Fundamental 40oxygenation Flashcards
Respiration
is the exchange of oxygen and carbon dioxide during cellular metabolism.
Ventilation
the process of moving gases into and out of the lungs
Perfusion
relates to the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs
Diffusion
is responsible for moving the respiratory gases from one area to another by concentration gradients. This is the exchange of respiratory gases in the alveoli and capillaries.
Inspiration
is an active process, stimulated by chemical receptors in the aorta.
Expiration
is a passive process that depends on the elastic recoil properties of the lungs, requiring little or no muscle work.
Surfactant
is a chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing.
Pt.s with advanced COPD:
lose the elastic recoil of the lungs and thorax. As a result, the patient’s work of breathing increases. In addition, patients with certain pulmonary diseases have decreased surfactant production and sometimes develop atelectasis
Atelectasis
is a collapse of the alveoli that prevents normal exchange of oxygen and carbon dioxide.
Compliance
the ability of the lungs to distend or expand in response to increased intraalveolar pressure. Compliance decreases in diseases such as pulmonary edema, interstitial and pleural fibrosis, and congenital or traumatic structural abnormalities such as kyphosis or fractured ribs.
Tidal Volume
the amount of air exhaled after normal inspiration.
Residual Volume
is the amount of air left in the alveoli after a full expiration.
Forced Vital Capacity
is the maximum amount of air that can be removed from the lungs during forced expiration
Pulmonary Circulation
to move blood to and from the alveolar capillary membrane for gas exchange
Diffusion
the process for the exchange of respiratory gases in the alveoli and the capillaries of the body tissues. Diffusion of respiratory gases occurs at the alveolar capillary membrane
Oxygen Transport System consist of :
the lungs and cardiovascular system. Delivery depends on the amount of oxygen entering the lungs (ventilation), blood flow to the lungs and tissues (perfusion), rate of diffusion, and oxygen-carrying capacity
3 Things influence the capacity of the blood to carry oxygen;
the amount of dissolved oxygen in the plasma, the amount of hemoglobin, and the tendency of hemoglobin to bind with oxygen
Hemoglobin
is a carrier for oxygen and carbon dioxide, transports most oxygen (approximately 97%). The hemoglobin molecule combines with oxygen to form oxyhemoglobin
Carbon Dioxide
a product of cellular metabolism, diffuses into red blood cells and is rapidly hydrated into carbonic acid (H2CO3)
Cardiovascular System
delivers oxygen, nutrients, and other substances to the tissues and facilitates the removal of cellular metabolism waste products by way of blood flow through other body systems such as respiratory, digestive, and renal
Stroke Volume
The volume of blood ejected from the ventricles during systole
Starlings Law
When the myocardium stretches, the strength of the subsequent contraction increases.
Myocardial Blood Flow
Is unidirectional through the four valves.
S1
Mitral valve and tricuspid valve close. This is when systole begins and ventricular pressure rises.
S2
Aortic and pulmonic valve close. This is when the ventricles empty and the ventricle pressure decreases.
Coronary Artery Circulation
Coronary arteries supply the myocardium with nutrients and remove wastes.
Cardiac Output
The amount of blood ejected from the left ventricle each minute
Cardiac Output Formula
Cardiacoutput(CO)=Strokevolume(SV)×Heartrate(HR)
Preload
end-diastolic volume
Afterload
resistance to left ventricular ejection
Autonomic nervous system
influences the rate of impulse generation and the speed of transmission through the conductive pathway and the strength of atrial and ventricular contractions.
Sympathetic nervous system
Increases the rate of impulse generation and impulse transmission and innervates all parts of the atria and ventricle.
Parasympathetic system
Decreases the rate and innervates atria, ventricles, and sinoatrial and atrioventricular nodes.
Sympathetic nervous system
Increases the rate of impulse generation and impulse transmission and innervates all parts of the atria and ventricle.
Conduction System
Originates with the sinoatrial (SA) node or pacemeaker and is transmitted to the atrioventreicular (AV)node, bundle of HIs, and Purkinje fibers.
Four factors influence adequacy of circulation, ventilation, perfusion, and transport of respiratory gases to the tissues:
Physiological, developmental, lifestyle and environmental.
Physiological Factors:
Decreased oxygen-carrying capacity, Hypovolemia, decreased inspired oxygen concentration, and increased metabolic rate.
Conditions affecting chest wall movement
Pregnancy, obesity, neuromuscular disease, musculoskeletal abnormalities, trauma, CNS alterations.
Influences of Chronic disease
One is chronic lung disease which causes oxygenation to decrease. Another disease is emphysema.
