowed
Stridor
Partial/or complete obstruction
Most urgent!
Pleural friction rub
Velcro sound
ABGs (Arterial Blood Gases)
Respiratory Acidosis (Hypoventilation)
Respiratory Alkalosis (Hyperventilation)
Metabolic Acidosis (DKA/Hyperventilation)
Metabolic Alkalosis (Significant losses)