Oxygenation and Perfusion Flashcards
1
Q
developmental considerations in infants
A
- chess is small, airways are short, and aspiration is a potential problem
- surfactant is an issue
- heart rate & respiration are high and BP is low
- breathing is loud
- breathes from abdomen
2
Q
developmental considerations in child and adolescents
A
- respiratory infections are more common
- immune system is building up
- blood vessels are growing/widening
- BP is increasing, heart rate & respiration is decreasing
- breathing moves from abdominal to thoracic
3
Q
developmental considerations in adults
A
- breathing is now thoracic
- tissues, airways, and alveoli become less elastic
- airways collapse more easily
- respiratory and abdominal muscles is reduced
- decrease stretch of chest resulting in decline in maximum inspiration and expiration
- increase risk for chronic disease, especially pneumonia and other chest infections
- decreased physical activity & elasticity of the heart, and stiffening of the heart valves can lead to a decrease in function of the heart
4
Q
causes of decreased gas exchange and increased work of breathing
A
- decreased elastic recoil of the lungs
- expiration requiring use of accessory muscles
- decreased skeletal muscle strength in thorax
- fewer functional capillaries and more fibrous tissue in alveoli
- reduction in vital capacity and increase in residual volume
5
Q
nursing strategies to address decreased gas exchange and increased work of breathing
A
- encourage rest periods as necessary
- encourage to stop or decrease smoking and second-hand smoking exposure
- teach breathing exercises
- remind about avoiding air pollutants
- caution about effect of extreme weather
- avoid opioids and sleeping pills
- discuss home management with patient and family
- teach ways to avoid infection and preventive measures
- use pillows as necessary for sleep
6
Q
causes of decreased ventilation and ineffective cough
A
- less air exchange; more secretions remain in lungs
- drier mucous membranes
- altered pain sensation
- different norms for body temperature; fever may be atypical
- greater risk for aspiration due to slower gastric motility
- impaired mobility and inactivity, effects of medication
7
Q
nursing strategies to address ventilation and ineffective cough
A
- encourage increased fluid intake, especially water
- use cool mist humidifier
- encourage attendance at pulmonary exercise rehabilitation program
- discourage use of over the counter drugs
- teach how to splint thorax and cough effectively
- instruct in use of supplemental oxygen
- teach avoidance of milk products if troublesome
8
Q
causes of decreased CO and ability to respond to stress
A
- reduction in elasticity of the heart’s tissues
- heart muscle becomes less efficient- works harder to pump the same amount of blood through the body
- progressive atherosclerosis in arterial walls and loss of elasticity
- capillary walls thicken slightly, leading to slower rate of exchange of gases, nutrients, and waste
9
Q
nursing strategies to address decreased CO and ability to respond to stress
A
- encourage physical activity in daily activities
- encourage healthy low-fat, low-salt diet, including plenty of fruits, vegetables, and whole grains
- assist with smoking cessation and/or avoid the use of tobacco
- teach importance of regular check up
- assist with weight control
- teach the importance of medication compliance
- teach stress-reduction activities
10
Q
assessment of medication
A
- narcotics, sedatives (oxycodone, valium)- can cause respiratory depression
- cardiac meds (antihypertensive, diuretics)- may effect pulse rate, blood pressure, and cardiac output
11
Q
assessment of lifestyle
A
- smoking, vaping, drug use,
- sedentary lifestyle
- obesity
- high fat/high sugar/high sodium diets
- cultural health practices
12
Q
assessment of enviornment
A
- poverty
- isolation
- pollution
- work exposure
- ability to safely exercise
- ability to control dust/pollen exposure
13
Q
assessment of psychosocial
A
- social support
- anxiety
- stress levels
