Introduction to the Respiratory System Quiz Game and Flash Cards

Oxygen Therapy Overview

• Oxygen therapy enhances tissue oxygenation, vital for patients with respiratory issues.
• Common delivery devices include nasal cannulas, nasal catheters, and various oxygen masks.

Techniques for Airway Management

• Effective coughing techniques are essential for maintaining a patent airway.
• Implementation of suctioning aids in clearing secretions and preventing airway obstruction.

Venturi Mask

• The Venturi mask precisely controls oxygen concentration, suitable for patients needing specific oxygen levels.

Safety Precautions

• Adhering to safety protocols is crucial in both clinical and home environments to prevent complications.

Hypoxia Indicators

• Signs and symptoms of hypoxia encompass neurological changes, vital sign alterations, cardiac dysrhythmias, and changes in mucous membrane color.
• Distinction between early and later signs of hypoxia is important for timely intervention.

Oxygen Therapy in COPD

• Patients with Chronic Obstructive Pulmonary Disease (COPD) require lower oxygen concentrations to avoid respiratory center suppression.

Airway Maintenance

• Endotracheal tubes are designated for short-term airway management.
• Tracheostomy is implemented for long-term airway maintenance and can utilize cuffed or non-cuffed tubes depending on patient needs.

Tracheostomy Care

• Tracheostomy care and suctioning can be performed by healthcare professionals, patients, or caregivers, and should always maintain sterile technique.
• A tracheostomy collar is used to deliver oxygen to individuals with a tracheostomy in place.

Suctioning Techniques

• The Yankauer suction catheter is specifically designed for oropharyngeal suctioning, essential for maintaining airway clearance.

Respiratory System Functions

• Primary role is the exchange of oxygen and carbon dioxide at the alveolar-capillary level.
• The alveolus is the key structure where gas exchange takes place.

Respiratory Mechanics

• One respiration consists of one inspiration (inhalation) plus one expiration (exhalation).
• Breathing requires pressure changes within the thoracic cavity to occur effectively.
• Lung expansion and contraction are influenced by musculoskeletal and neurological functions alongside physiological conditions.

Air Preparation

• Inhaled air is warmed, moistened, and filtered to prepare it for body use.

Activity Tolerance

• Decreased oxygenation and ventilation affect overall activity tolerance.
• Anxiety worsens pulmonary disorders, increasing oxygen demand in the body.

Breathing Techniques

• Breathing exercises enhance ventilation and can include:
  • Elevating the head and chest to maintain airway openness.
  • Deep breathing and coughing exercises to improve lung expansion.
  • Pursed-lip breathing to reduce the effort required for breathing.

Hydration and Humidity

• Adequate fluid intake and humidity are crucial for moistening secretions, aiding in their clearance from the airways.

Psychosocial Considerations

• Patients with laryngectomy require thorough psychosocial assessment due to vocal loss and potential neck/face disfigurement.

TB Diagnostics

• QuantiFERON-TB Gold (QFT-G) is a blood test approved by the FDA in May 2005 for diagnosing latent TB infection and active TB.
• QFT-G may offer greater specificity compared to traditional PPD skin tests.

SARS Information

• SARS is a serious acute respiratory infection caused by a coronavirus.
• Individuals suspected of having SARS should be placed in respiratory isolation, using appropriate disposable particulate respirators to protect others.

Introduction to the Respiratory System

• The respiratory system enables oxygen exchange for cellular respiration, vital for sustaining life.
• Understanding respiratory anatomy and physiology is crucial for nursing practice, especially in critical care settings.
• Nurses must perform various roles, including care for patients in diverse environments, requiring proficiency in respiratory assessment.

Respiratory System Functions and Anatomy

• External Respiration: Gas exchange between lungs and environment; air is inhaled, warmed, filtered, and moistened.
• Internal Respiration: Gas exchange at the cellular level; oxygen enters cells while carbon dioxide exits, facilitated by diffusion.
• Upper Respiratory Tract Components:
  • Nose: Filters, warms, and moistens air; contains nasal septum and turbinates to optimize surface area.
  • Pharynx: Serves as a passage for air and food; subdivided into nasopharynx, oropharynx, and laryngopharynx.
  • Larynx: Connects pharynx to trachea; contains vocal cords and is protected by the epiglottis to prevent food entry.
  • Trachea: Tube with C-shaped cartilage rings, leading to bronchi; lined with cilia and mucus to trap debris.

Lower Respiratory Tract Components

• Bronchial Tree:
  • Right bronchus is larger and more vertical, prone to aspiration; left bronchus is smaller and slightly horizontal.
• Bronchioles: Smaller branches of bronchi leading to alveoli.
• Alveoli: Main site of gas exchange; thin-walled and surrounded by capillaries; coated with surfactant to prevent collapse.

Mechanics and Regulation of Breathing

• Thoracic Cavity:
  • Contains lungs situated within the mediastinum; surrounded by pleura which produces serous fluid for lubrication.
• Regulation of Respiration: Governed by the medulla oblongata and pons, influenced by chemoreceptors responding to pH and gas levels in the blood.

Respiratory Assessment and Oxygen Therapy

• Comprehensive assessment needed for patients with respiratory issues; crucial for managing acute and chronic conditions.
• Subjective Data: Cough characteristics, shortness of breath (SOB) or dyspnea on exertion (DOE), and relief measures.
• Objective Data: Observations of respiratory distress, chest movement, lung auscultation for abnormal sounds (e.g., wheezes, crackles).
• Hypoxia symptoms include anxiety, disorientation, cyanosis, and clubbing of fingers as hypoxia progresses.

