Respiratory Part 1 Medical-Surgical Nursing Handout
I.
Structure & Anatomy
A. Nasal Cavity
B. Para-Nasal Sinuses
1.Description: _____________ area
2.______________________ with nasal cavity
C. Pharynx AKA: __________________
1.Passageway
a. __________________________  _____________tract
b. _________________  ______________________ tract
2.Contains:
a. ________________ & ________________
i.
____________ system
b. ___________________________ tubes
D. Larynx: AKA _______________________________
1.Function:____________________________
2.Contains
a. _____________________ = ______________________________
i.
Flap or elastic _____________________________
b. _____________________ cords  _________________________
E. Trachea: AKA _________________________________
1.Description: _____________________________________
a. Palpate= __________________________________________
2.Function: Conduct __________________________
F. Bronchi
1.Description
a. Branches into __________ tubes
b. Right
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i.
_________ diameter
ii.
More _______________________
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iii.
___________________ in length
G. Lungs
1.Location:_____________________ cage
2.Description
a. __________________________
b. Multiple ____________________________________
H. Bronchioles
1.No____________________ & NO _______________________
I. Alveoli: ________________________ Unit
1.____________________
2.______________________________
3.Surrounded by __________________________ ___________________
4._________________ membrane
5.Tendency to _____________________
a. ____________________________
J. Pleural Membrane
1.Location: _______________________ surface of _____________ and interior
__________________ of the _______________________
2.Function:
a. ______________________________
b. ____________________ pressure
c. Allows __________________________ - ______ friction
3.Pleural Space/Cavity: __________________________________
K. Mediastinum
1.Location: ________________________________________________
2.Contains:______________________, large ___________ vessels,
__________________, ______________________ Bronchi
L. Diaphragm
1.Location: ____________________ between _____________ & _____
2.Function: ______________ in respiration
M. Skeletal System
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1.Ribs: ____________________________________________________
2.Sternum
N. Pulmonary Circulation
1.Main function of respiratory system is to deliver ____________ to the
__________________ & remove ______________ from it.
2.Pulmonary artery : ________________________________
3.Pulmonary vein: __________________________________
Small Group Questions
1. Name the structures that air flows past on its way to the lungs
2. What is the function of the epiglottis?
3. What are the supporting structures of the trachea?
4. Where in the circulation of blood do you find deoxygenated blood?
5. How many lobes do the rt and lf lungs each have?
6. What is the purpose of the serous fluid btw the pleural membranes?
II.
Processes of Respiration
A. Ventilation
1.________________________of _______________ in and out of the
tracheobronchial tree. Delivering ___________ to the __________ and
removing __________
B. Perfusion
1.___________________ ______________ in the capillary bed of the lungs
C. Diffusion
1.Movement of _____________________________ across the
_________________ membrane
2.Flows from an area of __________________________ concentration to
__________________ concentration.
III.
Choking
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IV.
Changes associated with aging
A. Cartilage ____________________
B. Muscles _______________________
C. ___________ cough reflex
D. ___________ elasticity
V.
Assessment:
A. Subjective
B. History
C. Inspection
1.Normal Chest: Anterior/posterior diameter: _________________
2.Barrel Chest: Anterior-posterior diameter: __________________
a. D/T _____________________________________
3.Kyphosis: Abnormal curvature of the __________________ spine
4.Lordosis: Abnormal curvature of the __________________ spine
5.___________________ expansion of the chest
6.___________________________ muscles
7.Trachea: _____________________________
8.Color_________________________________
9.LOC ____________________________________________
10.
____________________________ state
D. Breathing Patterns
1.Eupnea: _________________________________________________
2.Tachypnea: ______________________________________________
3.Bradypnea: ______________________________________________
4.Hyperventilation: _________________________________________
5.Hypoventilation: __________________________________________
E. Auscultation
1.Purpose: Asses __________________ through ___________________
2.Procedure
a. ______________________ of stethoscope
b. ______________________  _______________________
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c. Compare ___________to _________________
3.Normal
a. Vesicular:
i.
Location heard: __________________________________
ii.
Quality: ________________________________________
b. Bronchial
i.
