12 resp system, 13 disorders w/ upper resp system, 14 disorders w/ lower resp system Flashcards
pt is scheduled to have direct laryngoscopy for removal of polyps, advise the pt
room _
ice_
mild _
hoarseness _
-room will be darkened
-an ice collar may be applied after the procedure to decrease swelling
-mild sore throat
-hoarseness may occur
Order in which air flows 1-6
external nares
larynx
trachea
right upper lobe bronchus & left main bronchus
bronchiole
alveoli
Mucous membrane lining the many small branches of the bronchial tree contains these tiny hairlike projections: c_, trap and propel small inhaled foreign particles towards entrance of respiratory tract; this reflex works to expel secretions and particles
cilia; cough
signals of changing levels of hydrogen ions, CO2, and O2 trigger the r_ c_ to send signals through the s_ c_ and s_ n_ to the peripheral nervous system and to the phrenic and intercostal nerves that control the diaphragm and respiratory muscles
respiratory center
spinal cord
spinal nerves
Breaths are initiated based on p_
pH
-about how many mL of air move in and out of lungs with each breath
-primary respiratory muscle
500 mL
diaphragm
-diaphragm contracts, moving d_
-other chest muscles contract, pulling rib cage u_ and o_, expanding the lungs and creating an area of negative pressure
-air from the atmosphere, has p_ p_, flows into the lungs
downward
up and out
posititve pressure
-Surfactant secreted by cells in the a_;
-d_ surface tension on alveolar wall, allowing for diffusion to take place
-when surfactant levels are l_, alveoli cannot properly e_, O2 and CO2 cannot cross the membrane adequately
alveoli
decreases
low, expand
when interstitial edema occurs in the l_ t_, alveolar membrane is thickened and gases cannot diffuses across membrane as easily
lung tissue
major portion of O2 attaches to the h_ portion of the h_ molecule carried by the e_ and forms o_
heme
hemoglobin
erythrocytes
oxyhemoglobin
-aging results in decreased c_ reflex, and increased potential for a_
-O_ may cause kyphosis, which impinges on lung e_
-muscle atrophy may affect r_ m_, diminishing their strength
cough
aspiration
osteoporosis
expansion
respiratory muscles
the extent to which the lungs are able to return to their original position after being stretched or distended: e_
elastance
broad term referring to diminished availability of oxygen to the body tissues
hypoxia
ability of the lungs to distend in response to changes in volume and pressure of inhaled air. L_ c_ first increases and then decreases with age as the lungs become stiffer and the chest wall more rigid: l_ c_
lung compliance
delivery of fluid through the blood vessels to body tissues: p_
perfusion
methods used to clear secretions from the airways: p_ h_
pulmonary hygiene
the force working against the passage of air, major determinant is the radius of the airway: r_
resistance
an abnormality of gas exchange with either an excess of CO2 or a deficit of O2 or both: r_ f_
respiratory failure
intrapulmonary s_ is the diverting of blood so that it does not take part in the gas exchange at the alveolar sites. When this occurs, blood enters the left side of the heart without being oxygenated, a possible cause of hypoxemia
shunting
produced by lipoprotein produced by cells lining the alveoli, lowers surface tension within alveoli preventing the collapse of the lung by stabilizing the alveoli and decreasing capillary pressures: s_
surfactant
clinically measured by CO2, movement of air from external environment to the gas exchange units of the lung and back to the environment: v_
ventilation
-O_ p_ diseases are characterized by problems moving air into and out of the lungs
-narrowing of the openings in the tracheobronchial tree i_ resistance to the flow of air, making it difficult for O2 to enter and contributing to air trapping, making exhalation difficult; examples of obstructive lung diseases- a_, e_, c_ b_, t_
obstructive pulmonary
increases
asthma
emphysema
chronic bronchitis
tumors
Pulmonary disease classifications, obstructive or restrictive:
airway diseases-
a_
c_
b_
o_ s_ a_
c_ b_
e_
asthma - o
COPD - o
bronchiectasis - o
obstructive sleep apnea -o
chronic bronchitis - o and r
emphysema - o
Pulmonary disease classifications, obstructive or restrictive:
Lung tissue disease-
p_ f_
sarcoidosis - r and o
p_
c_ f_
ARDS - o
pulmonary fibrosis - r
pneumonitis - r
cystic fibrosis - r
Pulmonary disease classifications, obstructive or restrictive:
extrapulmonary causes:
neurologic disorders (ALS, MD, MD) - r
body habitus conditions (scoliosis, obesity, arthritis)-r
p_ e_
a_
pulmonary effusion - r
ascites - r
Pulmonary disease classifications, obstructive or restrictive:
Lung diseases-
p_ hypertension
p_ e_
pulmonary hypertension - constriction or obstruction of blood flow in the lungs
pulmonary embolism - obstruction of blood flow in the lungs
certain groups: o_ a_, c_ i_, immunization against influenza and pneumonia is effective against reducing incidence of r_ d_.
