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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
Q

why do we yawn/sign?

A

to release surfactant

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26
Q

what do you worry about with a collapsed lung?

A

is it putting pressure on the heart?

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27
Q

Pleural Effusion

A

abnormal collection of fluid in the pleural cavity

  • exudate, sanguineous (blood)
  • could be caused by CHF, cancer, liver failure
28
Q

Empyema

A

infection in the pleural cavity

-usually from bacterial pneumonia

29
Q

Hemothorax

A
  • presence of blood in the pleural cavity
  • if large enough may need a chest tube
  • usually from trauma or aortic aneurism
30
Q

How do you diagnose disorders of the pleura?

A
  • chest x-ray ( lung field elevated, lung density)

- diminished lung sounds

31
Q

Treatment for Pleural Effusion

A

Thoracentesis

32
Q

Thoracentesis

A

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
Q

Pneumothorax

A
  • collapsed lung

- the presence of air in pleural space

34
Q

Spontaneous Pneumothorax

A
  • ruptured of an air filled bleb

- commonly seen in tall men

35
Q

Deviated trachea suggests…

A

pneumothorax

36
Q

Traumatic pneumothorax

A
  • 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
Q

Tension pneumothorax

A

air gets into the pleural space but cannot escape. gets worse with each breath
-could be a traumatic pneumothorax or spontaneous pneumothorax

38
Q

Tension Pneumothorax Mediastinal Shift

A
  • tracheal deviation
  • late sign of collapsed lung
  • compressing of the heart
  • will cardiac arrest if not treated
39
Q

With a tension pneumothorax, the structures in the mediastinal shift where?

A

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
Q

Causes of Atelectasis

A

[no air reached the end of the alveolar tree so the alveoli collapse]
-most commonly caused of airway obstruction

41
Q

what is a pulmonary toilet? who is it normally used for?

A
  • coughing/deep breathing/incentive spirometer

- for patients after surgery, anesthesia, pain, narcotics, immobility

42
Q

consolidation

A

fluid accumulation in one area

43
Q

Brachial Asthma

A
  • obstructive airway disorders
  • chronic inflammatory disease
  • variable recurring symptoms: air flow obstruction & bronchial hypersensitivity
44
Q

Extrinsic Asthma

A

exposure to allergen (pollen, pet dander)

45
Q

Intrinsic Asthma

A

-respiratory tract infections, exercise, cold air, environmental chemicals, emotional response

46
Q

bronchospasm

A

narrowing of airways, air can get trapped in lungs

47
Q

Obstructive Airway Disorders cause…

A

mismatch!!!

48
Q

What usually happens after someone experiences an asthma attack?

A
  • they tend to hyperinflate their lungs
49
Q

80-85% of chronic smokers will develop what?

A

COPD

50
Q

Emphysema

A
  • 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
Q

s/s of emphysema

A
  • barrel chest
  • “pink puffer”
  • pursed lip breathing
  • lack of cyanosis
  • use of accessory muscles
  • dramatic increase
52
Q

S/S of Chronic Bronchitis

A
  • “blue bloater”
    -cyanotic
    -fluid retention associated with right-sided heart failure
    -chronic productive cough
    -
53
Q

Chronic Bronchitis

A
  • obstruction of major and small airways
  • seen mainly in middle-aged men
  • from chronic irritation from smoking or recurrent infections
54
Q

Bronchiectasis

A
  • 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
Q

S/S of Bronchiectasis

A
  • clubbing of the fingers
  • marked dyspnea
  • cyanosis
56
Q

What are the Obstructive Airway Disorders?

A
  • bronchial asthma
  • extrinsic asthma
  • intrinsic asthma
57
Q

What are the Chronic Obstructive Pulmonary Disease (COPD)?

A
  • emphysema
  • Chronic Bronchitis
  • Bronchiectasis
58
Q

Cystic Fibrosis

A
  • 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
Q

S/S Cystic Fibrosis

A
  • 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
Q

What do we do for children with CF?

A
  • 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
Q

Interstitial Lung Disease

A

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
Q

Idiopathic Pulmonary Fibrosis

A
  • 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
Q

Sarcoidosis

A
  • multisystem disorder in which granulomas are found in many tissues and organs, particularly the lungs, skin and eyes
  • inflammation of alveoli
64
Q

Pulmonary Embolism

A
  • PE
  • 60% mortality
  • blood borne substance lodges in branch of pulmonary artery and obstructs blood flow
65
Q

Pulmonary HTN

A
  • abnormal elevation of pressure pulmonary arterial system

- increased pressure in pulmonary arteries

66
Q

Cor Pulmonale

A

-right sided heart failure resulting from primary lung disease

67
Q

ARDS: Acute Respiratory Distress Syndrome

A
  • 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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