HUMAN RESPIRATION CHAPTER FOR NURSES.pptx

Respiratory system slides

1. RESPIRATION

2. Respiration: Respiration: Respiration is the mechanism the body uses to exchange gases between the atmosphere and the blood ,and the blood and the cell. Respiration involves the following processes.... Ventilation; the movement of gases between in and out of the lungs (inspiration and expiration). Diffusion; the movement of oxygen and carbon dioxide between the alveoli and the red blood cells. Perfusion; the distribution of red blood cells to and from the capillaries. Insta ; husain.z.kmu

3. Purposes To acquire baseline data for subsequent evaluation To monitor abnormal respiratory status and identify changes To monitor patients at risk for respiratory alterations To evaluate effects of medication and activity on respiratory status

4. Equipment Watch with second hand. Flow sheet Pen (black)

5. Procedure Identify the patient Wash hands Collect equipment Be sure clients chest is visible remove bed linen Assess patients activity prior to checking respiration Place patient in a comfortable position Place hand against patients chest to feel his chest movements Chest the respiratory rate, rhythm and depth for 1 minute Wash hands Document in flow sheet and (if required) nurse,s notes.

6. Physiological control: The respiratory center (medulla oblangata) in the brain stem regulates the involuntary (adults normally breathe in a smooth, uninterrupted pattern, 12- 20 times / min) control of respiration. Ventilation is regulated by CO2, O2, and hydrogen ion concentration (PH) in the arterial blood. The most important factor in the control of ventilation is the level of CO2 in the arterial blood. An elevation in the Co2 level causes the respiratory control system in the brain to increase the rate and depth of breathing. The increased ventilatory effort removes excess CO2 by increasing exhalation. Insta ; husain.z.kmu

7. Mechanism of breathing: Inspiration / inhalation ( active process) Expiration / exhalation ( passive process) Pause Insta ; husain.z.kmu

8. Mechanism of breathing 1. Inspiration: During this phase the respiratory center sends impulses along the phrenic nerve, causing the diaphragm to contract. Abdominal organs move downward and forward, increasing the length of the chest cavity to move air into the lungs. The diaphragm moves approximately 1 cm, and the ribs retract upward from the body’s midline approximately 1.2 - 2.5 cm. During a normal, relaxed breath, a person inhales 500ml of air. This amount is referred as Tidal volume. Insta ; husain.z.kmu

9. Mechanism of breathing 2. Expiration / Exhalation: During expiration the diaphragm relaxes and the abdominal organs return to their original position. The thorax decreases in size, and thus the lungs are compressed. The ribs move downward and inward The sternum moves inward 3. Pause: the relaxation time between inspiration and expiration. The normal (breath) rate and depth of ventilation is called Eupnoea, interrupted by sigh. Insta ; husain.z.kmu

10. Types of breathing Costal (Thoracic ) Observed by the movement of the chest up ward and downward. Commonly used for adults 2. Diaphragmatic (Abdominal ) Involves the contraction and relaxation of the diaphragm, observed by the movement of abdomen. Commonly used for children. Insta ; husain.z.kmu

11. Factors affecting respiration: Body position Exercise Acute pain Medications Smoking Hemoglobin function Anxiety Abdominal trauma Neurological Injury Insta ; husain.z.kmu

12. Characteristics of the respiration: When the respiration rate is taken, several characteristics should be noted: Rate, Rhythm, Depth, and The quality or characteristics of breathing. Insta ; husain.z.kmu

13. Characteristics of the respiration: Respiratory Rate: It is the number of respirations per minute. The normal respiration rate for healthy adults at rest is 12 to 20 cycles per minute. Children have a more rapid rate of breathing than adults. Respiratory Rate Ranges of Various Age Groups Newborn 30–50 1–2 years old 20–30 3–8 years old 18–26 9–11 years old 16–22 12–Adult 12–20 Insta ; husain.z.kmu

