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CHAPTER 50
NUR 107
2014
Oxygenation
O2 CO2
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Copyright 2012by Pearson
E!"ation# $n"%
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O&'(ENAT$ON
O2 is taste)ess# "o)or)ess
A""o!nts 21* at+ospheri" air
Oxygen !se, +aintain ae-!ate "e))!)ar
oxygenation%.or Tx% o/ a"!te an "hroni" respiratory
prob)e+s
Hypoxe+ia inae-!ate oxygen )ee)s in
the b)oo
O2/)o rates ary atte+pt to +aintain
3aO2 2*
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H'PO&E6$A
Ta"hypnea
Ta"hy"aria
Rest)essness
E)eate P
38in Pa))or
Respiratory istress
Nasa) /)aringUse o/ a""essory +!s")es
Aentitio!s )!ng so!ns
Cyanosis
Con/!sion 9 st!por
raypnea ray"aria
Hypotension
Caria" ysrhyth+ias
Early signs
Late signs
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O&'(ENAT$ON
Assess:+onitor resp% rate# rhyth+# ebth 9 e//ort
6onitor 3aO2; A(:s
3aO2 ? 2* re-!ire n!rsing interentions
3aO2 ? @* = e+ergen"y
3aO2 ? @0* = )i/e threatening
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O&'(EN TO&$C$T'
6ay res!)t /ro+ high "on"entrations o/ oxygen
Be)iering 50*
ong !rations o/ oxygen therapy
6ore than 24 4@ hrs%
3y+pto+s, non=pro!"tie "o!gh# s!bsterna)
pain# nasa) st!//iness# N:D# heaa"he# sore
throat# hypoenti)ation%
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O&'(EN TO&$C$T'
$nterention
Be"rease oxygen as soon as "onition per+its
Use )oest oxygen ne"essary to +aintain
ae-!ate 3aO2
6onitor A(s
Use CPAP# iPAP or PEEP hi)e on a enti)ator
He)ps to e"reases the a+t% o/ oxygenneee /or an ae-!ate )o )ee) itho!t
"o+pro+ising )!ng "o+p)ian"e
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O&'(EN=$NBUCEB
H'PODENT$AT$ON
6ay o""!r in COPB ith "hroni" hypoxe+iaan hyper"arbia
COPB pts re)y on )o )ee)s o/ arteria) oxygen
as their pri+ary rie /or breathing3!pp)e+enta) oxygen at high )ee)s "an
e"rease or e)i+inate the respiratory rie6onitor /or resp% epression
O2 s!pp)e+ent +!st be at 1=2:+inDent!ri +as8 i/ to)erate6onitor OC
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STRUCTURES OF THE
UPPERRESPIRATORY TRACTCopyright2
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NoseSinuses/nasal
passagesPharynTonsils an! a!enoi!s"aryn# epiglo$$is%
glo$$is%&o'al 'or!s
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AEO"I here gas ex"hange ta8es p)a"e
A)eo)ar="api))ary +e+brane
3!r/a"tant )ipoprotein
pro!"e by a)eo)ar "e))sa"ts )i8e a etergent
re!"ing a)eo)ar s!r/a"e
tension%
itho!t s!r/a"tant# )!ng expansion be"o+esex"eeing)y i//i"!)t an the )!ngs "o))apse%
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LUNG COMPLIANCE
Co+p)ian"e )!ng re"oi)Abi)ity o/ the )!ngs an thorax to expanNe"essary /or nor+a) inspiration 9
expirationContin!a) tenen"y o/ the )!ng to "o))apse
aay /ro+ the "hest a))Be"rease in iseases s!"h as
p!)+onary ee+a# "ongenita) str!"t!ra)abnor+a)ities# /x ribs
Be"reases ith aging
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ENTI"ATION
Inspira$ion 0 inhala$ion
Epira$ion 0 ehala$ion
en$ila$ion is !epen!en$
upon#Clear air+ay
In$a'$ CNS
In$a'$ respira$ory 'en$er
A!e1ua$e pul,onary'o,plian'e/re'oil
Thora'i' 'apa'i$y $o
'on$ra'$/epan!
