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UNIT-VII RESPIRATION

UNIT-VII RESPIRATION. PRESENTED BY: Mrs. PRASHMA. LEARNING OBJECTIVES. Define respiration Describe the mechanics of respiration Explain the characterestics of respiration List out the factors affecting respiration Discuss the alterations in respiration

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UNIT-VII RESPIRATION

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  1. UNIT-VIIRESPIRATION PRESENTED BY: Mrs. PRASHMA

  2. LEARNING OBJECTIVES Define respiration Describe the mechanics of respiration Explain the characterestics of respiration List out the factors affecting respiration Discuss the alterations in respiration Explain the assessment of respiration

  3. INTRODUCTION Respiration, process by which an organism exchanges gases with its environment. The term now refers to the overall process by which oxygen is abstracted from air and is transported to the cells for the oxidation of organic molecules while carbon dioxide (CO 2) and water, the products of oxidation, are returned to the environment.

  4. RESPIRATION DEFINITION : • Mechanism that body uses to exchange gases between the atmosphere and the blood and the cells. • Respiration is the exchange between oxygen and carbon dioxide in the body.

  5. MECHANICS OF RESPIRATION • INSPIRATION • EXPIRATION INSPIRATION • During inspiration - contraction of muscles of respiration -diaphragm descends -rib cage rises. -abdominal organs move downward and forward

  6. MECHANICS OF RESPIRATION EXPIRATION • During expiration -relaxation of muscles of respiration -diaphragm rises -rib cage returns to normal position - abdominal organs return to original position.

  7. PHYSIOLOGY OF RESPIRATION: It involves ventillation, diffusion, and perfusion. Ventillation: • It is the movement of gases in and out of the lungs. • It is assessed by determining the rate ,depth, rhythm of respiration. Diffusion: • It is the movement of oxygen and carbon dioxide between the alveoli and the red blood cells. (in the blood vessel)

  8. PHYSIOLOGY OF RESPIRATION: Perfusion: • It is the distribution of red blood cells in the pulmonary • capillaries. • Oxygen delivers into cells and tissues. GAS EXCHANGE: • Oxygen enters lungs and reaches alveoli • Oxygen passes through alveolar membrane into the blood.(RBC) • Distribute into the tissues

  9. CONTROL OF RESPIRATION • Respiratory centre in the brain stem regulates the involuntary control of respirations. • Normal respiratory rate for an adult is 12 - 20 breaths / minute

  10. CHARACTERISTICS OF RESPIRATION • RATE It is the number of full respirations in a minute. (a) Age - At birth 30 - 60/ minute Infants 30 - 50/ minute Toddler 25 - 32/ minute Adolescent 16 - 19/ minute Adult 12 - 20/ minute

  11. CHARACTERISTICS OF RESPIRATION (b) Sex -Females have rapid respirations than males. (c) Emotions -stress increases the rate. (d) Exercise -Exertion increases metabolic rate and thus stimulates respiration. • Changes in external temperature. • Ingestion of food and digestion.

  12. CHARACTERISTICS OF RESPIRATION • DEPTH - by observing the movement of chest wall. • RHYTHM Normal - regular respiration

  13. Factors affecting respiration :- • Exercise -Rapid and deep respiration • Acute pain rapid and shallow respiration. • Anxiety -increases rate and depth of respiration. • Smoking -increased rate of respiration • Age • Body positions -erect posture promotes full chest expansion.

  14. Factors affecting respiration(conti…) :- • Medication -depresses respiration. • Neurological injury -Injury to brain stem impairs the respiratory centre. • Hemoglobin function

  15. ASSESSMENT OF DIFUSION AND PERFUSION • By measuring oxygen saturation: It is the amount of oxygen that is dissolved in blood. • Pulse oximetry: Method of measuring oxygen saturation.

  16. ALTERATIONS IN RESPIRATION • Bradypnea: Respiratory rate less than 12 breaths / minute. • Tachypnea: Increased rate of respiration, above 20 breaths/ minute. • Hyperpnoea: Labored respiration,increased breathing rate and depth.

