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D & D exam 4 > Ch. 23 Disorders of Ventilation & Gas Exchange > Flashcards

Ch. 23 Disorders of Ventilation & Gas Exchange Flashcards

1
Q

hypoxemia

A

reduced arterial blood PO2 ( partial pressure of oxygen, how much oxygen in in the blood)

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2
Q

What are some things that can cause hypoxemia/Hypoxia?

A
  • hypoventilation
  • impaired diffusion of gases
  • inadequate circulation of blood through pulmonary capillaries
  • mismatching of ventilation and perfusion
  • inadequate O2 in air you breathe
  • respiratory disease problems
  • neurological (head injury, not telling body to breathe)
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3
Q

Shunting

A

not having exchange of oxygen at the alveolar area b/c of fluid

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4
Q

what sympathetic compensation occurs with hypoxemia?

A
  • increase HR

- mild increase in BP brought on by vasoconstriction

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5
Q

Early Symptoms of Hypoxia

A

Restlessness
Anxiety
Tachycardia/Tachypnea

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6
Q

Late Symptoms of Hypoxia

A

Brachycardia
Extreme restlessness
Dyspnea (sever)

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7
Q

Symptoms of Hypoxia in Pediatrics

A 
Feeding difficulty
Inspiratory stridor
Nares flare
Expiratory grunting
Sternal retractions
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8
Q

anoxia

A

complete deprivation of oxygen

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9
Q

Central Cyanosis

A

tongue and lips

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10
Q

Peripheral Cyanosis

A

extremities, tip of nose, tip of ears

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11
Q

Hypercapnia

A
  • increase in carbon dioxide (PCO2) in blood

- increase CO2 will increase blood pH = Acidosis

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12
Q

Causes of Hypercapnia

A
  • hypoventilation (narcotics, pulmonary illness, trauma, obesity, sleep apnea)
  • mismatch of ventilation and perfusion
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13
Q

what are the two main determinants of how we get oxygen percentage?

A

-ventilation and perfusion (how much blood is reaching the alveoli)

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14
Q

A mismatch of ventilation and perfusion will cause…

A

increase CO2 and decreased O2

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15
Q

Respiratory Acidosis S/S

A
  • hypoventilation —-> hypoxia
  • rapid, shallow respirations
  • decrease BP with vasodilation
  • dyspnea
  • headache
  • hyperkalemia
  • dysrhythmias (increased potassium)
  • drowsiness, dizziness, disorientation
  • ” I cant catch my breath”
  • muscle weakness, hyperreflexia
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16
Q

Respiratory Acidosis Causes

A
  • decreased respiratory stimuli (anesthesia, drug overdose)
  • COPD
  • pneumonia
  • atelectasis
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17
Q

What is atelectasis?

A

-incomplete expansion of a lung or portion of a lung

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18
Q

how can we open up alveoli?

A
  • sit up
  • deep breathing
  • cough
  • Incentive Spirometer
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19
Q

Respiratory Alkalosis S/S

A
  • seizures
  • deep, rapid breathing
  • hyperventilation
  • tachycardia
  • low or normal BP
  • hypokalemia
  • lethargy & confusion
  • light headedness
  • nausea, vomiting
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20
Q

Causes of Respiratory Alkalosis

A
  • hyperventilation (anxiety, PE, Fear)

- mechanical ventilation (machine breathing too fast)

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21
Q

Parietal Pleura

A

-outside pleura layer on the lung

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22
Q

Visceral Pleura

A

-inside pleura layer, touching the lung

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23
Q

pulmonary surfactant

A

-the serous fluid between the parietal and visceral pleura that allows the lungs to expand comfortably

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24
Q

Pleuritis (Pleurisy)