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INSPIRATIONBiaphrag+ 9 inter"osta)s +!s")e "ontra"tionThora"i" "aity siFe in"reasesDo)!+e o/ )!ngs in"reases
$ntrap!)+onary press!re e"reases a)aysnegatieNegatie press!re in )!ngs "reates s!"tion that
ho)s the p)e!ra) +e+branes together as the
"hest expansAir r!shes into the )!ngs to e-!a)iFe press!reP!)+onary re"oi) enhan"es negatie press!re%
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EHA"ATION3iaphrag, an! in$er'os$als relaolu,e o* $he lungs !e'reases
In$rapul,onary pressure risesAir is epelle!O$her en$ila$ion Fa'$ors#
In$rapul,onary pressureTi$al &olu,e
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4AS ECHAN4E
O''urs a*$er $he al&eoli are &en$ila$e!Pressure !i5eren'es on ea'h si!e o* $he
respira$ory ,e,)ranes a5e'$ !i5usion
3i5usion o* oygen *ro, $heal&eoli in$o $he
pul,onary)loo! &essels
3i5usion o* 'ar)on !ioi!e*ro,
pul,onary )loo!
&essels in$o al&eoli
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A"EO"AR 3IFFUSION AN3PERFUSION
Bi//!sion= the pro"ess by hi"h oxygen an
"arbon ioxie are ex"hange at the
a)eo)ar="api))ary +e+brane%
Per/!sion= the b)oo /)o thro!gh
the p!)+onary "ir"!)ation%
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OY4EN TRANSPORT
Oygen is $ranspor$e! *ro, $helungs $o $he $issues
678 o* O2 'o,)ines +i$h Hg) in
R(Cs an! is 'arrie! $o $issues asoyhe,oglo)in
Re,aining oygen is !issol&e!
an! $ranspor$e! in plas,a an!'ells
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CAR(ON 3IOI3ETRANSPORT
9us$ )e $ranspor$e! *ro, $he $issues$o $he lungs
CO2 is 'on$inually pro!u'e! in 'ell
,e$a)olis,:;8 is 'arrie! insi!e $he R(C as
)i'ar)ona$e
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RESPIRATORYRE4U"ATION
Neural regula$ion >respira$ory 'en$er? is'on$rolle! )y $he ,e!ulla o)longa$a an!pons o* $he )rain
Che,i'al regula$ion
CO2 sensi$i&e @,e!ullaHy!rogen ion 'on'en$ra$ion3e'rease O2 'on'en$ra$ion @'aro$i' B
aor$i' )o!ies3e'rease ar$erial O2 'on'en$ra$ion@'he,ore'ep$ors
E,physe,a0 O2 'on'en$ra$ion plays a role
in regula$ing respira$ions
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T$BA DOU6E
Begree o/ "hest expansion !ringnor+a) breathing is +ini+a)# re-!iring)itt)e energy expenit!re%
500+) o/ air is inspire an expireith ea"h breath in the nor+a) a!)t
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CONTINUED
$nspiratory resere o)!+e = is thea+o!nt o/ air that "an be inha)e a/ter anor+a) or tia) inspiration
Expiratory resere o)!+e = a+o!nt o/air that "an be /or"ib)y exha)e a/ter nor+a) ortia) expiration
Resi!a) Do)!+e = the a+o!nt o/ air re+ainingin the )!ngs a/ter /or"e +axi+a) expiration
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CONTINUED
Dita) Capa"ityThe DC is the +axi+a) a+o!nt o/ air
that "an be exha)e a/ter +axi+a)inspiration%
The DC is the tota) o/ the tia)
