Oxygenation Flashcards
True or False: Do normal people breath through their nose?
True
What is the benefits of the olfactory region on the roof of the nasal cavity
Prevents Noxious gases from entering the Lungs
What is the Muciculliary Escalator, and what does it do?
Cilia on the pharnyx used to propels trapped mucus to the Nasal or Oral cavity for removal.
Breathing from your nose vs breathing through your mouth has what benefits for air entering your lungs
The rich supply of blood warms and humidify the air entering your lungs.
What does the epiglottis do when we swallow food or drink water?
Prevents food from entering the the airway were aspiration could take take place.
Shared pathway for food and Air?
Pharnyx
The lower Respiratory System consist of what?
Trachea, Bifurcation, Lobar Bronchi, Segmental bronchi, Bronchioles, Diaphragm, Alveoli,
Where does gas Exchange take place within the lungs?
Alveoli Sacs or Ducts
What does the upper respiratory tract consist of?
Nose, Epiglottis, Pharynx, Larynx
Detergent like phospholipids that cover the inside of the alveoli, Reduces surface tension and holds them open
Surfactant
What separates the chest from the abdominal cavity?
Diaphragm
Lies between the ribs and the main muscles used for breathing?
Intercostal Muscles
Modulla and pons are referred to as what system for breathing?
The respiratory control center?
What nervous system drives the lower and upper respiratory tract?
Central Nervous System
What is the mechanical process for Pulmonary ventilation?
Moves air in and out of lungs,
Changes in volume and pressure
Depends on complex coordination of neuromuscular activity
Diaphragm and intercostal muscles are used
Is exhalation active or passive?
Exhalation is passive
True or false:During inspiration does your Intrathoracic pressure increase?
False. Intrathoracic pressure decreases= air flow moves in
Is Inspiration active or Passive process
Active Process
When the airway becomes positive in pressure, and the lungs recoil, what is this?
Exhalation
Tidal volume is what?
The amount of air moving in and out of the lungs
upon inspiration and exhalation what is the tidal volume being moved per breath?
500 ml
Increased CO2 in the blood is referred to as?
Hypercarbia
During exercise what is the tidal volume that is being moved?
1500ml/breathe
When the external intercostal and diaphragm muscles contract what is this referred to as?
Inspiration
What does ventilation depends on?
Clear airway
Intact CNS and respiratory system
Intact thoracic cavity capable of expanding and contracting
Adequate pulmonary compliance and recoil
Gas diffusion is the process of what?
Moving Oxygen and CO2 between the alveoli and blood through the capillary membrane by diffusion
What is diffusion?
Moving from a higher concentration to a lower concentration.
What factors influence gas diffusion in the lungs?
Changes in available surface area
Thickening of alveolar-capillary membrane
partial pressure of gas
What is the first step in oxygen transport?
O2 crosses from alveolar-capillary membrane
O2 binds to what site during oxygen transport?
Hemoglobins
When your percentage of oxygen saturation is between 93-100% you are classified as what?
Oxyhemoglobulin
O2 diffusion occurs from capillary blood to where?
Various tissues
What factors affect could affect rate of transportation of oxygen?
Cardiac Output (CO) Number of Erythrocytes and blood hematocrits
How is CO2 produced?
Produced by the tissues as part of the metabolism
During carbon dioxide transport the amount of CO2 is dependent on what?
The amount of oxygen leaving the blood and entering the cells
Co2 is transported to the lungs in 3 ways. What are they and what is the percentage
Dissolved in plasma - PCO2 -5%
Inside the RBC’s as bicarbonate 65%
Combines with HGB for carboaminohemoglobin 30%
When unsaturated 02 exits Hgb what carries it back to the lungs to be exhaled?
CO2
What factors affect the rate of oxygen transport from lungs to tissues?
Cardiac Output
# of RBC’s and hematocrit
Excercise
The process by which blood flows through the body tissues to supply oxygen and nutrients.
Tissue Perfusion
Which Organs require continuous perfusion?
All organs require continuous perfusion
What is the rate of Arterial pressure of the Kidneys
60mm Hg
Which part of the CNS generate regular impulses to the diaphragm and respiratory muscles to rhythmically contract and relax?
