RESPIRATORY

• Respiratory system


  Brings in oxygen (O2) into the body and removes carbon dioxide (CO2) from the body
• Respiratory system


  • Delivers oxygen to the cells in your body
  • Supports your sense of smell
  • Warms air to match your body temperature and moisturizes it to the humidity level your body needs
  • Protects your body from harmful substances or microorganisms by preventing them from entering the body and removing them from respiratory surfaces

  
• Respiratory assessment

  1. Observation of the rate, depth and pattern of respirations

  2. Recognizing normal thoracic and abdominal movements

  3. Diaphragm contracts causing abdominal organs to move downward and forward, increasing the vertical space of the chest cavity

  4. Ribs lift upward and outward, and the sternum lifts outward to aid the transverse expansion of the lungs

  5. Diaphragm relaxes upward, the ribs and sternum return to their relaxed position, and the abdominal organs return to their original position

  
• Signs and symptoms of respiratory changes


  • Chest pain
  • Cough
  • Shortness of Breath (dyspnea)
  • Difficulty of breathing (DOB)
  • Pain during inspiration and expiration
  • Use of accessory muscle
  • Bluish or cyanotic appearance of nail beds, lips, mucous membranes and skin
  • Thick, frothy, Blood-streaked sputum (hemoptysis)
  • Daytime sleepiness or snoring and disordered sleep

  
• Difficulty of breathing (DOB)


  Subjective data collected during respiratory assessment

  
• Preparing the materials for respiratory assessment: examination gown, gloves, stethoscope, light source, mask, skin marker, pulse oximetry, second hand watch

  
• Preparing the client for respiratory assessment: Have the client remove all clothing, explain the procedure, have the client sit upright with arms relaxed, ensure comfortable room temperature, keep hands warm, provide privacy, remain nonjudgemental
• Objective data collected during respiratory assessment

  • Ruddy complexion
  • Use of accessory muscles
  • Assessing fremitus
  • Assessing chest expansion and diaphragmatic excursion
  • Assessing normal and adventitious breath sounds

  
• Respiration patterns

  • Eupnea - normal breathing
  • Bradypnea - slow breathing
  • Tachypnea - fast breathing
  • Hypopnea - shallow breathing
  • Hyperpnea - deep breathing
  • Dyspnea - difficulty breathing
  • Apnea - inability to breathe
  • Orthopnea - ability to breathe only in an upright position
  • Cheyne-Stokes - increase in depth and rate followed by a decrease, resulting in apnea, seen in the dying patient
  • Biot's respiration - depth and rate of respirations followed by periods of apnea

  
• Assessing respiratory rate and oxygen saturation are part of the objective data collected during respiratory assessment