o)!+e# inspiratory resere o)!+e#
an expiratory resere o)!+e%
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RESPIRATORY
ALTERATIONSHypoxia
$ns!//i"ient 02anyhere in the boy
Signs of Hypoxia
Rapi p!)se
Rapi sha))o respirations an
yspnea:/)aring o/ nares:"yanosis
$n"rease res)t)essness or)ightheateness:"on/!sion
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SIGNS/SYMPTOMS OF
HYPOXEMIAEar)y Ta"hy"aria Ta"hypnea Rest)essness
38in pa))or E)eate P 3x resp% istress
Nasa) /)aring
A"sessory +!s")esa# !ng so!ns
ate
Con/!sion# st!por
Cyanosis s8in 9
+!"o!s +e+branes raypnea
ray"aria
Hypotension
Caria" yshyth+ias
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HYPERCARBIA
Hyper"arbia
Hypoenti)ation# CO2a""!+!)ation
Cyanosis
)!ish is"o)oration o/ the s8in# nai)bes#
an +!"o!s +e+branes# !e to re!"e
He+og)obin "on"%
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CARDIOVASCULAR
ALTERATIONSConitions that A//e"t,
The /!n"tion o/ the heart as a p!+p
)oo /)o to organs an tiss!esCo+position o/ the b)oo an its
abi)ity to transport 02an C02
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CARDIOVASCULAR ALTERATIONS
Be"rease Caria" O!tp!t6$# Heart .ai)!re# P!)+onary
Ee+a
$+paire Tiss!e Per/!sion
$s"he+ia# T$A=stro8e# P!)+onaryE+bo)i
)oo A)terationsHypoo)e+ia# Ane+ia
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RESPIRATORY EFFORTS
Accessory Muscles:$n"rease )!ng o)!+e !ring inspirationC)ients ith COPB# espe"ia))y e+phesy+a#
/re-!ent)y !se a""essory +!s")es to in"rease
)!ng o)!+e%N!rse +ight obsere ")ai")es being e)eate
hen breathing; retra"tionsRes!)ts in energy expenit!re hi"h in"reases
+etabo)i" rate$n"rease +etabo)i" rates in"rease the nee /or
+ore O29 the nee to e)i+inate CO2
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FACTORS INF"UENCIN4RESPIRATORY FUNCTION
AgeEn&iron,en$
"i*es$yle% A'$i&i$y
Heal$h s$a$us9e!i'a$ions
S$ress% E,o$ions
(o!y posi$ion(o!y $e,p-/ En&iron,en$ $e,p
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(REATHIN4 PATTERNS
3uring inspira$ions% $he $hora'i''a&i$y ,us$ ha&e a lo+erpressure $han $he a$,osphere-
Eupenea nor,al(ra!y'ar!ia 0 D= )rea$hs/,inTa'hypnea 2 )rea$hs/ ,in
Hypo&en$ila$ion shallo+%irregular )rea$hing
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Breathing Patterns
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SY9PTO9S OF I9PAIRE3RESPIRATORY FUNCTION
HypoiaAl$ere! )rea$hing pa$$ernsO)s$ru'$e! or par$ially o)s$ru'$e!
air+ay
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HYPOIA
Con!i$ion o* insuG'ien$ oygenany+here in $he )o!y
Rapi! pulse
Rapi!% shallo+ respira$ions an!!yspnea In'rease! res$lessness or
ligh$hea!e!ness
Flaring o* naresSu)s$ernal or in$er'os$al re$ra'$ionsCyanosis
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A"TERE3 (REATHIN4PATTERNS
Apnea 'essa$ion o* )rea$hinguss,aul?s )rea$hing !eep rapi!
