Pulmonary Rehab Flashcards
Explain the V/ Q mismatch using the terms “shunt and dead
V/Q mismatch: either the lung gets blood flow with not enough O2 or O2 with not enough blood
dead space: excess oxygen ( V)
shunt: excess blood flow ( P)
Which volume is the amount of air that we inhale and exhale during one respiratory cycle
Tidal volume
Which is the amount of air remaining in the lungs at the end of normal exhalation
functional residual capacity
This breathing aid helps prevent infection and reduce atelectasis
Incentive spirometer
measures volume of air inhaled after inspiration
Which capacity is the total amount of air exhaled after maximal inhalation?
vital capacity
Indicator of ability to breathe deeply and cough
Reflects Inspiratory and expiratory muscle strength
This lung volume is directly affected in emphysema and pneumothorax infection since there is air trapping and increased intra thoracic pressure
residual volume
apnea ( breathing pattern definitions)
Lack of airflow to the lungs for >15 seconds
Biot’s respirations
CONSTANT increased rate and depth of respiration followed by periods of apnea of varying lengths
Cheyne-Stokes respirations
Increasing DEPTH of ventilation followed by a period of apnea
Kussmaul respirations
Increased regular RATE and DEPTH of ventilation
Paradoxic ventilation
Inward abdominal or chest wall movement with inspiration and outward movement with expiration
MISMATCH OF HOW THE CHEST WALL MOVES AND BREATHS GOING IN AND OUT
Bradypnea
Ventilation rate <12 breaths per minute
Hyperpnea
Increased depth of ventilation
Hyperventilation
Increased rate and depth of ventilation resulting in decreased PCO2
Hypoventilation
Decreased rate and depth of ventilation resulting in increased PCO2
Hoover’s sign
The inward motion of the lower rib cage during inhalation
Sighing respirations
The presence of a sigh >2-3 times per minute
Orthopnea
Dyspnea that occurs in a flat supine position. Relief occurs with more upright sitting or standing
What does arterial blood gas measure
pH
ventilation ( CO2)
oxygenation ( O2)
What happens the oxyhemoglobin dissociation curve shifts to the right
pH increases
alkalosis or hypocapnia
What happens the oxyhemoglobin dissociation curve shifts to the right
pH decreases
acidosis or hypercapnia
arterial blood gases purpose
streamlines medical or therapeutic interventions
examples- mechanical ventilation and breathing assist techniques
PaO2(PO2) vs. SaO2(O2saturation)
PaO2 =Partial pressure of dissolved O2in plasma
SaO2 = % of hemoglobin paired with O2 molecules
Air trapping
gas stuck in the lungs –> obstructive lung disease
little miss emphysema
Consolidation
some type of thing replacing alveolar air
bronchospasm
smooth muscle in the bronchi constrict
asthma
air trapping leads to
hyperinflation
Hypoxemia
low O2 levels in BLOOD ( below 60 mmHg)
60 to 80 mmHg = normal
Hypoxia
low level of oxygen in TISSUES
Respiratory distress
comes before respiratory failure
dyspnea, respiratory muscle fatigue, abnormal respiratory pattern and rate, anxiety, and cyanosis related to INADEQUATE GAS EXCHANGE
Non-rebreather mask (10-15 lpm)
60 to 80%
face mask that is connected to a reservoir bag that is filled with a high concentration of oxygen
Partial Rebreather ( 6-10)pm)
60 to 80%
a two-way valve present between the reservoir bag and mask
High flow nasal cannula
up to 100% FiO2
highest FiO2
Salt nasal cannula
25%-44% FiO2
FIO2
Concentration of O2 that is being breathed
What are the 3 continous lung sounds
- wheeze
- stridor
- rhonchi
wheeze- cause and more common with what type of respiration
airway obstruction, more common on expiration
Stridor- cause and when does it show up
special consideration
high-pitched wheeze
both inhale and exhale
A MEDICAL EMERGENCY
Rhonchi- cause and what it sounds like
low-pitched from airway obstruction,
snoring sound
discontinous adventitous breath that is like bubbling, popping sounds from fluid/secretions or sudden opening of closed airway
crackles
origin of extrapulmonary ( EP) sound
dysfunction outside of the lung tissue.
what are the 3 ADVENTITIOUS BS voice sounds
- Whispered pectoriloquy
- Bronchophony
- Egophony
what is the most common EP sound
pleural friction rub
= loud grating sound and present in inspiration and expiration
Whispered pectoriloquy
pt. whispers 1 2 3 and + for either consolidation or hyperinflation
+ for consolidation = CLEARLY AUDIBLE in distal lung fields
+ for hyperinflation = LESS AUDIBLE in distal lung
Bronchophony
Patient repeats the phrase “ninety-nine.”
results = similar to whispered pectoriloquy.
Egophony
Patient repeats the letter e.
If the auscultation in the distal lung fields sound like a, then there’s probably fluid in the air spaces or lung parenchyma
adult respiratory distress syndrome
PT considerations
associated with a lot of issues and a high mortality rate
HAVE PT. IN PRONE ( improves V/Q matching)
Flail chest - what it is and prognosis
= 2+ rib fractureswith two or more breaks per rib
= high morbidity and mortality rate
Bronchial LUNG AUSCULTATION ETIOLOGY
Fluid or secretion consolidation (airlessness)
may occur w/ pneumonia
Decreased or diminished (less audible) LUNG AUSCULTATION ETIOLOGY
Hypoventilation, severe congestion, or emphysema
Absent LUNG AUSCULTATION ETIOLOGY
Pneumothorax or lung collapse
General pulmonary treatment ideas for PT
- Breathing retraining exercises
- Secretion clearance techniques
- Positioning
- Functional activities
Exercise - Patient education
Monitoring VS
