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10 Respiratory System 2
10 Respiratory System 2
Conditions
1
2
Functions
• Primary
–Ventilation -
in 4 out of
gases
↳ molecules t pressure
Filtration = →
t pressure
–Alveolar Diffusion =
exchange of
gases
¥
↳ molecules =P concentration → bconontmtio
3
Centers i 1° -
Medulla
Oblongata
-
coz
zo
-
ping -
02
Muscles : 10 =
Diaphragm
20 =
Accessory
P Wa
b
M .
Oblongata
1. Phrenic
name
-
v4
Diaphragm
b
Rib expansion
to
Fluids = 10 no ml
-
H µ
760 mmmltg
fÉg.
,
Air
1-2) 760
02 -
Elastase -
inflation
coz
-
Anti
deflation
-
elastase
02
PA ,
PA .
?⃝
Hw t V02 →
Hzwz
THI -
back of head
- -
✗
b)
"
depression 610
c)
"
arrest
d) "
failure
• Secondary
–Sense of smell -
CN # 2
–Speech =
larynx
A :B
1:21
-
–A-B Balance ⇐
3
A :B =
1:20 .
Regpi lungs)
.
=
Pa Wy =
35 -4s mmHg
( carbonic acid )
Li
Hyo HIM
→
t V2
1.153 mtaolh
Renal 1 kidneys ) =
Conserve Hwz
↳
Metabolic
122 26 mtq / L )
-
24
Diagnostic Studies/
Therapies
4
Chest X-ray
• Radiographic visualization of the chest
• Ideal frequency:
Every 6 MOS
• Contraindication:
pregnancy
• Instructions:
• Hold his breath
• Remove metals from the chest
5
Lung Scan / YQ Scan
• Measures blood perfusion through the
lungs.
7
o Pre-op meds:
o Atropine SO4 =
Anticholinergic =
b salivation
↳ ✗
aspirations
o Valium =
minor tranquilizer =
* vasognl response
1 bradycardia )
o Topical anesthesia and anesthesia
suppress the reflex prevent resistance
gag =
8
• After the procedure are:
o Position : side -
lying
o DBCT -
aspiration
perforation
-
• Direct visualization
① Diagnostic
/
• Uses:
\
② Therapeutic
10
consent
• Before the procedure:
-
o Same with bronchography Pneop mug
o Position:
Before Supine
: t the neck $ lightly hyper extended
During :
Neutral
After : side lying
-
13
-
11
12
Thoracentesis
• Aspiration of fluid or air from the pleural cavity
• Uses:
• Diagnostic
• Therapeutic
prevent leakage
o Bed rest
RR
o Monitor VS -
'
b BP
18
Arterial Blood Gas Studies
• Purposes: 1. Ventilation = Pa z sa 02
,
2. A
-
B Balance =
pH , Paula , ltwz
• Common site of blood extraction =
Radial artery
Alternative Ulnar
↳ Allen 's Test
:
artery
• 10 ml pre-heparinized syringe
pH 7.35-745 B
-
Analyze the pH
__\B= Alkalosis Uncompensated
-
System
:
2. /
law, -
- Metabolic
-
Partially
-
tiny
715 b. A. Uncompensated
pit
=
Koz
=
3223 N
patina compensated
pH
=
751 P B '
P A Metabolic Alkalosis
Pawz = 49
Hwy =
33 P B
pH: 739 NBA
Fully compensated
Pawz : 48 PA pegpi .
Acidosis
HwÉ 35
④ 7:35
-
745
7400¥
pH±= 7. SI T B MM
31 dB Mixed Alkalosis
Pnloz
'
combined
Hoog -_
31 p B
PB
pH 751
}
=
Error
Paco ,
=
49 PA /
1$ ↳ µ
False
=
1%3 rending
ABM ☒
BABA
BABA .