14. Characteristics of the respiration: Respiratory Rate: Tachypnea—quick, shallow breaths Bradypnea—abnormally slow breathing Apnea—cessation of breathing Insta ; husain.z.kmu

15. Characteristics of the respiration:   Respiratory Rhythm: It refers to the regular and equal spacing of breaths. In a regular respiratory rhythm, the cycles of inspiration and expiration have about the same rate and depth. With irregular breathing patterns, the depth and amount of air inhaled and exhaled and the rate of respirations per minute will vary. Insta ; husain.z.kmu

16. Characteristics of the respiration: Respiratory Depth: The depth of respiration is the volume of air that is inhaled and exhaled. It is described as either “shallow” or “deep.” Rapid but shallow respirations occur in some disease conditions, such as high fever, shock, and severe pain. Hyperventilation refers to deep and rapid respirations, and hypoventilation refers to shallow and slow respirations. Insta ; husain.z.kmu

17. Characteristics of the respiration: Respiratory Quality: Respiratory quality or character refers to breathing patterns — both normal and abnormal. Labored breathing refers to respirations that require greater effort from the patient. Dyspnea —difficult and labored breathing during which the individual has a persistent, unsatisfied need for air and feels distressed Orthopnea —ability to breathe only in upright sitting or standing positions Breath Sounds: Normal respirations do not usually have any noticeable sounds. However, certain diseases and illnesses can cause irregular respiration sounds. Insta ; husain.z.kmu

18. Characteristics Of The Respiration: Abnormal breath sounds that are audible without amplification include the following: Stridor: A shrill, harsh sound, heard more clearly during inspiration but that can occur during expiration. This sound may occur when there is airway blockage, such as in children with croup and patients with laryngeal obstruction. – Stertor (stertorous breathing): Noisy sounds during inspiration, sounds similar to those heard in snoring. Crackles (also called rales): Crackling sounds resembling crushing tissue paper, caused by fluid accumulation in the airways. Insta ; husain.z.kmu

19. Characteristics Of The Respiration: Rhonchi — Rattling, whistling, low-pitched sounds made in the throat. Rhonchi can be heard in patients with pneumonia, chronic bronchitis, cystic fibrosis, or COPD. Wheezes — Sounds similar to rhonchi but more high pitched, made when airways become obstructed or severely narrowed, as in asthma or COPD. Cheyne-Stokes breathing — Irregular breathing that may be slow and shallow at first, then faster and deeper, and that may stop for a few seconds before beginning the pattern again. This type of breathing may be seen in certain patients with traumatic brain injury, strokes, and brain tumors. Insta ; husain.z.kmu

20. Assessment of respiration Respiratory rate Eupnoea ( 12 – 20/ min) Ventilatory depth: The depth of respiration is assessed by observing movement of chest wall A deep respiration involves a full expansion of the lungs with full exhalation. Ventilatory depth: Diaphragmatic breathing results from the contraction and relaxation of the diaphragm and is best observed by watching abdominal movements. Insta ; husain.z.kmu

21. Conti… Ventilatory diffusion and perfusion: The respiratory process of diffusion and perfusion can be evaluated by measuring the oxygen saturation of the blood. Color of skin Capillary refill Insta ; husain.z.kmu

22. Alterations in Respirations Apnea : Absence of breathing. Eupnea: Normal breathing Orthopnea : Only able to breathe comfortable in upright position (such as sitting in chair), unable to breath laying down. Dyspnea: Subjective sensation related by patient as to breathing difficulty. Paroxysmal nocturnal dyspnea attacks of severe shortness of breath that wakes a person from sleep Hyperpnea: Increased depth of breathing Tachypnea: Increased frequency without blood gas abnormality Bradypnea: is a respiratory rate that is lower than normal for age. Insta ; husain.z.kmu

23. Alterations in Respiration Hyperventilation : Increased rate or depth, or combination of both. Hypoventilation: Decreased rate or depth, or some combination of both. Kussmaul's Respiration: is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure. Insta ; husain.z.kmu