Gas Exchange Flashcards
What is gas exchange?
Oxygen is transported to cells and carbon dioxide is transported from the cells through the lungs and out of the body.
-Types of problems that cause gas exchange-Asthma, Pneumonia, COPD, Acute Respiratory Failure
What is the scope for gas exchange?
There is optimal gas exchange, impaired gas exchange, & no gas exchange (basically dead).
What is the process of breathing? Is it voluntary or involuntary?
Process of breathing is involuntary and continuously. Heart gets oxygenated blood and pumps it to the body where it needs to go.
Process of breathing
*The air is oxygenated & goes through nose, mouth, windpipe, bronchi (right bigger because heart takes up space on left side) and bronchioles and goes to alveoli (small air sacs). The job is done quicker and more oxygen transported. Oxygenated blood fills up air sac & pressure pushes oxygen to capillaries. Blood is being pumped through capillaries & CO2 is being pushed back into alveoli. Oxygen attaches to hemoglobin and sent to the heart. Oxygen is used and waste product of CO2 is sent back to lungs (alveoli) & sent out of body.
-Pt. may need oxygen when o2 level is low and ventilation is slow.
-COPD-Alveoli swells & gets inflamed. Surface area is decreased & can’t get rid of all CO2 and holds on to O2 because they can’t blow the CO2 off.
Populations at risk for developing problems with gas exchange
-Premature infant-Lungs are not fully developed & air sacs are sticky & don’t open up like they should when born prematurely. (Babies born before 30 wks.)
-Infants/Young children-Decreased surface area & risk for respiratory types of infections & come in contact with germs/infections in daycares.
*Toddlers like to put things in their mouth (Airway becomes obstructed).
-Older adults-Immune response is decreased. Catches cold/respiratory infections faster, immobility leads to respiratory problems.
What are some risk factors for respiratory problems of individuals?
-Smoking/allergies, air pollution, poor hand hygiene, overweight, anatomy, genetics
What should you assess in a person with impaired gas exchange?
-Infant RR-30-60 breaths a minute (Know normal)
-Older adult RR-12-20 breaths a minute (Tachypnea-over 20 breaths a minute/bradypnea-like 4
-Increased RR-hyperventilation/decreased-hypoventilation
*History-Ask about previous resp. history, & any medications, currently any SOB (Sitting still/moving around, how long, & anything to relieve it (sitting, resting, or any meds taken)
-Chest pain can be cardiac or lung issue (rate, location)
-Vital signs-normal inspiratory/expiratory-RR (Tell if regular/abnormal)-Count for full minute if abnormal, HR-Increased when not breathing well & compensates through increased HR to get blood to areas it needs to., Oxygen level-95-100%, Sit pt. up if laying flat & get 95%, -Temp.-Elevated temp. may be respiratory infection
-Inspection-orthopnea (Tripod, Sitting up with pillows, look for cyanosis, slumped breathing, difficulty breathing just by looking at pt. (clubbing fingers-chronic hypoxia-capillaries stretch & swell & makes fingertips swell-smokers, COPD
-Trachea should be midline & not shifted
Unequal chest expansion-Palpating chest for masses or lesions or pain, placing thumbs at spine to see if chest is rising & falling equally(Could be collapsed lung or more air in that lung)
-Blue lips-problem of cyanosis
-Pediatric grunting & retractions-Signs of resp. distress, Infants difficulty with breathing may not want bottle or eat (frequent breaks or push it away)
What happens with chronic lung diseases?
The lungs stay expanded & trying to get the air out in & rib cage stretches over time. (Barrel chest)
*Ex. COPD & Emphysema, & Bronchitis
Type of breathing technique for chronic lung diseases?
Pursed lip breathing-breathing in through the nose & out of mouth at a slow and controlled rate when feeling short of breath
What are some adventitious breath sounds heard with impaired gas exchange?
*Stridor-Swelling in upper airway-air movement heard, allergy reaction, facial swelling
*Wheeze-High pitched musical continuous sound/commonly heard on exhalation
*Rhonchi-sonorous wheeze/stuffed up can be cleared with cough
*Crackles-air passing through fluids or mucus, low pitched and moist (pulmonary fibrosis or edema)
Labs-Where is a ABG drawn from & what does it measure?
Artery & measures the PH of blood/Tells ventilation & oxygenation
-Ph-7.35-7.45
-PaCo2-35-45mmHg
-PaO2-80-100mmHg
-HCO3-22-26 mEq/l
-O2 sat 95-100%
*Looking to see if PH is too low-acidic/high-alkalosis, then look over CO2 level & then look at O2 level, If too high or low/bicarb may be trying to compensate with kidneys
*-CO2 is higher when not blowing off, Hyperventilation-holding on to CO2.
-PH-Low, CO2-High, & HCO3 Normal-Resp. Acidosis
-Anything above 7.45 is alkaline, CO2 is low & HCO3 IS Normal-Resp. Alkalosis
Anything below in PH-7.35-Acidic, CO2 is normal & HCO3 is low-Metabolic Acidosis
-When PH- is greater than 7.35-Alkalosis, CO2 is normal, & HCO3 is high-Metabolic Alkalosis
What is a included in CBC?
-Red blood cells (Number in body)
-Hemoglobin (Red blood cell-& if RBC low
-Hematocrit (gone be low-percentage)
-WBC-indicate infection & may need antibiotics-(Actively bleeding it will be low & if you just had a surgery)
-Anemia (Tired & weak-oxygen carrying ability to weak to carry & not enough RBCs to carry oxygen & demands more oxygen to function)
Sputum Culture
Want to hulk up the sputum & then spit it into cup/Get sample before any antibiotics are started
Chest X-Ray
Breathe in & hold air to see air moving through bronchioles., Fluid can be seen, white out on whole lung side (air, and etc.)
Pulmonary Function Test
Pt. is tested how much volume of air breathed in and out. Make sure they don’t smoke or exercise 6 hours before the test.
