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N110 Exam #3 > Respiration > Flashcards

Respiration Flashcards

1
Q

Trachea

A

*Airway
• Carries air through the neck and upper chest
• Divides the left and right main bronchi

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2
Q

Alveoli

A

Type 1: gas exchange

Type 2: produce surfactant to reduce surface tension to allow inflation

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3
Q

Pleura

A

• Reduces friction during respirations via serous secretions

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4
Q

Diaphragm

A
  • Promotes inhalation by contracting downward letting lungs expand
  • Promotes expiration by relaxing upwards compressing lungs
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5
Q

Pulmonary Ventilation: Inhalation

A

• Expansion of chest cavity and lungs creates negative pressure in lungs which draws air in

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6
Q

Pulmonary Ventilation: Exhalation

A
  • Diaphragm and intercostals relax–> chest and lungs return to normal size–> pressure rises past atmospheric–> forces air out
  • Requires no energy or effort
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7
Q

Respiration/Diffusion

A
  • Movement of CO2 and oxygen between air in alveoli and blood in capillaries
  • CO2= flows blood to lungs
  • Oxygen= flows lungs to blood
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8
Q

Transport/Perfusion

A
  • Oxygenated blood passing through body tissues

* CO2 returning to lungs from blood

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9
Q

Where is Breathing Controlled?

A

RESPIRATORY CENTERS in brainstem that use feed back from:
• Chemoreceptors
• Lung receptors

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10
Q

Chemoreceptors

A

• Detect changes in blood pH, O2, and CO2
• Respiratory centers increase/decrease ventilation in response
*Blood CO2 levels= PRIMARY STIMULUS for breathing
*Low blood CO2= secondary stimulus

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11
Q

Lung Receptors

A

• Sensitive to breathing patterns, lung expansion/compliance, airway resistance, respiratory irritants

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12
Q

Factors Affecting Pulmonary Function: Developmental: Adults

A
  • Smoking
  • Lack of exercise
  • Decreased: lung expansion, alveolar inflation, ventilation, immune response, cough, chemoreceptor response
  • Gastroesophageal reflux disease
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13
Q

Factors Affecting Pulmonary Function: Environmental

A
  • Stress: catecholamines (↑ blood clots, ↓ inflammatory/immune response)
  • Allergic Reactions: Hay Fever (histamine; nasal congestion/swelling); Asthma (anaphylaxis; bronchoconstriction, edema, spasms)
  • Air Quality: Air pollution
  • Altitude: High altitudes= hypoxemia/hypoxia; ↑ ventilation, RBC, hemoglobin, lung vol/pulmonary vasculature, vascularity of body tissues
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14
Q

Factors Affecting Pulmonary Function: Lifestyle

A
  • Pregnancy: ↑ oxygen/respiratory rate
  • Occupational: airway irritants, cancer
  • Nutrition: poor= ↓ ventilatory muscle strength
  • Obesity: respiratory Infections (poor ventilation/secretions not removed); Apnea (fat leads to obstructive sleep apnea)
  • Substance abuse: respiratory depressants (opioids, sedatives, anti-anxiety), alcohol, illicit drugs
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15
Q

Factors Affecting Pulmonary Function: Smoking

A
  • Constriction of bronchioles, ↑ fluid secretions into airway, inflammation, paralyzes cilia
  • Continued smoking= chronic bronchitis, emphysema, obstruction of bronchiole/alveolar walls
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16
Q

Factors Affecting Pulmonary Function: Medications

A
  • Respiratory depressants: anesthetics, opioids, anti-anxiety, sedative-hypnotics, neuromuscular blockers, magnesium sulfate
  • Good meds: anti-inflammatory (expectorants, decongestants, cough suppressants, corticosteroids), bronchodilators
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17
Q

Impaired Gas Exchange: URIs, Influenza, Pneumonia

A

• URIs: sneezing, stuffy nose, sore throat, mild fever, tearing, cough
• Influenza: fever/high fever, fatigue, weakness, muscle pain, nasal inflammation/discharge, headache, exhaustion (upper respiratory)
• Pneumonia: dyspnea, discolored sputum, fever, chills, cough, elevated WBC, malaise, pleural pain (lower respiratory infection)
-Treatment: anti-pyretics, expectorants, rest, humidity, hydration

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18
Q

Impaired Gas Exchange: Structural Pulmonary Abnormalities

A
  • Limited movement of the chest wall

* Lungs cannot expand/inflate

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19
Q

Impaired Gas Exchange: Airway Inflammation and Obstruction

A
  • Allergic reactions (asthma), irritants (smoke)

* Food, object, spasms, swollen tonsils/epiglottis

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20
Q

Impaired Gas Exchange: Alveolar-Capillary Membrane Disorders

A
  • Alveoli become stiff–> impaired gas exchange

* Pulmonary edema/fibrosis, ARDS

21
Q

Impaired Gas Exchange: Pulmonary Embolus and Pulmonary Hypertension

A

*poor blood flow (pulmonary circulation)=impaired gas exchange
• Embolus: obstruction (clot, air, fat)
• Hypertension: ↑ pressure= ↑ workload–>right sided heart failure

