Exam 3 Flashcards
Arterial Blood Gases (ABG)
Determine the O2 status and the acid/base balance
Mixed Venous Blood Gases
uses a pulm artery catheter to get venous sample
Pursed-lip breathing
exhalation through mouth with lips pursed together to slow exhalation. Holds O2 longer allowing more time for gas exchange
Orthopnea
sleep sitting up; indicates mod to severe distress; seen with COPD/asthma; main cause is mucous
Splinting
pain d/t chest expansion, voluntary decrease in tidal volume d/t thoracic or abd incision
Kussmaul Respirations
reg, rapid, deep resp due to metabolic acidosis, increase in CO2 excretion
Abdominal paradox
inward movement of abdomen during inspiration
Vesicular breath sounds
normal; soft, low pitched, gentle rustling sounds hear over all portions of the lungs
Bronchovesicular breath sounds
medium pitched over mainstem bronchi
Bronchial breath sounds
loud, higher pitched along trachea
**Rhonchi
rumbling, snoring or rattling heard on expiration
Hemoptysis
blood tinged, streaked, or frank red blood
Pack year
multiply number of packs of cigarettes smoked every day by the number of years smoked
2 packs a day X 30 years = 60 pack year
Tidal volume (TV)
air volume of each breath (total)
Inspiratory Reserve Volume (IRV)
maximum volume that can be inhaled after a normal inhalation
Expiratory Reserve Volume (ERV)
maximum volume exhaled after a normal exhalation
Vital capacity (VC)
the maximum volume of air exhaled from a maximal inspiration
VC=TV+IRV+ERV
Forced expiratory volume (FEV)
volume exhaled forcefully over time in seconds.
FEV1 - how much can be exhaled in 1 second
Position the patient for Thoracentesis
- sitting upright with the arms supported on an over bed table
- Assist physician with sterile procedure
- Monitor and document post procedure vital signs and breath sounds
How to draw ABGs
- Arterial blood draw with a heparinized syringe (from artery)
- Hold pressure for 5 minutes
- Put on ice immediately
- Avoid changing oxygen therapy for 20 minutes prior to draw and until results come back
trismus
inability to open mouth normally
crackles
short low or high pitched heard at end of inspiration (in bases) fluid on lungs
wheezes
high pitched musical sound caused by obstruction of airway & heard during expiration (give bronchodilator first)
friction rubs
creaking or grating from inflamed pleural surfaces rubbing accompanied by discomfort (give anti-inflammatory)
Chest x-ray
Posterior, anterior, or lateral. Can detect fluids, tumors, or foreign bodies w/ or w/o symptoms
Computerized Tomography (CT)
can note fine tissue density not visible on CXR, may be with or without contrast
- *W/ Contrast:
- assess for allergies
- lots of fluids after
- liver function - BUN/creatinine
Magnetic Resonance Imaging (MRI)
can detect pulmonary nodules, cancer, PE, pulmonary HTN, evaluate inflammatory activity
Ventilation Perfusion (V/Q Scans)
IV radioisotope given to assess perfusion. Great for assessing for PE. Ventilation without perfusion suggests PE
Pulmonary angiogram
inject dye and x-ray the vessels of the lungs; can be used to to diagnose PE
Positron Emission Tomography (PET)
assess lung nodules for malignancy
Pulmonary edema manifestations
severe respiratory distress, cyanosis, falling O2 sats, blood tinged sputum
Pulmonary edema medical management
oxygen, diuretics, morphine, vasodilators, possible intubation
Stroke volume (SV)
amount of blood ejected with each heartbeat
cardiac output (CO)
amount of blood pumped by ventricle in liters per minute
preload
degree of stretch of cardiac muscle fibers at end of diastole
contractility
ability of cardiac muscle to shorten in response to electrical impulse
afterload
resistance to ejection of blood from ventricle
ejection fraction
percent of end diastolic volume ejected with each heart beat
Norm - 50-70%
depolarization
electrical activation of cell-caused by influx of Na into cell while K exits cell
repolarization
return of cell to resting state-caused by re-entry of K into cell while Na exits
Mean Arterial Pressure (MAP)
1 systolic BP + 2 diastolic BP/3
Need MAP at least 60 to perfuse organs
