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Med Surg > 25 - Assessment: Respiratory System > Flashcards

25 - Assessment: Respiratory System Flashcards

1
Q

upper respiratory

A 
nose
mouth
pharynx
epiglottis
larynx
trachea
carina (the v)
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2
Q

lower respiratory

A 
mainstem bronchi (not in lungs)
bronchi
bronchioles
alveolar ducts
alveoli
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3
Q

small flab behind the tongue that closes over the larynx during swallowing

A

piglottis

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4
Q

olfactory nerve is found ___

A

within the mucose of the upper part of the nasal cavity

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5
Q

which lung has 3 lobes?

A

the right lung

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6
Q

tidal volume

A

volume of air exchanged w each breath

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7
Q

average tidal volume

A

500 mL

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8
Q

of each tidal volume, how much is anatomical dead space?

A

150 mL

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9
Q

primary site of gas exchange

A

alveoli

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10
Q

atelectasis

A

collapsed alveoli

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11
Q

why are post of patients at risk for atelectasis

A
  • decr mobility
  • effects of anesthesia
  • pain changes breathing pattern
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12
Q

how does ARDS lead to atelactasis

A

decr surfactant

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13
Q

surfactant

A

lipoprotein

-decr the surface tension needed to inflate

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14
Q

pulmonary circulation vs bronchial circulation

A

pulmo: gas exchange
bronchial: perfuses lungs

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15
Q

major muscle of respiration

A

diaphragm

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16
Q

oxygenation

A

process of obtaining O2 fr atmosphere + making it available to tissues/organs

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17
Q

how is the lung’s ability to oxygenate arterial blood evaluated by?

A

PaO2

SaO2

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18
Q

partial pressure of arterial blood?

A

PaO2

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19
Q

PaO2

A

dissolved O2 in blood

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20
Q

SaO2

A

amount of O2 bound to hemoglobin

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21
Q

Ventilation vs Respiration

A

vent: inspiration + expiration
resp: gas exchange

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22
Q

compliance

A

measure of ease of expansion

-low compliance> harder it is for lungs to expand

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23
Q

resistance

A

any obstacle of airway

  • main factor is change in diameter (i.e. asthma)
  • can be caused by excessive mucus/thickening of mucus
24
Q

respiratory center

A

medulla

25
Q

chemoreceptor

A

responds to change in chem compostn

  • PaCO2, pH
  • CENTRAL chemoreceptors are in medulla
26
Q

mechanical receptor

A

found in conduction upper airways, chest wall, diaphragm, alveoli capillaries
-stim by physio factors (irritants, muscle stretch, alveolar wall distortn)

27
Q

an incr in H

A

incr respiration + tidal volume

28
Q

an incr in PaCO2

A

more CO2 combines w H2O to make H2CO3 (carbonic acid)

  • low pH of cerebrospinal fluid
  • incr respiration + tidal volume
29
Q

Respiratory defense mechanisms

A 
1 filtration of air 
2 incr air turbulance in phrnx + lrnx
3 mucociliary escalator
4 ciliary beat
5 cough reflex
6 bronchoconstriction
7 alveolar macrophage
30
Q

alveoli macrophage is impaired by

A

cigarette smoke

31
Q

common side effect of ACE inhibitors

A

cough

32
Q

hemptysis

A

coughiing blood

-may be confused for hematemesis (vomit bld)

33
Q

wheezing indicates

A

airway obstruction

-asthma

34
Q

anorexia may be caused by

A

resp meds

35
Q

fatigue may be caused by

A
  • hypoxemia

- incr work of breathing

36
Q

dehydration can cause

A

thickening of sputum> obstruction

37
Q

ppl w chronic cough, esp women, may have _____ during paroxysm of coughin

A

urinary incontinence

38
Q

s/s hypoxia vs hypoxemia

A

hypoxia: restlessness, agitation
hypoxemia: inability to learn + retain info

39
Q

Subjective Data

A
  • SOB
  • dyspnea
  • cough
  • sputum production (color quality)
  • wheezing
40
Q

Objective Data

A
  • resp rate, quality, pattern
  • accessory muscle use
  • mouth or nose breathing
  • trachea positioning
  • shape, symmtr, mvmt of chest wall
  • skin + nails
  • palpate chest + back
  • lung sounds
41
Q

Diagnostics

A
  • ABG
  • chest xray
  • hemoglobin
  • hematocrit
42
Q

2 methods to assess efficiency of gas transfer in lungs + tissue oxygenation

A

1 pulse ox

2 ABGs

43
Q

SpO2 vs SaO2

A

both is amt of O2 attached to hemoglobin

-SpO2 is by pulse ox

44
Q

what is in an ABG

A

PaO2
PaCO2
pH
SaO2

45
Q

arterial catheter is usually inserted into

A

radial or femoral artery

46
Q

how to obtain ABG

A

before: indicate if pt is using O2. avoid changes in O2 therapy 15 min before obtaining sample
during: assist w positioning ( palm up hyperextended). collect blood in heparinized syringe. expel air bubbls
after: apply pressure for atleats 5 min to prevent hematoma

47
Q

what kind of syringe is used for ABG

A

heparinized syringe

48
Q

mild hypoxemia manifestations

A
  • restless
  • tachycardia
  • dysrhythmia
  • dyspnea
  • HYPERtension
49
Q

mod hypoxemia manifestations

A
  • HYPOtension
  • confusion
  • lethargy
  • dysrhythmia
  • resp distress
  • accessory muscle use
50
Q

severe hypoxemia manifestations

A
  • cyanosis
  • coma
  • resp arrest
  • cardiac arrest
51
Q

does a positive TB skin test mean that pt. has TB?

A

no

-it just means that pt has been exposed to antigen

52
Q

neg results in TB skin test could indicate

A
  • no exposure to TB
  • depressed cell-mediated immunity
  • —ie HIV
53
Q

TB skin test directions

A
  • use intradermal NOT subQ
  • circle injection site
  • do not remove circle mark
  • when charting, draw forearm + circle mark
  • when reading test results, check all 4 sides of the induration
  • DO NOT measure redded, flattened areas
54
Q

PFT spirometer use

A
  • insert mouthpiece
  • inhale as deep as possible
  • exhale as hard + fast +long as possible
55
Q

spirometer may be done before + after giving bronchodilators to determine ____

A

is airway obstruction is reversible

Med Surg (18 decks)

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