Medulla and Pons
Which gas primarily determine the rate and depth of respirations?
CO2
Insufficient oxygen anywhere in the body from the inspired gas to tissues is often referred to as?
hypoxia
Hypoxia is often caused by a side affect of _______ from a decreased rate or depth of air movement.
Hyperventilation
Low partial pressure of oxygen in the blood, or a low hemoglobin saturation
Hypoxemia
What is considered a normal breathing rate for a new and infant?
30-60 breathes
During your shift you take vitals signs of a 3 year old boy and you began you head-to-assessment. Your vitals read as 80HR, 98o2, 27 Resp, 99.1 Temp. Would you be concerned with his breathing pattern?
NO. Breathing pattern is within normal range of 20-30bpm.
Mr. Johnson, 68 year old man. He was recently transferred to your wing. You passed by his room and seen him slouched over watching TV. He was Alert and orientated. You entered the room and began taking his vitals. They read as followed: Temp 98.0, Resp 12, Pulse 60, 128/78. Should vitals be Re-assesed, or is everything fine?
Vitals should be re-assessed due to Mr. Johnson age and respiratory are outside of normal guidelines. Determine if this is norm from previous.
What system is in charge of transportation and circulating oxygen and nutrients to tissues?
Cardiovascular System
Which side of the heart is classified as having deoxygenated blood?
The Right side
The Right Atrium receives blood from where?
The Superior vena cava head neck, upper body, inferior vena cava trunk, and lower extremities
What is the order by way which the blood flows through the heart?
Right atrium>Tricuspid valve>Right Ventricle>Pulmonic valve>pulmonary artery>Lung>Pulmonary Veins>Left Atrium>Mitral valve>Left ventricle>Aortic valve>Aorta>Systemic circulation
What is the only Artery in the body that is deoxygenated?
The pulmonary Artery
What is the Primary pacemaker of the heart and where is it located on the heart?
The SA Nod - located at the superior Vena Cava.
The SA node impulses are depolarized by what?
Changes in NA, K and Calcium begins SA impulses.
During a short delay _______ allows the atria to fully contract then enters the intraventricular septum
AV Node
The Bundle of His down the left and right bundle branches are often referred to as?
Ventricular Pathway
Heart Rate and Cardiac Output are increased/decreased without change in stroke volume is determined by?
SA node
True or False: When the parasympathetic system is stimulated does the Heart Rate increase?
False: Heart Rate slows down during stimulation.
What is the amount of blood pumped by the ventricles each minute?
3.5-8L/Minute
During each beat the amount of blood ejected from the ventricles is often referred to as what?
Stroke Volume
What is the Formula to determine Cardiac Output?
Heart Rate X Stroke Volume
Yes or NO:MaryAnne gives birth at 28 weeks. Will this child need additional lung support to survive outside of the womb?
Yes
What is the most common Respiratory Illness elderly patients may experience?
Pneumonia
What is the #1 Risk factor of respiratory and cardiac disease?
Cigarette Smoking
What environmental factor increases risk of lung cancer and diseases?
Air Pollution
True or False: Less O2 is available for diffusion as you increase your altitude?
True: Altitude is a decreased partial pressure.
______ are substances that causes inflammatory response.
Allergens
A patient who comes in with Inflammatory response and bronchospasm is associated with having what?
Asthma
________ has decrease partial pressure but O2 diffusion is less while the O2 concentration starts the same
Altitude
Thickening of the air
Humidity and Heat
What does smoking do to the body?
Destroys Cilia, increases mucus production, decrease removal of mucus, increase bacterial growth, inflammation and tissue destruction.
True or False: Your lungs can be repaired 3-4 years after completely smoking?
True. Lung repair occur and can be listed as same risk as non smoker?
During smoking does Hear rate and Blood Pressure increase or Decrease?
Increase
While pt Johnson continues to smoke it displaces _____ with ______ therefore decreased _____ to tissues
O2, CO, O2
A person with restricted movement when lying down and shows signs of sleep apnea as well as increased oxygen needs could be listed as being what?
