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94 Cards in this Set
- Front
- Back
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What secretes surfactant?
What does it prevent? |
Surfactant is secreted by alveoli. It prevents collapse of alveoli.
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Define Pleura.
What does it do? |
Pleura is potential space between visceral and parietal layers. It's a thin layer that allows sliding. (stuck together like 2 glass slides)
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What is the diaphragm?
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muscle seperating the thoacic cavity from the abd cavity
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What is the sequence of Pulmonary Circulation?
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1. pulmonary art. carries deoxygenate blood from the R ventricle to the lungs
2. Blood is reoxygenated in the pulmonary cappilaries surrounding the alveoli 3. Blood flow back through the pulmonary veins to the L atrium and L ventricle |
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Is pulmonary Circulation a high or low pressure system with high or low resistance?
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Low pressure system
Low resistance |
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If pressure increases too much within the pulmonary circulation/capillary bed system what will happen?
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Fluid will move into alveoli resulting in pulmonary edema.
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What are the two essentials to respiration?
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Ventilation and Perfusion
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Define ventilation.
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moving air in and out of the lungs
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What happens during inspiration?
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1. volume of thorax increases
2. diaphragm descends 3. ribs are lifted up and out This lowers the pressure in the lungs. |
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What happens during expiration?
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1. chest wall and lungs recoil as muscles relax
2. rib cage lowers 3. diaphragm rises PASSIVE process |
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What's the respiratory control center?
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1. pons and medulla
2. chemoreceptors in carotid and aortic arch sensitive to p02 levels 3. voluntary control |
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What are chemoreceptors sensitive to?
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pH and pCO2
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What drives respirations?
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increased pCO2
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When ventilation and perfusion are adequate, what two gases exchange?
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O2 and CO2
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Define perfusion.
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adequate blood flow to the cappilaries surrounding the alveoli
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What is another name for "oxyhemoglobin"?
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saturated hgb
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If O2 dissociates from hgb and diffuses in to tissue cells, what is it now called?
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"reduced" hgb
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What is a oxyhemoglobin/hgb?
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a rbc carrying O2
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What is the color of saturated hgb?
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bright red (arterial)
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What is the color of reduced hgb?
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bluish-purple (venous)
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What are the seven diagnosis techniques in assessment of respiratory?
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1. chest x-ray: posterior, anterior, and lateral films
2. CAT scan: localize problem 3. Lung scan:Perfusion scan: will show areas of poor circulation 4. Bronchoscopy: bronchi visualized through fiberoptic tube 5. Sputum analysis: C and S smears 6. Pumonary funstion test: tests; ventilation and gas exchange, severity of impairment, lung volumes and compliance 7. Pulse oximetry: est. of SaO2 |
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What is compliance during a pulmonary funtion test:
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compliance is the stretchability or expandability of the lungs and thorax
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What are the 9 common S & Sx of repiratory diseases?
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1. Cough
2. Sputum 3. Dyspnea 4. Chest pain 5. Clubbing of fingers 6. Cyanosis 7. Hypoxia 8. Hypercapnia 9. Orthopnea |
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Define Cough.
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protective reflex to clear lower airway (clears sputum, dust, smoke, small foreign bodies)
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What produces sputum?
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goblet cells. increased amounts from irritation or inflamation.
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What needs to be noted about sputum as a nurse?
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amount. color. consistency. odor.
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Define hemoptysis.
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blood streaked sputum
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What does rusty sputum indicate?
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pneumococcal pneumonia
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What does sputum indicate?
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TB or cancer
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Define Dyspnea.
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difficulty in breathing
(how much activity does it take to induce dyspnea) |
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What are factors to consider if patient is displaying dyspnea?
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1. use of accessory muscles
2. patients position 3. flaring of nostrils 4. correlate with patiends activity |
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Why would a patient have chest pain with a respiratory disease? (2)
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1.pleura is irritated
2. pain related to angina or pulmonary emboli |
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Define Cyanosis.
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increase in amount of reduced hgb (unsaturated hgb)
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Where do you see central cyanosis?
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face: lips, under tongue, ear lobes
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What color is usually used in description of cyanosis?
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bluish tinge to skin and mucous membranes
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What does central cyanosis indicate?
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insufficient oxygenation of hgb in the lungs
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Define orthopnea.
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lying flat and getting dyspnea on exertion (DOE)
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Would an anemic person get cyanosis?
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No, because all the hgb they have is saturated and they have no reduced hgb.
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Define hypoxia.
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inadequate oxygenation of tissues
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What are the CNS, cardiac, and repiratory signs and symptoms of hypoxemia?
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CNS: confusion, restlessness, anxiety
Cardiac: early increase in h.r., if hypoxic state continues, pulse may decrease Resp: increased rate, use of accessory muscles, flared nostrils, and cyanosis |
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What is pO2 less than 80 an indicator of:
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hypoxemia
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Define hypercapnia.
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ventilation not adequate to rid blood of CO2 caused by alveolar hypoventilation
(pCO2 > 45) |
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What is hypercapnia commonly seen in?
