Pathophysiology - Pulmonary

Front 1

Dyspnea

Back 1

-Subjective feeling of inability to get enough oxygen or release carbon dioxide

-Aka – Shortness of Breath (SOB)

-When patient complains of SOB check oxygen and CO2 levels

-Symptom not sign

-Signs include fast breathing, shallow breathing, low O2 saturation

Front 2

Orthopnea

Back 2

Breathing dependant upon position

Front 3

Cough

Back 3

Protective reflex to keep lower airway clean

Front 4

Hemoptysis

Back 4

Coughing up blood
-Bright red and alkaline

Front 5

Clubbing

Back 5

-Enlargement of the ends of fingers
-Painless
- Capillaries enlarge to compensate for lack of oxygen

Front 6

Hypercapnia

Back 6

-Hypoventilation
-Inadequate ventilation
-Low Tidal Volume
-CO2 retained; above 45mmHg
- blood pH decreases; below 7.35
-most common cause - COPD

Front 7

Hypoxemia

Back 7

Not enough oxygen in arterial blood
pO2 below 80 mmHg

Front 8

Hypoxia

Back 8

Not enough oxygen in tissues

Front 9

Pulmonary Edema

Back 9

-excess fluid between cells making up lung tissue
-usually caused by heart failure
-left ventricle is doing a poor job of pumping blood into circulation
- Fluid in blod streams back into left atrium anf into pulmonary vein
- Sounds crackly

Front 10

COPD

Back 10

Disease of Alveoli
End Stage Pulmonary Disorder

Front 11

# of Lobes

Back 11

3 on right
2 on left

Front 12

Time spent breathing

Back 12

1/3 inhaling
2/3 exhaling

Front 13

Functional unit of the lungs

Back 13

Alveoli – location of O and CO2 exchange

Front 14

Pulmonary Circulation

Back 14

Pulmonary Artery
Arteriole
Capillary
Alveoli
Venule
Pulmonary Vein
Right Atrium

Front 15

How many Alveoli in lungs

Back 15

3 million
Surface area of a tennis court

Front 16

Tachypnea

Back 16

Greater than 24 breaths per minute
30+ breaths with visual signs evident

Front 17

Tachycardia

Back 17

Faster heart rate to compensate for lowered oxygen levels

Front 18

Comfort measures for tachypnea

Back 18

Fan on face
Basin of water – wet rags on face

Front 19

Eupnea

Back 19

Normal rhythmic breathing

Front 20

Bradypnea

Back 20

Below 8 breaths per minute
Common with narcotics as breathing is suppressed

Front 21

Chained stoats

Back 21

Alternating boats of bradypnea and tachypnea

Front 22

Tidal Volume

Back 22

- The amount of air breathed in or out during normal respiration
- 400 – 800 mL

Front 23

Hyperpnea

Back 23

-Heavy breathing to get rid of acid
- Kussmaul

Front 24

What to do with a morphine overdose?

Back 24

Stop Morphine Pump
Increase Oxygen
Narcan 0 reverse the effects of Narcotics

Front 25

Hypocapnia

Back 25

- Hyperventilation
- Too much ventilation
- CO2 is lost, increasing blood pH

Front 26

Symptoms of Hypocapnia or alkalosis

Back 26

- Lightheadedness
- Numbness in extremities and around mouth
- Loss of consciousness
- Squeezing chest pain
- Petechiae

Front 27

Coughing comfort measures

Back 27

-Sit up
-Hold pillow over incision
-Turn Head
- Breathe deeply

Front 28

Breathing Pain

Back 28

Localized
Worsens with coughing
Related to the breathing cycle

Front 29

Cardiac Pain

Back 29

Constant, diffuse pain

Front 30

Pleurotic pain

Back 30

When there is not enough pleural fluid to lubricate the lungs

Front 31

Oxemeter

Back 31

Measures hypoxia

Front 32

Causes of Hypoxemia

Back 32

High altitude
Decreased breathing sensation (opiod or narcotics)
Suffocation
COPD

