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Respiratory Cheat Sheet

📍 RESPIRATORY TRACT ANATOMY

    ┌─────────────────────┐
    │   Nasal Cavity      │ ← Warms, filters, humidifies air
    └──────────┬──────────┘
               │
    ┌──────────▼──────────┐
    │     Pharynx         │ ← Throat (nasopharynx, oropharynx)
    └──────────┬──────────┘
               │
    ┌──────────▼──────────┐
    │      Larynx         │ ← Voice box, contains vocal cords
    └──────────┬──────────┘
               │
    ┌──────────▼──────────┐
    │      Trachea        │ ← Windpipe, C-shaped cartilage rings
    └──────────┬──────────┘
               │
         ┌─────┴─────┐
         │           │
    ┌────▼───┐  ┌────▼───┐
    │ Right  │  │  Left  │ ← Main bronchi (R: wider, shorter)
    │ Bronch │  │ Bronch │
    └────┬───┘  └────┬───┘
         │           │
    [Bronchioles → Alveoli] ← Gas exchange occurs here!

**Right lung:** 3 lobes | **Left lung:** 2 lobes (smaller - cardiac notch)

📊 NORMAL RESPIRATORY VALUES

Vital Signs

Respiratory Rate (Adult)

12-20 breaths/min

Oxygen Saturation (SpO₂)

95-100%

Tidal Volume

500 mL

Peak Flow (Adult Male)

400-600 L/min

Arterial Blood Gases (ABGs)

Parameter	Normal Range	What It Measures
pH	7.35 - 7.45	Blood acidity/alkalinity
PaCO₂	35 - 45 mmHg	Carbon dioxide in arterial blood
HCO₃⁻	22 - 26 mEq/L	Bicarbonate (metabolic component)
PaO₂	80 - 100 mmHg	Oxygen in arterial blood
SaO₂	95 - 100%	Oxygen saturation (arterial)

🩺 LUNG ASSESSMENT MNEMONIC

IPPA – Systematic Respiratory Assessment

Inspect – Chest symmetry, respiratory rate/depth, use of accessory muscles, skin color
Palpate – Chest expansion, tactile fremitus, subcutaneous emphysema
Percuss – Resonance (normal), dullness (consolidation), hyperresonance (air trapping)
Auscultate – Breath sounds (vesicular, bronchial), adventitious sounds (crackles, wheezes, stridor)

🏥 COMMON RESPIRATORY DISORDERS

Disorder	Key Symptoms	Diagnostics	Nursing Interventions
Asthma	• Wheezing • Dyspnea • Chest tightness • Cough (worse at night)	• Spirometry (↓ FEV1) • Peak flow monitoring • Chest X-ray (hyperinflation)	• Administer bronchodilators • Monitor O₂ sat • Tripod position • Teach inhaler technique • Identify triggers
COPD (Emphysema, Chronic Bronchitis)	• Chronic dyspnea • Productive cough • Barrel chest • Pursed-lip breathing	• Spirometry (↓ FEV1/FVC) • ABGs (hypoxemia, hypercapnia) • Chest X-ray/CT	• Low-flow O₂ (2-3 L/min) • Bronchodilators + steroids • Pulmonary rehab • Smoking cessation • Energy conservation
Pneumonia	• Fever, chills • Productive cough (rust-colored) • Pleuritic chest pain • Crackles on auscultation	• Chest X-ray (infiltrates) • Sputum culture • CBC (elevated WBC) • Blood cultures	• Antibiotics (as ordered) • Monitor respiratory status • Encourage fluids (2-3L/day) • Deep breathing/coughing • Position: semi-Fowler's
Tuberculosis (TB)	• Persistent cough (>3 weeks) • Hemoptysis • Night sweats • Weight loss	• Mantoux/PPD test • Chest X-ray (cavitations) • Sputum AFB smear • Interferon-gamma test	• Airborne precautions (N95) • Negative pressure room • DOT therapy (6-9 months) • Monitor liver function (meds toxic) • Contact tracing
Pulmonary Embolism (PE)	• Sudden dyspnea • Chest pain (sharp) • Tachycardia, tachypnea • Hemoptysis (if infarction)	• CT angiography (gold standard) • D-dimer (elevated) • V/Q scan • ABGs (↓ PaO₂, ↓ SaO₂)	• High-flow O₂ • Anticoagulation (heparin → warfarin) • Monitor bleeding • Bedrest initially • Elevate legs (prevent DVT)

💡 QUICK NURSING TIPS

🚨 Emergency Signs:

SpO₂ < 90%
RR > 30 or < 10
Use of accessory muscles
Altered mental status
Cyanosis

💊 Common Meds:

Albuterol (bronchodilator)
Ipratropium (anticholinergic)
Prednisone (steroid)
Montelukast (leukotriene)

🎯 Positioning:

Dyspnea: High Fowler's
Pneumonia: Affected side up
Pleural effusion: Unaffected side

🫁 Breath Sounds:

Crackles = fluid (CHF, pneumonia)
Wheezes = narrowed airways
Stridor = upper airway obstruction

ABG Interpretation Cheat

Condition	pH	PaCO₂	HCO₃⁻	Common Causes
Respiratory Acidosis	↓ (<7.35)	↑ (>45)	Normal	Hypoventilation, COPD, opioid overdose
Respiratory Alkalosis	↑ (>7.45)	↓ (<35)	Normal	Hyperventilation, anxiety, PE
Metabolic Acidosis	↓ (<7.35)	Normal	↓ (<22)	DKA, renal failure, diarrhea
Metabolic Alkalosis	↑ (>7.45)	Normal	↑ (>26)	Vomiting, NG suction, diuretics

🫁 Respiratory System Quick Guide

IPPA – Systematic Respiratory Assessment

🫁 Respiratory System Quick Guide