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Nursing IV > Repiratory Assessment (Gas#1) > Flashcards

Repiratory Assessment (Gas#1) Flashcards

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1
Q

Definition of Hypoxemia and what can it lead to?

A

low partial pressure of oxygen in the BLOOD; it can lead to hypoxia

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2
Q

Hypoxia

A

shortage of oxygen in TISSUES

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3
Q

What 2 things can cause hypoxemia?

A

inadequate ventilation (ex. trauma) & decreased perfusion (ex. decreased cardiac output, pulmonary embolism)

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4
Q

What can cause hypoxia?

A

Atelectasis, Anemia (no O2 carrying capacity), decreased cardiac output & toxic substances

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5
Q

S/s of Acute Hypoxemia

A

Increased HR, Increased RR, Anxiety/Restlessness

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6
Q

Example of Acute Hypoxemia

A

pneumothorax

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7
Q

S/s of Chronic Hypoxia

A

Fatigue, decreased level of consciousness, cyanosis, clubbing of finger & toes

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8
Q

Example of Chronic Hypoxia

A

COPD

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9
Q

Ventilation

A

movement of air in and out of the lungs and the exchange of gases

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10
Q

3 things that affect Ventilation

A

1.) Resistance 2.) Compliance 3.) Diffusion

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11
Q

Resistance affects what and what is it?

A

It effects ventilation it is determine by airway size. The narrower the airway, the greater the resistance

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12
Q

Compliance affects what and what is it?

A

It effects ventilation and determines how easily the lung can stretch. Increased compliance= decreased elasticity; decreased capacity= lungs/thorax are stiff

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13
Q

Diffusion affects what and what is it?

A

It affects ventilation and is the movement of gas from an area of greater concentration to lesser concentration.

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14
Q

example of problems that cause a decreased compliance

A

pneumothorax, hemothorax, pleural effuision. pulmonary edema, ARDS, atelectasis

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15
Q

Ventilation perfusion ratio

A

the ratio of the amount of AIR reaching the alveoli to the amount of BLOOD reaching the alveoli

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16
Q

Shunt

A

Ventilation is impaired but perfusion is adequate. The % amount of blood passing through the lung not oxygenated

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17
Q

Shunting& dead space leads to ?

A

hypoxemia

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18
Q

Severe hypoxemia = what shunt percentage?

A

> 20% and requires mechanical ventilation or PEEP

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19
Q

Dead Space

A

Ventilated but perfusion is decreased

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20
Q

When are ventilation and perfusion both absent?

A

Atelectasis

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21
Q

Pneumothorax

A

A collection of air or gas in the pleural cavity. Gas enters following a perforation though the chest wall, e.g. chest trauma

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22
Q

Atelectasis

A

A collapsed or airless condition of the lung

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23
Q

Consolidation

A

Alveolar space contains the fluid instead of air; you cant stick needle in & extract fluid because you’ll collapse the lung. you can suck it out through a broncioscope

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24
Q

Pleural effusion

A

Fluid accumulates between the pleura and the chest wall. This impairs breathing, limiting the expansion of the lungs.

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25
Q

Fluids that accumulate in the pleural space

A

Serous fluid, blood, pus-empyema

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26
Q

Fluids that can accumulate in the alveolar space

A

Edema, Exudate, Pus, Inhaled water, blood

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27
Q

Pleural effusions can be caused by

A

kidney disease, HF, cirrhosis, peritoneal dialysis, pneumonia, cancer TB

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28
Q

If you have a pleural effusion because of HF what treatment would you receive?

A

Diuretics

29
Q

If you have a malignant effusion what treatment would you receive?

A

chemo or radiation or a sclerosing agent (induces scarring)

30
Q

1 pack a day for a year means/ 40 pack years means/ 5 pack years

A

1 pack year/ 1 pack a day for 40 years/1/2 pack for 5 years

31
Q

Funnel Chest

A

Sternum is closer to spinal column

32
Q

How do you figure out if patient has a barrel chest?

