- rapid, deep breathing - Metabolic acidosis - DKA (diabetic Ketocidosis)

Pulmonary Flashcards by Yuko Porter

The respiratory center in the a______ transmits impulses to the b________

a) brain stem
b) respiratory muscles

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In the brain stem, the pons & medulla control what?

Rate, Depth, Rhythm

The medulla
Sends signals to the muscles involved in breathing

The pons
Controls of breathing

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What is the Chemoreceptors?

Sensors that detect changes in CO2, O2, and pH

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What is ventilation?

Getting air into and out of the lungs

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Type 1 alveoli cells

95 percent of the alveolar surface, structure

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Type 2 alveoli cells

smaller, responsible for producing the surfactants

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To inhale the air O2 comes to the alveoli
Gas moves to simple diffusion a__________

*O2 is high** in b________
So O2 gas moves to c_______

a) high to low
b) alveoli
c) capillary

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CO2 is high in the a_________
-So CO2 moves to b________

a) capillary
b) alveoli

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Inhale O2 makes?

Simple gas diffusion occurs doing what?

intrapulmonary volume increase
= intrapulmonary pressure decreases

Gas move from high to low, so O2 comes into the lung

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Exhalation
Gas is out and diaphragms relax mean?

Simple gas diffusion occurs doing what?

= intrapulmonary volume decrease
= intrapulmonary pressure increases

Gas move from high to low, so CO2 goes out from the lung

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Compliance

The ability of?

Inhale or exhale?

Restrictive or obstructive?

lungs to expand

inhale

Restrictive

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Elastic recoil

The ability of?

inhale or exhale?

Restrictive or obstructive?

lungs to contract

Exhalation

Obstructive

(return to normal shape)

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Cohesive forces

a pleural fluid that fills the pleural space

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Intra-pleural fluid creates?

allowing the a______ to slide within the b_____ against the c________

a slippery surface

a) lungs
b) chest
c) thoracic wall

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Pulmonary Embolism (PE) risk factors

Smoking
Immobility (long flight, hospitalized, bed rest)
Obesity
Hypertension
Pregnancy

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PE leads?

Increase pulmonary a_____ pressure

Increase right b______pressure

Right-side heart failure
causes?

a)vascular
backflow to the right side of the heart

b) ventricular
- dilation of the ventricle

Decrease SV, CO, BP

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Restrictive

The issue with compliance or elastic recoil?

What is the lab value?

compliance

Air IN problem
Hard to INHALE

Low O2-hypoxia
Low O2 to the tissue

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Restrictive Disease examples

ARDS
Atelectasis
Kyphosis (round back)
Funnel chest (sunken breastbone)
Pleural effusion
Pneumothorax

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Obstructive

The issue with compliance or elastic recoil?

What is the lab value?

Elastic recoil
Air OUT problem
Hard to EXHALE

High CO2-hypercapnia

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Obstructive Disease example

Asthma
COPD

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Pneumothorax

Pulmonary cavity
(between parietal and visceral)
-little fluid
-Should not be any air in it
-Should be negative pressure

When air leaks,
intrapulmonary pressure (pulmonary cavity) turns positive

Now, the pulmonary cavity pushes to the lung
= lung collapses

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The O2-carrying capacity of whole blood is

The sum of the

dissolved O2 in the blood
amount bound to hemoglobin under saturating conditions

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Eupnea?

normal breathing

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Kussmaul?

rapid, deep breathing
Metabolic acidosis
DKA (diabetic Ketocidosis)

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Cheyne-Stokes?

-Breathing that starts out deep and becomes shallow with periods of apneas(stop)

Ischemia

Reduced blood flow some part of the body, heart or brain, isn't getting enough blood

Hypoxia

An absence of enough oxygen in the tissues

Hypoventilation

breathing that is too shallow or too slow to meet the needs of the body

Which of the following is TRUE regarding Acute respiratory distress syndrome (ARDS)?

It can cause severe pulmonary edema

Which is the most common cause of pulmonary edema?

Heart disease

COPD can be described as what kind of lung disease?

Inflammatory and Destructive

True or False: Is COPD preventable, not reversible, progressive and treatable but not curable

True

two types of emphysema ?