Obese
During Nursing school Sandra is performing a psychological health assessment on herself and discovered every time before her test her respiration rate increases and her depth of breathing increases. Sandra is showing signs for what?
Hyperventilation
During your assessment/Inspection what will you be looking for in patients who are showing signs of Respiratory distress?
Rate, Rhythm, Depth, Color, Dyspnea/Orthopnea, Use of Accessory Muscles, Positioning(Tripod), Chest Anteroposterior Diameter
Pt Showing Bluish Discoloration of the skin and mucus membranes due to desaturation of hemoglobin
Cyanosis
Cyanosis is not observed until at least ___ or more of unoxygenated hemoglobin per 100 ml of blood
5G
Dilation of vessels and hyperplasia of tissue in fingers and toes?
Clubbing. Occurs over time 6 months to 1 year?
Crackles are what?
Intermittent sounds occurring when air moves through airways that contain fluid.
There are 3 different type of crackles. What are they?
Fine, Medium, or coarse
Wheezes are defined as what?
Continuous sounds heard on expiration and sometimes on inspiration as air passes through airways constricted by swelling, secretions or tumors
What should you be looking for when a person produces sputum?
Amount, Color, Smell, Consistency
Having a bloody sputum is often referred to as?
Hemoptysis
Vesicular is defined as what?
Low-pitched soft sounds during expiration heard over most of lungsInspiration is longer than expiration
High pitched and longer, heard primarily over trachea, inspiration shorter than expiration
Bronchial
What is a pleural rub?
Low-pitched, dry gearing sound
Client who can ambulate 1 mile at their own pace before experiencing SOB. Is at what level of Dyspnea?
Level 1
A client performing ADL’s becomes short of breath is at what level of Dyspnea?
Level 3
Client becomes short of breath while lying down.
Orthopnea
What is considered abnormal is assessment or respiration?
Changes in rate and Depth,Exhaustion
Breathing effort, Positioning
Adventitious Sounds, Color
Clubbing,Increased A-P Diameter
When assessing/Inspection of Cardiovascular function what are you checking for?
Cerebral Perfusion (Cognition) Weight 10lbs= 5 liters of ECF
Skin: Color and Moisture
Peripheral Circulation (Cap refills, warmth, and color)
Edema, Varicosities, Toe Nails, Clubbing
How long should it take for Capillary Refill to occur?
3 Secs or less
A continuous noninvasive study of Arterial Hemoglobin oxygen saturation SaO2?
Pulse Oximetry
What factors affect Pulse oximetry readings?
Room Lighting, patients movement, cigarette smoking, nail polish, poor perfusion and temperature may affect accuracy
1+ pitting edema must have a percentage greater than____% of normal level?
30%
How long does it take for 2+ pitting edema to return to normal?
4 mins
Pitting edema that takes 8 mins to return to normal interstitial fluid is what level of edema?
4+
Tissue palpates and is firm or hard, skin surface shiny, warm, moist, and can no longer displace fluid is referred to as?
Brawny Edema
Mitral and tricuspid closure is associated with which sound of the “Lub, Dub”?
Lub
True or False: S1 is louder and the tricuspid and mitral areas?
False: Its louder at the tricuspid and apical areas
True or False: S2 is louder at the Aortic and pulmonic Areas of the heart?
True
A culture of sputum is defined?
Identify specific organism causing symptoms of respiratory difficulty.
True or False: Sputum is the same as saliva?
False. Sputum is from the lungs bronchi and trachea
What is AFB?
Acid Fast Bacilli. Associated with TB
Identifies antibiotics that are most effective against causative agents.
Sensitivity Test
What are 2 ways that Sputum can be obtained?
Coughing or Suctioning
When is the best time to obtain a sputum specimen?
In the Morning. Cough up secretions accumulate at night
True or False: Pt should clear throat before producing a sputum specimen?
False: Pt should not clear throat- Deep breaths and cough.
True or False: A nurse should offer an antiseptic mouth rinse prior to receiving sputum culture.
True: This will decrease contamination from mouth
What is the RBC average for male and female?
Male: 4.7 - 6.1
Female: 4.2 - 5.4
What are the normal hemoglobin level for male and female?
