Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 305 > Chapter 41: Oxygenation Part 1 (A&P) > Flashcards

Chapter 41: Oxygenation Part 1 (A&P) Flashcards

1
Q

Three steps in the process of oxygenation

A
  1. Ventilation
  2. Perfusion
  3. Diffusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ventilation

A

moving gases in and out of the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Perfusion

A

the ability of the CV system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diffusion

A

exchange of the respiratory gases in the alveoli and capillaries of the body tissues by concentration gradients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Poor diffusion is present in patients with

A
  • pulmonary edema (fluid CHF)
  • pulmonary infiltrates (pneumonia infection)
  • pleural effusion (fluid between the visceral and parietal pleura)
  • lobectomy
  • pneumothorax (lung collapse due to air in space around lung)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The amount of energy expended on breathing depends on what 3 factors?

A
  1. rate and depth of respirations
  2. lung compliance
  3. airway resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Inspiration

A

active process triggered by chemical receptors in the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Expiration

A

passive process: depends on elastic recoil ability of the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lung Compliance

A

ease of which the lungs can expand.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lung Compliance decreases in diseases such as:

A
  1. pulmonary edema
  2. interstitial and pleural fibrosis
  3. congenital or traumatic structural abnormalities (kyphosis or rib fracture)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Airway resistance includes

A

asthma, tracheal edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Surfactant

A

chemical produced in the lungs to keep the alveoli from collapsing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diseases processes can alter the lung elasticity (ability to recoil) such as

A

COPD: Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

COPD: Emphysema

A

-accessory muscles are used to increase lung volume but in the long term is not efficient and the patient will fatigue and decompensate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In patients with emphysema, assess for

A

-elevation of the clavicles during inspiration -> leads to air hunger, ventilatory fatigue and decreased lung expansion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Atelectasis

A
  • collapse of the alveoli.

- prevents normal exchange of oxygen and CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

decreased lung compliance =

A

increased airway resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

increased airway resistance =

A

increased use of accessory muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

increased use of accessory muscles =

A

increased work of breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

increased work of breathing results in:

A

increased energy expenditure, metabolic rate, need for more oxygen, and need for elimination of CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lung volumes include

A
  1. tidal volume
  2. residual volume
  3. forced vital capacity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

tidal volume

A

normal amount of air exhaled after a normal inspiration (usually around 500 ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

residual volume

A

amount of air left in the alveoli after expiration (necessary to keep alveoli expanded)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

forced vital capacity

A

amount of air that can be removed from the lungs during forced expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Delivery of oxygen to the body depends on

A
  1. ventilation
  2. perfusion
  3. diffusion
  4. oxygen carrying capacity (Hgb available)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are three factors that influence the capacity of the blood to carry O2?

A
  1. the amount of dissolved O2 in the plasma
  2. the amount of Hgb
  3. the tendency of Hgb to bind with O2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CO2

A

byproduct of cellular metabolism that diffuses into RBCs rapidly and combines with fluid to form carbonic acid (H2CO3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

H2CO3 dissociates to form

A

H+ and HCO3-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

After Hgb loses its O2 to the tissues (deoxyhemoglobin), what happens next?

A

it combines with CO2 and is transported via venous blood back to the lungs to be exhaled.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Regulation of Respiration includes 2 types

A
  1. Neural Regulation

2. Chemical Regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Neural Regulation of Respirations

A
  • includes the CNS.

- voluntary control of respiratory rate, depth and rhythm by the cerebral cortex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Chemical Regulation of Respirations

A
  • regulated by chemoreceptors located in the medulla, aortic body and carotid body to maintain normal blood gas levels.
  • regulates respiratory rate based on changes in CO2, O2 and H+ ion (pH of blood)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Stroke volume

A

amount of blood ejected from the ventricles during systole (each beat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Cardiac output

A

SV x HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Starling’s Law: in a healthy heart

A

as the myocardium stretches, the strength of the contraction increases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Starling’s Law: in a diseased heart

A

the increased stretch of the myocardium may be beyond its physiological limits resulting in decreased SV due to blood backing up in pulmonary circulation (left sided heart failure) or systemic circulation (right sided heart failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

The coronary arteries fill during

A

ventricular diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

During Ventricular Diastole

A

AV valves open as blood flows from the atria to the ventricles

39
Q

During Ventricular Systole

A

AV valves close and the Semilunar valves open.

