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194 Cards in this Set
- Front
- Back
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What is the Cardiopulmonary system? |
-Cardiovascular system ( heart) - Pulmonary system (lungs) *systems go hand in hand |
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Where does gas exchange occur? |
Alveoli |
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What muscles of the body are used for breathing? |
-Diaphragm ( muscle that separates the abdominal cavity) -Intercostal muscles |
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What is the function of the upper airway? |
-filters, warms and humidifies our inspired air. |
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What are the components of the upper airway? |
- nose -pharynx -larynx -epiglottis |
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What is the function of the lower airway? |
Clears the mucus and production of pulmonary surfactant. ** surfactant reduces surface tension improving over all lung function. |
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what are the Components of the lower airway? |
- Trachea - Right and Left main stem bronchi - Segmental bronchi - Terminal bronchial down to alveoli. |
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What pleura are the lungs lined with? |
Visceral Parietal |
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How many types of Alveoli are there? |
2 Types |
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Functions of the Respiratory System. |
- Oxygen transport - Respiration - Ventilation - Pulmonary diffusion and perfusion - Gas exchange - Co2 transport - Ventilation and perfusion balance |
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What happens if Co2 builds up in the system? |
increase in Co2 (Hypercapnea) = slow breathing, sleepy, confused. |
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Essentials for normal respiratory function. |
- functioning alveolar system in lungs - oxygenates venous blood - removes Co2 from blood - Carry nutrients and wastes to and from body cells. - transport air to and from lungs |
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What is Inspiration? |
Moving air into the lungs ** Active phase of ventilation |
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What is Expiration? |
Moving air out of the lungs ** Passive phase of ventilation |
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How does ventilation occur? |
Through gas exchange- intake of O2 and release of Co2 |
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What is diffusion? |
movement of O2 and Co2 through the blood and occurs at the alveoli. |
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What conditions can slow diffusion? |
- Pleural effusion -Pneumothorax -Asthma |
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What is Hypoxemia? |
low blood oxygen levels. |
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What is Respiration? |
process of gas exchange between atmospheric air and the blood AND the blood and the cells of the body. |
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What is normal respiratory function? |
- Capillary- tissue gas exchange - Control of ventilation - Defenses of the respiratory system |
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What is the control of ventilation? |
- Maintain normal blood levels of Co2 and O2. ~ PaCO2: normal levels 35-45 mmHg ~ PaO2- normal levels 80 to 100 mmHg ~ SaO2- normal levels 95-100% |
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What are some Cardiovascular complications that would effect gas exchange? |
- CHF - MI - Dysrythmia |
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Lifespan considerations for normal pulmonary function? |
Newborn and Infant - Rapid respiration ( 30-60 /min) - Immature resp. system (increase of infection) Toddler and Preschooler: - Risk for aspiration -20-30/ min School-age and Adolescent: - Smoking -18-26/min Adult and Older adult: (above 60yo) - Gas exchange and breathing become more difficult - Increase in respiratory infection - 16-25/min |
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Factors affecting Normal Respiratory Function |
- Lifespan - Flu/cold - Environment - Pollution - Allergens - Medications - Activity level - Lifestyle ( diet, pregnancy, occupation) - CNS abnormalities (Stroke) - Altitude |
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Describe a Vesicular breath sound |
Low pitched, soft sound during expiration. - heard on thorax |
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Describe a Bronchial breath sound |
High pitched then long sound. - heard primarily over trachea |
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Describe a Broncho-vesicular sound |
Medium pitched sound during expiration - heard over upper anterior chest and intercostal area. |
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Abnormal breath sounds (Adventitious) |
Crackle Wheezing Bronchi |
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What is the crackle sound? |
intermittent sound occurring when air moves through airways containing fluid. - fine, medium, coarse |
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What is the wheezing sound? |
*Whistling Continuous sound heard on inspiration & expiration as air passes through airways that are constricted by swelling secretions or tumors. |