)rea$hinghyper&en$ila$ion r/$ ,e$a)oli' a'i!osis(o!y a$$e,p$s $o )lo+ o5 CO2
Cheyne0s$o.es +aing B +aningrespira$ions
(io$?s respira$ions shallo+ 'lus$ers o*)rea$hs $ha$ are in$errup$e! )y apneaOr$hopnea ina)ili$y $o )rea$h e'ep$ in an
uprigh$ posi$ion
3yspnea !i5- )rea$hing @SO(
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O(STRUCTE3 AIRAY
Complete or partial obstruction may occur
anywhere along the resp. tract
Aspiration of foreign object
Tongue falls back & occludes oropharynxSecretions or mucus accumulation
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ADVENTITOUS LUNG SOUNDS
Adventitious abnormal
!artial obstruction
"ow#pitch snoring sound during inhalation
Complete obstruction
$o chest movement
%nability to cough or speak
Sternal & intercostal retractionsStridor high#pitch sound during inspiration
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ASSSS'$T
Hea)th Hx, physi"a) 9 /!n"tiona) prob)e+ yspnea# pain# a""!+!)ation o/ +!"!s#
heeFing# he+optysis# ee+a o/ the /eet#
/atig!e# ea8ness3:3x o/ yspnea# orthopnea# "o!gh
6aGor s:sx yspnea# sp!t!+ pro!"tion#
"hest pain# heeFing# ")!bbing o/ /ingers#
he+optysis# "yanosisC)!bbing o/ nai)s# sign o/ )!ng isease /o!n in
pts% ith "hroni" hypoxi" "onitions
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PHYSICAL ASSESSMENT
reathing pattern to be assesse itho!t ")ientsaareness%
Nor+a) respiratory rate ranges 12=20bp+% Rate greater than 20
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PHYSICAL ASSESSMENT
Hea)th 3tat!s= "hroni" i))ness "an "a!se
+!s")e asting in")!ing +!s")es o/ the
respiratory syste+
Rena):Caria"= "reate /)!i oer)oa# a//e"trespiratory /!n"tioning
Chest Tra!+a=i+pairs abi)ity to expan an
"ontra"t "hest
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PHYSICAL ASSESSMENT
Consierations re)ate to the ")ients nor+a)
breathing patterns# position# hea)th
prob)e+s# +ei"ations or therapies# an
"arioas"!)ar /!n"tion a//e"tingrespirations sho!) be +ae
Opiois= Bepress respiratory "enter#
e"reasing rate an epth o/ respirations
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PHYSICAL ASSESSMENT
Eniron+ent= A)tit!e#heat# "o)# an airpo))!tion a//e"t oxygenation%
Po))!te air= Heaa"he# iFFiness# "o!ghing#
"ho8ing# an stinging o/ eyes
Physi"a) (roth an Bee)op+ent
Conitions s!"h as s"o)iosis a//e"t breathing
patterns an "a!se air trapping%
Obese peop)e are o/ten 3O# ith a"tiity
!e to a)eo)i at the base o/ the )!ngs are not
sti+!)ate to expan /!))y
ASSSS C(ST
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ASSSS C(ST
C)$*%+,-AT%)$
1% arre) "hest = o""!rs as a res!)t o/ oerin/)ation o/ the )!ngs
2% .!nne) "hest o""!rs hen there is
epression o/ the )oer portion o/ the stern!+
I% Pigeon "hest isp)a"e+ent o/ the stern!+
4% Jyphos"o)iosis Abnor+a) "!rat!re o/ the
spine
3"o)iosis# Jyphosis# arosis
5% .)ai) Chest
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ASSSS'$T
Cyanosis a )luish 'oloring o* $he s.inJin!i'a$es hypoia
3e$er,ine! )y a,$- o* !eoygena$e!he,oglo)in in $he )loo!
Cyanosis appears +hen ;g/!" o*unoygena$e! he,oglo)in
A person +i$h a he,oglo)in o* D;g/!" +illno$ sho+ 'yanosis un$il ;g/!" o* $ha$)e'o,es unoygena$e!