  17. ALTERATIONS IN RESPIRATION • Apnea: - temporary stoppage of respiration for several seconds. • Hyperventilation: -increase in rate and depth of respiration. • Hypoventilation: -low rate and depth of respiration

  18. ALTERATIONS IN RESPIRATION • Cheyne-stoke’s respiration. - gradual increase in rate and depth of respiration followed by periods of apnea.( regular) • Kussmaul’srespiration/ air hunger -abnormally deep, regular and rapid respiration • Biot’s respiration -abnormally shallow breaths followed by irregular period of apnea.

  19. ASSESSING RESPIRATIONS Equipments required • Wristwatch in second hand or digital display • pen, vital sign flow sheet or record form

  20. STEPS • Determine need to assess client’s respirations - note risk factors for respiratory alterations - assess for signs and symptoms of respiratory alterations • Assess pertinent laboratory values: - arterial blood gases (ABGs) - Pulse oximetry (SPO2) - Complete blood count (CBC)

  21. STEPS(CONTI….) • Determine previous baseline respiratory rate from client’s record • Perform hand hygiene • Be sure client is in comfortable position preferably sitting or lying with the head of the bed elevated 45 to 60 degrees. • Be sure client’s chest is visible. If necessary move bed linen or gown

  22. STEPS(CONTI….) • Place client’s arm in relaxed position across the abdomen or lower chest or place nurse’s hand directly over client’s upper abdomen • Observe complete respiratory cycle( one inspiration and one expiration) • After cycle is observed, look at watch’s second hand and begin to count rate. When sweep hand hits number on dial, begin time frame, counting one with firs full respiratory cycle.

  23. STEPS(CONTI….) • Note depth of respirations, subjectively assessed by observing degree of chest wall movement while counting rate. • Nurse can also objectively assess depth by palpating chest wall excursion or auscultating the posterior thorax after rate has been counted. • Note rhythm of ventilatory cycle. Normal breathing is regular and uninterrupted.

  24. STEPS(CONTI….) • Replace bed linen and client’s gown. • Perform hand hygiene • Discuss findings with client as needed • If respirations are assessed for the first time, establish rate, rhythm and depth as baseline if within normal range. • Compare respirations with client’s previous baseline and normal rate, rhythm and depth.

  25. STEPS(CONTI….) • Note depth of respirations, subjectively assessed by observing degree of chest wall movement while counting rate. • Nurse can also objectively assess depth by palpating chest wall excursion or auscultating the posterior thorax after rate has been counted. • Note rhythm of ventilatory cycle. Normal breathing is regular and uninterrupted.

  26. RECORDING AND REPORTING • Record respiratory rate and character in nurse’s notes or vital sign flow sheet. • Indicate type and amount of oxygen therapy is used by client during assessment • Measurement of respiratory rate after administration of specific therapies should be documented in narrative form in nurse's notes.

  27. POINTS TO BE REMEMBERED • Clients with difficulty breathing such as those with CHF(Congestive heart failure)or abdominal ascites or in late stages of pregnancy should be assessed in the position of greatest comfort. • Repositioning may increase the work of breathing, which will increase respiratory rate • Respiratory rate less than 12 or greater than 20 requires further assessment and may require immediate intervention

  28. POINTS TO BE REMEMBERED(CONTI…) • Any irregular respiratory pattern or periods of apnea are symptoms of underlying disease in the adult and must be reported to the physician or nurse in charge. Further assessment may be required and immediate intervention may be needed. An irregular respiratory rate and short apneic spells are normal for newborns.

  29. SUMMARY • Today we discussed about meaning of respiration, mechanics of respiration, physiology and control of respiration, characteristics of respiration, factors affecting respiration, alterations in respiration and assessment of respiration.

  30. CONCLUSION While other vital signs can be measured continuously using technology, RR(respiratory rate) often relies on visual observation of chest movement at periodic intervals. Nurses must be aware of the importance of measuring RR immediately if they have concerns about the patient’s condition – but measuring RR over time is a much more useful measure of decline or recovery.

  31. EVALUATION MCQ’s 1 . Difficult or labored breathing • Apnea • Bradypnea • Dyspnea • Tachypnea 2. Very deep and rapid respiration is referred as • A. Hyperventilation • B. Hypoventilation • C. Polypnoea • D. Tachypnoea

  32. THANK YOU

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