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What is the bronchi sound? |
Snorish sound heard on inspiration & expiration. |
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Nursing assessments for Respiratory (objective) |
Watch and Inspect pt: - general appearance (color) - Use of accessory muscles - note & describe cough - note sputum color - respiratory effort Auscultate lungs |
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Nursing assessments for Respiratory (subjective) |
Ask patient: - Health history - Occupation - Onset, duration of any symptoms - Immunizations - Diet - Smoking |
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Diagnostic procedures for Respiratory |
- Sputum culture - PFT's (pulmonary function test) - CT scan - MRI - Capnography ( measures CO2 in inhaled& exhaled air) -Peak flow monitoring -Thoracentesis - ABG's - Bronchoscopy (done by Dr.) - Pulse-Ox - Chest x-ray |
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What is hypoxia? |
Inadequate amount of oxygen |
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What is dyspnea? |
difficulty breathing |
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What is hypoventilation? |
decrease rate or depth of air movement in the lungs |
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Early signs of hypoxemia |
Restlessness irritability agitation confusion |
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Late sign of hypoxemia |
Cyanosis ( central before peripheral) |
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Signs of hypoxemia |
Anxiety "Air hunger" Jugular vein distention tachycardia, tachypnea orthopnea bradypnea, bradycardia hypotension dysrhythmias apnea/death |
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Nursing Interventions: to promote respiratory functions |
- Use incentive spirometer - positioning - Deep breathing excercise (smell flowers, blow out candles) - hydration - avoid smoking - avoid stress -suctioning airway - managing chest tubes |
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Nursing interventions: to promote proper breathing |
- breathing techniques - slow breathing (pursed lips) - educate to take rest when needed - adequate nutrition -calm patient down |
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Nursing interventions: to promote comfort |
- Educate - have patient express feelings - positioning - fluid intake (6-8 glasses) - Distraction - nutrition - pace care by activity level |
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Types of Inhalers |
Mini Nebulizers Metered dose inahler (controlled dose) Inhaler with spacer Powder inhaler (breath activates) |
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Inhaler and cough medications |
Steroid and Anti-inflammatory (symbicort) Bronchodialators (anticholinergics) Cough: suppressants losange expectorants |
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Different types of COPD |
- Emphysema - Chronic bronchitis |
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What type of COPD can be present at the same time? |
Bronchitis & Emphysema |
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What is Bronchitis? |
Increase of mucus and inflammation |
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What is Emphysema? |
destruction and enlargement of air spaces ** air flow obstruction, changes lung tissue |
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What is "Chronic" bronchitis? |
sputum production for at least 3 months in each of two consecutive years. |
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Characteristics of Chronic bronchitis |
- Decreased airflow to and from the lungs - Excessive mucus accumulation - Inflammation - Eventual scarring of the bronchial tube lining - Reduced ciliary function due to mucus plugging - Narrowing of the airway |
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What is the most common risk factor/ irritant with COPD |
SMOKING |
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Signs and Symptoms of Chronic bronchitis |
- Chronic cough, frequent throat clearing - increased mucus - SOB - Hypoxemia occurs -> PaCO2 increases - Polycythemia - Cor Pulmonale |
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What is Polycythemia? |
"Blue bloater"- Bluish red skin discoloration from cyanosis and polycythemia. |
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What is Cor Pulmonale? |
Enlarged right heart ventricle ( cause by respiratory disorder) |
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How is Chronic bronchitis diagnosed? |
Chest x-ray Pulmonary Function Tests (PFT's)- Respiratory therapists normally do. |
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Treatment of chronic bronchitis |
- inhalers & nebulizers - steroids & bronchodialators - oxygenation - quite smoking - diaphragmatic breathing - Antibiotics ( if infection ) |
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Characteristics of Emphysema |
- Loss of lung elasticity - Hyperinflation of the lung - air trapping - overstretching and enlargement of the alveoli into bullae - Collapse of small airways ( bronchioles) |
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What does destruction of alveoli in the lungs lead to? |
Hypoxemia SOB Less surface area for gas exchange |
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What happens with hyper-inflated lungs? |