Ane,i' p$s- rarely sho+ 'yanosis-
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ASSESSMENT
Assess )ips# s8in# an nai) bes /or signs o/
periphera) "yanosis# s!"h as b)!e=gray tinge
or ")!bbing o/ the nai)s%
C)!bbing is a sign o/ )ong=ter+# i+paireoxygenation%
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LISTEN TO BREATH
SOUNDSAbnormal breath sounds
Normal breath sounds vs. Adventious
Crackles, wheezes, friction rubs
Voice Sounds vocal resonanceBronchophony intense & clear sound
Egophony distorted voice sounds
Whispered pectoriloquy a subtlesound
x
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SPUTUM
"ung?s rea'$ion $o irri$an$s or nasal!is'harge
(a'$erial in*e'$ion 0 $hi'.% yello+% green%rus$ 'olor spu$u,
iral in*e'$ion $hin% ,u'oi! spu$u,
"ung $u,or pin.0$inge! spu$u,
Pul,onary e!e,a pro*use% *ro$hy
spu$u,"ung a)'ess% )ron'hie$osis *oul
s,elling spu$u, ' )a! )rea$hx
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COUGH
Ti+ing; /re-!en"y= oes it get orse# hatagraates itK
Chroni"# A"!te# or Paroxys+a)
Pro!"tie or nonpro!"tie
Bry or +oist
ar8ing# Hoarseness# Ha"8ing
x
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CLUBBING
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3ign o/ )!ng isease /o!n in pts% ith
"hroni" hypoxi" "onitions# "hroni"
)!ng in/e"tions#
9+a)ignan"ies%
3ponginess o/ nai)
bes ith )oss o/
nai)=be ang)e
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CLUBBING
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ASSESS FOR CHEST PAIN
Pain Asso'ia$e! +i$h pul,onary or 'ar!ia'!isease
9ay o''ur +i$h pneu,onia% Pul,on!ye,)oli% lung in*ar'$ion% pleurisy% 'an'er
Relie* ,easures# analgesi'% regionalanes$he$i's
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NURSING MEASURES TO
PROMOTE RESPIRATORY
FUNCTIONEnsure a patent airwayPositioning
Encouraging deep
breathing, coughingEnsuring adequate
hydration
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3PUTU6, RE$E. 6EA3URE3Be"rease is"osity = in"rease hyration $nha)ation o/ aeroso)iFe so)!tions3top s+o8ing inter/eres ith "i)iary a"tion#
in"reases bron"hia) se"retions# "a!ses
in/)a++ation# re!"es s!r/a"tant%N!trition "onsierations = +ay be
"o+pro+ise !e to the s+e)) or taste o/sp!t!+
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THERAPEUTICMEASURESTO
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THERAPEUTIC MEASURES TO
PROMOTE RESPIRATORY
FUNCTIONMedicationsIncentive spirometryChest PTPostural drainageOxygen therapyArtificial airwaysAirway suctioningChest tubes
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ASSESSMENT OF COPD
L!estions regaring yspnea# "o!gh#sp!t!+ pro!"tion# re"ent "o)s
N!rse notes any post!ra) "hanges inrespiratory rate
Respiratory rate +ay be in"rease anexpiration pro)onge%
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COPD
Chest +ay hae an in"rease anterior=
posterior ia+eter
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TREATMENT
(oa) is to a))eiate a"!te sy+pto+s an
preent "o+p)i"ations% Treat+ent in")!es,
ron"hoi)ators to i+proe air/)o
Corti"osterois to e"rease in/)a++ationo /)o O2 i/ PaO2 is )ess than 55 or
3aO2 )ess than @@*
Antibioti"s
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NURSING DIAGNOSES
.o"!s on the i+pa"t o/ physio)ogi" "hanges
on the patients /!n"tioning%
Chroni" yspnea "an in/)!en"e a"tiity
to)eran"e an abi)ity to "are /or the se)/Co!ghing an 3O "an ist!rb s)eep an
"ontrib!te to /atig!e an ea8ness
Extra or8 on breathing "an in"rease
"a)orie re-!ire+ents b!t eating an
sa))oing +ay be )i+ite to yspnea%
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NURSING INTERVENTIONS
