Respiratory Function Flashcards
Primary function of the respiratory system
Replenishes the body’s oxygen supply and eliminates waste from the blood as Co2
Mouth, nose, and pharynx
Upper respiratory tract organs
Trachea, lobar bronchi, segmental bronchi, and the lungs
Lower respiratory tract organs
Bronchi branch into
bronchioles
Terminal destination is
the alveoli
Millions of sacs where gas exchange happens
alveoli
Transfers oxygen to organs
Alveoli
Neuromuscular coordinated effort of inspiration and exhalation that changes with age and disease
Ventilation
Passing of oxygen from the alveoli
Gas diffusion
Passing of gas from the alveoli into the blood
Gas transport
Control of ventilation is regulated by
CO2
This determines depth and frequency of ventilation
CO2
When CO2 is elevated, breathing rate is
higher
Most accurate indicator of oxygenation
Blood gas
Blood gas
O2 + CO2
This lines he tract
Cilia
This is protective in nature. Causes sneezing and coughing to protect lower respiratory tract
Cilia
Major function of the upper respiratory tract
Warm and humidify oxygen
Major function of lower respiratory tract
Further filtration and clean incoming air
The sneeze and the cough reflexes also protect the lungs and airways
Normal adult breathing rate
12-20 per minute
Which part of breathing takes longer, exhalation or inhalation?
Exhalation
The diaphragm goes in what direction during breathing?
Up
Normal increased breathing comes with ______ only
Exercise
Normal breathing should be
Nearly Effortless and almost unnoticeable
In the older adult, lung changes include
Decrease ciliary activity
Stiffening of chest wall
Cough is less propulsive
What happens if mucus pools in the lungs?
Bacteria builds in the sitting mucus
What encourages mucus movement in the lungs?
Coughing
A sudden constriction of the muscles in the walls of the bronchioles. It causes difficulty in breathing which ranges from mild to severe. Occurs in asthma, chronic bronchitis and anaphylaxis.
Bronchospasm or a bronchial spasm
FiO2
Fraction of inspired oxygen
It is a fraction of the amount of oxygen a patient is inhaling produced by an oxygen device such as a nasal cannula or mask.
FiO2
Percentage of oxygen in FiO2
21%
What can lower respiration rate and raise risk of aspiration?
CNS depressants
Compromissed immune systems need
Plasma, protein, and fluids
Fluids do what to secretions?
Thins and mobilizes secretions to make it easier to cough
Respiratory problems in obese patients
Stomach presses against the diaphragm and makes it more difficult to breathe
Restricted lung movement and airway obstruction will cause
O2 Deprivation and exhaustion
Lungs that stiffen tend to
Tend to collapse because they cannot expand
A complete or partial collapse of the entire lung or area (lobe) of the lung.
Atelectasis
It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid. There is no gas exchange
Atelectasis
Pulmonary fibrosis causes
Scarring of the lungs
RDS
Respiratory distress syndrome
Occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs, Typically occurs in people who are already critically ill or who have significant injuries.
ARDS - Acute respiratory distress syndrome
Smoke inhalation causes
Tar in the lungs
Fractured ribs can alter breathing because
Pain causes restriction of movement
Any process which reduces the diameter of the conducting airways
Airway obstruction
A seal like sound that is the sign of an emergency (airway obstruction)
Stridor
Treatment for airway obstruction
Suction, meds, cool air, and upright positioning
Types of inflammation that can cause airway obstruction
Asthma and Bronchitis
Coughing is a ______ response to an irritant
Reflexive
Clear, white sputum
allergic
Yellow, green sputum
infection
Bloody sputum
Hemoptysis
Hemoptysis could be a sign of
Cancer
Evident by forward leaning position
Accessory muscle use
Long term tissue hypoxia evident by bulbous fingertips
Clubbing
Muscles pulling against the ribs during altered breathing
retraction
Results from excess CO2 production or reduced CO2 exhalation from the lungs. Causes rapid breathing
Hypercapnia
Condition where there is too much CO2 and patient cannot exhale fully
COPD
A patient with COPD or barrel chest cannot receive
High levels of oxygen
Anything below ___ on a pulse oximetry indicates a need for oxygen
94%
CO2 monitor can be affected by
nail polish
Decreased lung vibrations indicate
fluid
Having a patient say “E” or “99” to feel wall vibrations
Tactile fremitus
Best views for chest X-ray
Posterior, anterior, and lateral views
Test to measure capacity of lungs or how well we take in oxygen
Pulmonary function test
Test of a sterile specimen taken from a patient who coughs in a cup. May also be taken by suction
Sputum culture
ABG
Arterial Blood Gas
Most accurate test of oxygenation
Arterial blood gas monitoring
Component of ABG:
