Ventilation and Gas Exchange Flashcards

1
Q

Why do we breathe?

A
  1. Increased CO2

2. Decreased pressure inside chest compared to outside chest

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2
Q

Normal Ventilation and Perfusion Ratio

A

4/5 (ventilation/perfusion) or 0.8

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3
Q

Lung perfusion is

A
  1. Gravity Dependent

2. Greatest in dependent lung area

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4
Q

Why does V-Q matching matter?

A

More blood mixing with air = Better perfusion

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5
Q

How would nurse position a client with unilateral pneumonia in bed? Why?

A

Good lung down; allows more air to mix with blood and increases perfusion

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6
Q

Causes of V/Q mismatch?

A
  1. Shunting

2. Alveolar Dead Space

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7
Q

Shunting

A

Circulation is OK

Ventilation is Decreased

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8
Q

Causes of Shunting

Examples

A

Airway Obstruction, Mucus, Edema
Restrictive Diseases
Atelectasis
Compensatory hypoxemic vasoconstriction

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9
Q

Alveolar Dead Space

A

Ventilation is OK

Circulation is Decreased

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10
Q

Causes of Alveolar Dead Space

Examples

A

Pulmonary Embolism
Fat Emboli, Sudden Dyspnea
DVT, Severe Hypoxemia

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11
Q

Obstructive Pulmonary Disease

Characteristics

A
Inspiration = Airways open wider
Expiration = Airways Narrow
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12
Q

What is Increased lung compliance?

A

Caused by hyperinflation of lung tissue
Elasticity is decreased so lung moves around more
AKA: Floppy lungs

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13
Q

Why does lung compliance matter?

A

Lungs help push the air out of the chest

Floppy lungs don’t work well to accomplish this

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14
Q

Types of Obstructive Pulmonary Disease

A

Asthma
Emphysema
Chronic Bronchitis

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15
Q

Etiology of Asthma

A

Obstructive Pulmonary Disease; Hypersensitivity response;
Genetic predisposition IgE response to allergies;
Chronic inflammation of bronchial mucosa

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16
Q

Why is Asthma often worse at night?

A

Decreased cortisol & epinephrine
Increased histamine
Gastroesophageal Reflux

17
Q

What times is asthma worse?

A

3am - 7am

18
Q

Chronic Obstructive Pulmonary Disease

COPD

A

Emphysema + Bronchitis
Chronic obstruction of airways
Irreversible functional damage

19
Q

COPD RISK FACTORS

A

Tobacco smoke; occupational dust; Air pollution;
Poor Nutrition; Comorbidities; Socioeconomic Status;
Advanced Age; Genes; Altered lung growth/development

20
Q

Restrictive Pulmonary Disease

A

Difficult to take air in; increased lung stiffness;
Shallow/rapid breathing; alveolar hypoventilation;
Increased dead space air; Lung, pleural space, chest cavity

21
Q

Pleural Cavity

A

Normally empty space

Lung expansion decreases when filled

22
Q

What kinds of fluids can cause pleural effusion?

A

Empyema
Hemothorax
Chylothorax

23
Q

Empyema

A

Pus-filled Pleural Effusion

24
Q

Hemothorax

A

Blood in the pleural cavity

25
Q

Chylothorax

A

Lymph in the pleural cavity

26
Q

Pneumothorax

A

Occurs when air inside chest equals air outside the chest

Can be simple or spontaneous or tension

27
Q

Spontaneous Pneumothorax

A

Atmospheric air within airways leaks into pleural cavity

28
Q

Tension Pneumothorax

A

Intrathoracic pressure > Atmospheric Pressure

Air enters and remains in the chest; unaffected lung compressed; trachea shift toward unaffected side

29
Q

Pneumothorax

A

Collapsed Lung

30
Q

Why is a pneumothorax serious?

A

Intrathoracic pressure changes;
Circulation through the great vessels changes
Decreased cardiac output = life threatening

31
Q

Definition of Chronic Bronchitis

A

Chronic airway inflammation

Coughing > 3 months for 2 years

32
Q

Primary Prevention Strategies

Chronic Bronchitis

A

Environmental Control of Airborne, non-Biodegradeable subst.;
Protective Gear

33
Q

Tertiary Prevention

Chronic Bronchitis

A

Supplemental O2
Anti-inflammatory Drugs
Lobectomy, pneumonectomy
Lung Transplant