Tea"h e//e"tie breathing patterns
$+proe airay ")earan"e
$+proe (as Ex"hange
Ta8e +ei"ations as orereEn"o!rage ae-!ate n!tritiona) inta8e
Preent $n/e"tions
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NURSING INTERVENTIONS
Ea)!ate A"tiity $nto)eran"e
Tea"h /a+i)y to assess patient orientation
Tea"h patient an /a+i)y abo!t COPB#
stress hea)thy behaiors# s+o8ing"essation# an signs o/ potentia) prob)e+s
Pro+ote hea)th s)eep patterns
Be"rease /ee)ings o/ poer)essness
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ASTHMA
Chroni" $n/)a++ation o/ airays )eaing to
inter+ittent obstr!"tion
Progressie airay obstr!"tion !nresponsie to
treat+ent )eas to e+ergen"y sit!ation
.or+ o/ obstr!"tie p!)+onary isease
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ETIOLOGY
$ntrinsi" etio)ogies=physi"a) an psy"ho)ogi"a)
stress# exer"ise in!"e
Extrinsi" etio)ogies= air po))!tants# a))ergi" response#
"o) an ry air# +ei"ations
iesprea spas+s o/ bron"hio)e s+ooth +!s")e
ith airay ee+a
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ASSESSMENT
3eere yspnea:heeFing ith expiration
Co!gh:.ee)ing o/ "hest tightness
$n"rease heart rate an b)oo press!re
Extre+e rest)essness# anxiety# agitation Ta"hypnea an !se o/ a""essory +!s")es
PLANNINGAND
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PLANNING AND
IMPLEMENTATION
Assess respiratory an oxygenation stat!s
A+inister s!pp)e+enta) O2
A+inister bron"hoi)ators
$enti/y:re+oe:aoi pre"ipitating /a"tors
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EXPECTED OUTCOMES/EVAL
Absen"e o/ yspnea# "hest tightness# heeFing
Respiratory rate o/ 12 to 24
i)atera))y ")ear an e-!a) )!ng so!ns
A/ebri)eAe-!ate air ")earan"e o/ ")ear thin se"retions
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INCENTIVE SPIROMETRY
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CHEST PHYSIOTHERAPYCopyright2
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OXYGEN THERAPY
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OXYGEN THERAPY
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Simple face mask
Partial rebreathermask
Nasal cannula
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OXYGEN THERAPY
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Nonrebreather mask
Venturi mask
OXYGENHOOD
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OXYGEN HOOD
OxygenTent
Oxygen Mask
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HUMIDIFIER VIDEO
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Cli'. here$o &ie+ a &i!eo on hu,i!iKers-
(a'. $o 3ire'$ory
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ARTIFICIAL AIRWAYS
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Oropharyngeal Airway
Nasopharyngeal Airway
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ARTIFICIAL AIRWAYS
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TRACHEOSTOMY TUBE
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CHEST DRAINAGE SYSTEM
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For pneumothorax or
hemothorax
Tubes are inserted into
the pleural cavity to drainfluid/blood and restore
negative pressure
Closed system with a
suction control chamber &water seal chamber
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PNEUMOSTAT
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For pneumothoraxwith small amounts
of fluid drainage
One way valveprevents back flow
HEI9"ICH CHEST
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HEI9"ICH CHEST3RAINA4E A"E
Use! +i$h a,)ula$ory pa$ien$sAllo+s air $o es'ape *ro, $he 'hes$
'a&i$y +i$hou$ air re0en$ering
3oes no$ 'olle'$ Lui!
