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130 Test 9 Oxygen > Notecards for all > Flashcards

Notecards for all Flashcards

1
Q

turbinates

A

3 bones that protrude in into the nasal cavity. They Increase the total surface area for filtering, heating, and humidying inspired air before it passes into the nasopharynx.

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2
Q

surfactant

A

Aveoli type II secrete surfactant (a fatty protein that reduces surface tension in the aveoli). Without this Atelectasis can occur (lung collapse)

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3
Q

arteries and veins carry blood where?

A

Vein carry oxygenated blood to the heart. Arteries carry deoxygenated away from the heart to the lungs, to re-oxygenate it.

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4
Q

ventilation

A

the process of moving air in and out of the lungs.
Require muscle and intact nerve intervention. (diaphragm -which is functioned by the phrenic nerve) and elastic properties.

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5
Q

perfusion

A

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

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6
Q

Diffusion

A

exchange of gases

From an area of high concentration to low concentration

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7
Q

movement of air in and out of the lungs

A

Move by pressure changes, for O2 to move into the lung there is a normal sub atmospheric pressure (negative pressure) causes the air to come in. Then it is no longer negative and will expire. It take effort to overcome the negative pressure, inspiration is active process and expiration is passive

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8
Q

Inspiration

Exhalation which is active and which is passive process

A

Inspiration~ active

Expiration~ passive

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9
Q

Inspiration

A

The active part uses the diaphragm and contracts the intercostal muscles contract and increases negative pressure which facilitates air entry into the lungs.

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10
Q

Pleura

A

continuous smooth membrane composed of two surfaces that totally enclose the lungs. The parietal pleura lines the inside of the chest cavity and the upper surface of the diaphragm. The visceral pleura covers the lung surfaces

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11
Q

What transports the gases

A

Hemoglobin

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12
Q

oxygen + hemoglobin

A

oxyhemoglobin

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13
Q

Carbon dioxide + hemoglobin

A

carboxihemoglobin

Carbon dioxide is also carried by bicarbonate

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14
Q

Control of Respiration

A

Medulla provides automatic control of respiration continuously. There are Chemoreceptors in the Medulla which are stimulated by high concentrations of CO2 and Hydrogen ion in the blood. Stimulated to a lesser degree by O2 in arterial blood.
Our drive is based on CO2 level. So when there is a High level of CO2 in our blood that’s our drive to breath to get more O2.
When COPD its the opposite, drive gets ruined because they have a high level of CO2 in their blood, so they respond to low O2 drive. So have to be careful the amount of O2 we give to a COPD patient.

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15
Q

Normal respiration

A

Normally when the Medulla is stimulated by high concentration of CO2, then the rate and depth of ventilation increases so that’s there’s more exhalation of CO2 and H+ and there’s more inhalation of the O2

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16
Q

Adequate fluid intake is essential to respiratory functioning

Ways it can be compromised

A
  • helps function of cilia
  • Mucous lining protect underlying tissue from irritation and infection, needs to be moist
  • prevents friction in the visceral.
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17
Q

Ventilation depends on the extent of perfusion in the area

Ways it can be compromised

A

~Blood circulation in tissues
~Does depend on adequate blood supply. Not enough blood less O2 carried
~ If a person is anemic it effects carrying capacity

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18
Q

All living cells require oxygen, which the body cannot store

Ways it can be compromised

A

Deprived of O2 = confusion, tired
High altitude
environmental O2: The BODY has a 200 times greater attraction for CO2

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19
Q

The air passageways must remain patent for respirations to occur

Ways it can be compromised

A 
Presence of CO2
Mucus, food, inhaled object, inflammation, tumors, 
Unconscious- tongue falls back
muscles will constrict
edema
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20
Q

Muscle movements provide the physical force essential for respiration

Ways it can be compromised

A

Accessory muscles: neck, back, diaphragm, intercostal

When breathing is labored you use accessory muscles

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21
Q

The pressure changes resulting from expansion and contraction of the thoracic cavity produce pulmonary gas exchange

Ways it can be compromised

A

~Atelectasis- part or complete collapse of lung
~ Immobility
~ Obstruction of the airway
~ Constriction
~ External Compression~ Tumor or Ascites fluid in abdomen pushing up and impinging on lungs

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22
Q

Hypoxia

A

Decreased amount of O2 available to cellls

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23
Q

There must be an exchange of oxygen and carbon dioxide between the blood and body cells.