"Barrel Chest" - flattens the diaphragm - increased work load= increased need for O2 - "Air Hunger" ( cant breathe) - inhalation begins before exhalation is complete - gas exchange is affected - uncoordinated breathing pattern results |
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Complications from Emphysema |
- Affects delivery of O2 to all tissues - Leads to organ anoxia (loss of O2 to other organs) - Hypoxemia - acidosis (pH goes down) - infection - Cardiac failure - dysrhythmias |
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COPD etiology/ risk factors |
- SMOKING #1 - air pollution - 2nd hand smoke - occupation - environment - Alpha 1 Antitrypsin deficiency (genetic) |
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Symptoms of Emphysema |
- SOB - DOE ( dyspnea on exertion) - Fatigue - weight loss |
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Nursing Intervention: Questions to ask when assessing COPD patient |
Do you smoke? (how long, how many) Do you use O2? ( how many L) Whats your occupation? Any family history? What activities can you tolerate? Any weight loss? How do you sleep? (sitting up, laying down) How many years were you diagnosed? |
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Nursing Intervention: Physical assessment for COPD patient |
- Respiration: Rate & Depth Use of accessory muscles ( nasal flaring) - Pule rate - peripheral oxygen saturation level - Cyanosis (sign of hypoxic) - asses cough - Auscultate lung sounds - look for clubbing fingers |
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What sounds may you hear in a COPD patient when auscultating lungs? |
- Diminished - Coarse ( bronchi) - wheezing - Stridor (will need vent or bi-pap machine) |
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Laboratory Assessments for COPD |
ABG ( arterial blood gases) Sputum collection (hemothesis- bloody sputum) Genetic blood test |
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Radiographic Assessment for COPD |
Chest X-ray ( diaphragm flattened) |
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Pulmonary fuction studies for COPD |
Spirometry PFT's |
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What does a Spirometer do? |
measures forced vital capacity and forced expiratory volume in 1 second to determine degree of airflow obstruction |
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What are PFT's? |
lung diffusion testing that measures how much air moves from the patient's lungs to his blood; body plethysmography measures lung volume. |
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whats the 1st line treatment for COPD? |
Bronchodilator therapy |
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what are some bronchodilator therapies? |
- Beta 2 agonists (short or long acting) - Anticholinergics - inhaled steroids - systemic steroids - Methylxanthines- Theophylline |
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Beta 2 agonists ( SHORT acting) examples |
Albuterol Xopenex (Levalbuterol) *** give to patients with increased heart rate Ventolin |
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Beta 2 agonists ( LONG acting) examples |
Foradil Serevent ** used for maintenance, NOT acute symptoms |
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Anticholinergic examples |
Short acting & long acting - Spiriva - Atrovent |
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Inhaled corticosteroid examples |
Pulmicort Flovent Azmacort |
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Systemic Corticosteroid examples |
Cortisone Hydrocortisone Methyprednisolone Prednisone |
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Treatment options for COPD patients |
Oxygen therapy Pulmonary rehabilitation- recommended for moderate to severe COPD |
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What is the GOAL for treating COPD |
reduce symptoms and improve quality of life- physically & emotionally. |
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Surgical management for COPD patients when medication therapy fails |
Bullectomy Lung Volume reduction surgery Lung transplant- LAST RESORT |
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What is a bullectomy? |
removes dead air spaces that inhibit lung function. |
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What is lung volume reduction surgery? |
portion of diseased lung is removed reducing hyperinflation and allows the functional tissue to expand. * disease MUST be end stage and focused in one area of the lung not wide spread. |
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What happens after lung transplant? |
Patient is on Steroid and Anti-rejection medicine for the rest of their life. |
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S&S of exacerbation of COPD |
- confusion - lethargy - Respiratory muscle fatigue - Peripheral edema - Worsening or new central cyanosis - Worsening hypoxemia |
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Complications from COPD |
- Respiratory failure (may require mechanical ventilation) - Pneumothorax - Chronic atelectasis - Pneumonia - Pulmonary artery htn (PAH) -> cor pulmonale and right heart failure |
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Pathophysiology of Asthma |
Reversible diffuse airway inflammation that leads to long-term airway narrowing. * chronic inflammatory disease of the airways |
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Symptoms of Asthma |