A
  • inflammation of the parietal layer

- pain will be localized and increased with respirations, not a continuous pain

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25
why do we yawn/sign?
to release surfactant
26
what do you worry about with a collapsed lung?
is it putting pressure on the heart?
27
Pleural Effusion
abnormal collection of fluid in the pleural cavity - exudate, sanguineous (blood) - could be caused by CHF, cancer, liver failure
28
Empyema
infection in the pleural cavity | -usually from bacterial pneumonia
29
Hemothorax
- presence of blood in the pleural cavity - if large enough may need a chest tube - usually from trauma or aortic aneurism
30
How do you diagnose disorders of the pleura?
- chest x-ray ( lung field elevated, lung density) | - diminished lung sounds
31
Treatment for Pleural Effusion
Thoracentesis
32
Thoracentesis
could be both diagnostic and treatment for pleural effusion, send fluid off to be tested but also removed the fluid and relieving the pressure
33
Pneumothorax
- collapsed lung | - the presence of air in pleural space
34
Spontaneous Pneumothorax
- ruptured of an air filled bleb | - commonly seen in tall men
35
Deviated trachea suggests...
pneumothorax
36
Traumatic pneumothorax
- Penetrating Injuries: "sucking chest wound"; open; gunshot, stabbing - Non-penetrating Injuries: no opening to outside air in chest; hit the steering wheel you break a rib and it punctures the lung
37
Tension pneumothorax
air gets into the pleural space but cannot escape. gets worse with each breath -could be a traumatic pneumothorax or spontaneous pneumothorax
38
Tension Pneumothorax Mediastinal Shift
- tracheal deviation - late sign of collapsed lung - compressing of the heart - will cardiac arrest if not treated
39
With a tension pneumothorax, the structures in the mediastinal shift where?
heart/vessels pushed towards unaffected side and squish the unaffected lung, the trachea is leaning towards the affected side (although lower down it is also pushed towards the unaffected side)
40
Causes of Atelectasis
[no air reached the end of the alveolar tree so the alveoli collapse] -most commonly caused of airway obstruction
41
what is a pulmonary toilet? who is it normally used for?
- coughing/deep breathing/incentive spirometer | - for patients after surgery, anesthesia, pain, narcotics, immobility
42
consolidation
fluid accumulation in one area
43
Brachial Asthma
- obstructive airway disorders - chronic inflammatory disease - variable recurring symptoms: air flow obstruction & bronchial hypersensitivity
44
Extrinsic Asthma
exposure to allergen (pollen, pet dander)
45
Intrinsic Asthma
-respiratory tract infections, exercise, cold air, environmental chemicals, emotional response
46
bronchospasm
narrowing of airways, air can get trapped in lungs
47
Obstructive Airway Disorders cause...
mismatch!!!
48
What usually happens after someone experiences an asthma attack?
- they tend to hyperinflate their lungs
49
80-85% of chronic smokers will develop what?
COPD
50
Emphysema
- loss of lung elasticity and abnormal enlargement of the air spaces distal to the terminal bronchioles, with destruction of the alveolar walls and capillary beds - enlargement of air space - destruction of lung tissue - enlargement of the lungs lead to hyperinflation, airways collapse during expiration - air becomes trapped in alveoli and lungs - INCREASING TLC
51
s/s of emphysema
- barrel chest - "pink puffer" - pursed lip breathing - lack of cyanosis - use of accessory muscles - dramatic increase
52
S/S of Chronic Bronchitis
- "blue bloater" -cyanotic -fluid retention associated with right-sided heart failure -chronic productive cough -
53
Chronic Bronchitis
- obstruction of major and small airways - seen mainly in middle-aged men - from chronic irritation from smoking or recurrent infections
54
Bronchiectasis
- uncommon type of COPD - a permanent dilation of the bronchi and bronchioles cause by destruction of the muscle and elastic supporting tissue as the result of a vicious cycle of infection and inflammation - not a primary disease, occurs secondary to persistent infection or obstruction - NOT FROM SMOKING!
55
S/S of Bronchiectasis
- clubbing of the fingers - marked dyspnea - cyanosis
56
What are the Obstructive Airway Disorders?
- bronchial asthma - extrinsic asthma - intrinsic asthma
57
What are the Chronic Obstructive Pulmonary Disease (COPD)?
- emphysema - Chronic Bronchitis - Bronchiectasis
58
Cystic Fibrosis
- disorder involving fluid secretion by the exocrine glands in the epithelial lining of the respiratory tract, GI tract, and reproductive structures - seen in children - excessive pulmonary secretion, constantly filled up with fluid
59
S/S Cystic Fibrosis
- nasal polyps, sinus infections, pancreatitis, excessive loss of sweat, trouble breathing, enlarged heart, fatty BMs, trouble digesting food, gallstones, - boys who have this don't have vas deferens - lots of mucus - don't see a lot of adults with it because the prognosis is poor
60
What do we do for children with CF?
- humidifiers - postural drainage is a technique for loosening mucus in the airway so that it may be coughed out - tapping is performed in certain areas with the patient in different positions
61
Interstitial Lung Disease
a diverse group of lung disorders that produce similar inflammatory and fibrotic changes in the intersitium or interalveolar septa of the lung - commonly classified as restrictive lung disorders because they result in a stiff and noncompliant lung - also called Diffuse Parenchymal Lung Disease - Idiopathic Pulmonary Fibrosis and Sarcoidosis
62
Idiopathic Pulmonary Fibrosis
- most common among interstitial lung disease - characterized by diffuse interstitial fibrosis - results in hypoxemia and cyanosis - gradual onset of a nonproductive cough and progressive dyspnea
63
Sarcoidosis
- multisystem disorder in which granulomas are found in many tissues and organs, particularly the lungs, skin and eyes - inflammation of alveoli
64
Pulmonary Embolism
- PE - 60% mortality - blood borne substance lodges in branch of pulmonary artery and obstructs blood flow
65
Pulmonary HTN
- abnormal elevation of pressure pulmonary arterial system | - increased pressure in pulmonary arteries
66
Cor Pulmonale
-right sided heart failure resulting from primary lung disease
67
ARDS: Acute Respiratory Distress Syndrome
- rapid onset - severe dyspnea - hypoxic - pulmonary infiltrates (white X-ray) it is a lung injury from.. -near drowning, aspiration of stomach contents (worry about with stroke), medications, infections (septic), burn patients (inflammatory process) could lead to Acute Respiratory Failure

D & D exam 4 (4 decks)

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