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3ESIRE3 OUTCO9ES
9ain$ain a pa$en$ air+ay I,pro&e 'o,*or$ an! ease o* )rea$hing
9ain$ain or i,pro&e pul,onary
&en$ila$ion an! oygena$ion I,pro&e a)ili$y $o par$i'ipa$e in
physi'al a'$i&i$ies
Pre&en$ ris.s asso'ia$e! +i$hoygena$ion pro)le,s
ARTERIALBLOODGASES
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ARTERIAL BLOOD GASES
ABGS
Ea)!ates respiratory /!n"tioning in a patient aneter+ine the a"t!a) )ee)s o/ CO2 an O2 in
arteria) b)oo%
The other a)!es erie /ro+ the A( ana)ysis are
Poer o/ hyrogen # HCOIArteria) sat!ration o/ the he+og)obin
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ABGS
ARTERIAL BLOOD GASES
pHpH 7.35 7.45PaCO2 35 45 mm Hg
PaO2 80 100 mm Hg
SaO2 92 98%HCO3 22 26 mEq/L
Base excess (BE) -2.0 to 2.0 mEq/L
CaO2 16-22 nL O2/dL
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OXYGEN SAFETY
No Smoking when in useKnow locations of closest fire extinguisher
Educate clients:
Hazards of smoking with oxygenTo wear cotton gowns, synthetics or wool
spark static electricity
Use of grounded electrical equipment
Assess clients whose main respiratory drive is
hypoxia for oxygen-induced hypoventilation
NANDANURSING
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NANDA NURSING
DIAGNOSES
AnxietyFatigue
Activity intolerance
Imbalanced nutrition: less than bodyrequirement
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NURSING INTERVENTIONS
Respiratory assessmentAppropriate application of oxygen delivery
systems
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NASAL CANNULA
delivers O2 at concentrations of 24-40%Flow rate 1-6 L/min
Safe and simple method, easy to apply
Flow rates may vary depending on depth of
clients breathing; dislodges easily
NC may cause nasal skin breakdown
Provide humidification for flow ratesM
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SIMPLE MASK
Covers nose & mouthDelivers 40% 60%
5 8 L/ min
For short-terms oxygen therapy
Minimum flow rate or 5 to ensure flushing of CO2 from
the mask
Mask may be poorly tolerated
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NON-REBREATHER MASK
Also covers nose & mouthOne-way valve and two exhalation ports
Delivers 80%-95% O2
10 15 L/minReservoir bag to stay 2/3 full during inspiration
& expiration
Delivers highest concentration possible
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VENTURI MASK
Also covers nose & mouthOne-way valve and two exhalation ports
Delivers 24%-55% O2
2 10 L/minDelivers the most precise oxygen
concentration with different size adaptors
Best suited for clients with chronic lungdisease
Expensive, & requires frequent
assessment
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PARTIAL REBREATHER MASK
Also covers nose & mouthDelivers 60%-75% O26 11 L/min
Reservoir bag with no valve, allows rebreathingup to 1/3 of exhaled air mixed with room air
Complete deflation of reservoir bag during
inspiration causes CO2 build up
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AEROSOL MASKS
Fits loosely over face or neck (tracheostomycollars)
Delivers 24% - 100% O2
Best for clients who do not tolerate other masks;
facial trauma & burnsDeliver high humidity
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NURSING CARE
Assess O2 needMonitor appropriateness of oxygen therapy
Document therapy response
Monitor O2 Sats, ABGs
Promote good oral hygiene
Rest, decrease environmental stimul
Support the anxious clieints
NURSINGCAREIN
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NURSING CARE IN
RESPIRATORY DISTRESSFowlers positionComplete a focus respiratory assessment
Promote adequate oxygenation: deep breathing &
supplemental oxygen
Promote airway clearance: coughing, suctioning
Stay with client
Decrease anxiety
QUESTION
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QUESTIONYou are caring for a client who had
abdominal surgery 24 hours ago. This
client has a 10yr old history of COPD.
hat inter!entions are necessary to
maintain a "atent airway####