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54 Cards in this Set
- Front
- Back
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what makes up the upper respiratory system & what is the function of it
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nose, sinuses, pharynx, larynx, trachea
a passageway that cleans, humidifies and warms the air as it travels into the lungs and CO2 is moved out |
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what is pulmonary ventilation
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air moving in & out of the lungs
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what is external respiration
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the exchange of O2 & CO2 between the alveoli & the blood
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what is internal respiration
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the exchange of O2 and CO2 between the blood & the cells
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what is gas transport
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it is O2 & CO2 being transported to & from the lungs & the cells of the body via the blood
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what are the structures of the lower respiratory system and the function
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lungs, pleura, bronchi & alveoli, rib cage & intercostal mms
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what are cilia and where are they found
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cilia are small hair-like projection in the lower airways that catch particles in the oropharynx and are expectorated or swallowed
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what impairs cilia function
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low & high O2 levels
dry, humidified air smoking |
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what happens when the oropharynx is obstructed & what causes it
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ventilation stops
occurs when neural control is lost, pharyngeal structures are swollen d/t injury, infection, severe allergic reaction, foreign body is aspirated |
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what is aspiration pneumonia and how does it occur
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it is a serious inflammation condition caused by partial or total paralysis of the swallowing mechanism resulting in foods & liquids entering the airways instead of the esophagus
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who are more at risk for aspiration pneumonia
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stroke patients, alcoholics, people undergoing surgery
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what causes bronchospasms
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cold air, exercise, emotional upset, exposure to bronchial irritants (smoke) cause the criss crossing smooth mms around the bronchioles to contract & impair air flow
complications to asthma & bronchitis |
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how can you tell if a pt. is in bronchospams
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severe dypsnea & fatigue
use of accessory mms (SCM, intercostals, traps) |
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what is pleural effusion
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serous fluid or inflammatory exudate that accumulates in the pleural space which is the space b/w 2 layers of membrane
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what is intrapleural pressure
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negative pressure created by the opposing movement of the lungs & chest wall that becomes even more negative during inspiration
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what nerve innervates the diaphragm
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phrenic nerve roots - C3 -C5
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TD - tidal volume
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amount of air moved in & out of lungs with each normal quiet breath; about 500mL
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IRV - inspiratory reserve volume
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max. amount that can be inhaled over & above normal inhalation; approx. 2100-3100 mL
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ERV - expiratory reserve volume
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max. amount that can be exhaled following a normal exhalation; 1000 mL
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RV - residual volume
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amount of air remaining in the lungs after maximal/forced exhalation; 1100mL
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TLC - total lung capacity
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the total volme of the lungs at their max. inflation
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functional residual capacity - FRC
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volume of air left in the lungs after a normal exhalation.
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what happens in the older clients
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residual capacity is increased and vital capacity decreases because of calcification of the costal cartligage & weakening of the intercostal mms which reduce the chest wall; vertebral osteoporosis which decrease spinal flexibility & increases the degree of hyphosis further increasing the anterior posterior diameter of the heart; and the diaphragm loses elasticity & flattens
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what is lung compliance
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it is the change of the lungs volume when their is an change in the intrapleural pressure; depends on the elasticity of the lung tissue & the flexibiilty of the rib cage
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respiratory passageway resistance
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is created by the friction encountered as gases move along the passageways, accumulations of mucus or infectious material & tumors; as resistance increases, gas flow decreases
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lung elasticity
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it is essential for lung distention during inspiration & lung recoil during expiration; decreased elasticity from disease such as emphysema impairs respiration
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what are the 3 things that affect respiration
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respiratory passageway resistance, lung compliance and lung elasticity
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what is surfactant and what does it do
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it is a lipoprotein produced by the alveolar cells and it interferes with the adhesiveness of the water molecules, reducing surface tensiona dn helps expand the lungs. if insufficient surfactant the surface tension forces can cause the alveoli to collapse in between breaths
