Assessment of Respiratory Function (Online Lecture) Flashcards
changes in respiratory status are increasingly recognized as one of he most sensitive indicators of
clinical deterioration
bleeding does what to respirations
increase
upper respiratory
warm and filter
lower respiratory
accomplishes gas exchange
4 steps of respiration
ventilation
oxygen diffusion
transportation
tissue extraction
ventilation
movement of air in and out of lungs
oxygen diffusion
diffusion of O2 and CO2 across alveolar membranes
transportation
need hemoglobin and cardiac output
tissue extraction
tissues have to be able to pull O2 out of blood stream to use it
respiration
the gas exchange between atmospheric air and blood between the blood and the cells of the body
ventilation
what is needed (your air pump)
diagprahm
ABG
hypo and hyper ventilaion
hypo: Co2 down
hyper: Co2 Up
increase airway resistance
more difficult to ventilate
decrease compliance
do not expand/expell
examples of diseases of ventilation issues
COPD, asthma, allergic reaction, edema
pulmonary artery is a low or high pressure system
low
diffusion
exchange of O2 and CO2 at the alveolar-capillary membrane
high ventilation perfusion ratio
dead space
no blood flow
perfusion issue
ex: PE
low ventilation perfusion ratio
shunt
ventilation issue
increase CO2 decrease PaO2
EX; collapsed alveloli
oxygen therapy is used to support
diffusion
changes in respiratory rate/pattern
biggest indicator for oxygen
what are some other manifestations for oxygen
mental status, confusion, agitation, anxiety lethargy, disorientation, comatose, dyspnea, BP changes, HR changes
late stages for oxygen
central cyanosis: lips are blue
example of acute hypoxic
alcohol intoxication
examples of chronic hypoxia
fatigue, lethargy, drowsiness, delayed reaction time
what should we monitor with oxygen
signs of hypoxia (should be improving)
ABG
pulse ox
what drives our decision for o2 amount
always want to use least amount of O2 necessary to support that patient
venturi mask
most reliable and accurate method for delivering precise concentrations of oxygen through non invasive means
high flow O2
combination of _____________________ allows higher rates than delivered by traditional O2 therapy
oxygen, compressed air humidification
complications of O2 therapy
suppressed respiratory drive and low O2 tension
who might have suppressed respiratory drive and low O2 tension
COPD
co2 drives respiratory rate
chronically high CO2 levels, the body becomes desensitized to that trigger and the trigger then becomes PO2 levels
O2 level in blood stream should go up and this could potentially surpassed resp drive
tricks brain into thinking they don’t need to breathe
other complications to O2 therpay
fire
oxygen toxicity
o2 concentrations of greater than 50% for extended periods of time (48 hrs) can cause an over production of free radicals, which can severely damage cells
oxygen toxicity symptoms
sub sternal discomfort, paresthesias, dyspnea, restlessness, fatigue, progressive respiratory difficulty, refractory hypoxemia (PO2 levels still low)
NPP
noninvasive positive pressure
keep alveoli open and help improve gas exchange wo having to intubate patient
NPP
CPAP
keep alveoli open
post op
breathe out against pressure
NPP
BiPAP
two types of pressure
NPP
risks
mask needs to be tight: skin breakdown
air into stomach: vomitting and aspiration
intubation
patent airway
mechanical ventilation
gold standard intubation
bilateral breath sounds followed by X ray
intubation monitor check cuff pressure
6/8 hours
how long of intubation until trache is considered
10-14 days
trache tubes are used to bypass upper respiratory so
easy to suction and prevent aspiration
what position should trache patients be in
high fowlers to prevent aspiration
trache suction
pre ox
no more than 120
only suction while pulling out
10-15 seconds
transportation we need
hemoglobin and cardiac output
measuring oxygen content
pulmonary cardiac level
pulse ox
ABG
calculation (noninvasive)
oxygen hemoglobin saturation curve
Po2 levels vary but pulse ox is same
rightward shift
decreased affinity
pick up more O2 and release more
higher PaO2
leftward shift
increased affinity
bond between O2 and hemoglobin stronger
less o2 released at tissues
lower Pao2
factors that affect affinity
carbon dioxide
hydrogen ion concentration
temp
23D5 phosglycernate
increase is shift to right
decrease is shift to left
pros of pulse ox
rapid reading
continous
non invasive
cons of pulse ox
unreliable
ox doesn’t equal paO2
doesn’t tell hypo vent/increase cos2
inaccurate reading in some pts
does spo2 equal sao2
no
does spo2 detect hypovent
no
________ PaO2 changes occur before spo2 changes 1%
large
extraction
ability of the tissues to excrate the o2 from blood and use it
barriers limiting excretion
edema
inflammation
fibrosis
cellular dysfunction
normal breath sounds
vesicular
bronchovesicular
bronchial
abnormal breath sounds
crackles
wheezes
friction rub
abnormal general apperence
barrel chest
pigeon cehst
kyphoscoloiosos
funnel chest
tidal volume
volume of air inhaled and exhaled with each breath
~500
inspiratory reserve
amount of air that can be inhaled with normal inhalation
expiratory reserve
Max amount of air that can be exhaled forcefully after normal exhalation
vital capacity
volume of air exhaled from point of max insirpation
forced expiratory volume
volume of exhaled at a specific time, usually over a second
ABG
measurement of arterial oxygenation and carbon dioxide levels
sputum tests
analyzed for infectious organisms
Chets xray
fluid
normal is black
CT
tumors, kidney fx,
ask for allergies
MRI
bad beacuse obese won’t fit
claustrophobia
lay still
implanted metal