40
Q

Conduction System of the Heart includes

A
  1. SA node (pacemaker)
  2. AV node
  3. Bundle of His
  4. Purkinje Fibers
41
Q

AV node

A

via intratrial pathways.

impulse is delayed before reaching bundle of his to allow the atrium to empty

42
Q

Factors that Affect Oxygenation

A
  1. Physiological
  2. Developmental
  3. Lifestyle
  4. Environmental
43
Q

Any condition affecting cardiopulmonary functioning directly affects the ability of the body to meet O2 demands including

A
  1. Respiratory Disorders
  2. Cardiac Disorders
  3. Other processes
44
Q

Respiratory disorders that affect oxygenation include

A

hyperventilation, hypoventilation, and hypoxia

45
Q

Cardiac disorders that affect oxygenation include

A
  • disturbances in conduction system
  • impaired valvular function
  • myocardial hypoxia
  • cardiomyopathic conditions
  • peripheral tissue hypoxia
46
Q

Other processes that affect oxygenation include

A
  • decreased O2 carrying capacity of blood (anemia, CO poisoning)
  • decreased inspired O2 concentration (drug overdose, obstruction)
  • increased metabolic demand of the body
  • hypovolemia (dehydration/volume loss from trauma)
  • alterations in chest wall movement (musculoskeletal or neuromuscular) pregnancy. obesity.
47
Q

Hypovalemia

A

decreased circulating volume -> decreased O2 to body tissues -> increased PVR (to compensate) -> increased HR (to increase amount of blood returned to the heart) -> increases CO

48
Q

Metabolic Rate

A

All increased metabolic activity increases metabolic demand. Ex) fever

49
Q

Factors Affecting Oxygenation: Trauma

A

Ex) Rib fracture causing Flail Chest

Ex) Surgical incisions: increased pain -> decreased RR or shallow respirations to avoid pain

50
Q

Factors Affecting Oxygenation: CNS alterations

A
  • cervical trauma (ex. paralysis of phrenic nerve which operates the diaphragm)
  • spinal cord injuries
  • neuromuscular diseases
51
Q

Factors Affecting Oxygenation: Chronic Diseases

A

ex) emphysema causes barrel chest due to overuse of accessory muscles and air trapping in the alveoli

52
Q

Normal CO2 levels

A

35-45 mm Hg

53
Q

Normal O2 levels

A

80-100 mm Hg

54
Q

Normal SpO2 levels

A

> 95

55
Q

Hypoventilation

A

when alveolar ventilation is inadequate to meet O2 demands of the body.

56
Q

Causes of hypoventilation

A
  1. atelectasis (collapse of the alveoli prevents normal exchange)
  2. COPD: respiratory drive from decreased O2 instead of increased CO2.
57
Q

Signs and Symptoms of Hypoventilation

A
  • mental status changes
  • dysrhythmias
  • potential cardiac arrest-convulsions
  • unconsciousness
  • death
58
Q

Hyperventilation

A

a state in which the lungs remove CO2 faster than it is produced by cellular metabolism

59
Q

Causes of Hyperventilation

A

severe anxiety (fever), drugs (amphetamines), or acid-base imbalances

60
Q

Signs and Symptoms of Hyperventilation

A
  • rapid respirations
  • sighing breaths
  • numbness and tingling of extremities
  • light-headedness
  • loss of consciousness
61
Q

Hypoxia

A

inadequate tissue oxygenation at the cellular level

62
Q

Causes of Hypoxia

A
  • decreased hemoglobin
  • decreased inspired O2
  • inability of tissues to extract O2 from the blood (CO poisoning)
  • decreased diffusion (pneumonia)
  • poor tissue perfusion (shock)
  • impaired ventilation (chest trauma)
63
Q

Signs and Symptoms of Hypoxia

A
  • apprehension
  • restlessness
  • inability to concentrate
  • decreased LOC
  • dizziness
  • behavioral changes
  • VS changes (increased pulse and depth of respirations)
  • fatigue
  • respiratory arrest
64
Q

What is a late sign of hypoxia?

