Respiratory Flashcards
(59 cards)
Respiratory rate of neonate
40-60
Respiratory rates for infant
30-53
Respiratory rates for toddler
22-37
Respiratory rates for preschoolers
20-28
Respiratory rates for school age child
18-25
Respiratory rates for adolescent
12-20
Respiratory rates for adults
12-20
Adequate breathing
Average rate
Rhythm
Quality
Depth(tidal volume)
What is agonal respiration
Agonal respirations are gasping type breaths. If seen in a cardiac arrest patient they usually appear soon after the person goes into cardiac arrest.
What does the patient need for agonal respiration
A patient with agonal restoration must be provided positive pressure ventilation.
What to do if patient is having agonal respirations and not yet in cardiac arrest.
Immediately check the patience pulse Because these respirations are often found early in cardiac arrest.
What are signs of inadequate breathing
Rate- The respiratory rate is inadequate , either too fast or too slow and outside of the range
Tackypnea- Is excessively rapid breathing rate and May indicate inadequate oxygenation and breathing especially in adults.
Bradypnea- Is an abnormally slow breathing rate And an ominous sign of inadequate breathing And oxygenation in infants and children.
Rhythm- An irregular breathing pattern may indicate a severe brain injury or medical illness. Most irregular breathing patterns also produce an inadequate rate ,depth and quality.
Quality- Breath sounds that are decreased or absent indicate an An adequate volume of air Moving in and out of the lungs with each breath.
Abnormal work of breathing
. Retraction
. Nasal flaring
. Abnormal breathing
. Diaphoresis
Abnormal upper airway sounds.( Occluded or partially occluded airway leads to inadequate breathing)
. Stridor
. Sonorous or snoring
. Gurgling
Abnormal breathing sounds( Heard on auscultation of the thorax)
. Wheezing
. Crackles
.rhochi- Snoring sound on auscultation
. Silent chest( No breathing sound heard)
. Unequal breath sounds(trauma, infection and pneumothorax)
Reduced minute ventilation
. Decreased title volume- chest does not rise adequately with each breath
. Inadequate respiration rate- Too faster too slow to maintain an adequate minute ventilation
inadequate chest wall movement or chest wall injury
. Paradoxical chest wall movement ( Chest wall segment moves in during inspiration and outduring expiration, Which is the reverse of normal)
. Splinting of the chest wall
. Asymmetrical chest wall movement
Irregular respiration pattern( Head injury,stroke, Is metabolic derangement, And toxic inhalation)
Rapid respiratory rate without clinical improvement in the Patient’s condition.
Bradypnea
Is an abnormally slow breathing rate and an ominous sign of inadequate breathing and oxygen and infants and children.
Signs of bradypnea
Rhythm- An irregular heart pattern may indicate a severe brain injury or medical illness. Most Irregular breathing patterns also Produced in an adequate rate,depth and quality.
Differences between normal spontaneous ventilation and positive pressure ventilation
. Air movement- In normal spontaneous ventilation , the negative pressure created by increasing size of the Thorax draws air into the lungs. Positive pressure ventilation is just that- You are delivering ventilation through positive pressure. You are forcing air into the lungs regardless of the pressure changes Thorax. If a patient has a condition or android that does not allow the door acts to expand Adequately, Such as a flail segment, There is not enough negative pressure generated to draw enough air into the lungs with Is the application of positive pressure ventilation, The patient negative pressure,, In this situation the treatment of Choice Is to force air into the lungs and Avioli
. Airway wall Pressure- Airway wall pressure is not affected during normal ventilation. However during positive pressure ventilation, The Airway walls are pushed outward creating a Larger space. This requires higher volume to fill The larger space and ventile The patient effectively.
. Esophageal opening pressure- The esophagus is a soft, Flexible structure. During normal ventilation, The sophogous remains collapsed and no air moves into it. Positive pressure venolation can over Calm the asophius opening pressure, Allowing air to enter the esophagus and fill the stomach with air Is during venolation. This leads to gastric distension and the Possibility of Regirgitation, Which?
Increases the risk of Compromising the airway and aspiration of gastric Contents.
. Cardiac output- Normal spontaneous ventilation does not Adversely effect the cardiac Is output or blood pressure. The negative pressure generated and the thorax prior to inhalation , acts like a vacuum and sucks venous Blood into the inferior vena cava from the body below The level of the diaphragm. This provides an adequate amount of venus blood volume to the right side Of the heart. Preload is dependent on Venus volume and the amount of blood ejected From the
Right ventricle. an adequate preload Contribute.
S to an adequate stroke volume, Cardiac output, And blood pressure. This Is known as cardiothoratic pump effect. During positive pressure venolation, The thorax generates positive pressure during the inhalation phase as air is forced into the lungs. With the loss of negative pressure generated during normal ventilation, The vacuum effect is diminished and Venus returns decreases. This sandy creases the pre load, Introduces a strug volume, Cardiac.
Output, Blood pressure, And profusion. In a patient with No pulse who is in cardiac arrest or has a condition in which air is already trapped in the lungs, Creating a more positive environment, Search as Pneumothorax This effect can be significant and lead to poor profusion of the brain heart and body.
The method that the m t can use to artificially ventilate the patient are as followed
Mouth mask
Bag-valve mask(BVM) Operated by two people Is operated by two people
Bag-valve mask(BVM) Is operated by one person
Indications that the patient is adequately ventilated
The rate of ventilation is adequate. Infants and children must be ventilated at a rate of twelve to twenty times per minute, Once every three seconds(20 times per minute) If a post is present. The rate for an adult with a pulse is ten to twelve times per minute, Once every six seconds(10 times per minute) Or once every five seconds(12 times per minute) Every ventilation should be delivered over one second. By delivering a slow constant ventilation over one second And not a fast sudden jet of air into the airway, The esophageal pressures Are much less likely to be overcome. Therefore, No.
Air or less air will Enter the esophagus And travel to the stomach, Thereby Reducing the incidence Is a gastric distinction, Vomiting, And Aspiration. If the patient has no pulse, The venolations are performed In conjunction With chess compression Add a ratio of thirty compressions to 2 Vinellations in adults, Children, And infants(excluding newborns) A ratio of fifteen compressions to 2 ventilations Should be used in Infants and children when two rescuers are available. The rate of venolation for a newborn Infant with a This pulse is forty two sixty Is ventilations per minute. In the new born with no pulse, The ratio Of chest compressions to ventilations is 3:1 or 90 Compressions to dirty ventilations.
The tidal volume must be consistent, It must also be sufficient to cause the chance to rise during Ventilation. Inspect the chest with each ventilation to ensure adequate rise.
The patient’s heart rate returns to normal.( Are there underlining conditions may prevent return Of a normal heart rates even when venolations are adequately Performed).
Color improvement- The pale, Grey, Or Cyanotic color Begins to lessen and disappear.
Inadequate ventilation indications of inadequate ventilation
. The ventilation rate is inadequate- Ventilating a patient too rapidly does not allow for adequate inhalation and can also cause gastric distention. To slow of rate of ventilation does not provide an adequate amount of oxygon. Other dangers associated with overventilation of patients are discussed later in the chapter.
. The chest does not Rise and fall with ventilation- This is.
An Indication Volume being delivered is not adequate. This may be due to failure to use the ventilation device Properly or to an airway Obstruction. A common.
Cause of An effective ventilation is a poor mask seal that allows a portion of The ventilation to escape. If the patient’s chest does not fall, It may be a sign that the airway is not properly opened or that the ventilation Device or upper or lower airway is obstructed, Preventing adequate Exhalation.
. The heart rate does not return to normal. With ventilation.-( Remember, However, To consider the source of the heart rate Disturbance, Is such as blood loss, Anxiety, Or heart problems.)
. Color does not improve.- The skin color Remains extremely pale, cyanotic, or grey
