Respiratory System #2 Flashcards
What is intercostal indrawing?
A pulling inward of the soft tissues between the ribs upon inhalation. This is a sign of increased use of the chest muscles for breathing and is a manifestation of respiratory distress
What is Epiglottis?
The flap that covers the trachea during swallowing so that food does not enter the lungs
What is uvulitis?
Uvulitis is inflammation of the uvula. This is the small tongue-shaped tissue that hangs from the top of the back part of the mouth.
Threat to a patients airway patency = what?
A threat to their life
What is the supine position?
Laying flat
What is erect positioning?
Sitting upright
What is the SNS response?
Under conditions of stress, the entire sympathetic nervous system is activated, producing an immediate widespread response called the fight-or-flight response. These include changes in blood flow to muscle and skin, as well as changes in blood pressure (BP), heart rate (HR), sweat release, and pupil diameter
What is normotension?
Normal blood pressure
What is eGFR?
Estimated glomerular filtration rate (eGFR): It is a measure of how well your kidneys filter blood.
What is DVT prophylaxis? (primary and secondary)
Primary prophylaxis is the preferred method with the use of medications and mechanical methods to prevent DVT. Secondary prophylaxis is a less commonly used method that includes early detection with screening methods and the treatment of subclinical DVT.
What does Prophylaxis mean?
treatment given or action taken to prevent disease.
What is DVT?
Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs. These blood clots can break free and travel throughout your blood stream and have the potential to become lodged in your lungs causing a pulmonary embolism
What is Pleuritic pain?
sharp chest pain (pleuritic pain) that worsens during breathing caused by inflammation of the two large and thin layers of tissue that seperate your lungs from your chest wall
Pleuritic pain will cause what? (in terms of VQ ratio)
It will contribute to alveolar hypoventilation (hypercapnia - inc CO2), decreasing gas exchange)
What is Alveolar hypoventilation?
Alveolar hypoventilation is defined as insufficient ventilation leading to hypercapnia
What is opioid analgesia?
The condition is characterised by a paradoxical response whereby a patient receiving opioids for the treatment of pain could actually become more sensitive to certain painful stimuli.
What can opioid analgesia do to a patients vital signs?
Lower their respiratory rate and LOC.
What does COPD stand for?
Chronic obstructive pulmonary disease
What is Emphysema?
Emphysema is a chronic lung condition in which the air sacs (alveoli) may be: Collapsed Destroyed Narrowed Overinflated Stretched
Overinflation of the air sacs is a result of a breakdown of the alveoli walls. It causes a decrease in respiratory function and breathlessness. Damage to the air sacs can’t be fixed. It causes permanent holes in the lower lung tissue. This is part of a group of lung diseases called COPD.
What are the two most common types of COPD?
The 2 most common conditions of COPD are chronic bronchitis and emphysema.
why is it bad the emphysema causes the alveoli to expand?
Because this is due to a loss of elasticity hence the alveoli loses its ability to recoil in expiration resulting in CO2 being “trapped” increasing aveolar PCO2.
What happens when there is a rise of alveolar PCO2?
This is often due to Emphysema and means CO2 cannot diffuse readily from pulmonary capillaries causing a build up in arterial blood (hypercapnia)
If the surface area of a alveoli is reduced what will happen?
Gas exchange will reduce between alveoli and pulmonary capillaries leading to hypoxaemia and hypercapnia
What does acute exacerbation mean?
an acute and transient worsening of preexisting symptoms in patients
What is PEEP?
Positive end-expiratory pressure (PEEP) is the positive pressure that will remain in the airways at the end of the respiratory cycle (end of exhalation) that is greater than the atmospheric pressure in mechanically ventilated patients
Whats a typical (baseline) RR for a patient who has COPD?
20-30 breaths/minute
What is a typical (baseline) SpO2 of a patient with COPD?
90-95
What are adventitious sounds?
Adventitious sounds refer to sounds that are heard in addition to the expected breath sounds (wheeze and crackles ect)
What is rhonchi?
This is a low-pitched sound that resembles snoring.
What is a CRT?
Capillary Refill Time
What are bronchodilators?
a drug that causes widening of the bronchi, for example any of those taken by inhalation for the alleviation of asthma.
Why do bronchodilators cause tachycardia?
It is this unwanted binding to receptors at other sites that causes side-effects. Stimulation of sympathetic receptors in the heart can cause tachycardia or arrhythmia, and stimulation of receptors in skeletal muscle can result in tremor. Other possible side-effects include muscle cramp and headache
How does hypoxaemia cause hypertension?
Acute hypoxic exposure increases heart rate and cardiac output via β-adrenergic stimulation, and can result in higher blood pressure and rate pressure product
What is a systemic inflammatory response?
an exaggerated defense response of the body to a noxious stressor (infection, trauma, surgery, acute inflammation, ischemia or reperfusion, or malignancy, to name a few) to localize and then eliminate the endogenous or exogenous source of the insult
Why does a systemic inflammatory response cause hypotension?
The widening (dilation) of the blood vessels and loss of fluid into the tissues can cause low blood pressure.
What is sepsis?
Sepsis is the body’s extreme response to an infection.
What are corticosteroids and what are their side effects?
Commonly referred to as steroids, corticosteroids are a type of anti-inflammatory drug. They can cause, Fluid retention, causing swelling in your lower legs, High blood pressure, Problems with mood swings, memory, behavior, and other psychological effects, such as confusion or delirium, an Upset stomach, and weight gain.
Why do we enchourage a patient with respiratory distress to start pursed lip breathing?
Enchourage pursed lip breathing to facilitate exhalation of CO2 (Reduce gas trapping) and to reduce dyspnoea.
How to COPD patients optimise their gas exchange?
By hypoxic vasoconstriction leading to altered alveolar ventilation-perfusion (essentially moving O2 to the areas that are better perfused)
Why is excessive O2 administration bad for patients with COPD?
It leads to increased blood flow to the poorly ventilated alveoli, thus increasing V/Q mismatch as it does not prevent hypoxic vasoconstriction it just increases the amount to which this occurs as these aveoli are still diseased. Hence this limits gas exchange causing worsening hypoxia and increased hypercapnia
Why is low PaO2 in the lung good for patients with COPD?
It leads to localised vasoconstriction so that areas of poor ventilation have appropriately poor perfusion, redirecting blood to better areas of ventilation and protects the patient from increasing V/Q mismatch
How can we simply explain why O2 is potentially harmful for a patient with COPD?
Giving too much O2 (hyperoxia) fools the arteries into thinking that everything is all okay so they perfuse everywhere rather than concentrating on the few areas with good gas exchange surface areas, thus worsening hypoxia.
What are CO2 retainers?
People who tend to retain more CO2 in their blood stream than others:
In severe cases, gas exchange in the lungs is impaired to the extent that CO2 builds up in the bloodstream as a chronic condition. These patients are termed CO2 retainers because quite literally their bodies retain more CO2 than normal.
How do we monitor PaO2?
using a point-of-care ABG analyzer.
What is Hyperkalemia
a higher than normal level of potassium in the bloodstream.
What is Hypokalemia?
low levels of potassium in your blood
What is HTN?
High blood pressure
