Unit 5/6 Kozier/Piillitteri Flashcards
Pilliteri reading
1170-1178
Kozier Reading
Unit 5
50: 1378-1403
Unit 6
31
Intrapleural
Pressure in the plural cavity around the lungs
Intrapulmonary Pressure
Pressure in the lung
Equal to atmosphere
Normal tidal volume
500 mL
Compliance
Lung stretching
Atelectasis
Partial lung collapse
Lung recoil
Opposite of compliance
Easing of stretching important for expiration
Hemoglobin
97% O2 is bound
Factors affecting O2 transoirt
Cardiac output
Erythrocytes
Hematocrit
Excercise
CO2 transport
Bicarbonate in RBC
CO2 in HGB
Carbonic acid in plasma
Medulla
Responds strongly to CO2 concentration and stimulates increased respiration
Emphysema
Controlled by O2 concentrations
CO2 chronically elevated
High O2 levels may stop breathing
Lungs at birth
Fluid drains
CO2 increases and then first breath
2 weeks to full infation
Factors decreasing adult lung functioning (Decreases)
Decreasing: Tissue elasticity Gas exchange Cough reflex Cilia movement Muscle/Bone strength Immune system Efficiency in eating
Environmental factors of Oxygenation
Temp
Pollution
Altitude
Lifestyle factors of Oxygenation
Exercise
Employment
Foreign substance inhalation
Hyperventilation and Oxygenation
PO2 rises
CO2 falls
Bronchioles dilate
Blood flow increases
Upper Airway Obstruction
Nost Phar and Lar
Caused by food, tongue falling back, Wet sounding secretions
Lower Airway obstruction
Bronchi and lungs
Caused by mucus and exudate
RR across lifespan
Neonate 40-80
Infant 30
Preschool 25
Adolescent and up 12-20
Pediatric Oxygenation diseases
Infection
Choking
Cystic Fibrosis
Asthma
Older Adults Oxygenation Diseases
Infection Emphysema COPD Pneumonia Smoking/Chemical Alpha1Antitrypsin
Older Adult Pneumonia symptoms
Absent fever Confusion Decreased appetite Increased VS Decreased O2
Interventions to manage COPD symptoms
Encourage wellness Disease prevention Pacing Smaller/Frequent meals Avoid environmental factors CI Medications
Interventions for pneumonia PTs
Change position Ambulate Deep breathing Breathing TX Medications Suctioning
Strido
Harsh high pitched sound
Found in lower obstructions
Peds medicine and bronchitis
Mostly to relieve symptoms
Cough syrup not indicated because sputum needs to be expressed
Bronchiolitis
Most common @ 6 months
Prevalent @ < 2 years
Winter and Spring
Correlation with developing asthma
bBronchiolitis symptoms
1-2 days URI 2-3 days of symptoms Hypoxia Flaring, retractions, wheezing Tachy Eating slows Easily Fatigued
RSV
Respiratory Syncytial Virus UREI and moves to bronchioles Need to be hospitalized Peaks in 48-72 hours Isolation precautions
RSV Symptoms
S/S of resp distress
Abnormal lung sounds
Apnea
RSV treatment
Dehydration Lethargic O2 (possibly vent) Abnormal lung sounds Hypoxia
RSV meds
Ribavarin (controversial AV)
RSV-IGIV
Palivizumab (both can be prophylactically given to Premie during winter)
Asthma
Most common chronic illness
S/S @ <5 years (Bronchiolitis might be initially diagnosed)
Asthma exacerbaters (Cops Map)
Cold Air Odors Pollen/Pollution Smoke Mold Aspirin Pets
Asthma Mechanisms (Bib)
Bronchospasm
Inflammation
Bronchial secretion increase
Asthma symptom
Dry cough Difficult exhaling Dyspnea Wheezing on exp more common Wheezing on inh signals acute
Asthma assesment
Visually assess for breathing distress Auscultate lungs Compare inhale/exhale time Pulse Ox Percussion is louder than normal
Asthma Weezing
Should be bilateral
If localized, may be aspiration
Decrease with S/S still persistent indicated acute emergency)
Asthma attack interventions
Don’t say “relax’
Have PT sit or stand
Meds
Hydrate but not milk
Classes of Asthma meds
Prophylactic Corticosteroids (flovent) Mast Cell agonist (Cromoly Na) Leukotriene Receptor Agonists Acute Bronchodilators (Buterols)
Status Asthmaticus
Persistent Unrelieved asthma attack
Status Asthmaticus ABG symptoms
Low O2
High CO2
Acidosis
Status Asthmaticus Treatment
Continue steroids and dilators O2 Warm PO Fluids D5.45 Intubation/Ventilation PRN
Asthmaticus O2 guidelines
Maintain > 90% O2 sat < 30% Face mask/cannula > 40% Venturi with rebreathing Humidified Assess for hyp/apnea from too much CO2