week 2: gas exchange Flashcards
define ventilation
process of inhaling oxygen into the lungs and exhaling CO2
what are three issues that affect ventilation
COPD, cancer, chest trauma
define diffusion
oxygen and carbon dioxide crossing the alveoli and entering blood stream
what are two issues that affect diffusion
COPD (emphysema)
lung infection
define perfusion
ability of blood to bring oxygen containing Hgb into cells and return CO2 containing Hgb into the alveoli
what are two issues that affect perfusion
pulmonary embolism, heart failure
what is hypoxia
inadequate transportation of oxygen to body cells (oxygenation failure)
what is hypercapnia
build up of carbon dioxide combined with water to produce carbonic acid (ventilation failure)
what are they two big things that a decrease in gas exchange will result in
hypoxia and hypercapnia
what does VQ stand for
ventilation perfusion
what is an intrapulmonary shunt
perfusion without ventilation, usually due to too much fluid in the lungs
what is atelectasis
partial lung collapse/lung collapse
what is dead space ventilation
ventilation without perfusion
what may cause dead space ventilation
pulmonary embolism
what may cause intrapulmonary shunt
lumbar pneumonia, atelectasis
how can you tell if chest pain is due to a lung issue or cardiac?
if they breathe and the chest pain is worse, it’ll be lung
if you breathe and the chest pain is unaffected, its cardiac
what should you monitor pre procedure for a bronchoscopy
monitor CBC, platelets, PTT, lytes, chest X ray
also make sure theyre NPO
what should one monitor post procedure for an endoscopy
monitor till sedation wears off, ensure gag prior to eating/drinking. monitor for bleeding, infection, hypoxemia
what is a thoracentesis
needle shoved right into lungs to aspirate fluid from pleural space
what should you monitor post procedure for a thoracentesis
CXR, vitals, assess lung sounds, check for perforation and leakage.
what are some risks for a patient after getting a thoracentesis
increased risk for infection and tension pneumothorax.
whats the difference between a moderate impairment in respiratory status and severe impairment
moderate: change in blood work, severe: change in tissue perfusion
what are the symptoms of a pulmonary embolism
sudden onset of dyspnea, sharp stabbing chest pain, hemoptysis, crackles, petechiae
what are the main interventions we do for a lung issue
optimise oxygenation and optimise ventilation through things like positioning, administer medications, manage secretions, optimise nutrition
what are the four surgeries that increase ventilation
tracheostomy, thoracentesis, chest tube, lung volume reduction surgery
what is lung volume reduction surgery
removing hyper inflated lung tissue containing stagnant airwha
what the upper airway cancer called
laryngeal
whats the lower airway cancer
cancer in the lung
what are the signs of late stage laryngeal cancer
pain, dysphagia, airway obstruction, SOB, weight loss, unilateral ear pain (same side as tumour), numbness
what are the signs of lung cancer
persistent cough, blood tinged sputum, wheezing, chest pain, weight loss, dyspnea
whats the worse case scenario for respiratory cancer
airway obstruction
what are the signs of airway obstruction with cancer
stridor, acc muscle use, wheezing, tachycardia, cyanosis
what is the surgery for laryngeal cancer
total laryngectomy: basically take out the larynx and vocal cords, leaving a permanent stoma in the neck.
how long should a laryngectomy patient be NPO after surgery
24-48 hours
what is the surgery for lung cancer
thoracotomy with lobectomy
what is a thoracotomy
surgical opening into thoracic cavity, part of lung removed
what is a lobectomy
removal of one lobe of the lung
what is a pulmonary contusion
common chest injury, usually with MVA, where hemmorhage and edema can occur within the alveoli
what is flail chest
multiple rib fractures, causing instability of the chest wall, usually resulting in one side expanding and contracting opposite to the other one
how does the chest move with flail chest
inspiration: affected area bulges in
expiration: affected area bulges out
what is a pneumothorax
lung collapse due to presence of air/blood into pleural space
what is a closed vs. open pneumothorax
Closed: hole not open to air
open: hope open to air
what is a hemothorax
blood collects in pleural space
what is a big sign of pneumothorax
no breath sounds on auscultation.
what is a tension pneumothorax
hole opening in pleural space, each breath bringing in more oxygen and increasing tension without any air going out
what is a mediastinal shift
pressure from tension pneumothorax pushes trachea to opposite side, leading to pressure on vena cava/aorta
how would one treat a tension pneumothorax
aspirate air out with needle
how does one treat a large pneumothorax
insert chest tube
how does one treat a small hemothorax
will resolve on its own
