Oxygenation Flashcards
three steps in the process of oxygenation
ventilation, perfusion, and diffusion
the process of moving gases into and out of the lungs
ventilation
major inspiratory muscle of respiration
diaphragm
relates to the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs
perfusion
responsible for moving the respiratory gases from one area to another by concentration gradients
diffusion
effort required to expand and contract the lungs
work of breathing (WOB)
ease at which the lungs can be expanded
compliance
an active process stimulated by chemical receptors in the aorta
inspiration
a passive process that depends on the elastic recoil properties of the lungs, requiring little or no muscle work
expiration
a chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing
surfactant
collapse of the alveoli that prevents normal exchange of oxygen and carbon dioxide
atelectasis
the amount of air exhaled after normal inspiration
tidal volume
the amount of air left in the alveoli after a full expiration
residual volume
maximum amount of air that can be removed from the lungs during forced expiration
forced vital capacity
what three things influence the capacity of the blood to carry oxygen?
the amount of dissolved oxygen in plasma, the amount of hemoglobin, and the tendency of hemoglobin to bind with oxygen
CNS controls the RR, depth, and rhythm, cerebral cortex regulates the voluntary control of respiration
neural regulation
maintains the rate and depth of respirations based on changes in blood concentrations of CO2 and O2, and in hydrogen ion concentration (ph), chemoreceptors sense changes in the chemical content and stimulate neural regulators to adjust
chemical regulation
volume of blood ejected from the ventricles during systole
stroke volume
Frank-Starling law of the heart
as the myocardium stretches, the strength of the subsequent contraction increases
pulmonary circulation
right side
systemic circulation
left side
atrioventricular valves
tricuspid and mitral
semilunar valves
aortic and pulmonic
the amount of blood ejected from the left ventricle each minute
cardiac output
the amount of blood in the left ventricle at the end of diastole
preload
the resistance to left ventricular ejection
afterload
the pacemaker of the heart
SA node
reflects the electrical activity of the conduction system
electrocardiogram (ECG)
represents the electrical conduction through both atria
p wave
indicates that the electrical impulse traveled through the ventricles
QRS complex
physiological factors affecting oxygenation
decreased oxygen-carrying capacity, hypovolemia, decreased inspired oxygen concentration, increased metabolic rate
extracellular fluid loss and reduced circulating blood volume
hypovolemia
conditions affecting chest wall movement
pregnancy, obesity, musculoskeletal abnormalities, trauma, neuromuscular diseases, CNS alterations
condition in which multiple rib fractures cause instability in part of the chest wall
flail chest
three primary alternations in respiratory functioning
hypoventilation, hyperventilation, and hypoxia
normal PaCO2
35 to 45 mm Hg
normal PaO2
80 to 100 mm Hg
occurs when alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate sufficient carbon dioxide
hypoventilation
state of ventilation in which the lungs remove carbon dioxide faster than it is produced by cellular metabolism
hyperventilation
inadequate tissue oxygenation at the cellular level
hypoxia
blue discoloration of the skin and mucous membranes
cyanosis
caused by electrical impulses that do not originate from the SA node (dysrhythmias)
disturbances in conduction
insufficient volume is ejected into the systemic and pulmonary circulation
altered cardiac output
acquired or congenital disorder of a cardiac valve by stenosis or regurgitation
impaired valvular function
coronary artery flow to the myocardium insufficient to meet myocardial oxygen demands
myocardial ischemia
hardening
stenosis
impaired closure
regurgitation
results when the supply of blood to the myocardium from the coronary arteries is insufficient to meet myocardial oxygen demands
myocardial ischemia
a transient imbalance between myocardial oxygen supply and demand that results in chest pain
angina pectoris
results from sudden decreases in coronary blood flow or an increase in myocardial oxygen demand without adequate coronary perfusion
myocardial infarction
shortness of breath, clinical sign of hypoxia
dyspnea
abnormal condition in which a patient uses multiple pillows when reclining to breathe easier or sits learning forward with arms elevated
orthopnea
coughing up blood from the respiratory tract (alkaline pH)
hemoptysis
vomiting of blood indicating GI bleeding (acidic pH)
hematemesis
high-pitched musical sound caused by high-velocity movement of air through a narrowed airway
wheezing
increase in both rate and depth of respirations
Kussmaul respiration
absence of respirations for a period of time
apnea
occurs when there is decreased blood flow or injury to the brainstem, periods of apnea followed by periods of deep breathing and then shallow breathing followed by more apnea
Cheyne-Stokes respirations
the process of adding water to gas
humidification
adds moisture or medications to inspired air by mixing particles of varying sizes with the air
nebulization
patient takes a slow, deep breath and holds it for two seconds while contracting expiratory muscles, then performs a series of coughs throughout exhalation
cascade cough
stimulates a natural cough reflex and is generally effective only for clearing central airways, while exhaling, the patient opens the glottis by saying the word huff
huff cough
for patients without abdominal muscle control, while the patient breathes out with a maximal expiratory effort, the patient or nurse pushes inward and upward on the abdominal muscles toward the diaphragm, causing the cough
quad cough
group of therapies for mobilizing pulmonary secretion
chest physiotherapy (CPT)
consists of drainage, positioning, and turning, and is sometimes accompanied by chest percussion and vibration
postural drainage
encourages voluntary deep breathing by providing visual feedback to patients about inspiratory volume
incentive spirometry
used to prevent using invasive artificial airways in patients with acute respiratory failure, cariogenic pulmonary edema, or exacerbation of COPD
noninvasive positive pressure ventilation (nppv)
a catheter inserted through the thorax to remove air and fluids from the pleural space, to prevent air or fluid from reentering the pleural, or to reestablish normal intrapleural and intrapulmonic pressures
chest tube
collection of air in the pleural space
pneumothorax
accumulation of blood and fluid in the pleural cavity between the parietal and visceral pleura
hemothorax
helps patients achieve and maintain an optimal level of health through controlled physical exercise, nutrition counseling, relaxation and stress management techniques, and prescribed medications and oxygen
cardiopulmonary rehabilitation
involves deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse
pursed lip breathing
exercise that improves efficiency of breathing by decreasing air trapping and reducing the WOB, promotes relaxation and pain control
diaphragmatic breathing
signs of hypoxia
restlessness, anxiety, increased RR, shortness of breath, use of accessory muscles, increased HR and BP, decreased oxygen saturation, dysrhythmias, disorientation, decreased LOC
