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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
What allows air into lungs?
Increased lung volume and decreased intrapulmonic pressure allow air to move from an area of greater pressure (outside lungs) to lesser pressure (inside lungs).
26
What results in expiration?
Relaxation of sternum, external intercostal muscles and diaphragm
27
Gas exchange (respiration) refers to what?
Refers to the intake of oxygen and release of carbon dioxide
28
What is gas exchange made possible by:
Made possible by respiration and perfusion
29
How does gas exchange occur?
Occurs via diffusion (movement of oxygen and carbon dioxide between the air and blood)
30
Factors Influencing Diffusion of Gases in the Lungs
Change in surface area available Thickening of alveolar–capillary membrane Partial pressure Solubility and molecular weight of the gas
31
How is oxygen carried in the body?
Oxygen is carried in the body via plasma and red blood cells.
32
How is most oxygen carried? What percent?
Most oxygen (97%) is carried by red blood cells in the form of oxyhemoglobin.
33
Carboxyhemoglobin
Hemoglobin also carries carbon dioxide in the form of carboxyhemoglobin.
34
What must occur between circulating blood and tissue cells?
Internal respiration between the circulating blood and tissue cells must occur.
35
Alterations in Respiratory Function
Hypoxia Dyspnea Hypoventilation
36
Hypoxia
inadequate amount of oxygen available to the cells
37
Dyspnea
Difficulty breathing
38
Hypoventilation
decreased rate or depth of air movement into the lungs
39
What is the main organ of circulation?
heart
40
What structures make up the heart
The heart is the main organ of circulation, composed of two upper atria and two lower ventricles
41
What two things does hemoglobin carry?
Oxygen is carried predominantly via red blood cells due to binding between the hemoglobin in RBCs and oxygen Hemoglobin also carries carbon dioxide
42
What controls contraction of the heart?
Electrical impulses control contraction of the heart muscles
43
What are the electrical impulses that control contraction of the heart muscles called?
Sinoatrial (SA) node, atrioventricular (AV) node, atrioventricular bundle
44
Alterations in the Cardiovascular System
Dysrhythmia or arrhythmia Myocardial ischemia Angina Myocardial infarction Heart failure
45
Factors Affecting Cardiopulmonary Functioning and Oxygenation
Level of health Developmental considerations Medication considerations Lifestyle considerations Environmental considerations Psychological health considerations
46
Respiratory Activity in the Infant: How are lungs transformed for infants?
Lungs are transformed from fluid-filled structures to air-filled organs.
47
How are infants chest, airways? What does this raise a problem for?
The infant's chest is small Airways are short Aspiration is a potential problem
48
How are the respiratory rate and activity of infants?
Respiratory rate is rapid and respiratory activity is primarily abdominal.
49
What is given to infants to open alveoli
Synthetic surfactant can be given to the infant to reopen alveoli.
50
What is normal to be heard in infants upon auscultation?
Crackles heard at the end of deep respiration are normal.
51
What age do kids get all their alveoli?
7 years old
52
Respiratory Activity in the Child: What makes landmarks less prominent?
Some subcutaneous fat is deposited on the chest wall, making landmarks less prominent.
53
How are the airways of children?
Eustachian tubes, bronchi, and bronchioles are elongated and less angular.
54
What are the number of routine colds in children?
The average number of routine colds and infections decreases until children enter daycare or school.
55
By the end of late childhood, how is a child's immune system?
By the end of late childhood, the immune system protects from most infections.
56
Respiratory Functioning in the Older Adult: How are the landmarks?
Bony landmarks are more prominent due to loss of subcutaneous fat.
57
What in older adults leads to the appearance of leaning forward?
Kyphosis contributes to appearance of leaning forward.
58
Barrel chest deformity results in what?
Barrel chest deformity may result in increased anteroposterior diameter.
59
How are the airways in older adults?
Tissues and airways become more rigid; diaphragm moves less efficiently.
60
How are older adults risk of disease?
Older adults have an increased risk for disease, especially pneumonia.
61
Nursing History
Usual patterns of respiration Medications Health history Recent changes Lifestyle and environment Cough or sputum Pain or dyspnea Fever or fatigue
62
Physical Assessment of the Respiratory System: What is the order of operations?
