Respiratory PATHology Flashcards
normal CO2 level
25-35
normal bicarbonate level
22-26
respiratory acidosis:
____ventilation
____ CO2 in blood
pH =
bicarbonate levels ____ (if compensating)
hypoventilation
excess CO2
pH < 7.35
increase
HR ____ in respiratory acidosis
increases
to compensate for decreased O2
respiratory alkalosis:
____ventilation
pH =
CO2 levels _____
hyperventilation
pH >7.45
decrease
infections (sepsis), hypoxia, fever, and high room temperature can lead to
respiratory alkalosis
if compensating, bicarbonate levels will ___ with respiratory alkalosis
decrease (to decrease the pH)
which type of acid-base balance disorder would need a rebreather mask?
respiratory alkalosis
signs and symptoms of respiratory alkalosis
light-headed
paresthesia in fingers and toes
rapid, deep breathing
twitching
anxiety
fear
signs and symptoms of respiratory acidosis
diaphoresis
headache
tachycardia
confusion
restlessness
apprehension
causes of metabolic alkalosis
loss of HCl acid (vomit, diarrhea)
renal disease - excreting acid
decreased plasma K+
excessive alkali ingestion
why is there decreased K+ with metabolic alkalosis?
loss of HCl causes K+ to follow
which medication class can cause metabolic alkalosis?
diuretics (loss of K+)
what is the compensation for metabolic alkalosis?
CO2 retension
metabolic alkalosis:
____ bicarbonate
pH =
_____, _____ breathing
increased
pH > 7.45
slow, shallow
metabolic acidosis:
____ bicarbonate
pH =
_____, _____ breathing
decreased
pH <7.35
rapid, deep breathing (Kussmaul)
signs and symptoms of metabolic alkalosis
slow, shallow breathing
confusion
hypertonic muscles
twitching
restlessness, irritability
apathy
tetany
coma (if severe)
seizure
uncontrolled diabetes can lead to _____. why?
metabolic acidosis
ketone bodies cause acidity
Kussmaul’s breathing is involved with
metabolic acidosis
(rapid, deep breathing)
causes of metabolic acidosis
GI issues - bicarbonate loss
liver disease - acid production
endocrine disorders (hypoxia)
hyperkalemia
signs and symptoms of metabolic acidosis
rapid, deep breathing
fatigue
fruity breath
headache
drowsiness
lethargy
nausea
vomiting
coma (if severe)
what are the 5 main steps in evaluating ABG results?
- examine pH
- examine CO2
- examine HCO3 (bicarbonate)
- determine if compensating
- check signs and symptoms
what is a normal blood pH?
7.35-7.45
if CO2 is too high, the pt is probably ___ventilating
hypoventilating
if CO2 is too low, the pt is probably ___ventilating
hyperventilating
if bicarbonate (HCO3) is too high, what acid-base disorder is present?
metabolic alkalosis
if bicarbonate (HCO3) is too low, what acid-base disorder is present?
metabolic acidosis
abnormal levels of CO2 indicate a ____ issue, while abnormal levels of bicarbonate indicate a ____ issue (respiratory/metabolic)
CO2 - respiratory
HCO3 - metabolic
which diseases comprise COPD?
chronic bronchitis
emphysema
increased lung size (obstructive diseases) decreases _____, ______, and _____
vital capacity, expiratory reserve, and functional capacity
is inhalation or exhalation an issue with obstructive diseases? what does it lead to?
exhalation
trapped air in lungs –> obstruction
what is the FEV1 in obstructive diseases?
decreased - <70%
emphysema:
compliance?
cross-sectional area?
HYPERcompliant
decreased cross-sectional area
(grapes to balloons)
hallmarks of chronic bronchitis
inflamed airway (bronchoconstriction) with mucus production
how does SpO2 change with exercise in emphysema pts?
beginning - normal
later - drop d/t accessory muscles fatigue
T/F: SpO2 is normal at rest for emphysema pts?
T (increased RR to compensate)
at rest, how do emphysema pts breathe?
shallow, rapid breathing
what are the 2 main types of emphysema?
panacinar
centrilobular
panacinar emphysema affects the ____ and is a ___ condition
alveoli
genetic
centrilobular emphysema affects the ____ and is due to ____
bronchioles
smoking
why does pursed lip breathing help with emphysema pts?
helps maintain positive pressure (think increased PEEP)
end stage emphysema can cause ___ side heart failure
right
which disease can cause cor pulmonale?
chronic bronchitis
what electrolyte is retained with end stage emphysema?
Na+
why are emphysema (end stage) more susceptible to clots?
increased RBC production to compensate for decreased O2
how may ribs should be seen on a normal chest x-ray?
5-7
what is the #1 cause for hypoxemia?
ventilation-perfusion mismatch
what diseases are obstructive?
COPD (emphysema and chronic bronchitis)
asthma
bronchiectasis
hallmarks of chronic bronchitis
excessive mucus
productive cough
less ciliary activity
blue (cyanosis)
what type of sputum is common with chronic bronchitis?
purulent
in chronic bronchitis, CO2 is ___ and O2 is _____
CO2 - high
O2 - low
T/F: compliance is usually normal with chronic bronchitis
T
pulmonary hypertension associated with chronic bronchitis can lead to
R ventricular failure:
cor pulmonale
jugular vein distention
fluid retention –> edema
what lung sound is heard with asthma?
wheezing (on the exhale)
(air through diff diameters)
adult onset of asthma is usually caused by
chronic bronchospasms
increased SNS
decreased PSNS
how does asthma become a chronic condition?
bronchial wall becomes thicker d/t inflammation –> higher edema and fluid build up –> obstruction
extrinsic triggers of asthma
allergic response
intrinsic triggers of asthma
IgE antibody issue
(not associated with allergens)
what is the main issue with restrictive lung diseases?
low compliance
what are the 3 types of bronchiectasis?
cylindrical
varicose
saccular (cystic)
what causes bronchiectasis?
chronic, recurrent infections
weakens walls –> retain secretions –> difficult to cough
what structure can be effected in restrictive lung diseases?
lung tissue, chest wall, or surfactant
which values are decreased with restrictive lung diseases?
vital capacity
ventilation (–> hypoxemia)
what breathing techniques should be taught to restrive lung disease pts?
breathing deeper
types of restrictive lung diseases
pneumothorax
atelectasis
pneumonia
acute respiratory distress syndrome (ARDS)
what causes a pneumothorax?
air in the pleural space (b/w parietal and visceral pleura) causes a more positive pressure
what is the most common restrictive disorder?
atelectasis
central mechanisms of atelectasis
ventilator
SNS issue
pain
extramural mechanisms of atelectasis
scoliosis
immobilization
mural mechanisms of atelectasis
asthma
2 types of pneumonia
lobar
bronchiole (aspiration, meconium)
lobar pneumonia is due to
consolidation
bronchiole pneumonia is due to
large amounts of sputum produced
which type of pneumonia is more diffuse?
bronchiole
what is normally the cause of ARDS?
infections (sepsis)
as the lung tissues tries to heal with ARDS, _____ is impaired
surfactant
