Chapter 10 Flashcards
external respiration
the gas exchange process that occurs between the alveoli and the surrounding pulmonary capillaries.
Internal Respiration
the gas exchange process that occurs between the cells and the systemic capillaries.
Cellular respiration and metabolism
alsoknown as aerobic metabolism, occurs in the cell. The process breaks down glucose in the presence of oxygen, produces high amounts of energy in the form of ATP, and releases carbon dioxide and water as a by-product.
serous fluid
acts as a lubricant to reduce friction when the layers of the pleura rub against each other during breathing
hypoxemia
low oxygen content in arterial blood.
hypoxia
an inadequacy in the amount of oxygen being delivered to the cells.
s/s of mild to moderate hypoxia
Tachypnea (increased respiratory rate)
Dyspnea (shortness of breath)
Pale, cool, clammy skin (early)
Tachycardia (increase in heart rate)
Elevation in blood pressure
Restlessness and agitation (from hypoxic brain cells)
Disorientation and confusion (from high carbon dioxide levels in the blood)
Headache
s/s of severe hypoxia
Tachypnea
Dyspnea
Cyanosis
Tachycardia
that may lead to dysrhythmias (irregular heart rhythms) and eventually bradycardia (slow heart rate)
Severe confusion
Loss of coordination
Sleepy appearance
Head bobbing (head bobs upward with inhalation and downward with exhalation) with droopy eyelids
Slow reaction time
Altered mental status
Seizure
infant and pediatric airway considerations
are smaller and more easily obstructed by foreign bodies, swelling, blood, mucus, and secretions.
tongue is large in relation to pharynx
lower airway is more narrow, flexible, and softer
more pliable thoracic cavity
Signs of an open airway
Air can be felt and heard moving in and out of the mouth and nose.
The patient is speaking in full sentences or with little difficulty.
The sound of the voice is normal for the patient.
abnormal upper airway sounds
snoring
crowing
gurgling
stridor
snoring
occurs when the upper airway is partially obstructed by the tongue or by relaxed tissues in the pharynx. The snoring and obstruction can be corrected by performing a head-tilt, chin-lift maneuver.
crowing
sound like a crow cawing that occurs when the muscles around the larynx spasm and narrow the opening into the trachea. Air rushing through the restricted passage causes the sound.
gurgling
sound like gargling, usually indicates the presence of blood, vomitus, secretions, or other liquid in the airway. Immediately suction the substance from the airway.
stridor
harsh, high-pitched sound heard during inspiration. It is characteristic of a significant upper airway obstruction from swelling in the larynx. may also be heard if a mechanical obstruction by food or other objects is present.
sign of blocked upper airway
Abnormal upper airway sound (stridor, snoring, crowing, or gurgling)
An awake patient who is unable to speak
Evidence of a foreign body airway obstruction
Swelling to the mouth, tongue, or oropharynx
head tilt chin lift vs jaw thrust
only use jaw thrust in trauma cases
How long do you suction for
15 seconds or until clear
what type of catheter is used for suctioning the mouth
hard catheter
signs of adequate breathing
Normal respiratory rate
Clear and equal breath sounds bilaterally
Adequate air movement heard and felt from nose and mouth (tidal volume)
Good chest rise and fall with each ventilation (tidal volume)
adult breathing rate
12-20
adolescent(12-15) breathing rate
12-20
school age kid (6-11) breathing rate
18-25
preschooler (3-5) breathing rate
20-28
toddler (1-2) breathing rate
22-37
infant (1 month-12month) breathing rate
30-53
neonatal (1 day-1month)
40-60
What must a pt have adequate breathing
adequate tidal volume and adequate respiration
respiratory arrest/apnea
when pt completely stops breathing
common causes of respiratory arrest
Stroke
Myocardial infarction
Drug overdose, especially opiates and other CNS depressants
Toxic inhalation
Electrocution and lightning strike
Suffocation
Traumatic injuries to the head, spine, chest, or abdomen
Infection to the epiglottis
Airway obstruction by a foreign body
agonal respiration
gasping-type breaths. If seen in the cardiac arrest patient, they usually appear soon after the person goes into cardiac arrest
abnormal breath sounds
Stridor
Wheezing
Crackles
Silent chest (no breath sounds heard)
Unequal breath sounds (trauma, infection, and pneumothorax)
Ventilate or oxygenate?
inadequate RR + Adequate tidal volume
PPV
Ventilate or oxygenate?
Adequate RR + inadequate tidal volume
PPV
How does positive pressure ventilation effect the cardiac output of the heart?
reduces pre-load and cardiac output
infant/children ventilation rate
12-20/min 3-5/sec
adult ventilation rate
10-12/min 5-6/sec
indicate adequate ventilation rate
sufficient ventilation rate
consistent tidal volume(chest rise/fall)
improved color
hr returns towards normal
how much of inhaled oxygen does the body use
5 percent inhaled, 16 percent exhaled
neonatal ventilation rate
40-60/min 1-1.5/sec
adult cpr ratio
30 compression/2 ventilations
pediatric cpr ratio 1 person
30 compression/2 ventilations
pediatric cpr ratio 2 person
15 compression/2 ventilations
neonatal cpr ratio
3 compression/1 ventilations
continuous positive airway pressure (CPAP)
a form of noninvasive positive pressure ventilation (NIPPV) used in the spontaneously breathing patient who needs ventilatory support
stoma
a surgical opening in the front of the neck through which the patient breathes air into the trachea
Signs of a severe partial airway obstruction with poor air exchange are:
Cough that becomes silent
Stridor heard on inhalation
Increase in labored breathing
severe airway obstruction adults
abdominal thrusts
severe airway obstruction infant
5 backslaps/ chest thrusts
indication for o2 administration
o2 level less than 94
The patient complains of dyspnea or exhibits signs of respiratory distress.
Signs of poor perfusion are present
Obvious signs of heart failure.
Suspected shock.
Any situation or condition in which hypoxia or hypoxemia is suspected.
