• dyspnea management:
-elevate head of bed
-resting before meals
-meds if possible
• client experiencing altered respiratory function and altered tissue perfu-sion (evaluation):
-Ask patient how they believe they're responding
-Compare patient's progress to expected outcomes
-modify care plan and reevaluate if not successful
• normal cardiac output: 4-6L Per minute at rest
• Cardiac output equation: HR x SV
• what is stroke volume affected by: preload, afterload, contractility
• preload: end diastolic pressure
• afterload: resistance to left ventricular ejection (hypertension increases this)
• forced vital capacity: the maximum amount of air that can be removed from thelungs during
forced expiration
• myocardial contractility of elderly population: stiffer with slower ventricularfiling rate
and prolonged cx time
• normal WBC count: 5,000-10,000/mm3
• what diagnostic test can show tumors in the lungs: X-ray
• what test is used to indicate if someone has tuberculosis: Tb skin test
• common laboratory studies used to assess the function of the respiratorysystem.:
HgB/RBC: O2 is transported through HgB in the RBCs
• how does impaired mobility negatively impact the body/respiratory sys-tem: it causes a
higher risk for atelectasis and pneumonia
• how to compensate for cardiac and peripheral adverse medical conditions by use of
mobility and positioning techniques to improve circulation.: -ambu-late pt
-reposition pt
-fluids
-incentive spirometry
-splinting
,• how often should you reposition a patient: every 2 hours
• what position is most effective for promoting lung expansion and reducing abdominal
pressure: Semi-fowler's position (you don't want the pt to be in supinepos)
• postural drainage: drainage, positioning, and turning accompanied by chestpercussion and
vibration (gravity aids drainage)
• chest percussion: clapping on chest wall over area being drained to force thesecretions
into larger airway for expectoration
• how much fluid should be given to a patient to liquify secretions: -
2800mL/24hrs
• how many times per hour should an incentive spirometer be used: 6-8 times/hr to increase
voluntary deep breathing amount (measure inspiration/expira-tion)
• splinting: post-op patient holding a PILLOW on their incision site to relieve painwhen
coughing and deep breathing
8-10 x/hr
• CPAP/BiPAP: Noninvasive ventilation.
-At home use: sleep apnea.
-Hospital use: help with oxygen and breathing
• Maintenance and Promotion of Lung Expansion: -ambulation
-positioning
-incentive spirometer
-noninvasive ventilation
• pneumothorax: air in the pleural cavity
• hemothorax: blood in the pleural cavity
• oxygen therapy may be used for: -relief/prevention of hypoxia
-environmental factors like smoke
• should you give COPD patients high levels of O2 if breathing spontaneous-ly: No, this may
result in decreased stimulus of breathing due to dec. of CO2 (NO more than 2 L/min)
• Labs/Dx tests for pt with altered cardiorespiratory function and alteredtissue perfusion:
HgB, RBC, CO2
• nursing process for client experiencing altered cardiorespiratory functionand altered tissue
perfusion (implementation): -Cardiopulmonary resuscitation (CPR)
-Cardiopulmonary rehabilitation
, -Respiratory muscle training
-Breathing exercises
• CPR: circulation, airway, breathing, defibrillation
• cardiopulmonary rehabilitation: exercise, nutrition, relaxation/stress manage-ment,
medications, oxygen, compliance, system hydration
• breathing exercises: pursed lip breathingdiaphragmatic breathing
deep-breathing and coughing exercises
• pursed lip breathing: involves deep inspiration and prolonged expirationthrough pursed
lips to prevent alveolar collapse.
• diaphragmatic breathing: useful for patients with pulmonary disease, postop-erative
patients, and women in labor to promote relaxation and provide pain control.
• cardiorespiratory conditions affecting sleep: -circadian rhythm
-insomnia
-sleep apnea
-narcolepsy
-sleep deprivation
-parasomnia
• circadian rhythm is affected by: - light, temperature, work routines
-Aging: experience weakening/ desynchronized circadian rhythm
• Good sleep hygiene: • Regular bedtimes, wake times (routine)
• Cool, quiet,
• Avoid large meals, alcohol, caffeine before bed
• Avoid heavy exercise before bed
• Avoid long naps during the day
• insomnia: recurring problems in falling or staying asleep
-ask sleep schedule
• hypoventilation: decreased rate or depth of air movement into the lungsCauses excessive
CO2 retention= respiratory acidosis & respiratory arrest
S/S: mental status change, dysrhythmias, cardiac arrect, convulsions, unconscious-ness, death
• hyperventilation: increased rate and depth of breathing Causes: severe anxiety, infection,
drugs, acid-base imbalance