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NURS 112 - TEST 5 - UNITS F.5 & (I) > PP - GAS OXYGENATION > Flashcards

PP - GAS OXYGENATION Flashcards

1
Q

bronchodilation

A

(expansion of the airway in the lungs) and

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2
Q

The respiratory system is comprised of the nose, oropharynx, larynx, trachea, bronchi, bronchioles, and lungs.

A

the nose, oropharynx, larynx, trachea, bronchi, bronchioles, and lungs.

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3
Q

ØThe upper airway consists of

A

the nasopharynx or nose, oropharynx or mouth, and the larynx.

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4
Q

ØThe lower airway includes

A

the trachea, bronchi, bronchioles and alveoli of the lungs.

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5
Q

ØThe right lung is made up

A

of three lobes.

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6
Q

ØThe left lung is made up

A

of two lobes.

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7
Q

ØThe lungs are responsible for

A

bronchodilation (expansion of the airway in the lungs) and bronchoconstriction (restriction of the airway in the lungs).

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8
Q

bronchoconstriction

A

(restriction of the airway in the lungs).

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9
Q

ØThe lungs are also linked with the nervous system by both the

A

parasympathetic and sympathetic systems.

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10
Q

ØVentilation

A

is the flow of air inside or outside of the alveoli. / Oxygen is transported into the alveoli and carbon dioxide is taken out.

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11
Q

ØPerfusion

A

is the flow of blood by the cardiopulmonary system into the alveolar capillaries. / ØOxygenated blood is directed into the capillaries and deoxygenated blood is returned to the lungs.

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12
Q

ØOxygenated blood is directed into the ________ and deoxygenated blood is returned to ____

A

capillaries / the lungs.

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13
Q

•Ischemia

A

•Insufficient blood flow of oxygenated blood to the tissues that can result in injury or death

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14
Q

•Hypoxia

A

•Insufficient oxygen reaching the cells

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15
Q

•Anoxia

A

•Total lack of oxygen in body tissues

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16
Q

•Hypoxemia

A

•Reduced oxygenation of arterial blood

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17
Q

ØWhen a person inhales, the diaphragm and intercostal muscles

A

contract, creating a negative pressure inside the lungs, and the thorax increases in size for inhalation.

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18
Q

ØWhen a person exhales, the diaphragm

A

relaxes, the intercostal muscles contract, and exhalation occurs.

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19
Q

ØSurfactant

A

, a lubricant made in the lungs, keeps the alveoli from collapsing.