Front 33

Signs of Pulmonary Edema

Back 33

Dyspnea
Audible wet bubble sounds
Visible neck vein
Hard and fast heart beat
Frothy pink sputum

Front 34

Aspiration -

Back 34

Food, fluid or particles into lungs
-Right lobe more likely to e affected
- leads to pneumonia

Front 35

Atelectasis

Back 35

Collapse of alveoli
Common after surgery
Smokers and elderly at increased risk

Front 36

Symptoms of Atelectasis

Back 36

Cough, but not prominent
Chest pain (rare)
Difficulty breathing
Low Oxygen saturation
Fever
Pleural effusion

Front 37

Atelectasis Prevention

Back 37

Encourage deep breaths
- this clears anathesia, causes cough to clear microbes

Front 38

COPD Hallmark

Back 38

Dyspnea due to CO2 retention in alveoli

Front 39

COPD Symptoms

Back 39

Dyspnea
Wheezing
Decreased respiratory volume

Front 40

Consequence of COPD

Back 40

Right sided heart failure
- as fibrotic alveoli impairs blood flow from right ventricle into pulmonary circulation.

Front 41

Three kinds of COPD

Back 41

Asthma
Emphysema
Pneumonia

Front 42

Asthma -

Back 42

Chronic disease of occasional inflammation and constriction
- Antigen/antibody response produces swollen airways, which interfere with the exhalation of carbon dioxide

Front 43

Cardinal sign of asthma

Back 43

Wheezing and trapping of mucs in the lower airway

Front 44

Cause of asthma

Back 44

Usually caused by environmental antigen and is reversible.

Front 45

Emphysema

Back 45

Characterized by loss of elasticity on lung tissue, destruction of structures supporting the alveoli and destruction of the capillaries feed the alveoli. Resulting in small airways that collapse during exhalation

Front 46

Barrel Chest

Back 46

Increase in anterior and posterior diameter due to trapping alveoli

Front 47

Peak flow meter

Back 47

Measures maximum ability to expel air from the lungs. Will be very low in pt with asthma

Front 48

Forced Expiration Volume

Back 48

Measures how much CO2 is retained.

Front 49

Purpose of pursed-lip breathing

Back 49

Uses force to expel trapped CO2

Front 50

PNA

Back 50

Pneumonia

Front 51

Pneumonia

Back 51

Upper respiratory Infection casued by viral, bacterial or fungal

Front 52

Bacterial Lung infections

Back 52

Usually more sever, but are treatable with antibiotics

Front 53

Viral Lung infections

Back 53

Treat symptoms, but can not cure

Front 54

Fungal Lung infections

Back 54

Usually only in immunosuppressed patients

Front 55

Tachypnea

Back 55

greater than 24 breaths per minute

Front 56

Bradypnea

Back 56

– less than 8 breaths per minute

Front 57

Eupnea

Back 57

– 10-20 breaths per minute with occasion sighs

Front 58

Chained stoats

Back 58

– alternating boats of bradypnea and tachypnea

Front 59

Tidal Volume

Back 59

– the amount of air breathed in or out during normal respiration (about 500mL)

Front 60

. What is atelectasis?

Back 60

– collapse of alveoli causing less room for gas exchange. Instruct pt to TCDB (Turn, cough, deep breath)

Front 61

What is the purpose of coughing?

Back 61

Keeps lower airway clean by getting rid of inhaled particles

Front 62

Asthma

Back 62

chronic disease of airway constriction and inflammation with excessive mucus in response to 1+ triggers

Front 63

Emphysema

Back 63

– loss of elasticity of the lung tissue and destruction of supporting alveoli: resulting in barrel chest cause by swelling which results from air sacs full of CO2

Front 64

. What is pneumonia

Back 64

= upper respirtory infection caused by viral, bacterial or fungal infection. Bacterial infection are usually more severe, but are treatable with antibiotics. Fungal infections ususlly only in immunocompromised patients

Front 65

What happens to arterial blood gas values with emphysema

Back 65

pH decreases