Ways it can be compromised

A

~Aveolar capillary membrane is thicker Becomes a problem

~excess fluid in tissue impedes transfer to tissue

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24
Q

Hypoxemia

A

decreasedO2 in the blood. Increased Co2 in the blood.

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25
Q

Hypoventilation

A

Decreased in rate or depth of air movement into the lungs

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26
Q

Hyperventilation

A

Increased in rate and depth of ventilation

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27
Q

4 factors affecting Oxygenation

A

~ Developmental
~ Physiological
~ Lifestyle
~ Environmental

28
Q

Physiological functions affecting oxygenation 7

A

~Alterations in Cardiac functions
~Alterations in Respiratory function
~Decreased O2-carrying capacity
~Decreased inspired O2 concentration
~Hypovolemia
~Increased metabolic rate
~Conditions affecting the chest wall movement

29
Q

Alterations in Cardiac functions

A

~disturbances in electric conduction system

~conditions that decrease cardiac output

30
Q

Alterations in Respiratory function

A

~hyperventilation- increase rate and depth of respiration which also involves blowing off more of Co2
~hypoventilation~ deceased rate and depth of respiration–> not blowing off less CO2 as normal (not uncommon for respirations to decreased to 8 or less)
~hypoxia- inadequate oxygenation at the cellular level–> causes–> decrease hemoglobin level–>decreased oxygen in inspired air as in high altitudes–> inability of tissues to extract oxygen from the blood as in edema–>decrease of transfer of oxygen at the aveolar level–>

31
Q

Norms
PaCO2
PaO2
SaO2

A

PaCO2 (partial pressure of carbon dioxide)-
35-45 mmHg
PaO2 (partial pressure of oxygen)- 80-100 mm Hg
SaO2 (oxygen saturation)- 95-100% mm Hg

32
Q

decreased O2-carrying capacity 2

A

~Anemia

~Inhalation of toxic substances (carbon dioxide)

33
Q

Deceased inspired O2 concentration

2

A

~Airway obstruction

~Deceased environmental O2 (altitude)

34
Q

Hypovolemia (2)

A

definition~Decreased blood volume
~shock
~severe dehydration

35
Q

Increased metabolic rate

A

~fever
~exercise
~pregnancy

36
Q

Conditions affecting chest wall movement 6

A

1) Pregnancy
2) Obesity
3) Musculoskeletal abnormalities
4) trauma
5) neuromuscular disease
6) central nervous system alterations

37
Q

Pursed lips (breathing) does what?

A

the pursed lips create a resistance to the air flowing out of the lungs, which prolongs exhalation and maintains positive airway pressure, thereby maintaining an open airway and preventing airway collapse.

38
Q

Signs of Hypoxia

A 
Increased breathing and heart rate. 
Changes in level of consciousness. 
Restlessness. 
Cyanosis (bluish lips and nailbeds). 
Chest pain
39
Q

Venturi mask

A

High Flow rate
Delivers oxygen concentrations of 24% to 60% with oxygen flow rates of 4 to 12 L/min, depending on the flow-control meter selected
v=Advantages
Controls the amount of specified oxygen concentration
Does not dry mucous membranes
Delivers humidity with oxygen concentration
Quiet
Ideal for CO2 retainers
Matches patients demands
Disadvantages
Hot and confining
Humidification can irritate skin
Decreased oxygen concentration if mask does not fit right
Interferes with eating , drinking and talking

40
Q

Partial rebreather

A

Some face masks have reservoir bags also called partial rebreathing bags.
Provides higher concentrations of oxygen to the patient.
A portion of the patient’s expired air is directed into the bag.
Conserves oxygen by having patient rebreath exhaled air.
Because this air does not take part in gaseous exchange, its oxygen concentration remains high.
When this air is added to the inflow from the oxygen source, the patient will breath in air with greater oxygen concentration.

41
Q

Non-rebreather masks (NRB)

A

Covers both nose and mouth
Has an attached reservoir bag
Reservoir bag connects to an external oxygen supply
Before an NRB is placed on the patient, the reservoir bag is inflated to greater than two-thirds full of oxygen, at a rate of 8–15 liters per minute (lpm).
Approximately ¹⁄₃ of the air from the reservoir is depleted as the patient inhales, and it is then replaced by the flow from the O2 supply.
If the bag becomes completely deflated, the patient will no longer have a source of air to breathe.
Exhaled air is directed through a one-way valve in the mask, which prevents the inhalation of room air and the re-inhalation of exhaled air.
The valve, along with a sufficient seal around the patient’s nose and mouth, allows for the administration of high concentrations of oxygen, 60–90% O2.
High concentrations of oxygen can be administered accurately
Oxygen flows into bag and mask during inhalation
Valves prevents expired air from flowing back into bag
Cannot be used with a high degree of humidity.

