Respiratory Patterns Altered Respiratory Function Unit I

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Respiratory PatternsAltered Respiratory
FunctionUnit I

• Tracy Petleski, MSN, RN

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Respiratory Patterns Unit l

• Functional health status
• Consideration with the older adult
• Transcultural differences

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Respiratory patterns
Functional health status
Nursing considerations
How does functional status effect the patient?
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Respiratory Assessment

• Upper respiratory tract
• Nose, sinuses, pharynx, larynx and trachea
• Lower respiratory tract
• lungs, pleura, mediastinum, lobes, bronchi and
  alveoli

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Function of respiratory tract

• Upper airway function
• passage way for air to be filtered, warmed and
  directed through the system. The trachea connects
  via the larynx to the lower tree during coughing.
  Vocalization
• Lower airway
• area of gas exchange
• maintain acid- base balance

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Review of Assessment

• Position
• visual observation
• mental status
• auscultation
• present history of illness
• remote history
• collaborative problems
• focused history and physical

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Review of Assessment

• Risk factors
• environmental exposure

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Normal Assessment

• Respiration- regular and easy. Respiratory rate
  is between 12-24
• no use of accessory muscle use
• Sputum if any is thin and clear, white or buff
  color
• AP diameter is 21in adults

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Normal Assessment

• Mucous membranes are pink
• chest rises symmetrically
• ability to breath during sleep
• absent of persistent cough
• can perform ADLs without respiratory distress

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Age related changes

• Muscle strength decreases
• Tidal volume decreases
• Alveoli surface area is reduced
• Elasticity is lessened
• Respiratory dead space in increased
• Chest wall mobility is decreased
• Capillary blood flow is reduced

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Age related changes

• Reduced efficiency of coughing response
• Lack of basilar inflation

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Transcultural considerations

• Cultural beliefs
• Individual practices- rituals
• Provide culturally specific care
• Universal care promote wellness
• Nurses role in working with clients of
• various cultures
• Self- awareness issues

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Transcultural nursing

• Culturally competent care
• Integration of attitudes, knowledge and skills
• Decisions making,judgments and critical thinking

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Transcultural nursing

• Dietary needs
• Religious practices
• Visitation
• Touching
• Eye contact
• Verbal communication
• Gender roles
• Alternative medicine eastern v. western, witch
  doctor, spirits and others chi

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Assessment findings

• Air hunger anxiety, posturing, diaphoresis,
  pallor, altered breathing patterns.
• LOC
• HX
• Medications
• Collaborative problems
• Triage

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Collaborative problems

• COPD
• Pneumonia
• Respiratory failure
• Pleural effusion
• Pnuemothorax
• Hypoxia
• Empyema

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Nursing diagnosis

• What is the problem?
• What possible actions could help the situation?
• What other problems are coexisting?

NADA
Reference book.
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Nursing diagnosis

• Ineffective breathing pattern r/t dec lung
  expansion 2nd, fld., pain, anxiety, fatigue,
  weakness exertional dyspnea, poor air exchange.
• Impaired gas exchange r/t altered oxygen supply
  2nd bronchospasm, obstruction of airway
  exertional hypoxia, cyanosis, pallor.

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Nursing diagnosis

• Knowledge deficit regarding condition, Tx,
  self-care, diagnosis r/t poor comprehension.
• Activity intolerance r/t poor exercise tolerance
  exertional dyspnea and hypoxemia.
• Ineffective airway clearance r/t copious
  tenacious secretions 2nd to inflammation, non-
  productive cough and rhonchi.

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Nursing diagnosis

• Risk for aspiration r/t dysphagia 2nd to CVA
• Anxiety r/t air hunger, verbalizes it, tremors,
  diaphoresis, tachypnea.

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Nursing goals

• Promote airway
• Promote adequate ventilation
• Maintain clear airway
• Liquefy secretions
• Position of comfort
• Decrease anxiety
• Prevent transmission

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Nursing goals

• Monitor progression of disease and pt.s response
  to Tx
• Promote coughing and deep breathing
• Promote ambulation and mobility
• Promote comfort and minimize discomfort
• Promote a carative relationship

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Nursing goals

• Encourage verbalization of fears as well as
  feelings
• Teach about pathophysiology and therapeutic
  management and goals as well as health promotion
• Teach modification of lifestyle
• Refer to specialist and community agencies

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Planning

• Standards of care
• Interdisciplinary care
• outcomes

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Implementation

• Independent nursing actions
• Collaborative nursing actions
• Documentation
• Delegation
• Legal/ ethical issues

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Evaluation

• Problem solving
• Discharge planning
• Cost
• Managed care
• Environment
• Community
• Resources
• Pt. family teaching

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Nursing health issues

• Trends in care