 NURSING MEASURES TO MAINTAIN NORMAL RESPIRATORY FUNCTION AND

OXYGENATION

Promoting Oxygenation

• Positioning the client to allow for maximum chest expansion

• Encouraging or providing frequent changes in position

• Encouraging ambulation

• Implementing measures that promote comfort, such as giving pain

medications

Deep Breathing and Coughing

Breathing exercises are frequently indicated for clients with restricted

chest expansion, such as people with chronic obstucted pulmonary
disease (COPD) or clients recovering from thoracic surgery.

• Abdominal (diaphragmatic) and pursed-lip breathing

 abdominal breathing permits deep full breaths with little effort.

 Pursed-lip breathing helps the client develop control over

breathing by creating a resistance to the air flowing out of the
lungs, thereby prolonging exhalation and preventing airway
collapse by maintaining positive airway pressure

Hydration

Adequate hydration maintains the moisture of the respiratory mucous

membranes. Fluid intake should be as great as the client cann tolerate.

• Humidifiers are devices that add water vapor to inspired air. Their
purposes are to prevent mucous membranes from drying and
becoming irritated and to loosen secretions for easier expectoration.

Incentive Spirometry
 • Incentive Spirometers, also referred to as sustained maximal
inspiration devices (SMIs), measure the flow of air inhaled through the
mouthpiece and are used to
 Improve pulmonary ventilation

 Counteract the effects of anesthesia or hypoventilation

 Loosen respiratory secretions

 Facilitate respiratory gaseous exchange

 Expand collapsed alveoli

Percussion, Vibration, and Postural Drainage

• Percussion, sometimes called clapping, is forceful striking of the

skinwith cupped hands. Percussion over congested areas can
mechanically dislodge tenacious secretions from the bronchial walls.
Cupped hands trap the air against the chest. The trapped air sets up
vibrations through the chest wall to the secretions.

• Vibration is a series of vigorous quiverings produced by hands that are

placed flat against the client’s chest wall. Vibration is used after
percussion to increase the turbulence of the exhaled air and thus
loosen thick secretions.

• Postural drainage is the drainage by gravity of secretions from various

lung segments.