42
Q

Partial Rebreather Mask

A

Conserves oxygen
Can be administered in concentrations of 40-60% using flow rates of 6-10L - This is useful when oxygen concentrations must be raised
Cannot be used with a high degree of humidity
Not recommended for COPD patients
Should NEVER be used with a nebulizer

43
Q

Face tent

A

Ideal for post anesthesia
Not enclosed and claustrophobic
Only for low oxygen concentrations

44
Q

Nasal Cannula

A

Simple, comfortable device for oxygen delivery
Oxygen delivered via cannulas with a flow rate of up to 6 L/min
Flow rates greater than 4 L/min not often used
Drying effect on nasal mucosa
Above 6 L/min the 02 is simply flushed out of the nose

Nasal cannula – Advantages
Safe and simple
Easily tolerated
Delivers low concentrations while allowing patient to eat, speak, drink
Does not impede eating or talking
Inexpensive and disposable
Nasal cannula – Disadvantage
Unable to use with nasal obstruction
Drying to mucous membranes
Can dislodge easily
Patient’s breathing pattern will affect exact FIO2  
Causes skin irritation or breakdown
Nose, ears, cheeks, under chin
45
Q

Oxygen Masks 4

A

Simple face mask
Venture mask
Partial rebreather mask
Non-rebreather mask.

46
Q

Low and High flow devices

A 
Low Flow:
Nasal cannula
Simple oxygen mask
Non-rebreather  mask
Face tent
High Flow:
Venturi mask
47
Q

Humidifying

A

nasal cannula 1-6 L/min
you only humidify for flow rates greater than 4
Simple mask starts at 5–>8
Venturi 4–>12

48
Q

Developmental factors

A

1) Infants and toddlers-up to the age of 3, are especially susceptible to respiratory infection
2) School age children and adolescents
3) Young and middle-aged adults
4) Older adults

49
Q

Lifestyle risks (5)

A

1) Nutrition
2) Exercise
3) Smoking
4) Substance abuse
5) Stress- (increase metabolic rate and O2 demand)

50
Q

Environmental factors (2)

A

1) Air pollution

2) Occupational pollutants

51
Q

Respiratory rates

A

Newborn————————-35-40
Infants (6 months)————-30-50
Toddler (2 yeas)—————-25-32
Child——————————-20-30
Adolescent———————–16-20
Adult——————————-12-20

52
Q

7 types of Respirations

A

1) Eupnea
2) Tachypnea
3) Bradypnea
4) Cheyne-stoke
5) Kussmaul
6) Dyspnea
7) Orthopnea

53
Q

Eunpnea

A

Normal relaxed breathing

54
Q

Tachypnea

A

fast breathing rate, >20 respirations/minute

55
Q

Bradypnea

A

slow breathing rate, <12 respirations/minute

56
Q

Cheyne-stokes

A

Tidal volume waxes and wanes cyclically with recurrent periods of apnea.

Causes include CNS dysfunction, cardiac failure with low cardiac output, sleep, hypoxia, profound hypocapnia

57
Q

Kussmaul

A

Deep, rapid respiration with no end-expiratory pause.

Causes profound hypocapnia

Seen in profound metabolic acidosis, i.e. diabetic ketoacidosis

58
Q

Dyspnea

A

labored, possibly painful, feeling of breathlessness

59
Q

Orthopnea

A

A abnormal condition in a person in which a person must sit or stand to breathe deeply or comfortably

60
Q

CPR

A

CAB (Chest compression, Airway, Breathing)

Chest compression are first

61
Q

Antitussives

A

Act by suppressing the cough reflex by direct action on the cough center in the medulla

62
Q

Expectorant

A

Suppresses cough reflex by liquefying and reducing the viscosity of thick, tenacious secretions

63
Q

Bronchodilator

A

Relaxes smooth muscle (lungs)

64
Q

Mucolytics

A

Decrease the viscosity of secretions by breaking disulfide links of mucoproteins

Dissolve various chemical bonds within secretions

65
Q

Corticosteroid

A 
Long onset ( not a rescue inhaler)
Increase capillary permeability

130 Test 9 Oxygen (5 decks)

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