Lung receptors --> located in the lung and chest wall, are sensitive to breathing patterns, lung expansion, lung compliance, airway resistance, and respiratory irritants.

The respiratory center then uses feedback from the chemoreceptors and lung receptors to adjust ventilation.

⬇ Lung expansion & alveolar inflation

• Costal cartilage begins to calcify

• lungs have less recoil ability

• alveoli lose elasticity

⬇ Immune response

⬇ Cardiac function

⬇ Diaphragm strength

• exhalation becomes less efficient, which causes air trapping

⬇ Effective cough reflex

• difficulty expelling mucus & foreign material

• drier mucus membranes

• less cilia in airways

Chemoreceptors respond slower - making hypoxia more likely when breathing problems occur

--> They relax the smooth muscle, opening up the airways

EXAMPLES:

• Beta-2 adrenergic agonists (Albuterol)

• Anticholinergics (Diphenhydramine -- Benadryl)

• Methylxanthine

Important in treating and controlling respiratory conditions like asthma .

EXAMPLES:

• Corticosteroids

**Can cause elevated blood pressure, tachycardia, and palpitations, especially in those with a history of cardiovascular conditions

EXAMPLES:

• Ephedrine

• Pseudoephedrine (Sudafed)

• Phenylephrine

Used to treat upper respiratory and nasal allergy symptoms

EXAMPLES:

• Benadryl

• Dramamine

• Zyrtec

The goal is to reduce the frequency of dry, unproductive coughing while making voluntary coughing more productive

Hypoxia—Inadequate Oxygenation of Organs and Tissues

Hypercarbia (Hypercapnia)—An Excess of Dissolved CO2 in the Blood (Hypoventilation)

Hypocarbia (Hypocapnia)—A Low Level of Dissolved CO2 in the Blood (Hyperventilation)

Airway Inflammation and Obstruction - Allergic reactions or irritation from smoke or other irritants (asthma) may cause airway inflammation. Obstruction due to a mechanical reason, or due to a foreign body, or spasm (laryngospasm)

Alveolar–Capillary Membrane Disorders - A change in the consistency of the lung tissue. The alveoli become stiff and difficult to ventilate, and gas exchange is impaired. Examples include pulmonary edema, acute respiratory distress syndrome (ARDS), and pulmonary fibrosis.

Atelectasis - Anything that reduces ventilation (tumor, obstructed airway) can cause atelectasis, or alveolar collapse

Example: Treating and preventing pneumonia or post op pneumonia

Maintain hydration to keep pulmonary fluids thin!!

3 types of Pneumonia: Bacterial, viral, chemical, or foreign body

Risk Factors --> sedentary lifestyle, post operative, comorbidities, patients in the hospital, patients on ventilators, pain (when coughing)

Assessment --> Cough, fatigue, chest pain from coughing, dark/yellow sputum, fever, chills, dyspnea, elevated white blood cell counts, crackles heard when auscultating breath sounds. Lung sounds = diminished/crackles/wheezing

Interventions --> Bronchodilators, antibiotics, push fluids, supplemental O2 PRN, incentive spirometer, sputum culture.

Healthcare-Associated Pneumonia: patients in long term care facilities and who have had a long hospital stay are at higher risk of developing pneumonia.

Wheezing- when air passes through swollen, constricted airways. Mucus secretions, edema, caused by allergies or asthma

Crackles- popping high-pitched sounds heard in inspiration. Fluid in longs causes this. Fluid overload, viral/bacteria secretions. Treated with diuretics for fluid overload. An expectorant for viral/bacterial secretions.

Stridor- high pitch; blockage or narrowing of the airways. Heard over the vocal chords.

• Labored breathing

• Chest rise and fall. Unequal if atelectasis is present.

• Respiratory rhythm, rate, depth (WNL --> 12-20 breaths/min)

• Assess vital signs

• Note LOC, restlessness early signs of hypoxia; decreased LOC

• Capillary refill time, if skin is cyanotic (peripheral early stage, central late-stage). Pallor

• Any sputum? What color?

Assessment

• Increased rate & depth of breathing to expel excess CO2

• Inhale may be longer then exhale

• Orthopnea (cannot lie down & breathe adequately)

• Barrel chest

• Malnutrition

• Depression

• Fatigue

• It can be acute or chronic

For example: ensure proper positioning (high fowler's, tripod, head tilt chin lift

Quizlet Inc. (2024). Quizlet. Quizlet. https://quizlet.com/

‌