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Fundamentals 1 > Chapter 39 Oxygenation and Perfusion > Flashcards

Chapter 39 Oxygenation and Perfusion Flashcards

1
Q

What are the 3 factors essential to normal functioning of the respiratory system?

A
  • integrity of the airway system to transport air to and from the lungs
  • properly functioning alveolar system in the lungs
  • properly functioning cardiovascular and hematologic systems (blood supply)
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2
Q

Oxygen and carbon dioxide must move through the ___ as part of the oxygenation process.

A

alveoli

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3
Q

Function of respiratory system?

A

transport and exchange of oxygen and carbon dioxide

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4
Q

The airway begins and ends where?

A

Begins at nose and ends at terminal bronchioles

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5
Q

What are microscopic hair-like projections, that propel trapped material and accompanying mucus toward the upper airway so they can be removed by coughing?

A

Cilia

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6
Q

What is necessary for ciliary action and for the production of watery mucus normally present in the respiratory tract?

A

an adequate fluid intake

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7
Q

What is involved in the upper airway and what is the upper airway’s function?

A
  • nose, pharynx, larynx, and epiglottis

- function: get the air in, filter it, and humidify inspired air

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8
Q

What is involved in the lower airway and what is the lower airway’s function?

A
  • trachea, right/left mainstem bronchi, segmental bronchi, and terminal bronchioles
  • function: conduction of air further down, mucociliary clearance, production of pulmonary surfactant
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9
Q

The lungs extend from the __ to the __.

A

From the base at the bottom of the diaphragm to the apex which is above the 1st rib.

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10
Q

Which lung has 3 lobes? 2 lobes?

A

3- right

2- left

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11
Q

What are smaller air sacs in the lungs?

A

alveoli

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12
Q

What is a detergent-like phospholipid, that reduces the tension between the moist membranes of the alveoli, preventing their collapse?

A

Surfactant

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13
Q

What is a serous membrane that lines the lungs and thoracic cavity?

A

Pleura

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14
Q

What pleura covers the lungs?

A

visceral

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15
Q

What pleura lines the thoracic cavity?

A

parietal

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16
Q

What is the movement of air into and out of the lungs?

A

Pulmonary Ventilation

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17
Q

What are the 2 phases of ventilation?

A
  • inspiration

- expiration

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18
Q

What is the active phase of ventilation?

A

Inspiration

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19
Q

What is the passive phase of ventilation?

A

Expiration

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20
Q

What happens during the process of ventilation (inspiration)?

A
  • the diaphragm contracts and descends, lengthening the thoracic cavity
  • the external intercostal muscles contract, lifting the ribs upward and outward
  • sternum is pushed forward, enlarging the chest
  • Increased lung volume and decrease intrapulmonic pressure (allows air to move from high to low pressure)
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21
Q

What happens during the process of gas exchange (respiration)?

A
  • intake of oxygen and release of carbon dioxide
  • movement of oxygen and carbon dioxide between the air and blood via capillaries
  • perfusion
  • diffusion (movement of gas or articles from areas of higher pressure to lower)
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22
Q

The process of oxygenated capillary blood passing through the tissues of the body.

A

Perfusion

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23
Q

The movement of gas or particles from areas of higher pressure or concentration to areas of lower pressure or concentration.

A

Diffusion

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24
Q

Which respiratory organ is the site of gas exchange?

A

Alveoli

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25
Q

What 4 factors influence diffusion of gases in the lungs?

A
  • change in surface area available
  • thickening of alveolar-capillary membrane
  • partial pressure
  • solubility and molecular weight of the gas
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26
Q

What causes thickening of the alveolar-capillary membrane?

A

anything due to inflammation

-pneumonia, pulmonary edema, etc.

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27
Q

What causes a change in the surface area available?

A

-destroyed tissues from smoking, broken rib, bed rest, etc. (anything that prevents the lungs from expanding as good)

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28
Q

How is oxygen carried throughout the body?

A

via plasma and red blood cells.

