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Nursing, LPN, Year 2 > x Respiration (Ms. Ci) > Flashcards

x Respiration (Ms. Ci) Flashcards

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1
Q

ABG used for ..

A
  • working with respiratory disorders

- reflects how well respiratory and metabolic functions maintain state of homeostasis

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2
Q

Components of ABG

A

-pH
-pCO2 (respiratory)
-HCO3 (metabolic)
-PaO2
-SaO2
Analyze figures to determine (Repiratory: Acidosis, Alkalosis; Metabolic: Acidosis, Alkalosis)

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3
Q

Acid/Base Balance

A
  • balance between Acid/Alkalinity
  • H+ content of body fluids
  • imbalances are life threatening
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4
Q

pH of Blood

A

7.35 - 7.45

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5
Q
  • pH measures …

- indicator of….

A

strength of acids and bases

  • scale: 0-14
  • indicates conc of H+
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6
Q

pH influences…

A
  • speed of cellular reactions

- cell Fx, permeability, Structure

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7
Q

Acids

A
  • LO pH #

- HI H+ ions

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8
Q

STEPS

A
  1. Analyze pH
  2. Analyze pCO2
  3. Analyze HCO3
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9
Q

ph 7.56
ph 7.22
ph 7.39

A
  • 7.56: alkaline
  • 7.22: acidic
  • 7.39: normal (7.35 - 7.45)
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10
Q

NOMALS

A

Respiration: 12 - 20 resp p/min
Blood ph: 7.35 - 7-45
pCO2: 35-45
HCO3: 22-26 m eq/L

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11
Q

pCO2

A
  • normal: 35-45
  • partial pressure of CO2
  • CO2 = Carbon Dioxide
  • ACID, gas while in blood
  • HI in body = acidosis
  • CO2 is a byproduct of cellular metabolism
  • CO2 dissolved in blood => Carbonic Acid (CO2, eliminated thru resp, via LUNGS; H20)
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12
Q

pCO2 levels (35 - 45)

A
  • 35, more CO2 in blood, RESP ACIDOSIS
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13
Q

pCO2 imbalance: Causes

A

Resp norm 12-20 p/min

Hypoventilation: Resp 20

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14
Q

pCO2 imbalance: Hypoventilation

A

Resp

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15
Q

pCO2 imbalance: Hyperventilation

A

Resp

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16
Q

pCO2 24
pCO2 49
pCO2 38
pCO2 75

A

pCO2 24: respiratory alkalosis (LO CO2)
pCO2 49: respiratory acidosis (HI CO2)
pCO2 38: normal
pCO2 75: respiratory acidosis (HI CO2)

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17
Q

HCO3: Bicarbonate (BASE)

A

normal: 22-26 m eq/L
- weak base controlled by kidney
- metabolic component

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18
Q

extra

A

extra

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19
Q

Metabolic Alkalosis

A
  • HCO3 >26

- loss of acid, presence of excess base

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20
Q

Metabolic Alkalosis: Causes

A
  • V (vomit stomach acid)
  • Suction (sucking out stomach acid)
  • HCO3 ingestion (antacid)
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21
Q

Metabolic Acidosis

A

-HCO3

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22
Q

Metabolic Acidosis: Causes

A
  • Renal Failure
  • Cardiac Arrest
  • prolonged fasting
  • lactic acidosis
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23
Q

HCO3 29
HCO3 16
HCO3 25
HCO3 12

A

HCO3 29: metabolic alkalosis
HCO3 16: metabolic acidosis
HCO3 25: normal
HCO3 12: metabolic acidosis

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24
Q

Interpreting ABGs

A

1) Is pH acidosis, alkalosis or normal (7.35 - 7.45)
2) evaluate pCO2 (35 - 45)
3) evaluate HCO3 (22-26)

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25
Q

3 Systems in place for Compensation

A

-chemical buffers
-lungs
-kidneys
GOAL: maintain acid/base balance

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26
Q

Compensation

A

Normal pH + 2 abnormal values (HCO3, pCO2)
means compensation has happened
-1 value is the problem, 1 is the compensation.
-chem buffers absorb or release H+ ions prn
-Bicarb/Carbonic acid system
-lungs adjust ventilation to control CO2
-kidneys excrete or absorb HCO3 or H+

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27
Q

Levels of Compensation

A
  • UNCOMPENSATED (ph LO, pCO2 UP, HCO3 N; 1 value is normal)
  • PARTIAL (ph NOT NORM, PCO2 UP, HCO3 UP; all 3 abnormal ==> pH becoming normal)
  • COMPLETE (pH fully adjusted, NORMAL, pCO2, HCO3 abnormal)
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28
Q

SEE PICS ON ABGs

A

SEE PICS ON ABGs and MATH

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29
Q

ABG w copensaion

A

problem is component with same favor as pH. If ph is normal , but more on acid side, the components, resp or met that is more acid is the initial problem. the other component does the compensation.