Post-Test
Number 1
A. Medulla oblongata
B. Cerebellum
C. Hypothalamus
D. Cerebral cortex
23
Number 2
A. Aspiration
B. Dysphasia
C. Projectile vomiting
D. Abdominal distention
24
Number 3
25
Number 4
26
Number 5
27
Number 6
28
Number 7
29
Number 8
30
Number 9
31
Number 10
32
PNEUMOTHORAX
• It is the accumulation of air in the
pleural space
• Primary complication:
24
Types
1. Tension
2. Secondary
3. Spontaneous
Symptoms:
o Pleuritic pain
o Increased RR
o Dyspnea
o Major complication:
Nursing Interventions:
• Monitor V/S, signs of shock
• Observe respirations
• Semi-Fowler’s position
• Analgesics as ordered
• Chest tube:
o Maintain
o asepsis
o patency
o Evaluate:
o amount of fluid
o breath sounds
Suction Patient
Apparatus
PLEURAL
EFFUSION
• Refers to an abnormal accumulation of fluid
in the pleural cavity.
Types:
• Hydrothorax (Transudate)
• Empyema (Exudates)
• Hemothorax (Blood)
• Chylothorax (Chyle)
Symptoms:
▪ Dyspnea
▪ Pleuritic pain
▪ Constant discomfort
Levels of severity:
o Minimal (300-500cc)
48
Number 1
49
Number 2
A. Hypoventilation
B. Pneumonia
C. Atelectasis
D. Mediastinal shift
50
Number 3
51
Number 4
52
Number 5
53
Situation
54
Number 6
A. Atelectasis
B. Scoliosis
C. Pneumonia
D. Hiatus Hernia
55
Number 7
56
Number 8
A. Morphine sulfate
B. Demerol
C. Codeine
D. Fentanyl
57
Number 9
58
Number 10
A. High-Fowler’s
B. Reverse Trendelenburg
C. Semi-Fowler’s
D. Lithotomy
59
Chronic
Obstructive
Pulmonary
Disease
41
Asthma Bronchitis Bronchiectasis Emphysema
COLD
COPD
CALS
42
Diagnosis: Impaired Gas Exchange
ASTHMA
ASTHMA
Other names:
Disorder:
Involvement:
ASTHMA
Pathophysiology:
ASTHMA
Hallmark:
Other symptoms:
BRONCHITIS
✓ inflammation of the bronchioles that impairs airflow
BRONCHITIS
Other names:
Disorder:
Involvement:
BRONCHITIS
Pathophysiology:
54
`
58
BRONCHITIS
Hallmark:
Other symptoms:
EMPHYSEMA
EMPHYSEMA
Other names:
Disorder:
Involvement:
EMPHYSEMA
Pathophysiology:
EMPHYSEMA
Hallmark:
Other symptoms:
Common Signs & Symptoms:
Over coughing
Laborious breathing
Dyspnea
Feeling of breathlessness
Anorexia
Tiredness (fatigue)
Increased RR
Greater breathing depth
Unusual irritability
Excessive weight loss ]
Management
Bronchodilators
Beta2 - Adrenergic Xanthine Derivatives
Agonists
Examples
Route
Advantage
Respiratory Therapy
1. Liquefy / Loosen
2. Dislodge
3. Expel / Expectorate
Oxygen therapy
• Administration:
• Common methods:
▪Nasal cannula
▪Venturi mask
Nutrition (Diet)
Coping and relaxation
High-Fowler’s / Orthopneic position
Intermittent Positive
Pressure Breathing /
Ventilation (IPPB / IPPV)
Avoidance of allergens
Lung exercises
a. Diaphragmatic breathing
b. Pursed-lip breathing
I - E Ratio:
Cromolyn Na
(Mast cell stabilizer)
Administer medications, as ordered
Remove pulmonary irritants
Encourage rest
Post-Test
Situation
97
Number 1
A. Dyspnea
B. Barrel- shaped chest
C. Chronic productive cough present on
most days for at least 3 months of the
year
D. Wheezing sound
98
Number 2
A. ABG values
B. Tidal volume
C. CVP
D. Serum electrolytes
99
Number 3
100
Number 4
A. Alcoholism
B. Cigarette smoking
C. Malnutrition
D. Infection
101
Number 5
102
Situation
103
Number 6
104
Number 7
A. Depression
B. Lethargy
C. Tachycardia
D. Cyanosis
105
Number 8
106
Number 9
A. Asthma
B. Emphysema
C. Bronchitis
D. Diabetes
107
Number 10
108