1. Inspect 2. Palpate 3. Percuss 4. Auscultate
63
Physical Assessment of the Respiratory System: Inspect
Inspect for general appearance, color (cyanosis, pallor), structural abnormalities of the chest, respiratory rate, rhythm and depth
64
Physical Assessment of the Respiratory System: Palpate
Palpate for temperature, chest expansion, tenderness, masses, pulsations
65
Physical Assessment of the Respiratory System: Percuss
Percuss to assess the position of the lungs, density of lung tissue
66
Physical Assessment of the Respiratory System: Auscultate
Auscultate breath sounds
67
Normal Breath Sounds
Vesicular Bronchial Bronchovesicular
68
Normal Breath Sounds: Vesicular
low-pitched, soft sound during expiration heard over most of the lungs
69
Normal Breath Sounds: Bronchial
high-pitched and longer, heard primarily over the trachea
70
Normal Breath Sounds: Bronchovesicular
medium pitch and sound during expiration, heard over the upper anterior chest and intercostal area
71
Abnormal (Adventitious) Breath Sounds
Crackles Wheezes
72
Crackles
Intermittent sounds occurring when air moves through airways that contain fluid
73
How are crackles classified as?
Fine Medium Coarse
74
Wheezes:
continuous sounds heard on expiration and sometimes on inspiration as air passes through airways constricted by swelling, secretions, or tumors
75
How are wheezing classified as?
Sibilant Sonorous
76
Common Diagnostic Methods to Assess Cardiopulmonary Function:
Electrocardiography Pulmonary function studies Capnography Thoracentesis Lab Studies:
77
Common Diagnostic Methods to Assess Cardiopulmonary Function: Pulmonary Function studies include:
1. Spirometry 2. Peak expiratory flow rate 3. Pulse oximetry
78
Common Diagnostic Methods to Assess Cardiopulmonary Function: Lab studies include
arterial blood gas, cardiac biomarkers, CBC, cytologic studies
79
Values Measured from Pulmonary Function Tests
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
Promoting Optimal Function:
Healthy lifestyle choices and behaviors Vaccinations
81
Important vaccinations for respiratory health?
Influenza Pneumococcal disease COVID-19
82
Promoting Optimal Function
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
How to promote proper breathing?
Deep breathing Using incentive spirometry Pursed-lip breathing Diaphragmatic breathing
84
Medications
For cough Bronchodilators Mucolytic agents Corticosteroids Antihistamines Leukotriene receptor antagonists
85
Medications for cough:
Suppressants Expectorants Lozenges
86
Administering Inhaled Medications: What is used?
Bronchodilators Nebulizers MDI DPI
87
Bronchodilator
Bronchodilators: open narrowed airways
88
Nebulizers:
disperse fine particles of liquid medication into the deeper passages of the respiratory tract
89
Meter-dose inhalers:
deliver a controlled dose of medication with each compression of the canister
90
Dry powder inhalers:
breath-activated delivery of medications
91
Providing Supplemental Oxygen involves:
Source of oxygen Flow rate Humidification Delivery Systems
92
Delivery Systems for supplemental oxygen
Nasal cannula (high or low flow) Simple mask Nonrebreather Venturi mask
93
Managing Chest Tubes steps:
1. Assist 2. Monitor 3. Check 4. Maintain
94
Managing Chest Tubes steps: Assist
Assist with insertion and removal of the chest tube.
95
Managing Chest Tubes steps: Monitor
Monitor the patient's respiratory status and vital signs
96
Managing Chest Tubes steps: Check
Check the dressing
97
Managing Chest Tubes steps: Maintain
Maintain the patency and integrity of the drainage system.
98
Precautions for Oxygen Administration
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
Type of Artificial Airways
Oropharyngeal and nasopharyngeal airway Endotracheal tube Tracheostomy tube
100
Nursing Skills to Support Respiration
Tracheal suctioning Assisting ventilation with mechanical ventilator Clearing an obstructed airway Administering cardiopulmonary resuscitation

NURS 402: Lecture (17 decks)

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