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29
Q

Most oxygen (97%) is carried by red blood cells in the form of ___.

A

oxyhemoglobin

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30
Q

Hemoglobin also carries carbon dioxide in the form of ___.

A

carboxyhemoglobin

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31
Q

Internal respiration between the ___ and ___ cells must occur.

A

circulating blood and tissue

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32
Q

Pulmonary ventilation is the process by which oxygenated capillary blood passes through body tissues. T/F?

A

False. Perfusion.

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33
Q

What are 3 alterations in respiratory function?

A

Hypoxia
Dyspnea
Hypoventilation

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34
Q

What is an inadequate amount of oxygen available to the cells?

A

Hypoxia

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35
Q

What is difficulty breathing?

A

Dyspnea

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36
Q

What is a decreased rate or depth of air movement into the lungs?

A

Hypoventilation

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37
Q

How many chambers does the heart have?

A

4
upper- atria
lower- ventricles

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38
Q

What do the upper chambers of the heart do?

A

The atria receive blood from the superior and inferior vena cava and the left and right pulmonary veins.

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39
Q

What do the lower chambers of the heart do?

A

The ventricles force blood out of the heart through the left and right pulmonary arteries and the aorta.

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40
Q

What do one-way valves do? Where are they located?

A

They direct blood flow through the heart.

Located at the entrance (tricuspid and mitral valves) and exit (pulmonary and aortic valves) of each ventricle

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41
Q

Deoxygenated blood (low in oxygen, high in carbon dioxide) is carried from the ___ side of the heart to the lungs.

A

Right

42
Q

What is a disturbance of the rhythm of the heart.

A

dysrhythmia or arrhythmia

43
Q

What causes dysrhythmias?

A
  • Caused by an abnormal rate of electrical impulse generation from the SA node, or from impulses originating from a site or sites other than the SA node.
  • They can also be caused by the abnormal conduction of electrical impulses through the heart.
44
Q

What can dysrhythmias cause disturbances in?

A
  • Heart rate, heart rhythm or both.
  • can affect the pumping action of the heart, can interfere with circulation, and can lead to alterations in oxygenation.
45
Q

What is a myocardial ischemia?

A

Decreased oxygen supply to the heart caused by insufficient blood supply

46
Q

What can myocardial ischemia lead to?

A

Impaired oxygenation of tissues in the body.

47
Q

What is myocardial ischemia usually caused by?

A

-atherosclerosis

48
Q

What is a temporary imbalance between the amount of oxygen needed by the heart and the amount delivered to the heart muscles, causing chest pain or discomfort?

A

Angina

49
Q

What is one type of acute coronary syndrome characterized by the death of heart tissue due to lack of oxygen?

A

Myocardial infarction, or heart attack

50
Q

What occurs when the heart is unable to pump a sufficient blood supply, resulting in inadequate perfusion and oxygenation of tissues.

A

Heart failure

51
Q

What disease are these symptoms accompanied with: shortness of breath, edema (swelling), and fatigue. ?

A

Heart failure

52
Q

What disease are these symptoms accompanied with: pain, anxiety, nausea, vomiting, indigestion, and shortness of breath.

A

Myocardial ischemia

53
Q

What can be the result of many heart conditions, including chronic hypertension, coronary artery disease, and disease of the heart valves?

A

Heart failure

54
Q

What factors affect cardiopulmonary functioning and oxygenation? (6)

A
  • level of health
  • developmental considerations
  • medication considerations
  • lifestyle considerations
  • environmental considerations
  • psychological health considerations
55
Q

What are the 5 guidelines for obtaining a nursing history?

A
  • determine why the patient needs nursing care?
  • determine what kind of care is needed
  • Identify current or potential health deviations
  • Identify factions performed by the patient for meeting respiratory needs
  • make use of aids of improve intake of air and effects on patient’s lifestyle/relationships
56
Q

Low-pitched, soft sound during expiration heard over most of the lungs.