Location heard: __________________________________
ii.
Quality: ________________________________________
4.Adventitious
a. Crackles: _____________________________________________
i.
Fine crackles ____________________________________
ii.
Course Crackles ;_________________________________
b. Wheeze:
i.
Sonorous ______________________________________
i. Caused by: ______________________________
ii.
Sibilant : ________________________________________
i. Caused by: ________________________________
VI.
Dyspnea
A. Significance: ________________________________________________
B. Orthopnea: _________________________________________________
1.Assoc. ______________________________________
C. Right ventricle:
1.If ______________________ airway resistance  ______ pressures 
____________ ventricle _________ work  __________ ventricular damage
D. Nrs. Management:
1.Find ______________________________
2.Give _______________________________
3.HOB _________________________
4.Communication: ________________________________
VII.
Cough
A. TO _______________ air form the lungs ______________________
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B. D/T ;___________________________________________________
C. Significance: _____________________________________________
1.Protective ______________________________
D. Nrs management:
1.________________ & Describe
2.___________________________
3._________________ control: __________________________
4.___________________ control
5.____________________________/ anti-tussives
VIII.
Sputum Production
A. Matter _______________________ from the ______________ tract that contains:
__________________________________________________
B. Significance: Purulent: _______________________________________
C. Nrs Management:
1.__________________  _______________________________
2.TCDB
3.No ___________________________
4.___________________ care
5._____________ appetite
D. Obtaining a sputum specimen
1.__________________ (from the __________________)
2.____________________ cup
3._______________ breath x___________
4.Cough deeply  ______________________________
5.Best time:______________________
IX.
Chest pain
A. Significance: ______________________________________________
B. Nrs Management:
1.Assess
2.Analgesics: __________________________________________
3.___________________ for pain
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X.
Hemoptysis
A. Definition: Expectoration of ______________ from the resp. tract
B. Significance
1._______________ or _______________
Hemoptysis
Hematemesis
Definition
From?
Description
2.Nursing management
a. ____________________________ & _______________________
XI.
Cyanosis
A. Definition: _________________ coloration of the skin
B. Significance
XII.
Assessment of breathing ability / Diagnostic assessments
A. Pulse oximeter
1.Normal SaO2 ________________
2.Decreased ( _________) : tissue is ________________________
3.Pulse oximeters are not reliable in
a. _______________
b. Dye
c. ___________________
B. Radiographic exams
1.Chest x-rays
a. Description: _______ dimensional
b. Purpose
i.
_____________; tumors, foreign _____________
2.CT scan
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a. Description: _____________________ tomography
i.
with or without __________________ medium
b. Purpose
i.
Tissue, tumor, foreign body, fluid
c. Nurse management
i.
Contrast medium: _______________________________
3.Angiography studies of the pulmonary vessels
a. Purpose: assess pulmonary _______________________
b. Description: Dye  _________ vein  ______________ 
____________
c. Pre-op: ___________ ___________________________________
d. Post-op:
i.
Position:
ii.
Check _____________________,
iii.
Assess ________________________
iv.
Fluids:________________________________________ _
4.Bronchoscopy
a. Description: _____________ inspection of larynx, trachea & Bronchi
via fiber optic tube
b. Purposes: __________________________ &
___________________________
c. Pre-op
i.
__________________
ii.
__________________
i. decrease __________________ response
ii. decrease ___________________________ reflex
iii. decrease _______________________
d. Post-op
i.
______________& _____________ Until gag returns
ii.
Check ______________________ &
______________________
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5.Thoracentesis
a. Purpose:
i.
Remove fluid for _____________________
ii.
Remove fluid for _____________________
iii.
Obtain ___________________
iv.
Instill _____________________
b. Pre-op
i.
Position: _______________________________________
c. Post-op
i.
VS.
ii.
Chest x-ray
iii.
Breath sounds
iv.
