Oxygenation

Question 1

_____ is the transport of oxygenated blood through the circulatory system to the cells and the return of oxygenated blood and CO2 from the cells

Answer 1

Oxygenation

Question 2

Oxygenation is impacted by what three elements?

Answer 2

Ventilation, Transport and Perfusion

Question 3

_____ is the exchange of O2 that enters the lungs and is expelled as CO2 from the lungs. can be impaired by any disorder that affects the nasoharnyx and lungs (ex. COPD, edema of the sinuses, etc)

Answer 3

Ventilation

Question 4

____ involves the ability of the hemoglobin to deliver O2 to the cells for metabolism and back to the alveoli to eliminate the CO2 produced by the cellular metabolism. Anemia from any cause impairs the transport.

Answer 4

Transport

Question 5

____ is the transport of O2 by the blood to the cells, tissues and organs. Impairment of this mechanism can result from decreased cardiac output, thrombi, and/or constriction of the blood vessels or from bleeding.

Answer 5

Perfusion

Question 6

insufficient oxygenated blood flow to the tissues that may result in cell injury or death.

Answer 6

Ischemia

Question 7

Insufficient O2 reaches the cells

Answer 7

Hypoxia

Question 8

No O2 reaches the cells

Answer 8

Anoxia

Question 9

decreased O2 in the arterial blood.

Answer 9

Hypoxemia

Question 10

Breath sounds that should not be heard. These are abnormal/extra breath sounds.

Answer 10

Adventitious Sounds

Question 11

Auscultated during inspiration and do not clear with cough; occurs when fluid is in airway (previously known as rales); sounds are not continuous (this sound can be heard with pneumonia, cardiac failure, and atelectasis)

Answer 11

Crackles

Question 12

May be auscultated during inspiration and/or expiration. The sounds are from air moving through narrowed passages; sound is continuous and music-like (heard with asthma, bronchitis, and/or chronic emphysema)

Answer 12

Wheezes

Question 13

Auscultated typically on inspiration over inflammation or the pleural area; many times is described as a grating sound (heard with pleuritis and presents with pain when breathing)

Answer 13

Pleural Friction Rub

Question 14

sounds like a crowing sound. This is a high pitched sound and is heard with croup and/or acute epiglottis

Answer 14

Stridor

Question 15

Client presents with difficult breathing unless sitting erect or standing. Results from an increase in pulmonary venous and capillary pressure in the lungs when client is lying supine, and is relieved when client is upright.

Answer 15

Orthopnea

Question 16

Breath sounds that sound distant due to “trapped air” (emphysema, COPD)

Answer 16

diminished breath sounds

Question 17

From birth, your lungs (filled with fluid) drain as you take your first breathes. your lungs gradually expand from birth until they reach full inflation around 2 weeks of age.

Answer 17

Focused Health Assessment of an Infant

Question 18

chest wall and airways become more rigid and less elastic; the amount of air exchanged is decreased, the cough reflex, and cilia action decrease. Mucous membranes become drier and more fragile. Decrease in muscular strength and endurance occur. osteoporosis, sedentary lifestyle, and other chronic life conditions can cause adequate lung expansion to compromise. an increase in gastroesphogeal reflux is more common in adults and increases risk of aspiration, which will lead to bronchospasm from the inflammatory response or pneumonia.

Answer 18

Focused Health Assessment of Older Adults

Question 19

What is the number one cause of any respiration disorder ?

Answer 19

Smoking

Question 20

What does occupation have to do with oxygenation?

Answer 20

Certain patient that work in factories may be exposed to chemicals and irritants that will increase their risk of respiratory complications.

Question 21

how does travel affect oxygenation?

Answer 21

cold weather and higher elevations affect the respiratory system more dramatically.

Question 22

how does environmental factors affect oxygenation?

Answer 22

exposure to smog, pesticides, and other irritants are greater in certain areas.

Question 23

what are the first signs of oxygen complications?

Answer 23

restlessness and confusion

Question 24

Under this particular circumstance individuals may hyperventilate which will cause a rise in O2 and a decrease in CO2. In extreme circumstances the body may release epinephrine which will cause the bronchioles to dilate which increases blood flow and O2 delivery. While great in the short term this can cause long-term complications in the cardiovascular system.

Answer 24

Stress

Question 25

what medications can greatly decrease the respiratory drive for an individual?

