Respiratory Flashcards
Peripheral chemoreceptors in the carotid bodies and aortic arch are sensitive to:
changes in arterial carbon dioxide, oxygen, and pH
Central chemoreceptors in the medulla oblongata detect
changes in arterial PCO2, cause a change in breathing
Major respiratory muscles
diaphragm and external intercostal
Accessory muscles
sternocleidomastoid and scalene muscles
Compliance of the lung
ability to stretch and expand
Most important cause of pulmonary artery constriction is
low PaO2 (alveolar hypoxia -> hypoxic vasoconstriction)
If low PaO2 is in one part of the lung
arterioles to that segment constrict, shunting blood to other, well-ventilated portions
If all lung segments affected by low PaO2
pulmonary HTN
Respiratory defense mechanisms
Mucociliary clearance system
- mucous
- IgA
- Cilia
- Cough reflex
- reflex bronchoconstriction
- alveolar macrophages
Atelectasis
collapse of alveoli or lung tissue
When is Atelectasis common?
after surgery (anesthetics can change breathing patterns)
Nursing interventions for atelectasis
repositioning, mobilize, DB&C exercises, incentive spirometry, pain management, PT, suctioning
Pneumonia
Acute inflammation of lung “parenchyma” (area used for gas exchange) caused by a microbial agent, usually associated with marked increase in interstitial fluid and alveolar fluid.
Predisposing factors for Pneumonia
age, air pollution, dysphagia, altered LOC, prolonged immobility, chronic diseases, immunosuppressant drugs, inhalation or aspiration of noxious substances, intestinal or gastric feeding
2 types of pneumonia
Lobar - consolidation of 1 lobe of 1 lung
Lobular or Bronchopneumonia - patchy consolidation throughout
Clinical Manifestations of pneumonia
productive cough, fever, SOB, dyspnea, chills, sweats, fatigue
OA: confusion (lack of O2)
Labs and Diagnostics for pneumonia
WBC, x-ray, C&S
Nursing interventions for intake with Pneumonia Pts
1500 calories/day min
3L fluid/day
Chronic Bronchitis
presence of a chronic productive cough that lasts at least three months a year for 2 consecutive years
Emphysema
Abnormal and permanent enlargement of alveoli due to rupture and damage reducing the surface area for gas exchange
COPD can present with both
emphysema and chronic bronchitis
COPD
- caused largely by smoking
- progressive, partially reversible airway obstruction
- increasing frequency and severity of exacerbations
- chronic inflammation found in airways and lung parenchyma
- excess mucus production (chronic productive cough)
5 Causes of COPD
- Smoking
- Occupational chemicals/dust
- Infection
- Heredity
- Aging
2 defining features of COPD
- Limited airflow during forced EXHALATION d/t loss of elastic recoil of alveolus, not fully reversible, structural changes in the lungs
- Airflow obstruction d/t mucus secretion, mucosal edema, and bronchospasm
Systemic effects of COPD
- cachexia (loss of skeletal mass)
- weakness, exercise intolerance and deconditioning
- osteoporosis
- chronic anemia
Clinical manifestations of COPD
- cough
- sputum
- dyspnea on exertion, then dyspnea at rest
- increased work of breathing
- barrel chest (air trapping in lungs)
- prolonged expiration and wheezes
- weight loss and anorexia
- fatigue
diagnosis of COPD confirmed by
spirometry: FEV1/FVC ratio < 70%
FEV1 – Max air that can be expired by lung in one second
FVC - Max gas that can be expired by lung in one second
Collaborative care for COPD
smoking cessation, pursed lip breathing, remove bronchial secretions, bronchodilators, long term O2 therapy, exercise, avoid high altitudes, surgery (lung volume reduction surgery, lung transplantation)
COPD complication
Cor Pulmonale:
hypoxia → pulmonary vasoconstriction → pulmonary HTN → R ventricular hypertrophy → COR PULMONALE → R sided HF