A

look at arm in comparison to back. Barrel=more than 2 inches

33
Q

Pigeon chest

A

sternum is far from spinal cord

34
Q

Tactile Fremitus

A

sounds generated by the larynx which can be felt as a vibration on chest wall

35
Q

Subcutaneous emphysema

A

air in subcutaneous tissue. It appears with chest trauma, chest tubes

36
Q

Diaphraagmatic excursion

A

the movement of the diaphram from its level during full exhalation to its level during full inhalation

37
Q

Wheezes

A

high pitched sound. Bronchitis=wheezes on inspiration

38
Q

Course wheezes

A

low pitched b/c there is a partial airway obstruction due to secretions

39
Q

Stridor

A

high pitched sounds. ex. croup

40
Q

Crackles/Rales

A

pooping sound heard on inspiration ex. fluid overload

41
Q

Pleural friction rub

A

dry, rubbing, grating

42
Q

Frothy pink sputum will be present in

A

pulmonary edem

43
Q

Mucopurulent (mucus and pus) & blood streaked sputum will be present in

A

pneumonia, chronic bronchitis, bronchietias

44
Q

Blood streaked sputum will be present in

A

Trauma by suctioning

45
Q

Blood streaked sputum with clots will be present in

A

pulmonary embolism

46
Q

Grossly bloody sputum will be present in

A

TB, cancer, chest trauma

47
Q

when should a Sputum collection be done and how much of a specimen do you need?

A

Morning, obtain about 15 ml. You can use postural drainage or sputum from suctioning or expectoration

48
Q

What should you tell your patient to do prior to sputum collection?

A

Rinse mouth with water, take several deep breaths and cough deeply to obtain sputum

49
Q

What id Dr looking for with a chest xray?

A

to see if lungs are fully inflated

50
Q

postural drainage

A

used to loosen mucus in the airway so that it can be coughed out

51
Q

MRI vs CT scan

A

MRI doesnt involve radiation. MRI=brain/skeletin; CT=chest

52
Q

Perfusion can

A

radioactive substance is injected into a vein in the arm

53
Q

ventilation scan

A

a radioactive tracer gas is inhaled into the lungs. Too much air retained in lungs=bright/”hot” spots. Not retaining enough inflation=dark/”cold” spots

54
Q

Tidal volume

A

amount of air moved in & out with normal breath sounds. Normal=500ml

55
Q

Inspiratory Reverse Volume (IRV)

A

amount of air forcibly inhaled over the tidal volume. Normal 2-3 liters. (“breath in until you cant breath in anymore) Old people have less than normal of this

56
Q

Expiratory Reserve Volume (ERV)

A

amount of air that can be forced out over the tidal volume. Normal 1 liter. (“breath out until you cant breath out anymore”) Old people have less than normal of this

57
Q

Residual Volume (RV)

A

amount of air that remains in the lungs after a forced Expiratory Reserve Volume (ERV). This is what keeps the alveoli open. Old people have double the amount of this

58
Q

Vital Capacity

A

Tidal Volume + Inspiratory Reverse Volume + Expiratory Reserve Volume

59
Q

Forced Expiratory Volume in 1 second (FEV1)

A

an important predictor of operative risk. COPD=decreased FEV1

60
Q

Bronchoscopy procedure

A

NPO, meds to decrease anxiety, spray throat to decrease gag reflex, nothing to drink until gag reflex comes back after procedure, they are awake the whole time

61
Q

Sweat test

A

to test for cystic fibrosis. electrical currents causes sweat production, paper collects sweat chloride >60=cystic fibrosis, if >60 then do pancreatic function

62
Q

Thoracentesis

A

can be used to aspirate fluid.

63
Q

Primary responsibility after a thoracentesis

A

listen to lung sounds

64
Q

pH, CO2, HCO3 levels

A

7.35-7.45, 35-45, 22-26

65
Q

In old people, does mucus production increase or decrease?

A

decreases which causes cilia to be less effective and causes them to be more susceptible to respiratory infections

66
Q

does the elasticity of the lungs increase or decrease in old people?

A

decreases and stiffens which makes breathing harder

67
Q

What happens to the diaphragm and intercostal muscles in old people?

A

it loses elasticity which limits chest expansion

68
Q

Surfactant

A

matures lung

Nursing IV (20 decks)

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