Answer 25

Benzodiazepine, sedative-hypnotics, anti-anxiety drugs (diazepam, lorazepam, midazolam), barbituates (penobarbital), and narcotics (morphine, and meperidine hyrdochloride)

Question 26

What should one assess during a focused assessment of oxygen ?

Answer 26

inspect the external nose for any deviations in shape, size or color and flaring or discharge from the nares. Lightly palpate the external nose to determine any areas of tenderness, masses and displacements of bone and cartilage. air moves freely as the client breathes thorugh the nares. mucosa pink, clear and watery discharge, no lesions.

Question 27

How should the pharynx, trachea and larynx look ?

Answer 27

mucous membranes should be pink and moist. Should be able to speak with little to no struggle (around 12 words per minute) ensure the trachea is midline and there are no difficulties swallowing or edema.

Question 28

____ rely mostly on diaphragmatic movement for breathing, their breathing will be most notable in the abdominal region.

Answer 28

Infants

Question 29

what is the normal RR and O2 sat for an adult?

Answer 29

12 - 20 and O2 sat over 92%

Question 30

what is the normal RR and O2 sat for an toddler

Answer 30

20-30 and O2 sat over 93%

Question 31

What is the normal RR and O2 sat for an infant?

Answer 31

30-60 and O2 sat over 93%

Question 32

soft-intensity, low-pitched, “gentle sighing” sounds created by air moving through smaller airways (bronchioles and alveoli) best head during inspiration at the base of the lungs. Heard at a 5:3 ratio

Answer 32

Vesicular

Question 33

moderate-intensity and moderate pitched “blowing” sounds created by air moving through larger airway (bronchi), best heard between scapulae and lateral to the sternum at the first and second intercostal spaces. Heard at a 1:1 ratio

Answer 33

broncho-vesicular

Question 34

high-pitched, loud, “harsh” sounds created by air moving through the trachea, best heard over the trachea. Heard at a 1:2 ratio

Answer 34

Bronchial

Question 35

Continuous, low-pitched, coarse gurgling, harsh, louder sound with a moaning or snoring quality. Best heard on expiration but can be heard on both inspiratory and expiratory primarily over trachea and bronchi, but can be heard over most lung areas. Caused by air passing through narrowed air passages as a result of secretions, swelling or tumors. May be altered with coughing

Answer 35

Rhonci

Question 36

diagnostic test that measures the acidity (pH) and levels of O2 and Co2 in the blood. this is used to check how well your lungs are able to move O2 in the blood and remove CO2 from the blood. Normal 7.35-7.45

Answer 36

Arterial Blood Gas (ABG)

Question 37

diagnostic test that is used to detect and identify bacteria or fungi that are possibly infecting the lungs and breathing passages. Best to get in the morning. Request that the patient take a deep breath and cough ensuring that the sputum is from deep within the chest. Ask that they spit in the cup, transfer specimen as necessary. If patient is unable to cough or does not understand how to cough, you may need to suction.

Answer 37

Sputum Specimen

Question 38

diagnostic testing that determines the level of O2 in the blood. Normal is 95% and above. with COPD patients the normal is 89-90%, you don’t want to up O2 too much to get a better O2.

Answer 38

Pulse Oximetry

Question 39

diagnostic test that measures lung volume and capacity. The client breathes into a machine attached to a computer to measure their pulmonary function in comparison to someone the exact same as them (think a clone: same height, weight, etc)

Answer 39

Pulmonary Function Test

Question 40

diagnostic testing that is measured with a peak flow meter. it tests what their current respiratory status is at that very moment.

Answer 40

Peak Expiratory Flow Rate (PEFR)

Question 41

what does green indicate from a PEFR ?

Answer 41

good, this is where their personal best is. IF they are currently utilizing certain interventions this is a good sign to continue using them.

Question 42

What does yellow indicate from a PEFR?

Answer 42

Intervention of their own is needed. they may need albuterol or another short-acting inhaler, but can manage on their own.

Question 43

What doe red indicate from a PEFR?

Answer 43

needs medical intervention, patient needs to be seen immediately because they are likely in some type of respiratory distress.

Question 44

invasive procedure that views the airways and lungs using a bronchoscope and may diagnose lung disease. Since this is an invasive procedure it will require consent. Patients need to be NPO 4 - 8 hours prior to the procedure and are mildly sedated. Most patients wont recall the occurrence.

Answer 44

Bronchoscopy