USCR Air Flashcards
Transport of 02 is dependent on what systems?
Respiratory System(lungs, trachea, pharynx, gas exchange) Cardiovascular System (02 transported in blood) Hematologic System (blood with 02 attached) Nervous System (control centre)
What is ventilation?
movement of air in and out of lungs; the process of inhalation and exhalation
What is respiration?
The act of breathing; transport of oxygen from the atmosphere to the body’s cells and transport of carbon dioxide from the cells to the atmosphere
What is diffusion?
The movement of gases or other particles from an area of greater pressure or concentration to an area of lower pressure or concentration
What is perfusion?
Passage of blood constituents through the vessels of the circulatory system
Function of respiratory system?
gas exchange & transport of respiratory gases in & out of body
Process of respiration?
Pulmonary ventilation (breathing in-out) Gas exchange Transport of respiratory gases (taking gas to tissues)
What is pulmonary ventilation?
movement of air in & out of lungs
Phases of pulmonary ventilation?
- Inspiration/Inhalation (pressure gradient needed. pressure inside cavity must be lower than outside)(requires energy)
active phase where the muscles of thorax bring air into lungs
2.Expiration/Exhalation
passive phase where air moves out of lungs (relax + recoil, no energy needed)
What does pulmonary ventilation depend on?
clear airways
intact nervous system
functioning thoracic cavity
adequate lung compliance (expand) & recoil
Respiration pathway?
Oxygen (O2) diffuses from alveoli into blood in the pulmonary capillaries
Carbon dioxide (CO2) diffuses from the blood into the alveoli & is exhaled
(blood) Right side of heart to lungs to left side of heart to tissue
Respiration diffusion is influenced by?
any change (Δ) in the surface area available for gas exchange
thickening of the alveolar-capillary membrane
partial pressures of respiratory gases (high altitude) (pulmonary embolism can affect this)
What is transport of respiratory gases?
Depends on cardiovascular system
Delivers oxygenated blood to left (L) side of heart (♥) & tissues = perfusion
Delivers deoxygenated blood to pulmonary system
How is 02 transported?
bound to hemoglobin (oxyhemoglobin)
3 ways 02 is transported in the body?
mostly carried in plasma as bicarbonate (HCO3-)
small amount binds with Hgb = carboxyhemoglobin
minimal in plasma
Transport of respiratory gases is influenced by?
exercise
cardiac output
tissue perfusion
# of erythrocytes (RBC)
Where is respiratory regulation located?
medulla oblongata of brain stem
respiratory center stimulation leads to increase rate & depth of respiration
Factors that influence oxygenation?
Age and Developmental Considerations Health Status Medication Lifestyle Environment Psychological Health
Age & developmental considerations?
lifespan consideration (surface ares for gas exchange decreases with age)
Health considerations?
Underlying health problems (obesity)
Pregnancy
Surgery (OR)/Pain
Medication considerations?
A variety of medications can decrease the rate and depth of respirations.
Opioids: morphine, codeine, sleeping pills, alcohol
Pills + Alcohol = decreased rate of respiration; can lead to death
Lifestyle factors?
Sedentary individuals (not expanding their lungs by sitting)
Smoking
Diet:
Vegetarians (no arteriosclerosis, because not eating fat)
High intake of saturated fats
High salt intake
Occupation
Factors that influence oxygenation?
environment: altitude, air pollution heat, cold
Psychological health status influence?
Psychological & physiological responses to stress can affect oxygenation: (stress-anxiety-shallow breathing)
Stress stimulates sympathetic nervous (constriction of airway)
Release of epinephrine & norepinephrine
epinephrine causes ♥ to contract more forcefully & bronchioles to dilate
norepinephrine causes vasoconstriction ⇒ ↑BP
assessment of air consist of what 3 components?
pt health history (bcf, subjective data, scp)
objective data (physical exam, intake/output observation)
diagnostic & laboratory data
Health history BCF includes?