Male: 14 - 18 g/dL
Female: 12-16 g/dL
What percentage of hematocrit is normal for male and female?
Male: 42 - 52%
Female: 37 - 47%
What are the Cardiac Biomarkers?
Creatine Kinase (CK, CPK) and Troponin
When are the Cardiac Biomarkers released?
When the heart is damaged
What are the 4 Electrolytes?
Potassium (K), Sodium (Na)
Magnesium (Mg), Calcium (Ca)
Where are RBC’s developed?
Within the bone Marrow
What is the lifespan of RBC’s?
120 Days
The spleen does what for the RBC’s?
It removes old or dying RBC’s
What is the normal PaO2 level for Arterial Blood Gas (ABG)?
80 - 100mmHg
What should the level be for ABG related towards PaCO2?
35 - 45mmHg
What should the bodies average pH level be between?
7.35 - 7.45
True or False: Is CO2 necessary to maintain acid-base balance within the body?
True
True or False: Does CO2 have and affinity for hemoglobin for O2?
True
_______ is indicted by hydrogen ion concentration of the blood?
pH of Blood
Where can ABG be drawn from?
Radial, Branchial or Femoral Artery
How much ABG is drawn?
3-5 CC’s
What is the purpose of receiving a chest x-ray?
detect pulmonary disorders: pneumonia, tumors, detect cardiac disease, heart failure, enlarged heart, Assess position of catheters and tubes
What is the purpose of the pulmonary function Test?
To measure the ability of lungs to efficiently exchange oxygen and CO2
What can the pulmonary function test determine what?
lung volume and capacity, the effects on lung disease on lung volume
The EKG records what?
Electrical impulses that stimulate the heart to contract, Evaluates arrhythmias, conduction defects, myocardial injury, hypertrophy
P Wave
Atrial Depolorization associated with atrial contraction
QRS complex
Ventricular depolarization associated with ventricular contraction
T wave
Represents ventricular depolarization - normal electrical activity
What are examples of different types of machines used for a stress test?
Bicycle or Treadmill
What is the purpose of a Stress test?
Study that stresses the heart in some ways to evaluate heart during stress
What chemicals could be used for a stress test?
Adenosine, Dobutamine
When is the stress test over with?
Once the HR is increased to 80-90% of target rate for adults 150-200 BPM
What is a skin test used for?
Identifies allergic reactions to specific substances.
What is a bronchoscopy?
Visualization of larynx, trachea and bronchi using a flexible fiberoptic scope.
What is a bronchoscopy capable of doing?
Obtain sputum cultures and biopsy, remove tumors, obstruction or foreign objects - control bleeding.
True or False: Is it necessary to obtain an informed consent for an invasive procedure such as a bronchoscopy?
True: It is necessary
True or False: Is Pt NPO after procedure to prevent aspiration?
True: Pt is NPO for 6-8hrs or until gag reflex returns.
What is an incentive spirometry, and how is it used?
Encourage deep breathing deep - inspiration. Should be done once an hour 5-10x.
What are the goals of Oxygen Therapy?
Improve tissue oxygenation
Decrease work of breathing in patients with dyspnea
Decreased work of the heart in clients with heart disease
True or False: In order to administer oxygen to a patient a nurse must obtain an order from MD?
True: Order is required
When assessing pt response to oxygen therapy what would you be assessing for?
Color, LOC, HR, RR, Effort, O2 saturation.
What would be some safety considerations for a patient going home with oxygen therapy?
No smoking, Humidication may be needed, avoid using oil, no materials that generate static electricity, have a fire extinguisher on premises, Notify fire dept about 02 at home, O2 canister must have a holder.
What is an oxygen oxymizer?
Stores O2 in a reservoir while client breaths out and delivers higher concentrations of O2. Does not require humidifier.
How can venous stasis be prevented?
do not cross knees or wear tight socks, leg extensions, applying anti-embolism stockings, pneumatic compression devices, impulse foot pump, anticoagulation prophylaxis
What is the Fetal Flow chart for the heart?
Blood enters the right atrium>flows through the foramen ovale into the left atrium (small part flows to the right ventricle> pulmonary )>Left Ventricle> Aorta> Heart and Brian> rest of perspective body