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30
Q

Interpret this ABG

  • ph 7.36
  • CO2 50
  • HCO3 29
A
  • ph 7.36: normal (but more acid)
  • CO2 50: acidic
  • HCO3 29: alkaline
  • RES Acidosis w complete compensation by kidney (problem is resp because that value is acidic as does the ph lean towards. the compensation is by the other component, kidney)
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31
Q

LUNG CA

A
  • Cancer of Lung Tissue
  • mostly epithelial lining
  • 2 Types: Small Cell Lung CA (SCLC) and Non Small Cell Lung CA (NSCLC)
32
Q

2 Types Lung CA

A 
Small Cell Lung CA (SCLC) 
(OAT Cell Carcinoma)
-rapidly growing
-usually Dx after mets.
-1yr survival rate after Dx
-LO prognosis

Non Small Cell Lung CA (NSCLC)
Squamous, Adeno, Large Cell Carcinoma

33
Q

Lung CA: Risk

A
  • SMOKING
  • air pollution
  • diesel ex
  • exposure to radon, uranioum, asbestoss
  • family Hx
  • prior Hx of having lung CA
  • UP 65
  • prior bronchitis, TB up risk
34
Q

Lung CA

A

smoke inhalation –> irritation to epithelial lining–> cells mutate –> growth of abnormal/CA cells

35
Q

Lung CA: SS

A
  • Dyspnea
  • Wheeze
  • Chest Pain
  • Hemoptysis (blood in sputum)
  • hoarse voice
  • freq lung infec
  • fatigue
  • weight loss
36
Q

Lung CA: Dx

A
  • CxR
  • CT Scan
  • MRI
  • Biopsy w bronchoscope
  • Sputum Cytology (lab analyzes cells)
  • btatin/bone scans (mets?)
  • cough that keeps getting worse
37
Q

Lung CA: Rx

A
  • wedge resection: remove sm portion of lobe
  • segmental resection: remove lg portion of lobe
  • lobectomy: remove entire lobe
  • Pneumonectomy: remove 1 entire lung
38
Q

Lung CA: Rx

A
  • Stages: I, II, III, IV (mets)
  • Chemo
  • Radiation

2 Type
SCLC
NSCLC

39
Q

Small Cell Lung CA, SCLC (Oat Carcinoma)

A
  • rapid growth
  • mets @ time of Dx
  • Rx: chemo.radiation/sx
  • palliative
  • poor prognosis, survival LESS than 1 yr
40
Q

Non Small Cell Lung CA, NSCLC

A

-85% of CAs

41
Q

Pulse Oximetry

A
  • non-invasive
  • measures arterial O2 sat(SaO2)
  • measeures % of HgB saturated w O2
  • Continuous or Intermittent monitoring
42
Q

Inaccurate Pulse Ox readings d/t

A
  • vasoconstriction (cold, vasopressors)
  • hypothermia/hypotension
  • probe exp to bright light/sunlight
  • pt mvmt
43
Q

What is O2 saturation?

A
  • O2 carried by blood attached to HgB
  • 1 HgB per 4 O2 molecules
  • O2 sat = how much O2 blood carries as a % of the max it could carry
44
Q

100 HgB molecules can carry how many Os

A

400 Os

45
Q

what percentage O2 if HgB only carrying 360 O2?

A

360/400 = .9 x 100 = 90%

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58
Q

Ventilator to prevent Atelectasis

A

inhale to expand chest

59
Q

Ventilation

A
  • mvmt of air in/out lungs
  • 2 phases: inspiration/expiration
  • relationship btw press/volume
60
Q

Relationship btw Vol and Pressure

A
  • Air flows to change in pressure. from HI pressure to LO
  • UP in volume –> DEC in pressure
  • inspriation –> lung expansion –> UP volume
61
Q

Atmospheric Pressure

A
  • 760 mmHg

- during inspiration, lung pressure is less than atmospheric

62
Q

Inspiration

A
  • Active process

- cause by muscular contractions mainly of diapragm and intercostal muscles

63
Q

Expiration

A

mainly used by Passive process
-elastic recoil of diaphragm
-relaxation of intercostal muscles
In COPD, expiration is active.

64
Q

Pleural Space has Negative Pressure

A
  • Air tight vacuum

- lung collapses if air introduced

65
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Pneumothorax

A

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74
Q

Chest Tube

A
  • water acts as sealant, prevents air from returning to chest cavity
  • shot NOT see bubbles = air leak
  • water level w fluctuate w breathes (Tidaling)
75
Q

Caring for a Chest Tube

A
  • pleurovac should be lower than patient
  • resp status
  • dressing
  • tube for kinks
  • drainage
  • correct suction
  • water seal
  • measure output I+O
76
Q

How to position pt w Chest Tube

A
  • anyway that is comfortable
  • encourage walking
  • just prevent canister above pt (leaks)
  • be careful not to pull out tube
  • if it does, put vaseline dressing on insertion point to prevent air going in

Nursing, LPN, Year 2 (27 decks)

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