Developmental data Age Health state data Health care systems factors Patterns of living
Subjective data includes?
Usual patterns of respiration Recent Δs Cough Sputum Chest pain (heart telling you there is not enough 02 supply) Dyspnea Fever Fatigue
self care practices of health includes?
Exercise Smoking Food Health Surveillance Vaccine practices
Who should get flu Vx?
+ 65
residents of long term care facilities
weakened immune system individuals
individuals whose work puts them at risk (RN, MD)
Objective data assessment of air?
Physical Examination
Proceed in an organized manner
Use techniques of: Inspection (look) Palpation (touch) Auscultation (listen) Peripheral cyanosis is not a good indication but central (inside) (ex:tongue color) is a good indication
Inspection techniques?
rate, rhythm, depth
Cough
Sputum
Use of supplemental O2
O2 saturation
(O2 sat)
Temperature PO, AX, PR (T° in degrees Celsius)
Increase in temp. = increase oxygen demand
Physical exam?
color of skin, mucous membranes, conjunctiva
Cyanosis: Bluish discoloration of skin and mucous membranes caused by reduced oxygen in blood
Posture, thorax, speed of cap refill, nail clubbing, palpation, temp., auscultation, BP,
Why do we need to monitor and record a patient’s fluid intake?
When you drink, you increase blood volume
Why do we need to monitor and record a patient’s output?
urine, to see if it matches the input of fluid
What factors may influence a patients ability to receive fluids?
edema
patient that cannot swallow
Labs & Diagnostic Tests?
Sputum/throat culture (will tell you what microorganism is living in the organism and multiplying)
best time for specimen collection is early AM before (ac) breakfast
Pulmonary Function Tests (PFTs) (tells us lung expansion)
Complete Blood Count (CBC) (measure hemoglobin, WBC)
Chest X-ray
Hypoxia?
Insufficient tissue oxygenation anywhere in the body
02 stat measure used
Hypoxemia?
A condition in which the level of oxygen in the blood is less than normal.
measured by blood gas
** SIGNS & SYMPTOMS (S+S) OF INADEQUATE OXYGENATION?
Respiratory: Tachypnea Dyspnea on exertion &/or at rest Pause for breath between sentences, words Flaring of nares Use of accessary muscles
Cardiovascular: Tachycardia Mild hypertension Arrhythmias Hypotension Cyanosis (central cyanosis) Cool, clammy skin
Central Nervous System: Unexplained anxiety restlessness or irritability confusion or lethargy Combativeness ↓ed level of consciousness (LOC) -to coma
Other Diaphoresis ↓d urinary output Unexpected fatigue usually sitting, often lean forward
PROMOTING OXYGENATION?
Nurse interventions;
Position patient for maximum chest expansion, (semi-fowler 45 degrees)
Encourage frequent changes in position,
Encourage/assist with postural drainage,
Encourage ambulation/mobility,
Providing analgesics for pain (promoting comfort),
Providing adequate hydration and encourage use of humidifiers,
Encouraging deep breathing and coughing exercises,
Encourage use of Incentive Inspirometry,
Providing medications as prescribed e.g.. Bronchodilators, anti-inflammatory’s,
Providing oxygen therapy.
incentive inspirometer
STANDARD ACTION DEMAND: OXYGENATION?
Maintain/improve oxygenation in a (an) — year old male/female patient diagnosed with ——-, POD# —-, by:
- Following a regular exercise program with 30-45 minutes of moderate activity 3-4 times /week.
- Maintaining a normal body weight.
- Avoiding chemical substances that cause respiratory depression.
- Practicing pursed-lip breathing q1-2h.
- Practicing deep breathing & coughing (DB+C) q1-2h.
- Using an incentive spirometer 10x/hour while awake.
- Δing position frequently q1-2h, allowing for expansion of the chest wall & free movement of the diaphragm.
- Breathing humidified air prn.
- Managing pain prn.
