Tidal volume (TV) (normal breaths) : volume of gas either inspired or exhaled during each breath ▪ Functional residual capacity (FRC) (max volume exhaled) : volume of gas remaining in lungs when lungs & chest wall at end-expiratory position
Clubbing Figure 12- 9
Nursing Goals ▪ Promote oxygenation ▪ Prevent infection ▪ Prevent further lung damage ▪ Promote rehabilitation
Common Respiratory Patient Care Problems ▪ Ineffective airway clearance – Cough medicine can cause r/t soothing nerve endings in throat ▪ Water should not be taken immediately after a cough syrup – In bacterial and chronic resp diseases, sputum is foul smelling ▪ Frequent mouth care helps remove pathogenic micro- organisms from oral cavity and diminishes possibility they will be aspirated – Especially important after turn, cough, deep breathing exercises
More problems ▪ Ineffective breathing patterns – High fowlers best facilitates breathing – Orthopnea : ability to breath only in upright position – Full stomach contributes to dyspnea ▪ Small frequent feeding preferred – Pursed lip and diaphragmatic breathing may lessen dyspnea ▪ Help open with pressure
Orthopneic position Figure 12- 11
And then. . . ▪ CO2 is respiratory stimulant and body responds to increase of CO2 by increasing resp rate to “blow off” CO2 ▪ Hypercapnia : retention of excessive CO2 – Causes: Narcotic overdose ▪ Hypocapnia : Deficit of CO2 from hyperventilation – Causes : Increased metabolic rate (fever & anxiety) salicylate overdose, and improper use of mechanical ventilation ▪ Respiratory failure: ABGs used to determine – Present when PaO2 < 50 and PCO2 >50 – Will lead to cardiac arrest from resp acidosis if not corrected
Abnormal Respiratory Patterns – know these pg 274 ▪ Biot's respiration (head injuries )– fast, deep irregular respirations ▪ Cheyne‑Stokes respiration (near death) – become faster and deeper, then slower and shallower with periods of apnea ▪ Kussmaul's respirations (diabetics or ketoacidosis) – fast, deep respirations with no pause ▪ Apneustic respiration (apnea) – ????? You should know this (Also refer to Figure 12-13.)
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- Fall '19
- cough, Upper Respiratory, of Respiratory Disorders