A

Vesicular

57
Q

High-pitched and longer, heard primarily over the trachea

A

Bronchial

58
Q

Medium pitch and sound during expiration, heard over the upper anterior chest and intercostal area

A

Bronchovesicular

59
Q

Wheezes are continuous, musical sounds, produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors. T/F?

A

True

60
Q

What are the 3 types of adventitious lung sounds?

A
  • crackles
  • wheezes
  • rhonchi
61
Q

Intermittent sounds occurring when air moves through airways that contain fluid.

A

Crackles

62
Q

continuous musical sounds heard on expiration and sometimes on inspiration as air passes through airways constricted by swelling, secretions, or tumors.

A

Wheezes

63
Q

What are low pitched rattling sounds that can be considered course crackles?

A

Rhonchi

64
Q

What is a cardiac coronary catheterization?

A
  • Invasive procedure
  • We put a probe through the femoral artery and it goes into the heart
  • We need pressure on this site, monitory for bleeding, and no movement until the bleeding has stopped.
65
Q

What is a cardiac exercise stress test?

A

We can: Put an EKG on a patient and have them walk or run on the treadmill.

  • We watch how the heart and heart rhythm respond to it.
  • We also can give them medication if they are not very active, and it will simulate stress from exercise.
  • Noninvasive.
66
Q

What is an echocardiogram?

A

Ultrasound of the heart where they look at the blood flow through the heart, in the heart and in the valves and into the chambers.
-noninvasive

67
Q

What is an endoscopic study?

A

An endoscopic visualization

We go through the radial arterial line.

68
Q

What is a holter monitor?

A

Patient can wear this for a few days
Noninvasive
Captures heart activity for a time period

69
Q

What is a lung scan?

A

Nuclear imaging test

We look at air or blood movements through the blood

70
Q

What does radiography look at?

A

Looking at chest x-ray

We look at size and structure and placement of heart

71
Q

Total amount of air inhaled and exhaled with one breath.

A

Tidal volume

72
Q

Maximum amount of air exhaled after maximum inspiration

A

Vital Capacity

73
Q

Max amount of air that can be forcefully exhaled after a full inspiration

A

Forced Vital Capacity

74
Q

The amount of air exhaled at a specific time interval; for example, in the first, second, and third seconds after a full inspiration

A

Forced Expiratory Volume

75
Q

The amount of air contained within the lungs at maximum inspiration.

A

Total lung capacity

76
Q

The amount of air left in the lungs at maximal expiration

A

Residual Volume

77
Q
  • The maximum flow attained during the FVC
  • The speed at which the maximum flow is obtained during a forced expiratory maneuver.
  • Indicator of how the patient is doing
A

Peak Expiratory Flow Rate

78
Q

What are the 6 Nursing Interventions Promoting Adequate Respiratory Functioning?

A
  • Teaching about a pollution-free environment
  • Promoting optimal function
  • Promoting comfort
  • Promoting proper breathing
  • Managing chest tubes
  • Promoting and controlling coughing
79
Q

When a cough does not occur as a result of reflex stimulation of the cough-sensitive areas

A

Voluntary Coughing

80
Q
  • Accompanies respiratory tract infections and irritations.
  • Many times respiratory infections lead to the production of respiratory secretions.
  • These secretions can trigger the cough mechanism. When the cough is productive, it helps clear the airway.
A

Involuntary Coughing

81
Q

Depresses the function of the cough reflex

Medicines we use: codeine (most used), dextermorphan, etc.

A

Cough suppressants

82
Q

Facilitates the removal of the secretions
Liquifying the secretions more so it is easier to cough up
Ex; guaifenesin

A

Expectorants

83
Q

Contains a local anesthetic (benzocaine)
Mild affect
Suppress irritation that can cause the cough

A

Lozenges

84
Q

What does suctioning the airway do?

A

Suctioning irritates the mucosa and removes oxygen from the respiratory tract, possibly causing hypoxemia (insufficient oxygen in the blood).
-you should preoxygenate the patient before suctioning.

