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ABSN > 333 oxygenation > Flashcards

333 oxygenation Flashcards

1
Q

ventilation

A

the movement of gas in and out of the lungs (this is what we measure respirations with, normal is 12-20 we are concerned even if slightly outside of range

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2
Q

diffusion

A

the oxygen and carbon dioxide exchange between the alveoli and the red blood cells

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3
Q

perfusion

A

the distribution of the oxygenated red blood cells to the tissues in the body

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4
Q

what type of process is breathing

A

passive ; it is regulated by O2, CO2 and pH of blood

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5
Q

hypercarbia + bodies response

A

increasing of CO2 ; body knows to increase rate and depth of breathing to remove CO2

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6
Q

what does lung volume depend on

A

age, gender, height

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7
Q

tidal volume

A

amount of air exhaled following normal inspiration

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8
Q

alveoli function

A

to promote gas exchange

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9
Q

between children and adults, who has a higher respiration rate

A

children

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10
Q

what type of breathers are children and males vs females

A

children & males are abdominal breathers and females are thoracic breathers

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11
Q

what could possibly increase RR?

A

pain, anxiety, medications , ect

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12
Q

expected (normal) breath sounds

A

bronchial, bronchovesicular, vesicular

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13
Q

adventitious (abnormal) breath sounds

A

crackles, wheezing, rhonchi, stridor

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14
Q

crackles/rales

A

fine to coarse bubble sounds, associated with air passing through fluid or collapsed small airways

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15
Q

wheezes

A

high pitched whistling, narrow obstructed airways pts w/ asthma or having an allergic reaction

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16
Q

rhonchi

A

loud low pitched rumbling, fluid or mucus in airways, can resolve with coughing

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17
Q

stridor

A

choking, high pitched and loud -> could hear plural friction rub d/t inflammation (often seen in children)

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18
Q

vesicuclar lung sounds

A

low pitch, heard over most of normal lung

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19
Q

broncro-vesicular lung sounds

A

medium pitch, heard over mainstream bronchi

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20
Q

bronchial (tracheal) breath sounds

A

high pitch, normally heard over trachea

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21
Q

bradypnea

A

rate of breathing is regular but abnormally slow (<12 breaths/min)

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22
Q

tachypnae

A

rate of breathing is regular but abnormally rapid (>20 breaths/min)

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23
Q

hyperpnea

A

respirations are labored, increased depth, and increased in rate (>20 bpm, occurs normally during exercise)

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24
Q

apnea

A

respirations cease for several seconds -> persistent cessation results in respiratory arrest

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25
Q

hyperventilation

A

rate and depth of respirations increase (hypocarbia sometimes occurs)

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26
Q

hypoventilation

A

respiratory rate is abnormally low, and depth of ventilation is depressed (hypercarbia sometimes occurs)

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27
Q

if a pt O2 is 100% on oxygen, what should you do

A

try to wean their oxygen down to 97/98

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28
Q

SPO2

A

peripheral, uses red light (what we put on the pt’s finger for vitals)

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29
Q

SAO2

A

arterial

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30
Q

can physician prescribe certain limits for O2 stats

A

yes - some populations you don’t want stating in the upper 90s, Drs can prescribe less (ex: wean pt O2 to be 88%)

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31
Q

what can interfere with SPO2

A

activity, nail polish (dark), if they are cold, if they have edema, arterial disease

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32
Q

work of breathing

A

the effort to expand and contract lungs, determined by rate and depth / the ease the lungs can be expanded + airway resistance

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33
Q

breathing is inspiration and expiration, what type of process is each

A

inspiration is an active process (uses muscles), expiration is a passive process (depends on the elastic recoil of our lungs)

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34
Q

what is surfactant

A

a chemical produced to maintain surface tension of the alveoli to prevent them from collapsing

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35
Q

pt’s w/ COPD lose what which causes them to have an increased work of breathing

A

the elastic recoil of their lungs

36
Q

what is a way to evaluate work of breathing

A

evaluate accessory muscle use -> the intercostal muscles & abdominal muscles, being used to expand the lungs but this will fatigue

37
Q

compliance

A

the ability for the lung to distend or expand in response too intra-avila pressure (this relies on the intrathoracic pressure changes)

38
Q

what is going to increase work of breathing

A

decreased compliance, increased airway resistance and/or increased accessory muscle use

39
Q

examples of times that increased airway resistance might be present

A

decreased diameter related to broncho constriction, asthma, trachyal edema

40
Q

what are the 4 main factors that affect oxygenation

A

physiological (main one we focus on), developmental, lifestyle and environmental

41
Q

factors affecting oxygenation: decreased oxygen-carrying capacity

A

low hemoglobin levels (anemia, low RBC to carry oxygen), carbon monoxide (a poisoning bc hemoglobin binds w/ carbon monoxide vs oxygen so spreading that through the body)

42
Q

what are the s/s of anemia

A

fatigue, decreased activity tolerance, paleness

43
Q

factors affecting oxygenation: hypovolemia

A

decreased circulating amounts of blood

44
Q

factors affecting oxygenation: decreased inspired oxygen concentration

A

high altitude (decreased oxygen in the air), hypoventilation

45
Q

factors affecting oxygenation: increased metabolic demand

A

exercise, wound healing, fever

46
Q

factors affecting oxygenation: chest wall movement

A

pregnancy or obesity (reduced lung volumes, might not be able to lay flat) musculoskeletal diseases, trauma, neuromuscular diseases, CNS alterations (phrenic nerve controls diaphragm so C3-5 injury impairs) (medulla oblongata regulates ventilation)

