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57 Cards in this Set
- Front
- Back
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Revew the A+P
of lungs |
Trachea, R and L main stem
bronchus, bronchi, alveolar duct, alveoli. The continuous exchange of O2 & CO2 is required. Alveoli transfer O2 to blood and CO2 from blood which is released back into the air via lungs |
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Ventilation
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includes both inspiration
(active movement of air in) and expiration (passive movement of air out). Factor in control is level of arterial CO2 causes brain to increase RR to rid excess CO2 |
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Perfusion
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Distribution of red blood
cells to and from the pulmonary capillaries |
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Diffusion
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movement of gases O2 and CO2
from high to low concentration across alveolar cap membrane. O2 atomosphere into arterial blood. CO2 arterial blood back to atmosphere. |
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Compliance
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measure of lung and thoracic
elasticity or ability to contract/expand. If decreased lungs difficult to inflate (pulm edema/effusion) If increased loss of elasticity and destruction of alveolar walls (emphysema) |
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Hypoventilation
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alveolar ventilation fails to
meet body's O2 demand or eliminate CO2. Caused by atelectasis and COPD. S+S change in LOC, decrease RR |
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Hyperventilation
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ventilation in excess, blowing
off CO2 too much. Anxiety, fear. S+S dizzy, HA |
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Hypoxia
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inadequate tissue oxygenation
or low levels of arterial O2. Caused by: decreased Hgb level, high altitued (diminished O2 inspired) Poor tissue perfusion w/ oxygenated blood, impaired ventilation |
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S+S of
hypoxia |
apprehension, restlessness,
inability to concentrate, decreased LOC, dizzy, rapid pulse, rapid RR |
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Cyanosis
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blue discoloration of skin &
mucous membranes caused by presene of desaturated Hgb in cap. late stage of hypoxia. CENTRAL-tongue, soft palate, conjunctivia. PERIPERHAL -extremities, nail beds |
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Discuss the role of
chemoreceptors in the control or respiration |
chemoreceptor responds to change
in chem composition of fluid surrounding it. located near the respiratory center. are sensitive to changes in the pH |
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Humidification
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process of adding water to
gas. temp influences amt of h2o a gas can hold. air/02 with a high relative humidity keeps airways moist, help reduce fever, loosens secretions. necessary for pts receiving 4L/min |
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Nebulization
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adding moisture or meds to
inspired air by misting particles w/ air. improves clearance of secretions by allowing our body's natural mechanism for resp debris removal |
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Chest
Physiotherapy (CPT) |
group of therapies used in
combination to mobilize pulmonary secretions. should be f/u by coughing or suctioning. postural drainage, chest percussion, vibration |
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Normal changes
with aging |
Decreased resp. muscle
mass/strenght, # of cilia, airway clearance, cardiac output, PaO2. Increase resp. rate, risk of aspiration, infection |
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Dyspnea
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sign of hypoxia,
manifests as breathlessness. difficult or uncomfortable breathing. |
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Orthopnea
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abnormal ocndition in which
patient must use multiple pillows when lying down or must sit with arms elevated in order to breath |
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Clubbing
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increased depth, bulk,
sponginess of distal digit (finger/foot) due to hypoxemia (chronic), lung ca, bronchiectasis |
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Tachypnea
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Increased rate of respirations
> 20/min. Possibly due to fever, anxiety, hypoxemia |
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Hypoxic drive
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when a patient depends on a
deficiency of O2 to stimulate respiration (COPD) |
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Pursed lip
breathing |
exhalation thru the mouth with
lips pursed together in order to slow exhalation. Possibly caused by COPD, asthma |
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Physiological
factors affecting oxygenation |
Decreased O2 carrying capacity
(anemia)Decreased inspired O2 concentration (airway obstruction)Hypovolemia (fluid loss)Increased metabolic rate (increased tissue O2) |
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Conditions that
affect chest wall movement: Pregnancy |
Fetus and large uterus force abd
contents to push up and against diaphragm |
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Obesity
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decreased compliance,
increased work of breathing, decreased lung volume, fatigue, CO2 retention. lungs cannot fully expand and pulmonary excretions are not mobilized |
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Musculoskeletal
abnormalities |
Pectus excavatum, kyphosis,
lordosis, scoliosis |
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Trauma
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Multiple rib fx can cause a
flail chest can lead to hypoxemia. Shallow breaths to reduce pain. |
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Neuromuscular
disease |
Can cause paralysis of the
respiratory muscles. Impaired ventilation may cause hypoxemia, atelectasis |
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CNS
alterations |
Injury to medulla oblongata and
spinal cord may disrupt normal breathing regulation, leading to abnrml breathing patterns, reduced lung volumes, hypoxemia |
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Influences of
chronic disease |
decreased oxygenation as a
secondary effect (chronic hypoxemia leading to secondary polycythemia) |
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Kussmaul's respirations
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abnormally deep, regular and
increased in rate. causes of respiratory compensation for a metabolic acidosis |
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Cheyne-Stokes
respiration |
respiratory rate and depth are
irregular alternating periods of apnea and hyperventilation. Caused by instability in the feedback control |
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Atelectasis
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collapsed airless alveoli.