Hyperventilation
a state of ventilation in which the lungs remove carbon dioxide faster than it is produced by cellular metabolism. Severe anxiety, infection, drugs, or an acid-base imbalance induces hyperventilation
Hypoventilation
occurs when alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate sufficient carbon dioxide. As alveolar ventilation decreases, the body retains carbon dioxide
Hypoxia
inadequate tissue oxygenation at the cellular level. It results from a deficiency in oxygen delivery or oxygen use at the cellular level. It is a life-threatening condition. Untreated it produces possibly fatal cardiac dysrhythmias.
Cyanosis
blue discoloration of the skin and mucous membranes caused by the presence of desaturated hemoglobin in capillaries, is a late sign of hypoxia
Causes of Hypoxia
Decreased hemoglobin level and lowered oxygen[carrying capacity of blood, diminished concentration of inspired oxygen, which occurs at high altitudes, inability of tissues to extract oxygen from the blood, as with cyanide poisoning, decreased diffusion of oxygen from the alveoli to blood as in pneumonia, poor tissue perfusion with oxygenated blood, as with shock and impaired ventilation as with multiple rib fractures, or chest trauma.
Disturbance in Cardiac Conduction
Caused by electrical impulses that do not originate from the SA node (dysrhythmias)
Dysrhythmias are a primary conduction disturbance such as:
Response to ischemia, valvular abnormality, anxiety, drug toxicity, caffeine, alcohol, or tobacco use.
Atrial fibrillation
Common dysrhythmia frequently seen in older adults. The rhythm is irregular because of multiple pacemaker sites and unpredictable conduction to the ventricles.
Altered Cardiac Output
Insufficient volume is ejected into the systemic and pulmonary circulation; the result of left-sided or right-sided hear failure.
impaired valvular function
Acquired or congenital disorder of a cardiac valve by stenosis or regurgitation.
Myocardial Ischemia
Coronary artery flow to the myocardium insufficient to meet myocardial oxygen demands; results in angina, myocardial infarction(MI), and or acute coronary syndrome(ACS).
Factors that influence patient’s oxygenation:
Physiological, developmental, lifestyle, and environmental,
Developmental factors that affect tissue oxygenations:
infants and toddlers due to risk for URI as a result of frequent exposure to other children, immature immune system, and exposure to send hand smoke, school-aged children and adolescents are at risk due to exposure to URI, cigarette smoking or secondhand smoke. Young and middle-aged adults are exposed to multiple cardiopulmonary risks factors such as unhealthy diet, lack of exercise, stress, OTC and RX drugs, illegal substances, and smoking. Finally, older adults are at risk due to cardiac and respiratory systems undergoing changes throughout the aging process and lifestyle risk factors.
Cardioproctective Nutrition:
Diets rich in fiber; whole grain; fresh fruits and vegetables; nuts; antioxidants; lean meats; and omega-3 fatty acids.
Exercise
People who exercise for 30 to 60 minutes daily have a lower pulse rate and blood pressure, decreased cholesterol level, increased blood flow, and greater oxygen extraction by working muscles.
Smoking
Associated with heard disease, COPD, and lung cancer. The risk of lung cancer is 10 times greater for a person who smokes than for a nonsmoker
Substance Abuse
Excessive use of alcohol and other drugs impairs tissue oxygenation.
Stress
A continuous state of stress or severe anxiety increases the metabolic rate and oxygen demand of the body.
Environmental factors
The incidence of pulmonary disease is higher in smoggy, urban areas than in rural areas. In addition, a patient’s workplace sometimes increases the risk for pulmonary disease. Occupational pollutants include asbestos, talcum powder, dust, and airborne fibers. For example, farm workers in dry regions of the southwestern United States are at risk for coccidioidomycosis, a fungal disease caused by inhalation of spores of the airborne bacterium Coccidioides immitis. Asbestosis is an occupational lung disease that develops after exposure to asbestos.
Assessment of cardiopulmonary functioning:
In-depth history of a patient’s normal and present cardiopulmonary function which includes past impairment in circulatory or respiratory functioning, methods that a patient uses to optimize oxygenation, review of drug, food, and other allergies, Physical examination, laboratory and diagnostic tests.
Inspection Process
Examine the skin and mucous membranes, LOC, breathing patterns, and chest wall movement.
Percussion Process
Presence of abnormal fluid or air; diaphragmatic excursion.
Palpation Process
Chest, feet, legs, and pulses.
Auscultation Process
Normal and abnormal heart and lung sounds.
