Exam 3-LAH Study Guide|Elaborated| NR 302 Health Assessment 1 -2021

Exam 3-LAH Study Guide|Elaborated| NR 302 Health Assessment 1 -2021Exam Guide |Elaborated| NR 302 Health Assessment 1 -2021Chapter 15 – Respiratory 4 major functions  Supplying oxygen for energy  Removing carbon dioxide  Acid-base balance (homeostasis)  Maintaining heat exchange Control of respirations – normal stimulus, alternative stimulus and what condition  Pons and medulla  Normal stimulus (Hypercapnia)  Decrease in O2 in blood (Hypoxemia)  Inspiration (Active) expiration (passive) Lower – bronchi, pleural membranes, muscles of respiration (normal, accessory)  Bronchi- right main bronchus  Pleural membranes- the parietal lines diaphragm and thoracic wall, the visceral lines outer surface of lung, and pleural fluid acts as lubricant  Muscles of inspiration- normal( intercostal muscles, diaphragm), accessory ( neck, abdomen, chest) Anterior Landmarks – sternum (Angle of Louis, sternal angle, 2ICS), clavicle, costal angle (normal)  Costal angle < 90 degrees Posterior Landmarks – vertebra prominens, spinous processes (T1 to T4), CVA tenderness  Vertebra prominens- C7 (if 2 bumps equally prominent C7, T1)  Spinous processes- aligned w/ same numbered rib to T4  CVA tenderness- kidney problems References Lines – anterior, posterior, and lateral thorax  Anterior- sternal, midclavicular, anterior axillary  Posterior- vertebral, scapular, posterior axillary  Lateral- anterior axillary, midaxillary, posterior axillary Lobes (3 on right, 2 on left), apex versus base  Right- upper, middle, lower lobes  Left- upper, lower lobes  Apex (highest point) anterior and 3-4 cm above clavicle  Base (lower border) Pediatric (AP:Transverse diameter, abdominal breathing, role of surfactant)  AP: transverse 1:1 ratio  Abdominal breathing until 5-7 yrs Pregnant (Diaphragmatic breathing, SOB, costal angle changes, lordosis)  Muscles and cartilage of the ribs relaxes o Diaphragm rises into chest to accommodate fetus o Diaphragmatic breathing o Shortness of breath (SOB), dyspnea, increase awareness of breathing in last trimester  Total oxygen demand can increase 20%  Costal angle widens  Deeper breathing, respiratory rate unchanged  Lordosis or swayback, “waddling” gait Geriatric (overall aging changes to respiratory rate and depth, vital capacity, alveoli); cough ability, kyphosis