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NURS 402: Lecture > Oxygenation and Perfusion > Flashcards

Oxygenation and Perfusion Flashcards

Exam 4/Final

1
Q

Factors essential to normal functioning of the respiratory system

A
  1. Integrity of the airway system to transport air to and from lungs
  2. Properly functioning alveolar system in lungs
  3. Properly functioning cardiovascular and blood supply
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2
Q

Properly functioning alveolar system in lungs means:

A
  1. Oxygenates venous blood
  2. Removes carbon dioxide from blood
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3
Q

Properly functioning cardiovascular and blood supply means

A

Carry nutrients and wastes to and from body cells

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4
Q

Function of the upper airways

A

Function: warm, filter, humidify inspired air

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5
Q

Components of the upper airways

A

Nose
Pharynx
Larynx
Epiglottis

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6
Q

Functions of the lower airways/tracheobronchial tree:

A

Functions: conduction of air, mucociliary clearance, production of pulmonary surfactant

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7
Q

Components of the lower airways/tracheobronchial tree

A

Trachea

Right and left mainstem bronchi

Segmental bronchi

Terminal bronchioles

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8
Q

What are the main organs of respiration?

A

Lungs

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9
Q

How does the lungs exist in the body?

A

Extend from the base of the diaphragm to the apex above the first rib

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10
Q

How many lobes does the lungs have:

A

Right lung: 3 lobes

Left lung: 2 lobes

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11
Q

What are the lungs composed of?

A

The lungs are composed of elastic tissue

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12
Q

Alveoli

A

small air sacs where gas exchange occurs

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13
Q

Surfactant

A

reduces the surface tension between alveoli, preventing their collapse

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14
Q

Pleura

A

serous membrane lining the lungs (visceral) and thoracic cavity (parietal)

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15
Q

Respiratory function includes:

A
  1. Pulmonary ventilation
  2. Respiration
  3. Perfusion
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16
Q

PULMONARY VENTILATION

A

is the movement of air into and out of the lungs (inspiration and expiration)

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17
Q

RESPIRATION

A

involves gas exchange between the atmospheric air in alveoli and the blood in the capillaries

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18
Q

PERFUSION

A

is the process by which oxygenated capillary blood passes through body tissues Inspiration: the active phase of ventilation

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19
Q

Pulmonary ventilation is mostly controlled by what?

A

Diaphragm

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20
Q

What influences breathing

A

Parasympathetic and sympathetic nervous systems

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21
Q

Process of Ventilation

A

The diaphragm contracts and descends, lengthening the thoracic cavity.

The external intercostal muscles contract, lifting the ribs upward and outward.

The sternum is pushed forward, enlarging the chest from front to back

Increased lung volume and decreased intrapulmonic pressure allow air to move from an area of greater pressure (outside lungs) to lesser pressure (inside lungs).

The relaxation of these structures results in expiration.

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22
Q

During inspiration, what does the diaphragm do?

A

The diaphragm contracts and descends, lengthening the thoracic cavity.

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23
Q

During inspiration, what does the external intercostal muscles do?

A

The external intercostal muscles contract, lifting the ribs upward and outward.

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24
Q

During inspiration, what does the sternum do?

A

The sternum is pushed forward, enlarging the chest from front to back

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25
Q

What allows air into lungs?

A

Increased lung volume and decreased intrapulmonic pressure allow air to move from an area of greater pressure (outside lungs) to lesser pressure (inside lungs).

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26
Q

What results in expiration?

A

Relaxation of sternum, external intercostal muscles and diaphragm

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27
Q

Gas exchange (respiration) refers to what?

A

Refers to the intake of oxygen and release of carbon dioxide

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28
Q

What is gas exchange made possible by:

A

Made possible by respiration and perfusion

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29
Q

How does gas exchange occur?

A

Occurs via diffusion (movement of oxygen and carbon dioxide between the air and blood)

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30
Q

Factors Influencing Diffusion of Gases in the Lungs

A

Change in surface area available

Thickening of alveolar–capillary membrane

Partial pressure

Solubility and molecular weight of the gas

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31
Q

How is oxygen carried in the body?

A

Oxygen is carried in the body via plasma and red blood cells.

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32
Q

How is most oxygen carried? What percent?

A

Most oxygen (97%) is carried by red blood cells in the form of oxyhemoglobin.

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33
Q

Carboxyhemoglobin

A

Hemoglobin also carries carbon dioxide in the form of carboxyhemoglobin.