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20
Q

AGE RELATED DIFFERENCES •Babies born after 30 weeks gestation have

A

sufficient surfactant to prevent the alveoli from collapsing

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21
Q

AGE RELATED DIFFERENCES •Infants are

A

nose breathers until about 3 months

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22
Q

AGE RELATED DIFFERENCES •Respiratory patterns in newborns may be

A

irregular with brief pauses (usually not more than 10-15 seconds

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23
Q

AGE RELATED DIFFERENCES •Respiratory muscle strength decreases →

A

maximal inspiratory and expiratory force

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24
Q

AGE RELATED DIFFERENCES •Alveoli less elastic and more

A

fibrous → dyspnea

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25
AGE RELATED DIFFERENCES •Decrease in erythrocytes →
anemia → ↓ ability to transport oxygen
26
ØHypoxemia
is when there is a limited amount of oxygen in the blood.
27
ØRetraction
s are when the muscles are pulled inward and occur between the ribs when inspiration occurs. Intercostal retractions are a sign that the airway is blocked.
28
ØHypoxia
is a lack of oxygen at the cellular level.
29
ØLung compliance
is the point to which a lung can expand in response to increased pressure within the alveoli (intraalveolar).
30
ØAirway resistance
is the pressure that exists when the diameter of the airway is narrowed.
31
ØLung compliance and airway resistance increase * the work of breathing which
results in accessory muscle use.
32
an increase in the work of breathing leads to
Accessory muscles use is an indication of
33
Accessory muscles use is an indication of
respiratory distress.
34
deoxygenated blood enters thr heart through the
IVC / SVC inferior vena cava / superior vena cava
35
ØDeoxygenated blood leaves the right * and is routed to _______ into what valve
Atrium and is routed to the right ventricle through atrioventricular (tricuspid) valve.
36
Deoxygenated blood then flows from the right ventricle through which valve
pulmonary valve (a semilunar valve)
37
after the pulmonary valve, blood goes to the
to the pulmonary artery / trunk
38
once blood is in the pulmonary artery / trunk it goes Ø into the
R /L lungs. Carbon dioxide is eliminated.
39
ØThe alveoli are
the very small air sacs where the exchange of oxygen and carbon dioxide takes place.
40
CAPILLARIES are
blood vessels in the walls of the alveoli.
41
ØOxygenated blood then flows
into the pulmonary veins (4 - two from each lung)
42
The pulmonary veins empty into the
left atrium
43
after the left atrium blood flows through which valve
The mitral valve (/ˈmaɪtrəl/), also known as the bicuspid valve or left atrioventricular valve. The heart valves are all one-way valves allowing blood flow in just one direction.
44
the mitral valve allows blood to pass into the
left ventricle
45
from the left ventricle blood then passes through which valve
aortic valve (semilunar valve). It is also called aortic semilunar due to its semilunar shape. ensure that oxygen-rich blood does not flow back into the left ventricle.
46
blood flows from the left ventricle through the aortic valve to the
aorta / aortic arch
47
from the aorta- Systemic circulation carries
oxygenated blood to the capillaries in the tissues of the body.
48
Pulmonary circulation carries
Pulmonary circulation is the system of transportation that carries de-oxygenated blood from the heart to the lungs to be re-saturated with oxygen before being dispersed into the systemic circulation
49
Causes of Impaired Gas Exchange
Acute respiratory illness Airway obstructions (tumors, thick secretions, foreign body, swollen airways) Neurologic conditions that effect the brain and spinal cord Cardiovascular conditions that affect blood flow Hematologic conditions especially anemia Lung problems (atelectasis, hypoventilation, chronic lung disease) High altitudes
50
•Pleural effusion
•Fluid in the chest cavity
51
•Pneumothorax
•Air leaking into the pleural cavity
52
•Tension pneumothorax
•Air is trapped in pleural cavity collapsing the lungs
53
•Crepitus
Air in the subcutaneous tissues
54
•Hypoxia
•Decrease oxygen to the tissues
55
•Hypoxemia
•Decrease oxygen in the blood
56
•Atelectasis
•Collapsed lung or partial collapse of the lung
57
•Cyanosis
•Bluish color of lips or skin related to decreased oxygen levels in the tissues
58
Normal Breath Sounds
bronchial, bronchovesicular, vesicular
59
Breath sounds are normal when they are heard where
they are supposed to be heard
60
•Bronchial normal if
heard over the sternum
61
which breath sound is •Loudest on inspiration
bronchial
62
•Bronchovesicular heard when the stethoscope is .
s partly on the sternum and partly on the chest wall
63
