PNUR 124
Week 8 Study Guide
Discuss the nursing role in the prevention and transmission of infectious respiratory conditions in the
hospital and in community settings.
● Wear appropriate PPE
● Hand hygiene
● Chain of Infection
Structures of the Respiratory System
1
,PNUR 124
Normal Respiratory Process
● Ventilation: movement of air into and out of the lungs and has two phases
o Inspiration (movement of air into the lungs)
Diaphragm contracts and relaxes and flattens
Intercostal muscles contract; increases size of chest cavity
The lungs stretch and volume increases
The pressure in lungs is slightly less than atmospheric pressure (this causes air to rush
in).
o Expiration (movement of air out of the lungs)
Passive
Muscles relax
Diaphragm rises
Ribs descend
Lung recoil
The pressure in the chest cavity increases (compressing the alveoli)
Pressure in lungs greater than atmospheric causes gases to flow out of the lungs
● These two phases make up a breath, which normally occur 12-20 per minute
Factors Affecting Respirations
● Airway resistance
o Resistance to airflow (the narrower the airway, the greater the resistance to flow)
o Determined by size of the airway through which the air is flowing.
o ↑resistance results in a greater than normal respiratory effort to enable ventilation.
o Some factors that directly affect airway resistance:
o Thickening of bronchial mucosa (chronic bronchitis)
o Obstruction of the airway (by mucus)
o Contraction of bronchial smooth muscle (asthma)
o Loss of lung elasticity (emphysema)
● Respiratory center of the brain
● Chemoreceptors in the brain, aortic arch, and carotid arteries
● Compliance of lung
o The dispensability of the lung, or how well the lung stretches.
o A measure of the elasticity, and the ability of the lung to expand. (consider an elastic band,
when it is stretched it returns to its normal shape)
o Compliance is normal if the lungs and thorax easily stretch and distend when pressure is
applied. (↑or ↓ compliance occurs if lungs have lost elasticity e.g., pneumothorax, atelectasis,
pulmonary edema).
● Elasticity
● Surface tension of alveoli
Physiological Factors Affecting Respirations.
● Increased metabolic rate
● Hypoxia
2
, PNUR 124
● Hyper/hypoventilation
● Hypercapnia
● Anemia
● Fever : ↑ metabolic rate = increase tissue O2 demand
● Airway obstruction
● High altitude: atmospheric O2 concentration ↓
Age Related Changes
● The older adult experiences multiple changes to the
respiratory system:
● Decreased elastic recoil
● Decreased cilia
● Less effective cough force
● Chest wall becomes stiffer
● Decrease response to hypoxemia
● Decrease functioning alveoli
● Decrease cell mediated immunity and alveolar
macrophages.
Discuss current issues, trends and research related to respiratory infections.
●
Describe the practices followed in infection control for patients with:
Influenza**** (while not on your course outline specifically for this week (as it is a review from
discussions on infection control), this is such a common infectious respiratory condition it should be
reviewed and reinforced again
Tuberculosis
Pneumonia
Identify which populations of individuals should be immunized against the ‘flu’ .
●
State common side effects of the flu vaccine.
●
What individuals should not be given the flu vaccine?
●
Nursing Assessment of Respiratory System
● Subjective Data
o Past Health history (of any resp disorders, dyspnea etc.)
o Medications
o Surgery
3
Week 8 Study Guide
Discuss the nursing role in the prevention and transmission of infectious respiratory conditions in the
hospital and in community settings.
● Wear appropriate PPE
● Hand hygiene
● Chain of Infection
Structures of the Respiratory System
1
,PNUR 124
Normal Respiratory Process
● Ventilation: movement of air into and out of the lungs and has two phases
o Inspiration (movement of air into the lungs)
Diaphragm contracts and relaxes and flattens
Intercostal muscles contract; increases size of chest cavity
The lungs stretch and volume increases
The pressure in lungs is slightly less than atmospheric pressure (this causes air to rush
in).
o Expiration (movement of air out of the lungs)
Passive
Muscles relax
Diaphragm rises
Ribs descend
Lung recoil
The pressure in the chest cavity increases (compressing the alveoli)
Pressure in lungs greater than atmospheric causes gases to flow out of the lungs
● These two phases make up a breath, which normally occur 12-20 per minute
Factors Affecting Respirations
● Airway resistance
o Resistance to airflow (the narrower the airway, the greater the resistance to flow)
o Determined by size of the airway through which the air is flowing.
o ↑resistance results in a greater than normal respiratory effort to enable ventilation.
o Some factors that directly affect airway resistance:
o Thickening of bronchial mucosa (chronic bronchitis)
o Obstruction of the airway (by mucus)
o Contraction of bronchial smooth muscle (asthma)
o Loss of lung elasticity (emphysema)
● Respiratory center of the brain
● Chemoreceptors in the brain, aortic arch, and carotid arteries
● Compliance of lung
o The dispensability of the lung, or how well the lung stretches.
o A measure of the elasticity, and the ability of the lung to expand. (consider an elastic band,
when it is stretched it returns to its normal shape)
o Compliance is normal if the lungs and thorax easily stretch and distend when pressure is
applied. (↑or ↓ compliance occurs if lungs have lost elasticity e.g., pneumothorax, atelectasis,
pulmonary edema).
● Elasticity
● Surface tension of alveoli
Physiological Factors Affecting Respirations.
● Increased metabolic rate
● Hypoxia
2
, PNUR 124
● Hyper/hypoventilation
● Hypercapnia
● Anemia
● Fever : ↑ metabolic rate = increase tissue O2 demand
● Airway obstruction
● High altitude: atmospheric O2 concentration ↓
Age Related Changes
● The older adult experiences multiple changes to the
respiratory system:
● Decreased elastic recoil
● Decreased cilia
● Less effective cough force
● Chest wall becomes stiffer
● Decrease response to hypoxemia
● Decrease functioning alveoli
● Decrease cell mediated immunity and alveolar
macrophages.
Discuss current issues, trends and research related to respiratory infections.
●
Describe the practices followed in infection control for patients with:
Influenza**** (while not on your course outline specifically for this week (as it is a review from
discussions on infection control), this is such a common infectious respiratory condition it should be
reviewed and reinforced again
Tuberculosis
Pneumonia
Identify which populations of individuals should be immunized against the ‘flu’ .
●
State common side effects of the flu vaccine.
●
What individuals should not be given the flu vaccine?
●
Nursing Assessment of Respiratory System
● Subjective Data
o Past Health history (of any resp disorders, dyspnea etc.)
o Medications
o Surgery
3
