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

x Respiration (Ms. Ci) Flashcards

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
3 Systems in place for Compensation
-chemical buffers -lungs -kidneys GOAL: maintain acid/base balance
26
Compensation
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+
27
Levels of Compensation
- 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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SEE PICS ON ABGs
SEE PICS ON ABGs and MATH
29
ABG w copensaion
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.
30
Interpret this ABG - ph 7.36 - CO2 50 - HCO3 29
- 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)
31
LUNG CA
- Cancer of Lung Tissue - mostly epithelial lining - 2 Types: Small Cell Lung CA (SCLC) and Non Small Cell Lung CA (NSCLC)
32
2 Types Lung CA
``` 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
Lung CA: Risk
- 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
Lung CA
smoke inhalation --> irritation to epithelial lining--> cells mutate --> growth of abnormal/CA cells
35
Lung CA: SS
- Dyspnea - Wheeze - Chest Pain - Hemoptysis (blood in sputum) - hoarse voice - freq lung infec - fatigue - weight loss
36
Lung CA: Dx
- CxR - CT Scan - MRI - Biopsy w bronchoscope - Sputum Cytology (lab analyzes cells) - btatin/bone scans (mets?) - cough that keeps getting worse
37
Lung CA: Rx
- wedge resection: remove sm portion of lobe - segmental resection: remove lg portion of lobe - lobectomy: remove entire lobe - Pneumonectomy: remove 1 entire lung
38
Lung CA: Rx
- Stages: I, II, III, IV (mets) - Chemo - Radiation 2 Type SCLC NSCLC
39
Small Cell Lung CA, SCLC (Oat Carcinoma)
- rapid growth - mets @ time of Dx - Rx: chemo.radiation/sx - palliative - poor prognosis, survival LESS than 1 yr
40
Non Small Cell Lung CA, NSCLC
-85% of CAs
41
Pulse Oximetry
- non-invasive - measures arterial O2 sat(SaO2) - measeures % of HgB saturated w O2 - Continuous or Intermittent monitoring
42
Inaccurate Pulse Ox readings d/t
- vasoconstriction (cold, vasopressors) - hypothermia/hypotension - probe exp to bright light/sunlight - pt mvmt
43
What is O2 saturation?
- 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
100 HgB molecules can carry how many Os
400 Os
45
what percentage O2 if HgB only carrying 360 O2?
360/400 = .9 x 100 = 90%
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Ventilator to prevent Atelectasis
inhale to expand chest
59
Ventilation
- mvmt of air in/out lungs - 2 phases: inspiration/expiration - relationship btw press/volume
60
Relationship btw Vol and Pressure
- Air flows to change in pressure. from HI pressure to LO - UP in volume --> DEC in pressure - inspriation --> lung expansion --> UP volume
61
Atmospheric Pressure
- 760 mmHg | - during inspiration, lung pressure is less than atmospheric
62
Inspiration
- Active process | - cause by muscular contractions mainly of diapragm and intercostal muscles
63
Expiration
mainly used by Passive process -elastic recoil of diaphragm -relaxation of intercostal muscles In COPD, expiration is active.
64
Pleural Space has Negative Pressure
- Air tight vacuum | - lung collapses if air introduced
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Pneumothorax
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Chest Tube
- 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
Caring for a Chest Tube
- pleurovac should be lower than patient - resp status - dressing - tube for kinks - drainage - correct suction - water seal - measure output I+O
76
How to position pt w Chest Tube
- 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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