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34
Q

What must occur between circulating blood and tissue cells?

A

Internal respiration between the circulating blood and tissue cells must occur.

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35
Q

Alterations in Respiratory Function

A

Hypoxia

Dyspnea

Hypoventilation

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36
Q

Hypoxia

A

inadequate amount of oxygen available to the cells

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37
Q

Dyspnea

A

Difficulty breathing

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38
Q

Hypoventilation

A

decreased rate or depth of air movement into the lungs

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39
Q

What is the main organ of circulation?

A

heart

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40
Q

What structures make up the heart

A

The heart is the main organ of circulation, composed of two upper atria and two lower ventricles

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41
Q

What two things does hemoglobin carry?

A

Oxygen is carried predominantly via red blood cells due to binding between the hemoglobin in RBCs and oxygen

Hemoglobin also carries carbon dioxide

42
Q

What controls contraction of the heart?

A

Electrical impulses control contraction of the heart muscles

43
Q

What are the electrical impulses that control contraction of the heart muscles called?

A

Sinoatrial (SA) node,
atrioventricular (AV) node,
atrioventricular bundle

44
Q

Alterations in the Cardiovascular System

A

Dysrhythmia or arrhythmia

Myocardial ischemia

Angina

Myocardial infarction

Heart failure

45
Q

Factors Affecting Cardiopulmonary Functioning and Oxygenation

A

Level of health

Developmental considerations

Medication considerations

Lifestyle considerations

Environmental considerations

Psychological health considerations

46
Q

Respiratory Activity in the Infant: How are lungs transformed for infants?

A

Lungs are transformed from fluid-filled structures to air-filled organs.

47
Q

How are infants chest, airways? What does this raise a problem for?

A

The infant’s chest is small

Airways are short

Aspiration is a potential problem

48
Q

How are the respiratory rate and activity of infants?

A

Respiratory rate is rapid and respiratory activity is primarily abdominal.

49
Q

What is given to infants to open alveoli

A

Synthetic surfactant can be given to the infant to reopen alveoli.

50
Q

What is normal to be heard in infants upon auscultation?

A

Crackles heard at the end of deep respiration are normal.

51
Q

What age do kids get all their alveoli?

A

7 years old

52
Q

Respiratory Activity in the Child: What makes landmarks less prominent?

A

Some subcutaneous fat is deposited on the chest wall, making landmarks less prominent.

53
Q

How are the airways of children?

A

Eustachian tubes, bronchi, and bronchioles are elongated and less angular.

54
Q

What are the number of routine colds in children?

A

The average number of routine colds and infections decreases until children enter daycare or school.

55
Q

By the end of late childhood, how is a child’s immune system?

A

By the end of late childhood, the immune system protects from most infections.

56
Q

Respiratory Functioning in the Older Adult: How are the landmarks?

A

Bony landmarks are more prominent due to loss of subcutaneous fat.

57
Q

What in older adults leads to the appearance of leaning forward?

A

Kyphosis contributes to appearance of leaning forward.

58
Q

Barrel chest deformity results in what?

A

Barrel chest deformity may result in increased anteroposterior diameter.

59
Q

How are the airways in older adults?

A

Tissues and airways become more rigid; diaphragm moves less efficiently.

60
Q

How are older adults risk of disease?

A

Older adults have an increased risk for disease, especially pneumonia.

61
Q

Nursing History

A

Usual patterns of respiration
Medications
Health history
Recent changes
Lifestyle and environment
Cough or sputum
Pain or dyspnea
Fever or fatigue

62
Q

Physical Assessment of the Respiratory System: What is the order of operations?

A
  1. Inspect
  2. Palpate
  3. Percuss
  4. Auscultate
63
Q

Physical Assessment of the Respiratory System: Inspect

A

Inspect for general appearance, color (cyanosis, pallor), structural abnormalities of the chest, respiratory rate, rhythm and depth

64
Q

Physical Assessment of the Respiratory System: Palpate

A

Palpate for temperature, chest expansion, tenderness, masses, pulsations

65
Q

Physical Assessment of the Respiratory System: Percuss

A

Percuss to assess the position of the lungs, density of lung tissue

66
Q

Physical Assessment of the Respiratory System: Auscultate

A

Auscultate breath sounds

67
Q

Normal Breath Sounds

A

Vesicular

Bronchial

Bronchovesicular

68
Q

Normal Breath Sounds: Vesicular

A

low-pitched, soft sound during expiration heard over most of the lungs

69
Q

Normal Breath Sounds: Bronchial

A

high-pitched and longer, heard primarily over the trachea

70
Q

Normal Breath Sounds: Bronchovesicular

A

medium pitch and sound during expiration, heard over the upper anterior chest and intercostal area

71
Q

Abnormal (Adventitious) Breath Sounds

A

Crackles

Wheezes

72
Q

Crackles

A

Intermittent sounds occurring when air moves through airways that contain fluid

73
Q

How are crackles classified as?

