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Fundamentals of Nursing Ch 34
Supporting Respiratory Function
42
Nursing
Undergraduate 1
10/10/2010

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Term
Key Nursing Diagnoses for Respiratory Function
Definition
1) Ineffective Breathing Pattern
2) Ineffective Airway Clearance
3) Impaired Gas Exchange
Term
Ineffective Breathing Pattern
Definition
A state in which the rate, depth, timing, rhythm, or chest/abdominal wall excursion during inspiration, expiration, or both, does not maintain optimum ventilation for the individual
Term
Ineffective airway clearance
Definition
A state in which an individual is unable to clear secretions or obstructions from the respiratory tract
Term
Impaired gas exchange
Definition
A state in which the individual experiences an excess of deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane (specify hypercapnia or hypoxemia)
Term
Common Respiratory Disorders:
Restrictive Disorders
Definition
Atelectasis, Pleural effusion, Hemothorax, Pneumothorax, Pneumoconiosis
Term
Common Respiratory Disorders:
Obstructive Disorders
Definition
Pneumonia, Asthma, Emphysema, Tuberculosis, Lung Cancer
Term
Atelectasis
Definition
A collapsed or airless state of the lung or a portion of a lung, caused by obstruction, hypoventilation, restriction to expansion, or absence of surfactant. May be a whole lung, a lobe or a lobule, or it may be diffuse microatelectasis (scattered microscopic areas of collapse that cumulatively represent significant nonfunctional lung tissue).
Term
Pleural effusion
Definition
Accumulation of fluid in the space between the visceral pleura and parietal pleura of the thorax, usually from an inflammatory process secondary to pneumonia, malignancy, or trauma
Term
Hemothorax
Definition
Bleeding into the pleural space secondary to trauma to the chest. May occur in a motor vehicle accident or fall, or it may follow thoracic surgery
Term
Pneumothorax
Definition
Air from the lung leaking into the pleural space, or atmospheric air entering the pleural space through a traumatic opening in the chest wall. Spontaneous pneumothorax can occur at high altitudes in depressurized airplane cabins
Term
Pneumoconiosis
Definition
A group of fibrotic lung diseases caused by prolonged inhalation of dust particles, usually from industrial dust (silica, asbestos); eventually develops a chronic obstructive component
Term
Pneumonia
Definition
Inflammation of the lung with consolidation and exudation. May be infectious (viral, bacterial, fungal) or inflammatory (aspiration of vomitus, chemicals, gases, oily substances, foreign bodies). The airways are reduced by consolidation and fill with edema, exudate, and sputum
Term
Asthma
Definition
An inflammatory response that constricts the bronchi and causes edema and increased production of sputum. Can be caused by allergic response to allergens, such as pollen, dust, smoke and animal dander or secondary to chronic infections or heart disease. Marked by recurrent attacks of dyspnea, with wheezing due to spasmodic constriction of the bronchi and increased production of sputum
Term
Asthma
Definition
An inflammatory response that constricts the bronchi and causes edema and increased production of sputum. Can be caused by allergic response to allergens, such as pollen, dust, smoke and animal dander or secondary to chronic infections or heart disease. Marked by recurrent attacks of dyspnea, with wheezing due to spasmodic constriction of the bronchi and increased production of sputum
Term
Emphysema
Definition
Pathological accumulation of air in tissues or organs, usually refers to pulmonary emphysema where air (Co2) accumulates in the alveoli because of loss of elasticity. Fatique and dyspnea are the most prominent symptoms.
Term
Tuberculosis
Definition
An infectious, inflammatory, reportable disease that is chronic in nature and commonly affects the lungs, although it may occur in almost any part of the body.
Term
Lung Cancer
Definition
Malignant growths of the lung tissue. Early symptoms are vague or may not appear at all. The earliest and most common symptom is a dry, hacking cough.
Term
Defining Characteristics of Ineffective breathing pattern
Definition
Hypoventilation, Hyperventilation, Dyspnea
Term
Hypoventilation
Definition
Decrease in the rate and depth of breathing, clinically defined as PaCO2 greater than 45mm Hg.
Term
Hyperventilation
Definition
Increase in the rate and depth of breathing, clinically defined as PaCO2 less than 35 mm Hg
Term
Dyspnea
Definition
the subjective sensation of difficulty in breathing and is usually associated with increased rate of breathing.
Term
Related Factors to Hypoventilation
Definition
Pain, Immobility, Medications, Muscle or nerve dysfunction, Restictions to expansion, fatigue
Term
Related Factors to Hyperventilation
Definition
severe anxiety, fear or metabolic disease. Acidosis resulting from metabolic disease such as renal failure or diabetes
Term
Related Factors to Dyspnea
Definition
variety of neurological, respiratory, metabolic and cardiac conditions
Term
Hypoxemia
Definition
deficient oxygen levels in the blood
Term
Hypoxia
Definition
inadequate oxygenation at the level of body tissues
Term
Hypercapnia
Definition
a high carbon dioxide level in the blood, usually resulting from failure of the lungs to remove carbon dioxide
Term
Bronchospasm
Definition
spasm of the smooth muscles of the bronchi or the bronchioles that results in decreased airway diameter
Term
chest percussion
Definition
using cupped hands to rhythmically clap on the chest wall over various segments of the lungs to mobilize secretions
Term
chest physiotherapy
Definition
an approach to mobilizing and draining secretions from gravity-dependent areas of the lung that uses a combination of postural drainage, chest
Term
cough
Definition
a sudden audible, forceful expulsion of air from the lungs, usually an involuntary, reflexive action in response to an irritant
Term
diaphragmatic (abdominal) breathing
Definition
breathing in which the majority of ventilatory work is accomplished by the diaphragm and abdominal muscles; deliberate use of the diaphragm and abdominal muscles to control breathing
Term
endotracheal tube
Definition
a catheter passed through the nose or mouth into the trachea for the purpose of establishing an airway
Term
hemoptysis
Definition
coughing and spitting up blood as a result of bleeding from any part of the lower respiratory tract
Term
incentive spirometer
Definition
a device that provides a visual goal for the measurement of inspiration, thus encouraging the client to execute and sustain maximal inspiration
Term
postural drainage
Definition
a technique in which a client assumes one or more positions that will facilitate the drainage of secretions from the bronchial airways
Term
pulse oximetry
Definition
a method of measuring the oxygen saturation of functional hemoglobin in the blood
Term
pursed-lip breathing
Definition
a technique of mouth breathing that creates slight resistance to exhalation by contracting the lips to reduce the size of the opening, thus maintaining an even reduction of intrathoracic pressure during exhalation
Term
respiration
Definition
the exchange of oxygen and carbon dioxide between the atmosphere and the cells of the body; a series of metabolic activities by which living cells break down carbohydrates, amino acids and fats to produce energy in the form of ATP
Term
sputum
Definition
mucus secreted from the lungs, bronchi, and trachea; may include epithelial cells, bacteria, and debris
Term
ventilation
Definition
the process of exchanging air between the ambient air and the lungs; pulmonary ventilation refers to the total exchange of air, whereas alveolar ventilation refers to the effective ventilation of the alveoli
Term
vibration
Definition
a technique of chest physiotherapy whereby the chest wall is set in motion by oscillating movements of the hands or a vibrator for the purpose of mobilizing secretions
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