Cuased by inadequate lung expansion due to anesthesia, analgesia. Treatment - increasing tissue oxygenation. happens at bases. Use an i.s. |
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Tracheal
sounds |
Tracheal breath sounds are
heard over the trachea. These sounds are high pitched, harsh and sound like air is being blown through a pipe (hollow quality). air flow in upper airways |
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Bronchial
sounds |
Bronchial sounds are present
over the large airways. loud and high in pitch with a short pause between inspiration and expiration; expiratory sounds last longer than inspiratory sounds. air moving thru trachea close to chest wall |
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Vesicular sounds
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soft, blowing, or rustling
sounds heard throughout most of the lung fields. normally heard throughout inspiration, continue without pause through expiration, and then fade away about one third of the way through expiration. Air moving thru smaller airways |
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Bronchovesicular
sounds |
heard in the posterior chest
between the scapula and in the center part of the anterior chest. sounds are softer than bronchial sounds, but have a tubular quality. equal during inspiration and expiration; air moving thru large airways |
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Early and late
S+S of inadequate oxygenation |
Early: apprehension,
irritability, tachypnea, tachycardia, HTN. Late: combativeness, coma, cyanosis, hypotension |
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Sputum characteristics
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Color - clear, white, yellow, green, brown, red.
Color changes - same all day, clear with cough. Quantity - decreased, increased. Consistency - frothy, watery. Blood? Odor? |
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Pulse
oximetry |
noninvasive technique that
determines O2 saturation. SpO2 >95 %. Probe placed on finger |
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WBC's
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total count can indicate
infection if > 11,000 (4,000-11,000)Leukopenia < 4,000. WBC diff % of each type of leukocyte. |
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Hemoblogin
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measurement of gas-carrying
capacity of RBC's. can dx anemia, determine fluid deficit. norm 12-17. |
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Pulmonary Function
Tests (PFT's) |
evaluate lung function by
measuring lung volumes and airflow, dx pulmonary dz. Use of a spirometer to diagram air. |
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Arterial blood
gases |
determines acid-base
balance. |
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Crackles
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caused by fluid in the small
airways or atelectasis. referred to as discontinuous sounds; heard on inspiration or expiration.popping sounds produced are created when air is forced through respiratory passages that are narrowed by fluid, mucus, or pus. |
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Rhonchi
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heard continuously during
inspiration or expiration, wheezing. caused by air moving through airways narrowed by constriction or swelling of airway or partial airway obstruction. |
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Wheezes
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an adventitious or abnormal
breath sound heard when listening to the chest as a person breathes. Wheezes are continuous and musical sounding, and usually caused by airway obstruction from swelling or secretions. Wheezes can be high or low pitched, and are also known as rhonchi. |
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Bronchophony
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The spoken or whispered
syllable is more distinct than normal upon auscultation. PNA |
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Egophony
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Spoken "e" similar to
"a" on auscultation. PNA |
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Classic cues
to respiratory problems |
SOB (dyspnea), wheezing,
pleuritic cp, cough, sputum production, hemoptysis, voice change, fatigue |
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How can healthy
lifestyle decrease risk of respiratory problems? |
Regular exercise,
diet/nutrition, tobacco, alcohol, caffeine |
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Nursing interventions
to promote lung expansion, mobilization of pulmonary secretions and maintenance of a patient airway |
Humidification, nebulization,
CPT, suctioning techniques |
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Standard procedure for
collecting a sputum specimen |
Can be obtained by
expectoration, tracheal suction, or bronchoscopy. Specs are sent to lab for organism i.d. Must be collected with sterile technique |
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Pulse ox -
proper use, purpose, monitoring |
Continual monitoring of SpO2.
Assess pt for factors that could affect sat. Determine baseline. Set alarms accordingly. |
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Differentiate between
the following O2 systems: Nasal cannula Simple face mask |
Nasal cannula - pt can
eat/talk, slow flow rate, easily dislodge (up to 6L) Simple face mask - mod O2 amt, short-term, loose-fitting, sensation of smothering (min 5L) |
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Venturi
Non-rebreather |
Venturi - plastic face mask,
precise, high flow rates, pt cannot speak easily/eat/talk Non-rebreather - prevents expired air from entering bag, precise, high O2, pt can't talk/eat |
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MDI
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Metered dose inhaler; device
used to produce local effects such as bronchodilation by delivering meds directly to resp tract. makes high pitch sound if incorrectly used. |
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Yankhauer
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used for oropharyngeal
suctioning, just mouth and buccal cavity as fluid and mucous accumulate in mouth. |
