RESPIRATION :
Human survival depends on the ability of oxygen “oxygen”(O2)
to reach body cells and for carbon dioxide (CO2) to be removed from the cells.
· Respiration is a mechanism the body uses to exchange
gases between the atmosphere and the blood and the blood and the cells.
· Respiration is the act of breathing it is the process
of taking in oxygen and giving out of carbon dioxide.
· Respiration consists of an inspiration ,expiration and
pause.
· Respiration may be internal and external the exchange of gases between the blood and the air in the
lungs is called external or pulmonary respiration .
· The exchange of gases between the blood and the tissue
cell is called internal or tissue respiration.
· Respiration involves ventilation (The movement of
gases in and out of the lungs), diffusion (the movement of oxygen and carbon
dioxide between the alveoli and the red blood cells).
· And perfusion (The distribution of red blood cells to
and from the pulmonary capillaries.
· The respiration is controlled by the respiratory
center in the brain called medulla oblongata the nerve fibers of the autonomic
nervous system and chemical composition of food .
Assessment of
Respiration :
· The respiration rate is the number of ventilation
occurring each minute. One inspiration +one expiration =one respiration .
· More accurately called ventilation .
· Respiratory rate may be over 100 breaths each minute
or as slow as 12 breath or less each minute, depending on the age and health
status of the patient.
· A respiration can be assessed by visual inspection
,watch the chest rise and fall.
· The respiratory rate can also be obtained by
auscultation of air movement in the lungs by listening with stethoscope.
· Respiration can be counted by palpation if the nurse
places the hand on the chest and feels movement .
· Mostly ,respiratory rate is assessed by visual
inspection because this method makes the
patient less consciousness of what nurse is doing .
· Respiration : “respiration is the act of breathing it
includes the intake of oxygen and out put of carbon dioxide that is respiration
consists of inspiration and expiration “.
Characteristic of Respirations:
· The rate is the number of breaths in one minute. The normal
rate of respiration of an adult will be
16 to 20breaths per minute.
· Depth is usually described as normal shallow or deep.. a
normal average man at rest inspires and exhales
about 500cc of air with each respiration .if more than this quantity of
air passes in and out of the lungs the
respiration is said to be deep. If the quantity of air considerably less the
respiration said to be shallow.
· The
rhythm of respiration refers to the time interval between
each breath. When respiration is regular the time interval is similar between
each breath .when respiration is irregular the time interval varies.
Abnormal Respiration :
The following terms are usually used to describe
respiration :
1. Eupnoea: Normal respirations normal rate , depth and rhythm for
age
2. Dyspnea : Difficult or labored breathing. May be accompanied by other signs of labored
breathing’s such as nasal flaring , retraction of skill around the ribs and
above and below the sternum rate of breathing.
3. Tachypnea: Increased rate of breathing .above normal for age
group
4. Bradypnea:
Decreased rate of breathing. Below normal for age
group.
5. Apnea : Absence of berthing . may be periodic , so
respiration occur with periods of apnea lasting 10 seconds or more
6. Hyper
ventilation : Increase in
rate and depth of respiration.
7. Hypoventilation
: Decrease in rate and depth of ventilations.
8. Hyperpnoea
: Increased depth of breathing with normal rate.
9. Cheyne
stroke berthing : A cycle of
ventilation with increasing rate and depth to a point ,than decreasing rate and
depth followed be period of apnea
10. Kussmaul
‘s breathing : increased rate
and depth, appears labored and similar to fainting related to renal failure and
metabolic acidosis
11. Biot’s
Breathing : similar to
cheyne stroke breathing because of intermittent period of apnea.
12. Orthopnea: Discomfort in breathing in any but exact sitting or standing position.
13. Hiccough : It expands the small airways. It is a protective
mechanism
14. Hiccough : it is due to spasms of diaphragm and glottis.
15. Cyanosis : Blueness or discoloration of the skin and mucous
membrane caused by lack of oxygen in the tissues.
16. Air hunger
: A from of dyspnea in which there are deep sighing
respirations.
17. Anoxia
(Hypoxia): it is the lack
of oxygen to the tissues.
18. Rale (Rahl)
: An abnormal ratting or bubbling sound caused by the
mucous in the air passages as seen in bronchitis or pneumonia.
19. Anoxaemia: (Hypoxemia) it is lack of oxygen in the blood stream.
20. Asphyxia: It is state of suffocation this condition is produced
by prolonged interference with a
sufficient supply of oxygen.
Factor that affect /influence respiration are as
follows:
1. Exercise: Increases rate and depth to meet the body’s greater
oxygen need.
2. Acute pain
: Increase rate and depth as a result of sympathetic
situation.
3. Anxiety and
stress : Increases rate and depth as
result of sympathetic situation
4. Age: with growth from infancy to adult hood ,the lungs capacity increase .and respiratory rate
gradually decline with old age lungs elasticity and depth of respiration
decrease and respiratory rate decreases.
5. Sex: Men have a great lung capacity than women.
6. Body
position : Straight , erect posture
full chest expansion.
7. Medications: Narcotic ,analgesics, and sedative depress rate and
depth . amphetamines and cocaine may increases
rate and rhythm.
8. Brain stem
injury : Impairs the respiratory
center and inhibits respiratory rate nd
rhythm.
9. Smoking : long term smoking changes lungs airways increasing
rate of respiration.
When assessing respiration
the nurse counts the respiratory rate and listens to breath sounds. Breath
sounds are heard by listening various locations over the chest with a
stethoscope.
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