Respiratory System Flashcards
Primary purpose of the respiratory system
gas exchange
body parts of upper respiratory tract
nose, nose hair, mouth, pharynx, epiglottis, larynx, trachea.
body parts of lower respiratory tract
bronchi, bronchioles, alveolar ducts, alveoli, lung lobes.
where in lower respiratory tract does gas exchange occur?
bronchioles, alveolar ducts, and alveoli
two main blood supplies to the respiratory system
pulmonary and bronchial
structures of the chest wall
ribs, diaphragm, pleura
define ventilation
movement of air into and out of the lungs
define respiration
exchange of oxygen/carbon dioxide -alveolar capillary/capillary cell membrane
with deep breaths, lungs produce…
surfactant
oxygen carrying RBC
hemoglobin
injury to the C4…
…cannot breathe anymore (C4 connected to diaphragm)
In an older adult, they have decreased ability to…
…deep breathe, leads to decreased production of surfactant, leads to atelectasis, now at risk for pneumonia
ABG
arterial blood gases; taken from radial or femoral artery; most accurate way to measure O2
ABGs evaluate what?
pH, partial pressure of CO2, partial pressure of O2, bicarbonate,
PaCO2
reflects adequacy of lungs ventilation and CO2 elimination. Respiratory parameter
PaO2
reflects body’s ability to pick up O2 from the lungs
HCO3
reflects the kidney’s ability to retain and excrete HCO3 -metabolic
culture and sensitivity for sputum culture
identify microbe and find what antibiotic to use
cytology for sputum culture
looking at cells for malignancy
gram stain for sputum culture
fastest and first thing to do to get the correct type of broad spectrum antibiotic started while waiting on results of the other tests
what is the size of induration and meaning of a positive reading of a skin test
10mm wide or greater; and that the pt had exposure to the antigen, not the disease is currently active
for immunocompromised pts, what size induration will be present for a positive reading
CBC lab values include and reveal…
WBC - differential, RBC, Hgb, can reveal info about conditions that may be contributing to respiratory symptoms
Elevated WBC indicates…
infection
WBC differential indicates…
elevated neutrophil levels= bacterial
elevated basophil and eosinophils= allergic reaction
pulse oximetry norms
93-100%
Chest X-Ray (CXR)
screen, diagnose, evaluate change
PA and lateral views (posterior and anterior)
Computed Tomography (CT) Scan (cat scans)
diagnose lesions difficult to see on x-ray, cross sections, contrast media (avoid of use metformin), evaluate BUN/creatinine. Allergy to shellfish or iodine, don’t use contrast,
Magnetic Resonance Imaging (MRI)
diagnose lesions difficult to assess by CT scan, contrast media not iodine based, metal objects MUST be removed, not pacemakers or internal defibrillators. the magnet aligns with hydrogen ions in body to produce a detailed image.
Pulmonary Angiogram
xray image using contrast dye that looks at blood vessels of the lungs. can show PE, aneurysm, AVM, etc…uses fluoroscopy (live xray)
PET scan
uses a radioactive material called a tracer which is given IV and collects in highly active organs/tissues. can screen diagnose cancer. an increased glucose could give a false positive reading glucose >150 test cancelled
VQ scan
rarely used; inhaled radioisotopes to identify areas of lung not receiving air flow or blood flow
NPO after bronchoscopy until…
…gag reflex returns
Lung Biopsy
anticoags will be d/c prior to procedure INR has to be 1.5 for procedure
Room air is ?%
21% O2
Every liter of O2 gives ?%
4% O2
Nasal Canula
1-6 L/min
COPD pt. O2 level…
do not give more than 2-3L/min ; increased amount of O2 will decrease hypoxic drive and pt. will stop breathing
Simple Face Mask
5-10 L/min 40-60%; minimum is 5-6 L/min to prevent rebreathing of exhaled air. Short term or in an emergency
Partial Rebreather
6-11 L/min ; pt. rebreathes about one third of the expired air and the oxygen that is mixed in the reservoir bag. DO NOT use for COPD pt.
Non-Rebreather Mask
6-15 L/min; highest concentration via mask, Pt only breathes full O2. flow rate must be sufficient to keep bag from collapsing during inspiration. Emergency situation
BIPAP
noninvasive positive pressure ventilation ; used to wean pt off ventilator before NC. improves tidal volume
CPAP
continuous nasal positive airway pressure; to open collapsed alveoli.
Chest Physiotherapy (CPT) goals and involvement
moves secretions; goal= expectorating and/or suction; involves: postural drainage, chest percussion, chest vibration
CPT: Postural Drainage
uses gravity, place affected area in uppermost position
CPT: Chest Percussion and Vibration
used in conjunction with Postural Drainage, position for 10-15 min. Percussion= clapping on chest with cupped hands. Vibration= palms of hands on chest wall and vibrate upon exhale
Suctioning
limit to 10 sec at a time; use for adventitious breath sounds, decreased O2 sats, gurgling during respiration, and labored breathing
diphenhydramine (Benadryl)
1st generation antihistamine
fluticasone (Flonase)
intranasal corticosteroids
pseudoephedrine (Sudafed)
decongestant
opioids: codeine and hydrocodone
non-opioids: dextromethorphan (Robitussin DM)
antitussives - dampen cough reflex
Guaifenesin (Mucinex)
expectorant
acetylcysteine (Mucomyst)
breathing treatment mucolytic
Rescue respiratory drugs
steroids end in -sone, bronchodilators (albuterol), anticholinergics (to keep dilation)