Primary and secondary

hat this indicate? pH 7.32 (7.35-7.45) PaO2 61 mm Hg (80-100) PaCO2 58 mmHg (35-45) HCO3 33 mEq/L(22 to 26) SaO2 86% (≥ 95%)

Hypoxia, Respiratory acidosis, attempted metabolic compensation

Primary emphysema causes?

Alpha 1 antitrypsin deficiency Genetic PPL who don't smoke Young people

Secondary emphysema

People who are smokers The most preventable respiratory illnesses because it is so strongly linked to smoking.

What is Cystic Fibrosis?

mutation in CFTR gene dysfunction absence of protein

Is cystic fibrosis inherited from one parent or both?

To be born with cystic fibrosis, a child has to inherit a copy of the faulty gene from **both of their parents**

Hypoventilation?

Breathing that is too shallow or too slow to meet the needs of the body Hypercapnia (increased pCO2) =Resp Acidosis

How do you position a patient with a flail chest?

The injured side of the chest should be positioned down

Flail chest?

Two or more contiguous rib fractures

atelectasis?

Complete or partial collapse of a lung

Pneumothorax

A collapsed lung Air leaks into the space between the lungs and chest wall

Hyperventilation?

Rapid or deep breathing, usually caused by anxiety or panic “Blow off” too much CO2 Hypocapnia (decreased pCO2)=Resp Alkalosis

Ischemia?

Reduced blood flow

Hypoxemia?

A low level of oxygen in the blood Decreased O2 in the Arterial Blood leading to a decrease in partial pressure (PaO2)

Hypoxia?

Decreased O2 in Cells of the TISSUES

Hypoxia effect organ to the brain?

The brain is of special interest for hypoxia | (Brain cannot store oxygen but has high demand)

Hypoxia effect the organ to the cell?

Cells go from aerobic to anaerobic metabolism Lactic Acid Leads rapidly to metabolic acidosis Cellular death can result from extreme or prolonged hypoxia

Hypoxia s/s?

#1 sign for Brain Hypoxia-—Change in LOC Atelectasis Cor Pulmonale

Pulmonary hypertension?

A type of high blood pressure that affects arteries in the lungs and in the heart

Cor pulmonale?

A condition that causes the right side of the heart to fail

Pulmonary Edema causes? ## Footnote **Increased left atrial pressure**

Increased left atrial pressure -backflow, too many RBCs -Increase pulmonary capillary hydrostatic pressure (too much fluid leaks out)

Pulmonary Edema causes? **Injury to capillary**

Injury to capillary - Increase capillary permeability - Leaks more fluid into interstitial space

Pulmonary Edema causes? Blockage of lymphatic vessels

-Inability to remove excess fluid -Accumulation of fluid in interstitial space Symptoms Dyspnea Extreme shortness of breath Cough Wheezing(base)

A patient who has required prolonged mechanical ventilation has the following arterial blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L. The nurse interprets these results as? a. metabolic acidosis. b. metabolic alkalosis. c. respiratory acidosis. d. respiratory alkalosis.

Which laboratory value should the nurse examine when evaluating uncompensated respiratory alkalosis? a) PaO2 b) Anion gap c) PaCO2 d) HCO3-

The nurse is caring for a diabetic patient in renal failure. Which laboratory findings would the nurse expect? a) pH 7.3, PaCO2 36 mm Hg, HCO3- 19 mEq/L b) pH 7.5, PaCO2 35 mm Hg, HCO3- 35 mEq/L c) pH 7.3, PaCO2 47 mm Hg, HCO3- 23 mEq/L d) pH 7.35, PaCO2 40 mm Hg, HCO3- 25 mEq/L

ANS: A Patients in renal failure develop metabolic acidosis.

A patient who is comatose is admitted to the hospital with an unknown history. Respirations are deep and rapid. Arterial blood gas levels on admission are pH, 7.20; PaCO2, 21 mm Hg; PaO2, 92 mm Hg; and HCO3-, 8. You interpret these laboratory values to indicate:

A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Which of the following would be a potential cause for respiratory acidosis? a. Diarrhea b. Vomiting c. Hyperventilation d. Hypo-ventilation

d. Hypo-ventilation

A pt's blood gases show a pH greater of 7.53 & bicarbonate level of 36 mEq/L. The nurse realizes that the acid-base disorder this pt is demonstrating is which of the following? a) respiratory acidosis b) metabolic acidosis c) respiratory alkalosis d) metabolic alkalosis

d) metabolic alkalosis

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Pulmonary Flashcards

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