Site: __________________________________________
6.Sputum studies
a. Culture and sensitivity
7.WBC
a. Normal______________________cell/mm3
b. Elevated_____________________________________
c. Decreased ____________________________________
8.Hemoglobin
a. Normal: ______________ g/dl
b. Elevated: ____________________________________________
c. Decreased: ___________________________________________
9.Hematocrit
a. Normal: ________________
b. Elevated: ____________________________________________
c. Decreased: __________________________________________
XIII.
Oxygen Therapy
A. Goal: provide adequate ________________ or O2
Flow Rate
Nursing consideration
Nasal Cannula
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Simple mask
Venturi
B. Safety precautions
XIV. Nebulizer
A. Deliver _________________ or ___________________ directly to the lungs
B. ___________________  _____ systemic side effects
C. Indications: Must be able to ________________________
D. Medications
1.___________________________ (Albuterol / Ventolin)
2.Corticosteroids
3.Mucolytic agents (Acetylcysteine)
4.____________________________
XV.
Metered dose inhaler
A. Purpose: admin. __________________ meds directly into the ______________
B. Procedure
1.Canister into unit correctly
2.________________ gently
3.Hold inhaler – breath ____________ slowly (not into inhaler)
4.Place _____________________ into your mouth
5.Close ______________ around it
6.Tilt head _______________
7.Keep ______________ out of way
8.Press __________ of the canister firmly & breath in through your mouth
9.____________ inhaler from mouth
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10.
____________ breath for several seconds
11.
Breath out ______________
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12.
___________ your mouth afterward to help reduce unwanted side effects
XVI. Incentive Spirometry
A. Device to encourage ________________ breathing
B. Prevent and treat ______________________
C. Procedure: ___________________________
Directed Reading
Chapter 21: The Respiratory System & Assessment
1.
2.
3.
4.
5.
6.
7.
What protective reflexes are absent when a person is unconscious?
What is surfactant?
How does airway resistance affect respiration?
How are compliance and elasticity related?
What are common respiratory changes associated with aging?
What are the nursing responsibilities for a client receiving a pulse oximetry test?
What are the nursing responsibilities for a client receiving or after receiving an ABG
(Arterial Blood Gas) study?
8. When (or for what are) acid-fast stains & cytology laboratory studies ordered?
9. What nursing care should be provided to a client after having undergone a bronchoscopy
in the doctor’s office?
10. Describe the movement of the diaphragm and chest wall during inspiration and
expiration.
Chapter 22: Caring for Clients with upper respiratory disorders
Pages 524 - 534
1.
2.
3.
4.
5.
6.
How are influenza viruses transmitted? Describe their incubation period.
What pathogens are commonly associated with pharyngitis?
What is the most important measure to reduce the risk of influenza?
What allergy should be assessed for before administering the influenza vaccine?
What is the action / purpose of decongestant medications?
What are the nursing implications and client teaching associate with taking decongestant
medications?
7. What is the action / purpose of antihistamines?
8. What are the nursing implications and client teaching associate with taking
antihistamines?
9. A client has the flu – identify 3 nursing diagnosis that this client may have?
10. What is epistaxis and how is it normally treated?
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Chapter 23: Caring for Clients with lower respiratory disorders
Pages 552- 564; 566-584
1. How is TB transmitted and what increased ones risk of developing TB?
2. Most antitubercular medications are toxic to what organ and therefore a client taking
these medications should be told to do (or not do) what?
3. What does a positive TST or Mantoux test indicate? (What does it NOT indicate)?
4. What type of sputum test is needed to diagnose TB
5. What are common triggers for an asthma attack?
6. What is status asthmaticus?
7. What is the purpose / function of Beta-Agonists? What nursing implications are
associated with these medications?
8. What is the function of anti-cholinergic medications? What nursing implications are
associated with these medications?
9. What is the function of Corticosteroid medications in relationship to asthma? What
nursing implications are associated with these medications?
10. What is the function of mast cell stabilizers medications? What nursing implications are
associated with these medications?
11. What is the only way to slow the progression of COPD?
12. What is a common comorbidity of Chronic Bronchitis?
13. What types of over-the-counter medications should be avoided in clients with COPD?
14. Why does Oxygen use with COPD patients need to be carefully observed?
15. Describe pursed-lip breathing & diaphragmatic / abdominal breathing.
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