47
Q

what alters respiratory function

A

illness and conditions affecting ventilation or oxygen transport

48
Q

goal of ventilation

A

normal arterial carbon dioxide tension and normal arterial oxygenation tension

49
Q

what type of blood do you need to use to know about oxygen levels or CO2 levels in your blood

A

arterial blood from the arterial artery, usually radial (venous blood has been deoxygenated)

50
Q

ABG labs

A

PaO2: 80-100
PaCO2: 35-45
spO2: >95%
EtCo2: 35-45

51
Q

EtCO

A

the amount of CO2 at the end of exhalation, less invasion than ABG

52
Q

hypoventilation

A

inadequate alveolar ventilation to meet demand (not getting enough gas exchange so not enough O and/or too much CO2)

53
Q

causes of hypoventilation

A

medications (sedatives, opioids), alveolar collapse aka atelectasis (lung diseases), anesthesia

54
Q

S/s of hypoventilation

A

mental status changes, dysrhythmias -> can lead to cardiac arrest, convulsions, unconsciousness, death

55
Q

atelectasis

A

collapsed alveoli which prevents respiratory gas exchange (diagnosed by xray -> white where there should be black); can lead to lung collapse which leads to res distress, pneumonias, res failure

56
Q

is atelectasis preventable by the nurse

A

yes -> bed side techniques (incentive spirometer, get pt out of bed, cough, deep breath)

57
Q

conditions associated with atelectasis

A

immobility, obesity, sleep apnea, chronic lung disease

58
Q

hyperventilation

A

removing CO2 faster than it is produced by cellar metabolism

59
Q

causes of hyperventilation

A

anxiety attacks (severe), infection/fever, drugs, pH imbalance, aspirin poisoning, amphetamine use think increased work of breathing

60
Q

S/s of hyperventilation

A

rapid respirations, sighing breaths, numbness/tingling of hands & feet, light headedness, loss of consciousness

61
Q

Hypoxia

A

inadequate tissue oxygenation at the cellular level so not enough Q to meet needs (can be related to a delivery problem)

62
Q

why do we care so much about hypoxia

A

if left untreated can lead to cardiac dysrhythmias because the heart needs oxygen to function

63
Q

causes of hypoxia

A

decreased hemoglobin levels/low oxygen caring capability, diminished oxygen concentration of inspired oxygen (high alt), inability of tissues to get oxygen from blood (cyanide poisoning), decreased diffusion of oxygen from alveoli to blood (infections/pneumonia), poor perfusion w/ oxygenated blood (shock), impaired ventilation from traumas (rib fractures -> if it hurts to breath pt will take short, shallow breaths)

64
Q

S/s of hypoxia

A

apprehension, restless, inability too concentrate, decreased level of consciousness, dizziness, behavioral changes, difficulty staying still/lying flat, fatigue yet agitated, increases pulse & res, initially increased BP but then leads to shock & low BP, cyanosis (late sign), n/v, chest pain

65
Q

Cyanosis

A

blue discoloration of skin / mucous membranes not a reliable sign of oxygen status but is a clue

66
Q

central cyanosis affects what

A

tongue, soft palate, conjunctiva of eye (hypoxemia)

67
Q

peripheral cyanosis affects what

A

extremities, nail beds, earlobes (vasoconstriction not oxygenation)

68
Q

chronic hypoxia

A

associated with chronic lung conditions (most common is COPD) -> s/s cyanotic nail beds, sluggish cap refill, clubbing, barrel chest (1:1)

69
Q

developmental considerations of oxygenation: young & middle adults

A

focus on avoidance of oxygenation problem risk factors (smoking, unhealthy lifestyle, environment)

70
Q

developmental considerations of oxygenation: older adults

A

mental status changes typically first sign of any issues, more susceptible to respiratory infections & compromise, low reserve

71
Q

what is dyspnea commonly associated with

A

hypoxia

72
Q

what is dyspnea related to

A

shortness of breath (exercise, excitement, disease)

73
Q

S/s of dyspnea

A

use of accessory muscles, nasal flaring, increased rate/depth can be rated on an analog scale

74
Q

questions to ask related to dyspnea

A

when does it occur, what improves it, is it worsened by something

75
Q

DOE

A

“dyspnea on exertion”

76
Q

hemoptysis

A

bloody sputum

77
Q

what is more effective way to move secretions through the airways- coughing or artificial suctioning

A

coughing because it is coming from the lung

78
Q

sputum specimen collection

A

-best time is early in the morning
-wait 1-2 hours after pt eats
-sterile container
-may require suction if pt can’t cough up enough
**need to know steps, in potter & perry*

79
Q

sputum culture and sensitivity test

A

obtained to identify a specific microorganism or organism growing in sputum; identifies drug resistance and sensitivities to determine appropriate antibiotic therapy

80
Q

sputum for acid-fast bacillus

A

screens for presence of AFB for detection of TB by early morning specimens on 3 consecutive days

81
Q

sputum for cytology

A

obtained to identify lung cancer (differentiates type of cancer cell)

82
Q

pulmonary function test- basic ventilation studies

A

function varies by ethnic group determines ability of the lungs to efficiently exchange O and CO2; used to differentiate pulmonary obstructive from restrictive disease

83
Q

Peak Expiratory Flow Rate (PEFR)

A

the point of highest flow during maximal expiration (normal in adults is based on age and wt); reflect changes in large airway sizes, excellent predictor of overall airway resistance in pt w/ asthma (daily measures foo early detection of asthma)

84
Q

Bronchoscopy

A

looking for masses, pus or foreign bodies

85
Q

lung scan

A

looking at the structure for abnormalities

ABSN (145 decks)

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