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resp disease with obstructed airway, decreased resp. movement (rib fracture, sedation, chest surgery), pateints with reduced amts of healthy lung tissue
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What are Sx of hypercapnia?
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confusion, headache, asterixis (flapping of hands)
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If hypercapnia is chronic, patient may be adjusted to high levels of CO2 causing the respiratory system to no longer be senstive to what?
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CO2. (in these patients, decreased pO2 drives respirations)
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What will happen if you give a patient with chronic hypercapnia high levels of pO2?
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It will take AWAY their repiratory drive. Low levels of pO2 drive their respirations.
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What is hypocapnia due to? Is it common or uncommon?
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Uncommon. Hyperventilation.
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What is the primary funtion of water in the body?
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primary body fluid
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Define deficit of water.
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dehydration: water content less than normal in relation to electrolytes
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Define excess of water.
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Overhydration/Water Intoxication: water content exceeds normal in relation to electrolytes
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What are the causes of water deficit? (3)
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1. no available water
2. diabetes 3. insipidus |
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What is a cause of excess water?
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SIADH
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What are symptoms and complications of a deficit of water? (8)
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1. lose of weight
2. decreased skin turger 3. dry mucous membranes 4. increase in Hct 5. decrease of urine volume 6. decreased BP 7. thirst 8. confusion (common in elderly) |
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What are the symptoms and complications associated with excess amounts of water in the body? (4)
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1. weight gain
2. edema 3. hemodilution (decrease in Na and Hct 4. bounding pulse |
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What is the normal value of Na+?
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135-145 mEq/L
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Define hyponatremia.
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Na < 135
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Define hypernatremia.
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Na > 145
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Define hypovolemia.
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decreased volume of blood
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Define hypervolemia.
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excess in blood volume
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What does Hct stand for?
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hemo concentration
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What is the normal concentration of Hct?
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35% to 45%
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What is the normal value of K+?
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3.5 - 5.5 mEq/L
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What is K+ important for?
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muscle contraction all over the body, rhythmic cardiac contraction, pulse rate and efficiency
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What controls the levels of K+?
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kidneys
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Define Hypokalemia.
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K+ < 3.5
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Define Hyperkalemia.
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K+ > 5.5
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What causes Hypokalemia?
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diuretics
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What causes hyperkalemia?
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acute renal failure, burns and crushed injuries
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What is a symptom of hyperkalemia?
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heart: ventricular fib causes cardiac arrest
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Normal levels Ca++
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9 - 11 dL
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Define hyocalcemia.
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Ca++ < 9 mg
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Define hypercalcemia.
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Ca++ > 11 mg
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What is a cause of hypercalcemia?
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prolonged immobility
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What are the 5 symptoms of hypocalcemia?
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1. numbness, tingling of extremities
2. muscle cramps/twitching 3. + trousseau's sign (carpopedal spasm with BP cuff on arm) : + chvosteks sign, facial muscle twitching when tap facial nerve in front of ear 4. hyperactive reflexes 5. tetany, convulsions |
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What are symptoms of hypercalcemia?
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renal stones and pathologic fracture
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What is respiratory acidosis?
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carbonic acid excess
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What causes respiratory acidosis?
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any condition which interferes with normal respiration so that CO2 is reatianed:
pnemonia, emphysema, and bronchitis |
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What are symptoms of respiratory acidosis?
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resp. difficulty, increased pulse and respirations. with respiration disease, resp. system can't compensate so buffer system and kidneys will work to correct it.
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What are the lab values of respiratory acidosis? pH and pCO2
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decreased pH and increased pCO2
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Define respiratory alkalosis.
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carbonic acid deficit
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What causes respiratory alkalosis?
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any condition causing hyperventilation so that excess CO2 is "blown off"
anxiety |
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What is a symptom of resp. alkalosis?
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kidneys will compensate by excreting bicarb (HCO3) and retaining H+
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What are the lab values in resp. alkalosis? pH and pCO2
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increased pH
decreased pCO2 |
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Define metabolic acidosis.
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excess acids produced
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What causes metabolic acidosis?
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diabetes - glucose available, but no insulin. break down protien and fat causes acidosis
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What are symptoms of metabolic acidosis? (5)
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1. increased rate and depth of resp. to "blow off"
2. kidneys will excrete more H+ 3. kussmahl response: rapid and deep resp. 4. disorientation 5. breath funky |
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Define metabolic alkalosis.
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base bicarbonate excess
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What is a cause of metabolic alkalosis?
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N/G suctioning
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What is a symtom of metabolic alkalosis?
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slow, shallow resp. (CO2 retained)
kidney will retain H+ and excrete HCO3 (bicarb) |
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SaO2 (O2 saturation)
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95% - 100%
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HCO3 (bicarb)
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22 - 26 mEq/L
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pCO2
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35 - 45 mm Hg
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pO2
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80 - 100 mm Hg
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arterial blood pH
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7.35 - 7.45
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