h_ w_, n_, should also be immunized
older adults
chronically ill
respiratory disease
healthcare workers
nurses
influenza vaccine prepared from c_ e_, screening pt’s for allergy to e_ is important
chicken embryos
eggs
assessing an older adult: important to obtain smoking and alcohol Hx. Approx _% of throat cancer occurs in people who both smoke and immoderately drink alcohol, _ times more common in men
90%
4 times
-bronchovesicular breath sounds:
found over the m_ b_ below the level of the clavicles, besides the sternum; posteriorly between the s_
-sounds: moderate to high p_ with a h_, muffled quality; equal time of inspiration and expiration
mainstem bronchi
scapulae
pitched
hollow
-c_ produced by air passing through moisture in the smaller airways
-f_ c_ are high pitched, can be heard in pt’s who have atelectasis, fibrosis, pneumonia, or early congestive heart failure
-c_ c_ are louder, low in pitch and are heard in pt’s with bronchitis, pulmonary edema, and resolving pneumonia
-if c_ are heard, have pt take a deep breath, c_, then listen again. If c_ are no longer present, atelectasis has been cleared
crackles
fine crackles
coarse crackles
crackles
cough
crackles
In pt’s with altered breathing patterns, coach the pt to perform this type of breathing p_-l_ and d_.
-the h_ f_ position is best for pt’s with dyspnea, this position supports and allows the respiratory muscles to function at maximum efficiency
pursed-lip
diaphragmatic
high fowlers
the measurement and display of CO2 levels: c_
capnography
retention of excessive amounts of CO2, result of hypoventilation, where the usual amount of CO2 is not eliminated by exhalation
hypercapnia (capina= CO2 in blood)
a deficit of CO2, occurs as a result off hyperventilation, can result in respiratory alkalosis.
Conditions include: those with increased metabolic rate like thyrotoxicosis, persistent fever, acute anxiety; salicylate overdose, and improper use of mechanical ventilation
hypocapnia
clinical signs of r_ a_:
hyperactive neuromuscular reflexes, tetany, carpopedal spasms, vertigo, blurred vision, and diaphoresis
respiratory alkalosis
r_ f_ defined by arterial blood gases: arterial oxygen below 50mm Hg, partial pressure of carbon dioxide equal or greater than 50mm Hg
respiratory failure
alterations in nutrition and hydration:
a_ and i_ n_ common in pt’s with respiratory disorders (particularly when the disorders are chronic. Pt may have an impaired sense of taste or smell, or sputum can leave a bad taste in the mouth or cause nausea. Pt may fear chewing or swallowing may bring on an attack of coughing or may be so tired that eating or preparing food is too exhausting
anorexia and inadequate nutrition
d_-b_ exercises and c_ t_ should be planned whenever the pt is able to do them w/ or w/out assistance. Should be followed by good mouth care and a short period of uninterrupted rest
deep-breathing
coughing techniques