22
Q

Impaired Gas Exchange: CNS and Neuromuscular Abnormalities

A

*CNS problem–> messes with breathing–> impaired gas exchange
• Stroke, trauma
*NM problem–> messes with breathing/movement of muscles–> impaired gas exchange
• Stroke, trauma, spinal cord injury

23
Q

Focused Assessment of Respiratory System: Cough

A
  • Dry, productive, hacking
  • Worsens/betters
  • When it occurs/how long
  • Meds/side effects
  • Other clinical findings
  • Sputum color/odor/timing/amount
24
Q

Focused Assessment of Respiratory System: Sputum Color

A
  • White/clear: viral infection (cold)
  • Yellow/green: infection
  • Black: dust, smoke, soot
  • Rust: pneumonia, TB, blood
  • Hemoptysis: coughing up blood
  • Pink/frothy: pulmonary edema
  • Foul-smelling: bacterial infection (pneumonia, lung abscess)
25
Q

Focused Assessment of Respiratory System: Chest Pains

A
  • Pain affects rate/depth of respirations
  • Patient in pain is at risk for atelectasis due to shallow breathing
  • Medicate–> reassess–> encourage coughing/deep breathing
26
Q

Focused Assessment of Respiratory System: Dyspnea

A
  • Closed questions/yes or no answers
  • Sudden/gradual onset
  • Severity
  • Getting better/worse
  • Sleep/conversational dyspnea
  • Stridor (high pitched inhale, immediate attention)
  • Wheezing (musical, obstruction, asthma)
27
Q

Inspection of Pulmonary System: What to Be Aware of When Assessing Breathing Patterns

A
  • Pain affects rate/depth of respirations
  • Patient in pain is at risk for atelectasis due to shallow breathing
  • Medicate–> reassess–> encourage coughing/deep breathing
28
Q

Inspection of Pulmonary System: What to Be Aware of When Assessing Breathing Patterns

A
  • Closed questions/yes or no answers
  • Sudden/gradual onset
  • Severity
  • Getting better/worse
  • Sleep/conversational dyspnea
  • Stridor (high pitched inhale, immediate attention)
  • Wheezing (musical, obstruction, asthma)
  • Look for: grunting, retraction, body position, nasal flaring, body position, accessory muscle use
29
Q

Percussion

A

sound

30
Q

Palpate

A

touching

31
Q

Auscultation of Breath Sounds: Patient Position?

A

• Sitting, upright

32
Q

Auscultation of Breath Sounds: Stethoscope prior to auscultating?

A

• Clean and warm it

33
Q

Auscultation of Breath Sounds: Instructions to patient?

A

•

34
Q

Auscultation of Breath Sounds: How to record findings?

A

•

35
Q

Normal: Bronchial

A
  • Location: trachea
  • Description: hollow, tubular, low-pitched
  • Ratio/Predominance: 1:3/expiration
36
Q

Normal: Bronchovesicular

A
  • Location: mid-chest, between scapulas
  • Description: normal, combo of bronchial and vesicular
  • Ratio/Predominance: 1:1/expiration
37
Q

Normal: Vesicular

A
  • Location: most lung area (louder at base/periphery)
  • Description: soft, low-pitched; MOST COMMON
  • Ratio/Predominance: 3:1/
38
Q

Adventitious: Fine Crackles

A
  • Cause: Early I/E (chronic bronchitis); Late I (CHF, atelectasis, pneumonia)
  • Description: Higher-pitched vs. coarse crackles, brief, discontinuous, popping
39
Q

Adventitious: Coarse Crackles

A
  • Cause: air bubbling in airway

* Description: Louder/higher-pitched/longer vs. fine crackles, brief, discontinuous popping

40
Q

Adventitious: Wheezing

A
  • Cause: narrowing of airway

* Description: musical, high/low pitch

41
Q

Adventitious: Stridor

A
  • Cause: obstruction in airway

* Description: high-pitch, noise, inspiratory

42
Q

Adventitious: Rhonchi

A
  • Cause: obstruction/secretion in airway

* Description: low-pitch, rattling, snoring

43
Q

Adventitious: Pleural Friction Rub

A
  • Cause: Rubbing of inflamed surfaces

* Description: low-pitch, creaky, grating

44
Q

Adventitious: Absent or Diminished

A

• Cause: Obesity, Hyperinflation, Hypoventilation

45
Q

Adventitious: Absent or Diminished

A

• Cause: Obesity, Hyperinflation, Hypoventilation

46
Q

Arterial Blood Gas (ABG)

A
  • O2/CO2 in arterial blood
  • pH, PO2/PCO2, SaO2, HCO3 (bicarbonate)
  • Hemoglobin, PO2, SaO2= best measures of oxygen in tissues
47
Q

Pulse Oximetry

A
  • Measures SaO2
  • Percentage of hemoglobin molecules carrying oxygen
  • 95%-100%
48
Q

Spirometry

A
  • Air moving in/out of lungs

* Lung volume/capacity varies with body size, age, and exercise

49
Q

Why/How we Collect Sputum Samples

A 
• To precisely diagnose
Expectorated
1. Verify test being done
2. Position patient in semi/high fowlers
3. Mouth rinse
4. Pad any abdominal incisions 
5. Ask patient to breathe deep and cough into container
6. Gloves
7. Label with test name, date, time
8. Plastic bag
9. Lab

N110 Exam #3 (6 decks)

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