A

cyanosis

65
Q

Alterations in Cardiac Functioning

A
  1. Cardiac Rhythm
  2. Strength of Contraction
  3. Blood flow through the heart or to the heart muscle
  4. Decreased peripheral circulation
66
Q

Cardiac Rhythm

A

conduction disturbances (dysrhythmias)

67
Q

Causes of dysrhythmias

A
  • ischemia
  • valvular abnormality
  • anxiety
  • drug toxicity-caffeine, alcohol or tobacco
  • complications of acid-base or electrolyte imbalances
68
Q

Types of Dysrhythmias

A
  1. tachydysrhythmias
  2. bradydysrhythmias
  3. supraventricular dysrhythmias
  4. ventricular dysrhythmias
69
Q

Tachydysrhythmias and Bradydysrhythmias

A
  • decreased CO (tachycardia by decreasing filling time; bradycardia by decreasing heart rate)
  • decreased BP
70
Q

Supraventricular Dysrhythmias

A
  • supra ventricular tachycardia (rate 150-250)

- atrial fibrillation/flutter

71
Q

Ventricular Dysrhythmias

A
  • Life threatening
  • Ventricular Tachycardia
  • Ventricular Fibrillation
72
Q

Calculation of HR from an E

A

not sure if you need to know this? Slide 31

73
Q

Failure of the heart to pump a sufficient volume of blood to the systemic and pulmonary circulation (pump failure) occurs in:

A
  • HF
  • CAD
  • Cardiomyopathy
  • Valvular Disorders
  • Pulmonary Disease
74
Q

Left Sided Heart Failure

A

decreased functioning of the left ventricle resulting in decreased CO

75
Q

Sign and Symptoms of Left Sided Heart Failure

A
  • fatigue
  • SOB on exertion
  • dizziness
  • confusion (tissue hypoxia)
  • rales
  • cough
  • dyspnea
76
Q

Left Sided Heart Failure results in

A

blood pooling in the pulmonary circulation causing pulmonary congestion.

77
Q

Right Sided Heart Failure

A

impaired function of the right ventricle is usually a result of pulmonary disease or long-term impaired left-sided heart failure

78
Q

Primary Signs and Symptoms of Right Sided Heart Failure

A
  • increased PVR
  • increased O2 demand of the heart
  • decreased blood ejected from right ventricle -> blood begins to back up in systemic circulation
79
Q

Other Signs and Symptoms of Right Sided Heart Failure

A
  • Weight gain
  • Distended neck veins
  • Hepatomegaly
  • Splenomegaly
  • dependent peripheral edema
80
Q

Impaired Valvular Function

A

congenital or as a result of disease. Stenosis and regurgitation

81
Q

Stenosis

A

flow of blood through the valves is obstructed causing the ventricle to hypertrophy leading to L or R sided heart failure

82
Q

Regurgitation

A

valves do not close all the way causing back-flow of blood (causes a murmur)

83
Q

Myocardial Ischemia: Angina

A

imbalance between myocardial O2 supply and demand.

84
Q

Angina is precipitated by

A

activities that increase myocardial O2 demand (exercise, stress, eating a big meal).
usually lasts 3-5 minutes.

85
Q

Myocardial Infarction

A
  • sudden decrease in coronary blood flow or an increase in myocardial O2 demand with inadequate coronary perfusion.
  • may occur at rest, lasts 20 minutes or more, unrelieved by any measures
86
Q

How does age influence oxygenation?

A

heart disease, decrease in functional cilia (decreases the effectiveness of the cough mechanism)

87
Q

How does lifestyle factors influence oxygenation?

A
  • smoking
  • low-cholesterol/low-Na = diet
  • HTN
  • Exercise
  • Sedentary life-style
88
Q

How does nutrition influence oxygenation?

A
  • obesity (decreased lung expansion, increased body tissue demands)
  • malnourished-muscle wasting (cough efficiency is reduced putting patients at risk for retention of pulmonary secretions)
89
Q

How does exercise influence oxygenation?

A

people who exercise 30-60 min/day have decreased HR, BP and cholesterol; increased blood flow and O2 extraction by muscles

90
Q

How does smoking influence oxygenation?

A
  • COPD, lung cancer, increase peripheral vascular resistance, CAD.
  • Nicotine causes vasoconstriction increase BP, decrease coronary perfusion.
91
Q

How does substance abuse influence oxygenation?

A

impairs oxygenation in two ways:

  1. usually poorly nourished
  2. depresses the respiratory center (may cause permanent lung damage (inhalants))
92
Q

How does stress influence oxygenation?

A

increases metabolic rate and O2 demand

93
Q

How does environmental factors influence oxygenation?

A

-pollution, occupational hazards/pollutants (ex asbestos, dust and airborne spores)

NURS 305 (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions