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18 Cards in this Set

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what is FEV
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functional expiratory volume
volume of air exhaled in the specified time during the performance of forced vital capacity; FEV is vol. exhaled in 1 second (usually 80% called FEV1a) All of it forced out in 3 secs. (FEV3). (a clue to severity of expiratory airway obstruction
what is VC
***************************
vital capacity
Pt takes a big breath and blows into a spirometer. Values set by age, body build, weight, gender. Most will exhale 80% in one sec. Vital Capacity performed w/ a maximally fourced expiratory effort (this vp is often reduced in COPD b/c or air trapping
what is lung compliance
how much the lungs can expand
things that affect this in old people
loss of elastin
stiffer airways that restrict air flow
the deal with COPD is ...

has to do with air trapping
the push air out of our lungs
expiratory breathing becomes labored from air trapping in the lungs
ventilation & respiration are not the same thing how
respiration=lung vol/capacity measured by lung compliance
ventilation=the ability of the lungs to expand and contract
how do chemoreceptors work?
what are they?
hydrogen ion concentration (pH) of arterial blood
chemoreceptors tell us when to breath
what happens though when a receptors is used and used and used alot?
it becomes less sensitized
so receptors having to constantly respond to a bunch of TRAPPED CO2 start ignoring signals! b/c there is so much co2 trapped so the body switches b/c those receptors are working so are going to breath by reading the partial pressure of o2 instead. so the stimulis to breath is lack of o2 and not co2!
so *************************
if a COPD guy is using Po2 to breath and not usuall co2 chemoreceptors to breathe, what can happen if you turn their o2 up b/c you see them having trouble breathing?
they could stop breathing b/c the body thinks its got enough o2 so it says IM good! So know EXACTLY what pt's o2 is set at and ck that no one has messed w/ it like family members!!!!
again why could you kill a pt by tampering w/ o2 setting?
the body is reading po2 and not pco2 ..the amount of o2 delivered. we don't just walk in and turn up o2 on a pt having trouble breathing
gas exchange (oxygeniation) in the alveolar capillary membrane is determined by
****************************
. avalibility of hemoglobin
. the regional blood flow
. level of arterial o2 content
. cardiac output
is co2 normally in tissues?
no ITS TAKEN OUT, excreted
and if you DO have co2 in your tissues your HYPOXIC
or hypercapnic
pH of blood 7.35 - 7.45
which is the low end and what is it?
what does a rise in pH mean?
7.45 is higher than 7.35 so that is a no. rising
7.35 is acidotic the low end
**************************
so a rise in pH means alot b/c its on a log scale
what is the job of the kidney's?
to either absorb or excret sodium bicarb. point is w/ COPD pts, kidney see them retaining co2, and acid builds up in blood, (ph) changes, and kidneys try to compensate w/ changing pH of blood using sodium bicarb to do it. BUT the kidneys can become overwhelmed at this
****************************
so you might see someone's pH as normal but co2 is hi why???
so pt is blowing off too much co2 , hyperventilating from stress, so your not retaining enough co2 to retain acid, so your in respiratory alkalosis blowing off too much acid and kidneys say "get rid of sodium bicarb! bring it back to homeostatis!"
hyperventalaion makes you

alkalosis?
acidosis?
hyperventilation makes you
alkalosis hypocapnia
lungs remove too much co2 so you blow off too much acid
so arterial blood gas (ABG) has to compensate using kidneys
so if your scarred shitless
you hyperventilate on the rollercoaster
you blow off lots of co2
you get alkalosis
this is called hypocapnia
what do the kidneys do then
compensate by equalizing w/ retention of sodium bicarb
it can't raise the pH by pulling in co2 so it will auto correct by lowering sodium bicarb to equal out the pH of the blood
too much co2 is hypercapnia
this is from hypoventilation
this results in
respiratory acidosis
so kidneys will increase in bicarb in the ABG to compensate Right? Dig?
so hypoxia goes along w/ hyPER capnia right/ but not the same thing. why
not enough o2 means you have too much co2 and thats hypercapnia, too much co2 b/c not enough o2 means lots of co2