A

Fine

Medium

Coarse

74
Q

Wheezes:

A

continuous sounds heard on expiration and sometimes on inspiration as air passes through airways constricted by swelling, secretions, or tumors

75
Q

How are wheezing classified as?

A

Sibilant

Sonorous

76
Q

Common Diagnostic Methods to Assess Cardiopulmonary Function:

A

Electrocardiography

Pulmonary function studies

Capnography

Thoracentesis

Lab Studies:

77
Q

Common Diagnostic Methods to Assess Cardiopulmonary Function: Pulmonary Function studies include:

A
  1. Spirometry
  2. Peak expiratory flow rate
  3. Pulse oximetry
78
Q

Common Diagnostic Methods to Assess Cardiopulmonary Function: Lab studies include

A

arterial blood gas,

cardiac biomarkers,

CBC,

cytologic studies

79
Q

Values Measured from Pulmonary Function Tests

A

Tidal volume (TV)

Vital capacity (VC)

Forced vital capacity (FVC)

Forced expiratory volume (FEV)

Total lung capacity (TLC)

Residual volume (RV)

Peak expiratory flow rate (PEFR)

80
Q

Promoting Optimal Function:

A

Healthy lifestyle choices and behaviors

Vaccinations

81
Q

Important vaccinations for respiratory health?

A

Influenza

Pneumococcal disease

COVID-19

82
Q

Promoting Optimal Function

A

Teaching about a pollution-free environment

Reducing anxiety

Maintaining good nutrition

Promoting comfort

Promoting proper breathing

Promoting and controlling coughing

Performing chest physiotherapy

Meeting oxygen needs with medications

83
Q

How to promote proper breathing?

A

Deep breathing
Using incentive spirometry
Pursed-lip breathing
Diaphragmatic breathing

84
Q

Medications

A

For cough
Bronchodilators
Mucolytic agents
Corticosteroids
Antihistamines
Leukotriene receptor antagonists

85
Q

Medications for cough:

A

Suppressants
Expectorants
Lozenges

86
Q

Administering Inhaled Medications: What is used?

A

Bronchodilators

Nebulizers

MDI

DPI

87
Q

Bronchodilator

A

Bronchodilators: open narrowed airways

88
Q

Nebulizers:

A

disperse fine particles of liquid medication into the deeper passages of the respiratory tract

89
Q

Meter-dose inhalers:

A

deliver a controlled dose of medication with each compression of the canister

90
Q

Dry powder inhalers:

A

breath-activated delivery of medications

91
Q

Providing Supplemental Oxygen involves:

A

Source of oxygen

Flow rate

Humidification

Delivery Systems

92
Q

Delivery Systems for supplemental oxygen

A

Nasal cannula (high or low flow)

Simple mask

Nonrebreather

Venturi mask

93
Q

Managing Chest Tubes steps:

A
  1. Assist
  2. Monitor
  3. Check
  4. Maintain
94
Q

Managing Chest Tubes steps: Assist

A

Assist with insertion and removal of the chest tube.

95
Q

Managing Chest Tubes steps: Monitor

A

Monitor the patient’s respiratory status and vital signs

96
Q

Managing Chest Tubes steps: Check

A

Check the dressing

97
Q

Managing Chest Tubes steps: Maintain

A

Maintain the patency and integrity of the drainage system.

98
Q

Precautions for Oxygen Administration

A
  1. Avoid open flames in the patient’s room
  2. Place no smoking signs in obvious areas
  3. Check to see that electrical equipment in the room is in good working order
  4. Avoid wearing and using synthetic fabrics (builds up static electricity)
  5. Avoid using oils in the area
99
Q

Type of Artificial Airways

A

Oropharyngeal and nasopharyngeal airway

Endotracheal tube

Tracheostomy tube

100
Q

Nursing Skills to Support Respiration

A

Tracheal suctioning

Assisting ventilation with mechanical ventilator

Clearing an obstructed airway

Administering cardiopulmonary resuscitation

NURS 402: Lecture (17 decks)

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