Assessment Flashcards
What is anatomic dead space?
How much of your tidal volume is anatomic dead space?
The amount of air that doesn’t reach the alveoli. It is in the trachea and bronchi and doesn’t take part in the gas exchange.
150 mL of 500 mL (average)
What is tidal volume?
The amount of air exchanged in 1 breath (usually around 500 mL)
What are the pores of Kohn?
Interconnections between alveoli that allow them to share air (and bacteria)
What is atelectasis?
Collapsed, airless alveoli
Why is deep breathing important?
Inflates alveoli and prevents atelectasis. Allows you to clear any mucus and promotes surfactant production.
–Tell patient to deep breath-hold it for 5 seconds-let it out. This holding breath allows alveoli to pop open and be functional. Have them progressively hold breath longer each time.–
The lungs receive de-oxygenated blood from heart through the ___ventricle.
Right
The lungs return oxygenated blood to the heart at the ___atrium.
Left
What is too much fluid in intrapleural space called?
–Remember intrapleural space is space in between parietal and visceral pleura and allows layers to slide without friction–
Pleural effusion
–Can happen with HF or poor lymph drainage from that area–
How many ribs do we have?
24 total
12 on each side
What does PaO2 represent?
Amount of dissolved O2 in plasma.
It will be in mmHg.
This will be a blood gas reading.
What is a normal range for PaO2?
What is it’s equivalent in SaO2 reading?
80—-100 mmHg
> 95%
What is a severe hypoxemia range for PaO2?
What is it’s equivalent in SaO2 reading?
<40 mm Hg
<75%
What is SaO2?
It is a ratio so value will be a %. Oxygen that is bound to hemoglobin in comparison to how much O2 the hemoglobin can carry.
Which is passive-exhalation or inhalation?
Exhalation
What is compliance?
The ability of the lungs to expand.
This is a result of the elasticity of the lungs and recoil of chest wall.
–Decreased when lungs have fluid–
–Increased when alveoli destroyed in COPD–
What is the main factor that affects resistance of lungs?
Diameter of airway
Where are chemoreceptors for pH and PaCO2 located?
Medulla
Carotid
Aortic arch
What are some of the defense mechanisms to protect respiratory system?
Air filtration (mucus and nose hairs)
Mucociliary clearance system (mucus and cilia)
Cough reflex
Bronchoconstriction
Alveolar macrophages
What are some geriatric changes in respiratory function?
Decreased amounts of: alveoli, immune function, cilia, muscle strength to cough.
Lungs become more stiff, barrel chest.
Respiratory control centers aren’t as sharp so body has decreased response to hypoxia.
–All of this means geri population higher risk of aspiration and pneumonia–
What is med term for coughing up blood?
Hemoptysis
What is med term for difficulty breathing while lying flat?
Orthopnea
What is classic sign of TB?
Night sweats
What are some EARLY CV signs of hypoxia?
What are some LATE CV signs?
Dysrhythmias
Mild HTN
Tachycardia
Cyanosis
Cool, clammy skin
Hypotension
What are some early neuro signs of hypoxia?
Late neuro signs?
Apprehension
Confusion
Lethargy
Restlessness
Irritability
Combative
Coma
What are some early respiratory signs of hypoxia?
Late signs?
Activity intolerance
Tachypnea
Dyspnea at rest
Can’t finish sentences without stopping for breath
Retractions
Use of accessory muscles
What is fremitus?
A normal finding.
The vibration of the chest when a person speaks.
Can auscultate for fremitus or do tactile fremitus.
Have the person say “99”
What is increased fremitus a sign of?
Lungs denser with fluid, secretions or tumor. Vibration will be louder than normal.
What is decreased fremitus a sign of? What if absent?
Lungs further away like in a barrel chest.
Absent fremitus means pneumothorax or atelectasis.
When percussing over lungs, what is normal sound called?
Resonance
(low pitched)
When percussing over a hollow organ like the stomach, how is the sound described?
Tympany
–also heard over a pneumothorax–
When percussing over dense tissue, how is the sound described?
Flat
(Soft, high pitched, short sound)
What is egophony?
EE-GOFF-UH-NEE
Auscultation over chest
Have patient say “EE”
If you heard an “AA” instead of “EE”
this could mean pneumonia or pleural effusion.
When is a sputum sample best obtained?
First thing in morning after patient cleans mouth.
What are the 5 ABG tests and normal values?
pH: 7.35–7.45
PaCO2: 35–45
PaO2: 80—100 mmHg
SaO2: >95%
HCO3: 22—-26
What is the purpose of a thoracentesis?
Obtain specimen of lung fluid
Remove fluid
Instill medication
What is the difference between a CPAP and a bi-PAP?
C-PAP is Continuous positive pressure at one setting (used on most sleep apnea patients)
Bi-PAP delivers 2 levels of pressure, one for inhale and one for exhale. (better for people with COPD)
Where is carina in children vs adults?
Children at T3
Adults at T6
Which bronchi is most likely to become obstructed in children?
Right
Which retraction site in children indicates mild distress?
Moderate distress?
Severe distress?
The worst distress?
First: Nasal flaring then
Intercostal
Substernal and Subcostal
Suprasternal
Supraclavicular
Sternocleidomastoid muscles
(called wry neck, kid will flex head forward and muscles will pop out in neck)