Oxygen Therapy Essentials

• Various devices available based on patient needs; nurse's competency directly affects patient outcome.
• Flow rate ordered in liters per minute; the FiO2 indicates the concentration of oxygen provided.
• Safety protocols include avoiding sources of combustion, proper storage of oxygen cylinders, and monitoring skin integrity when using devices.

Lifespan Considerations

• Normal arterial oxygen levels decline with age; older adults are more susceptible to skin irritation from oxygen devices.
• Careful monitoring and adjustments in therapy may be required to avoid respiratory drive complications in patients with chronic lung issues.

Summary

• Reviewed respiratory system anatomy and assessment techniques.
• Importance of understanding both upper and lower respiratory systems for effective nursing care.### Early Interventions to Prevent Impairment
• Loosening straps can help prevent facial or pressure injuries.
• Repositioning tubing ensures proper oxygen delivery and comfort.
• Adding padding over ears reduces discomfort from medical devices.

Administering Oxygen

• Oxygen therapy is like medication; follow the six medication rights.
• Requires a healthcare provider’s order and must be critically evaluated.
• The nurse is responsible for the correct administration and adjustment of oxygen flow rates.
• Placement of oxygen devices can be delegated, but flow rate adjustments cannot.

Patient Considerations for Oxygen Therapy

• Increased oxygen levels may alter respiratory drive in some patients.
• High oxygen levels can cause pulmonary tissue scarring and blindness.
• Prolonged exposure to high FiO2 can cause lung changes similar to ARDS.

Oxygen Equipment

• Nasal Cannula: Insertion into nasal cavity; up to 6 L/min provides 24-44% FiO2; humidification needed above 4 L/min; assists patient mobility but risks necrosis.

• Masks:

  • Simple Face Mask: 5-8 L/min with 35%-55% FiO2.
  • Partial-Rebreather Mask: 6-12 L/min delivering 60-90% FiO2; prevents bag collapse during inspiration.
  • Non-Rebreather Mask: 6-15 L/min providing 70-100% FiO2; includes valves to prevent bag deflation.
  • Venturi Mask: Delivers consistent FIO2 between 24-55%, regardless of breathing pattern.

Patient Education on Oxygen Use

• Proper application of oxygen equipment and safety precautions is vital.
• Avoid making unapproved adjustments to the oxygen flow rate.
• Encourage mobility to promote secretion clearance.
• Instruct on cough techniques, fluid intake, and oral hygiene.

Diagnostic Exams for Respiratory System

• Chest X-Ray: Visualizes thoracic cavity; identifies abnormalities and pulmonary disorders.
• CT Scans: Non-invasive imaging of lung tissue; used for lesions detection; may require patient teaching to ease anxiety.
• Pulmonary Angiography: Contrast imaging of pulmonary vasculature to detect embolism and lesions.
• Ventilation-Perfusion (V/Q) Scan: Assesses airflow and blood flow in lungs; abnormal scans suggest pulmonary embolism.

Pulmonary Function Tests (PFT)

• Evaluate presence and severity of respiratory disease.
• Assess lung volumes, ventilation, and gas exchange via spirometry.
• Includes measurements like Vital Capacity (VC), Inspiratory Capacity (IC), and Total Lung Capacity (TLC).

Surgical and Invasive Diagnostic Procedures

• Mediastinoscopy: Endoscopy for lymph node biopsy using general anesthesia.
• Bronchoscopy: Visualization of bronchi; allows for biopsy and secretion collection; strict patient monitoring post-procedure.
• Sputum Specimen Collection: Obtained for lab analysis; proper technique necessary to ensure quality samples.

Arterial Blood Gas (ABG) Analysis

• Essential for diagnosing and monitoring respiratory disorders.
• Measures the exchange of oxygen and carbon dioxide, along with acid-base balance.
• Normal ABG Values:
  • pH: 7.35-7.45
  • PaCO2: 35-45 mmHg
  • PaO2: 80-100 mmHg
  • HCO3: 21-28 mEq/L
  • SaO2: 95%

Conclusion on Summary of Oxygenation and Diagnostics

• Understand key concepts of oxygen administration, equipment, and patient interaction.
• Recognize diagnostic tests for respiratory assessment and their implications for patient care.
• Emphasize the importance of patient education and safety during oxygen therapy and diagnostic procedures.### Method of Instruction
• Lecture format with an instructor to student ratio of 1:60.
• Instruction duration is 5 minutes, emphasizing large group interaction.

Student Engagement

• Assess student comprehension through questions and explanations.
• Address misunderstandings and provide feedback on the lesson.
• Review and summarize key points of the lecture.

Main Points of Review

• Key terms related to the respiratory system.
• Anatomy and physiology of the respiratory system.
• Nursing assessment techniques for patients with respiratory disorders.
• Overview of oxygen therapy.
• Common diagnostic tests for respiratory conditions.
• Interpretation of arterial blood gases (ABGs).
• Classroom activities to facilitate interaction and understanding of diagnostic exams and patient assessment.

Importance of Assessment

• Assessing respiratory function is crucial for identifying normal and abnormal ventilation signs in patients with respiratory disorders.
• The goal of care is to early detect ventilatory dysfunction, ensuring prioritized and effective patient care.

Student Evaluation

• Students demonstrate accomplishment of training learning objectives (TLO) as outlined in the Individual Student Assessment Plan.
• Evaluation methods consist of written tests, oral assessments, simulated performance exercises, and clinical performance evaluations.

Feedback and Remedial Training

• Feedback is vital for effective learning and should be scheduled and provided post-evaluation.
• Clarify previous instruction and reinforce learning during follow-up lessons.
• Correct any learning and performance errors, responding to student questions.
• Remedial training available "after hours" before reevaluation sessions.