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what are the 3 reasons exchange & transport of gases may be impaired
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ventilation (flow of gases into & out of the alveoli)
perfusion (flow of blood in the adjacent pulmonary capillaries) diffusion (transfer of gases b/w the alveoli & the pulmonary capillaries) |
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bronchoscopy
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a direct visualization of the larynx, trachea, & bronchi through a bronchoscope to identify lesions, remove foreign bodies & secretions, obtain tissue for biopsy & improve tracheobronchial drainage
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what are the nursing care for clients who have bronchoscopy
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routine preoperative care (VS, O2 sat, etc), oral care, resuscitation & suction equipment @ bedside; postoperative care (VS, O2 sat, etc), avoid eating/drinking for approx. 2 hrs or until full awake with intact gag reflex, provide an emesis basin & tissues for expectorating sputum & saliva, monitor color & characteristics of respiratory secretions (normal to find blood tinged secretions for several hrs after)
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thoracentesis
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a large bore needle is inserted into through the chest wall into the pleural space to obtain a specimen of pleural fluid for diagnosis
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what are genetic considerations for respiratory disorders
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deficiency of alpha1-antitrypsin (a protein that protects the body form damage by its immune cells leaving the lungs susceptible to emphysema)
asthma cystic fibrosis (gene defect that results in defective transport of chloride & sodium by epithelial cells which results in thick mucous that clogs the lungs, leads to infection, & block pancratic enzymes from reaching the intestines to digest food a familial history of lung cancer |
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what are some age related changes in the elderly in the respiratory system
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decreased elastic recoil of lungs during expiration because of less elastic collagen & elastin
loss of skeletal mm strength in the thorax & diaphragm alveoli are less elastic, more fibrotic & have fewer functional capillaries cough is less productive PO2 reduces as much as 155 by age 80 |
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URI - upper respiratory infections
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are highly contagious because they spread through airborne droplets
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rhinitis
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can be acute or chronic & it is the most common upper respiratory disorder
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what are complications of pharyngitis & tonsilitis
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Scarlett Fever, abscess, Rheumatic Fever, Acute poststreptococcal glomerulonephritis
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what is the pathophysiology of obstructive sleep apnea
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pharynx collapses, skeletal mm decrease, tongue falls back against post pharyngeal, airflow obstruction, asphyxia, sleep interrupted
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what can obstructive sleep apnea do
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cause cor pulmonale (R sided heart failure), HTN, ischemic heart disease, exacerbation of heart failure
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what causes Legionairres' disease
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gram negative bacteria usually found in water (water-cooled air conditioners)
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what is the major concern with pneumonia
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aspiration
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who are at risk for aspiration
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stroke pt, unconscious pt, pt with tube feedings, children playing with toys or food, intoxicated people, drowning victims, petroleum distillate ingestions - kerosene, gas, furniture polish, model airplane glues, etc, & powder inhalation
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what can happen with TB
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destroyed kidneys and adrenals
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where does it occur
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upper lobe or upper parts of lower lobe however it can affect other organs
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if the Mantoux test is positive does that mean the person has TB
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no, it means that they have come in contact with the virus
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what was TB known as
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consumption
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how do you you if you have Primary TB
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calcified lesions on chest xray or positive skin test
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Secondary TB
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afternoon low grade fever, night sweats, fatigue, anorexia, wt loss, cough (initially dry & then productive with purulent sputum), general anxiety, dyspnea & orthopnea
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if you have a >10mm induration are you positive on the Mantoux test
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ye but if not immunocompromised you have been exposed but not infected
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who should be screened for TB
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all healthcare personnel, immunocompromised individuals, people living with a person with TB, born in countries with high prevalence of TB, alcoholics & drug users, medicallly underserved low-income,
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what are the antitubercular agents
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Isoniazid (INH), Rifampin (Rifadin) & Ethambutol (Myambutol) along with Pyrazinamide (tebrazid) & Streptomycin
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Isoniazid (INH)
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good for tx & prophylaxis; the SE are peripheral neuritis & hepatotoxicity (liver)
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Rifampin (Rifadin)
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good for tx, pill is red and turns tears, urine, sweat, etc red-orange, use with INH for active TB; SE/AE are hepatotoxicity (liver), blood disorders - decreased RBC (anemia),
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Ethambutol
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used as 1st line agent against TB; substitute for INH when INH restistant strain suspected
SE/AE: optic neuritis, renal damage, peripheral neuropathy, thrombocytopenia |
