Chapter 36: Alterations of Pulmonary Function Flashcards
s/sx of pulm dz
Dyspnea and cough
Altered breathing patterns
Hyperventilation -> resp alk. CO2 lost.
Hypoventilation -> resp acidosis. CO accumulates
Hemoptysis -> coughing up blood
Abnormal sputum
Cyanosis
Chest pain
Clubbing
dyspnea
Subjective sensation of uncomfortable breathing
severe dyspnea
Flaring of the nostrils
Use of accessory muscles of respiration
Retraction of the intercostal spaces
dyspnea on exertion
SOB with activity
orthopnea
Dyspnea when lying down
Often related to left side heart failure
paroxysmal nocturnal dyspnea
Awaking at night and gasping for air; must sit up or stand up
cough and sputum
Cough: Protective reflex that helps clear the airways by an explosive expiration. Acute coughm-> Resolves within 2 to 3 weeks. Chronic cough -> Lasts longer than 3 weeks.
Abnormal sputum: Changes in amount, consistency, color, and odor provide information about the progression of disease and the effectiveness of therapy.
Hemoptysis: Coughing up blood or bloody secretions
abnormal breathing patterns
Adjustments made by the body to minimize the work of the respiratory muscles
kussmaul respirations (hyperpnea)
Slightly increased ventilatory rate, very large tidal volume, and no expiratory pause
Trying to blow off acid -> metabolic acidosis.
labored breathing
increased work of breathing
restricted breathing
Disorders that stiffen the lungs or chest wall and decrease compliance
Ex. Obesity. Weight compresses breathing
Cheyne-stokes respirations
Alternating periods of deep and shallow breathing; apnea lasting 15 to 60 seconds, followed by ventilations that increase in volume until a peak is reached, after which ventilation decreases again to apnea
hypoventilation
Alveolar ventilation is inadequate in relationship to the metabolic demands.
Leads to respiratory acidosis from hypercapnia.
Low RR and Low vT
Result is -Increased CO2 (>40mm Hg) and Decreased pH (Resp Acidosis)
Is caused: Over sedation #1, airway obstruction, chest wall restriction, altered neurologic control of breathing.
Causes:
- Central
Drugs (narcotics), Head injury/Spinal Cord injury - Chest wall disorder: Neuromuscular Diseases, Obesity, Kyphosis/scoliosis
- Damaged Lung Structure: asthma, COPD
hyperventilation
Alveolar ventilation exceeds the metabolic demands.
Leads to respiratory alkalosis from hypocapnia.
Is caused: anxiety, Pain, fever
cyanosis
Bluish discoloration of the skin and mucous membranes
Develops with five grams of desaturated hemoglobin, regardless of concentration
peripheral cyanosis
Most often caused by poor circulation
Best observed in the nail beds
central cyanosis
Caused by decreased arterial oxygenation (low partial pressure of oxygen [Pao2])
Best observed in buccal mucous membranes and lips
clubbing
Bulbous enlargement of the distal segment of a finger or toe.
Graded 1-5 based on nailbed changes
Associated with diseases causing hypoxemia
chest pain
pleural and chest wall
pleural pain
Is the most common pain caused by pulmonary diseases.
Is usually sharp or stabbing in character.
Infection and inflammation of the parietal pleura (pleuritis or pleurisy) can cause pain when the pleura stretch during inspiration and are accompanied by a pleural friction rub.
chest wall pain
may be from the airways
may be from muscle or rib pain
conditions caused by pulm dz or injury
Hypercapnia: Increased carbon dioxide (CO2) in the arterial blood, Occurs from hypoventilation
Hypoxemia: Hypoxemia (blood) versus hypoxia (tissue), Reduced oxygenation of arterial blood
caises of hypoxemia
in order of most to least common
1. V:Q Mismatch** Ventilation and perfusion are different than what it should be
- Hypoventilation
- Shunt
- Thickened diffusion barrier
- Low inspired O2 (Altitude)
most common cause of hypoxemia in pt with pneumonia, atelectasis, PE
V:Q mismatch
* does improve with O2