85
Q

Open narrowed airways

  • A type of medication that make breathing easier by relaxing the muscles in the lungs and widening the airways (bronchi)
  • ex; alb sterol
A

Bronchodilators

86
Q
  • Disperse fine particles of liquid medication into the deeper passages of the respiratory tract
  • Changes medication from a liquid to a mist so you can inhale it into your lungs.
A

Nebulizers

87
Q

Deliver a controlled dose of medication with each compression of the canister

A

meter-dose inhalers

88
Q

Breath-activated delivery of medications

The medication is released only when you take a deep, fast breath in through the inhaler.

A

Dry powder inhalers

89
Q

Nasal cannula:

A

The most commonly used oxygen delivery device.
The cannula is a disposable plastic device with two protruding prongs that are inserted
high flow

90
Q

Nasopharyngeal catheter

A

A type of airway adjunct, a tube that is designed to be inserted into the nasal passageway to secure an open airway

91
Q

Transtracheal catheter

A
  • A small plastic catheter is surgically placed in your neck and sits in your windpipe (trachea).
  • A method used to deliver oxygen directly to the lungs.
  • It is used to treat chronic hypoxemia (low blood oxygen).
92
Q

Simple mask

A
  • Low flow
  • Connected to oxygen tubing, a humidifier, and a flow meter, just like the nasal cannula.
  • This mask has vents on its sides that allow room air to leak in at many places, thereby diluting the source oxygen.
  • The vents also allow exhaled carbon dioxide to escape
  • For someone that breathes through their mouth
93
Q

Partial rebreather mask

A
  • Low flow
  • Similar to a simple face mask, but is equipped with a reservoir bag for the collection of the first part of the patient’s exhaled air.
  • The remaining exhaled air exits through vents.
  • The air in the reservoir is mixed with 100% oxygen for the next inhalation.
  • Thus, the patient rebreathes about one third of the expired air from the reservoir bag.
  • This type of mask permits the conservation of oxygen
  • An additional advantage is that the patient can inhale room air through openings in the mask if the oxygen supply is briefly interrupted.
94
Q

Nonrebreather

A
  • Low flow
  • Delivers the highest concentration of oxygen via a mask to a spontaneously breathing patient.
  • It is similar to the partial rebreather mask except that two one-way valves prevent the patient from rebreathing exhaled air.
  • The reservoir bag is filled with oxygen that enters the mask on inspiration.
  • Exhaled air escapes through side vents
95
Q

Venturi Mask

A
  • High flow

- A medical device to deliver a known oxygen concentration to patients on controlled oxygen therapy

96
Q

tent

A

-A tent-like device that is used in a medical setting to deliver high levels of oxygen to a bedridden patient.

97
Q

What respiratory accommodations would you expect to observe in your patient due to COPD?

A
  • Higher respirations bc of shallow rapid breathing
  • They will be in a tripod position (hunched over holding himself up with one hand)
  • Might use pursed-lip breathing- helps them inhale and exhale better
98
Q

As her condition worsens, what effects would you expect her to develop?

A
  • Fatigue
  • Anxiety
  • Cyanosis (blue skin)
  • Finger clubbing
  • Anorexia because they won’t have enough energy to breathe and eat at the same time
  • Barrel chest
99
Q

A person with COPD is at greatest risk for which illness?

A

Pneumonia
-Anyone with chronic lung disease, cystic fibrosis, asthma, COPD etc, are at higher risk for lung infections because their respiratory system is challenged and they can’t fight infections as well as a healthy person could.

100
Q

How would your patient’s COPD impact her dietary needs?

A
  • Need more high protein, calorie, and nutrition.
  • They can’t sit and have a whole meal so their needs increase
  • Increase fluid intake to break up secretions
101
Q

Why is it important to monitor oxygen flow rate in patients with COPD?

A
  • It can cause the respiratory affect to stop working, which results in hypoventilation, that results in respiratory failure
  • We don’t want to keep bumping COPD patients up to like 12 or 15 on a daily basis bc that can lead to negative effects

Fundamentals 1 (24 decks)

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