PaO2
Partial pressure of oxygen
The ability to pass oxygen into the blood from the air sacs of the lungs, and pass carbon dioxide (CO2) back into the lungs from the blood
Diffusion
Another name for allergic asthma
Extrinsic asthma
Non allergic asthma. Can be triggered by stress or illness
Intrinsic asthma
Component of ABG:
PaCO2
Partial pressure of carbon dioxide
PaO2 level below 80 is considered
Hypoxemia
Measures the amount of oxygen that is available to the tissues
PaO2
Measures the amount of carbon dioxide excreted from the tissues
PaCO2
A bicarbonate that buffers the acid from CO2 and is a good indicator of kidney function
HCO3
Blood oxygen saturation
SpO2
Measures the percentage of hemoglobin in the arteries that is saturated with oxygen
SpO2
End tidal CO2. CO2 measured at the end of exhalation. A good marker for perfusion
EtCO2
Scale of acidity
pH
Normal pH levels
7.35 -7.45
Normal PaCO2 values
35-45 mm Hg
Normal PaO2 values
80-100mm Hg
Normal HCO3 values
22-26 mEq/L
Normal SpO2 values
95% - 100%
Normal EtCO2 values
35-45mm Hg
A quick but invasive test done under sedation where a tube camera is inserted into lungs
Bronchoscopy
in a nursing diagnosis, R/t or related to, is asking
the underlying cause
First stage of smoking cessation:
Does not plan on quitting
Precontemplation
Second stage of smoking cessation:
Thinking about quitting
Contemplation
Third stage of smoking cessation:
Making a plan to quit
Preparation
Fourth stage of smoking cessation:
Process
Action
Fifth stage of smoking cessation:
Continuing the process
Maintenance
How often should a spirometer be used?
10 times per hour
Types of coughs:
Several short coughs. Effective for COPD patients, prevents stretching
Stacked coughs
Types of coughs:
A deep inhale followed by a few huffed coughs
Low-flow Huff cough
Types of coughs:
Assisting patient to cough by pushing against the diaphram. Used with neuromuscular patients
Quad cough
Types of coughs:
Encouraged after surgery. Abdominal splinting maybe needed
Deep Cough
Clapping and cupping to break up secretions
Chest physiotherapy
A simple technique for slowing down a person’s breathing and getting more air into their lungs
Pursed lip breathing
Adding moisture to oxygen delivery to help hydrate thick sputum
Aerosol therapy
Designed to ensure that the medication is delivered into the lungs completely and effectively during aerosol therapy
Spacer
Hand held aerosol therapy that has saline and oxygen
Nebulizer
This is used to reverse hypoxemia, decrease work of breathing or work of heart in cardiac patients
Oxygen therapy
Oxygen administration:
Set a ____ flow to get desired effect and slowly _____ if needed
Lowest flow and slowly increase
O2 administration is prescribed in either _______ or _______
flow or concentration
Is expressed in liters per minute
Flow
Is expressed as a percentage or as a fraction of inspired O2
Concentration
Safety Considerations for O2 Administration
drying effect on respiratory mucosa
oxygen toxicity
destructive change lungs, especially alveoli
Physical and psychological components
Anxiety control, activity modification, & comfort measures
Dyspnea Management
PaCo2 below 35
Rapid breathing
Uses ventilator to assist in respiration
BiPAP – bilevel positive pressure
Uses O2 under continuous positive pressure
Used with sleep apnea
CPAP
Continuous positive airway pressure
CPAP
Selection of oxygen systems is done by
doctor
Oxygen toxicity can cause
Retinal blindness
Assisted ventilation reminds
the patient to breathe
Most common oxygen delivery
Nasal cannula
Method of oxygen delivery:
mixes with room air and uses 1-6 Liters. Concentration is 22%-44%
Nasal cannula
Method of oxygen delivery:
Moderate, restrictive. Uses 6-10 liters 40%-60%
Simple mask
Method of oxygen delivery:
Reservoir mask. High flow, 10-15 liters. 90% concentration. Used for critically ill patients
Nonrebreather
Method of oxygen delivery:
Can deliver precise amounts of oxygen. 3-8 liters and 24%-50% concentration. Noisy and claustrophobic
Venturi Mask
Type of mask that can also be converted to a simple mask by removing the valve
Nonrebreather (Reservoir) Mask
Nursing care of oxygen therapy
TPR & BP airway patency mental status oxygen gauge/setting tubing is free-flowing ABG’s & pulse oximetry
Surgical procedure used to reinflate lung
Chest tube
This is used to collect chest tube contents. Air, blood, effusions
Drainage canister
The three parts to drainage canister
Collection
Water seal
Suction control
Placement of drainage canister
Below patient chest level
Oral or Nasal Pharyngeal Airways are made of
rubber or plastic
Patients who cannot cough effectively enough may need
Suctioning
Always do pulse ox unless doc orders
Blood gas
During suctioning, make sure to ________ and _________ your patient to prevent atelectasis and hypoxemia
Preoxygenate and hyperinflate