•If bronchovesicular sounds are heard in the periphery of the lung can be indicative of
consolidation beginning (pneumonia or atelectasis)
64
•Vesicular
•Soft blowing sounds best heard on inspiration
65
vesicular is always a normal sound as
it is not heard anywhere else
66
•Crackles
•Associated with inflammation, infection, or fluid of the small bronchi, bronchioles, and alveoli.
67
Crackles best heard on •Best heard on
inspiration.
68
Can be fine (like
rubbing hair between your fingers), medium or course (like pulling Velcro apart)
69
•Rhonchi
•Louder sounds heard best on expiration
70
•Rhonchi•Denotes
obstruction to outflow of air in the large bronchi, usually thick secretions
71
Rhonchi •Can be cleared with
coughing
72
•Wheezes
•May be heard on inspiration and expiration
73
Wheezing •Means
consolidation in the airways or caused by air moving through airways narrowed by constriction or swelling of airway or partial airway obstruction
74
•Friction rub
•Low-pitched, grating, or creaking sounds that occur when inflamed pleural surfaces rub together during respiration
75
•Pleural friction rub is easy to confuse with a
pericardial friction rub.
76
To determine whether the sound is a pleural friction rub or a pericardial friction rub, ask the patient to
hold his breath briefly. If the rubbing sound continues, its a pericardial friction rub
77
Pericardial friction rub because
because the inflamed pericardial layers continue rubbing together with each heart beat - a pleural rub stops when breathing stops.
78
a pleural rub stops when
breathing stops.
79
Changes in Vital Signs
increased respiratory rate / decreases oxygen stauation / increased heart rate / increased temperature
80
•Increased respiratory rate
•Increased work of breathing
81
•Decreased SaO2 (oxygen saturation)
•Not enough oxygen transported on the hemoglobin
82
•Increased heart rate
•Anxiety due to SOB •Need for more perfusion of oxygen
83
•Increased temperature
•Usually relates to infection such as pneumonia or respiratory syncytial virus (RSV) - LOOK IT UP
84
•Usually relates to infection such as
pneumonia or respiratory syncytial virus (RSV)
85
Abnormal Inspection
Position to ease work of breathing (sitting leaning forward) Anxious Impaired mental status Use of accessory muscles Pursed lip breathing Paleness of skin and lips Cyanosis clubbing of the nails Barrel chest Asymmetric thorax Scoliosis Trachea deviation
86
Abnormal Inspection - infants / toddlers
Infants/toddlers Flaring of the nares Chest wall retractions Grunting with inspiration Cyanosis when sucking Need to stop feeding to breathe
87
Diagnostic Tests
Labs Pulmonary Function Studies Bronchoscopy Peak Flow ABG Radiographic Studies
88
Diagnostic Labs
Arterial Blood Gas (ABG) CBC Sputum examination Skin tests
89
Radiographic Studies
CXR Computed tomography (CT) Ventilation-perfusion scans Positron Emission Tomography (PET)
90
Clinical management - Primary
Infection Control Smoking Cessation Immunizations Preventing post-op pulmonary complications
91
Clinical management - Secondary
Screening for risk factors Early diagnosis Prompt treatment of existing health problems
92
Clinical management - Collaberative Intervention
Smoking cessation Pharmacologic therapy Airway management and support Chest physiotherapy and postural drainage Nutrition Therapy Positioning
93
Clinical management - Invasive Procedures
Chest tube Thoracentesis Bronchoscopy
94
Clinical management - Collaberative Intervention - Pharmacology Therapy
Drugs that affect upper airway Lower airway bronchodilators Mucolytic and expectorants Cough suppressants Antimicrobials Aids for smoking cessation
95
Clinnical Management - Collaberative Interventions - Positioning
High Fowlers or semi-fowlers Tripod positioning or leaning forward over a table to sleep Lying horizontally (hypoxic with acute lung disease)
96
High Fowlers or semi-fowlers
Uses gravity to move the diaphragm away from the lungs
97
Lying horizontally (hypoxic with acute lung disease)
•Ventilation and profusion are effected by gravity.
98
Clinical Management - Other Interventions
Alternate activity with periods of rest Increase air circulation, especially in the COPD patient. Offer to listen how they are coping with impaired gas exchange and how it has changed their lives. Call case management if there is a need for additional resources.
99
Conditions That Increase the Need for More Oxygen
Activity Fever Pain Asthma Pneumonia Sleep disorders Bronchitis Bronchitis COPD Severe Allergies Anemia Heart Failure Neurological disorders like stroke
100
Nursing Interventions for Patients with Impaired Oxygenation
Turn, cough, and deep breathe Incentive spirometry Nebulizer treatments Chest physical therapy Supplemental oxygen

NURS 112 - TEST 5 - UNITS F.5 & (I) (9 decks)

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