1. VITAL SIGNS RESPIRATIONS

2.  The exchange of oxygen & carbon dioxide in the lungs and tissues initiated by the act of breathing  Includes 2 processes: external & internal respiration RESPIRATION

3. ventilation (movement of air in & out of lungs) exchange of oxygen (O2) & carbon dioxide (CO2) across the alveolar membrane in lungs EXTERNAL RESPIRATION

4. what occurs at the cellular level (O2 is released from hemoglobin to the cell & the cell releases CO2 INTERNAL RESPIRATION

5. Nose Pharynx Larynx Trachea Bronchi Lungs (R = 3 lobes & L = 2 lobes) ORGANS OF RESPIRATION

6.  Diaphragm controls inhalation & exhalation  Slight negative pressure created in the chest during inspiration draws air into the lungs  Gas exchange occurs in the alveolar sacs  Surfactant secreted by the alveoli keeps the alveoli open RESPIRATION

7. An involuntary autonomic function Controlled by respiratory center in the pons and medulla in the brainstem Triggered by increased levels of CO 2 or serum hydrogen ion concentration or by decreased levels of O 2 Respirations

8. Respiratory center works with feedback mechanisms. The carotid body receptors alter rate and depth of respiration based on CO2 content of the blood. O2 and CO2 are diffused across capillaries in the lungs to maintain normal O2, CO2 and H+ levels. Respirations

9.  Rate - # of times a person breathes per minute  Depth – shallow/ deep  Rhythm – pattern-regular or irregular  Quality or Effort– effortless/respiratory distress ? ASSESSMENT OF RESPIRATIONS

10. Adult = 12-20/min. Child = 20 - 30 Infant = 20 - 40 Newborn = 30 - 50 Rhythm should be regular & effortless NORMAL RANGE OF RESPIRATIONS

11. PATIENT SHOULD NOT BE AWARE THAT RESPIRATIONS ARE BEING COUNTED (usually count inconspicuously while taking pulse) CANNOT TAKE RESP IF PT TALKING!!! MEASURING RESPIRATIONS

12. Observe the number of times the client’s chest or abdomen rises(inspiration) and falls (expiration) MEASURING RESPIRATIONS

13. Count each breath for 30 seconds & multiply by 2 (one complete cycle of inspiration & expiration = 1 breath) If patient is ill or has irregular respirations, count for a full minute MEASURING RESPIRATIONS

14. Age-Newborn  Adult Exercise-Increases Pain-Increase Fever-Increases Meds-Depends on the med-Morphine will decrease, Caffeine will increase Emotions/Stress-Can either increase or decrease Brain injury, disease condition FACTORS AFFECTING RESPIRATIONS

15. Eupnea- normal rate & rhythm Dyspnea- difficult or labored breathing Tachypnea- increased respirations Bradypnea- slow or shallow breathing RESPIRATORY PATTERNS

16.  Kussmaul- fast, deep respirations  Apnea- absence of breathing  Cheyne-Stokes- resp faster & deeper, then slow & shallow w/periods of apnea  Biot’s-Irregular respirations of variable depth (usually shallow), alternating with periods of apnea RESPIRATORY PATTERNS

17. Increased rate & depth of breaths & CO2 is blown off causing CO2 levels to  (seen after severe exertion, anxiety, or fear, fever, & diabetic acidosis) HYPERVENTILATION

18.  decrease rate & depth of breathing that causes an  increase in CO2 retention (ie. caused by over medication) HYPOVENTILATION