- Cough - Chest tightness - Wheezing - Dyspnea - Allergy - Smoking - Weather- cold, excessive heat - outdoors |
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What is the strongest predisposing factor for asthma? |
ALLERGY |
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What assessment do you need for asthma pt? |
Need good history: Family history Environmental history |
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Testing for Asthma |
PFT's Sputum & blood tests (elevated eosinphils) ABG's |
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Complications of Asthma |
Status asthmaticus Respiratory failure Pneumonia Atelectasis Airway obstruction |
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What is status asthmaticus? |
Rapid onset, severe persistent asthma that does not respond to conventional therapy. |
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Management of Asthma |
treat hypoxemia (O2) fluids (IV) Inhalers/ Nebulizers |
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Nursing Diagnosis: Impaired Gas Exchange |
Airway maintenance Monitor lung sounds Drug therapy Administer LOW FLOW O2 as ordered Chest PT Mechanical ventilation if necessary Surgical management |
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Nursing Diagnosis: Ineffective Breathing Pattern |
Asses respiratory rate & pattern Assist to high Fowler's position Breathing techniques (Diaphragmatic, pursed lip) Administer bronchodilators Energy conservation |
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Nursing Diagnosis: Ineffective Airway Clearance |
- Positioning to facilitate breathing - Assess breath sounds - Suction if needed - Hydrate client with at least 8-10 glasses of fluid - Teach and supervise effective coughing tech. - perform chest PT if ordered |
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Nursing Diagnosis: Ineffective therapeutic management/ knowledge deficit. |
- Assess level of understanding about disease and prescribed treatment regimen. - Discuss client's perceptions of disease and affect on life style. - Assist in identifying problems or difficulties integrating treatment plan - Refer to community resources |
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Nursing Diagnosis: Risk for Inadequate Nutrition |
Monitor nutritional status: - Increase intake of high calorie foods - Increase fluids Monitor I & O's, weight, Hgb, albumin levels. Advise client to eat small, frequent meals - High protein meals - Use nasal cannula during meals |
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Nursing Diagnosis: Anxiety |
Psychological interventions - support groups - support during episode Asses prior coping mechanisms Complimentary/ alternative therapy - relaxation - biofeedback - hypnosis Listen to concerns Encourage verbalization of feelings Include client in decision making |
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Nursing Diagnosis: Risk for sleep pattern disturbance |
- promote relaxation - scheduled care activities to allow period of uninterrupted sleep - instruct client in measures to promote sleep |
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What are some breathing exercises? |
Breath slowly- promotes complete exhalation Inhale through the nose Diaphragmatic breathing- *good for COPD pt's |
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How do you perform Diaphragmatic breathing? |
Teach patients: 1. place hand on the abdomen and on the chest 2. breath in through pursed lips (sucking straw) while tightening the abdominal muscles 3. push firmly inward and upward on the abdoman while breathing out |
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What is the goal for diaphragmatic breathing? |
use and strengthen the diaphragm during breathing. |
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How do you perform pursed lip breathing? |
Purse the lips- patient should position the lips as though sucking through straw. Sitting upright: Inhale through the nose while counting to 3 Exhale slowly and evenly against lips while tightening the abdominal muscles. During exhalation the patient counts to 7. |
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Why use pursed lip breathing technique? |
Creates a smaller opening for air movement which prolongs expiration. |
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Reasons for using Incentive Spirometer |
- promotes deep breathing of the patient - encourages max lung inflation and prevents or reduces atelectasis. * gauge allows the patient to measure their progress |
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What is the GOAL of incentive spirometer? |
sustain maximum inspiration |
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General rule with oxygen therapy |
Use the lowest O2 concentration possible to achieve an acceptable blood oxygen level. |
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Why is oxygen therapy used? |
* primary reason: reverse hypoxemia it is administered to maintain an adequate amount of O2 in the blood or the PaO2. |
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How is oxygen ordered? |
Either: - Flow - Liters per minute - Concentration (% or fraction of inspired air) |
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How do you select which oxygen device? |
Depends on the clients status and which one will meet the goal of the therapy. |
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What are the Advantages of O2 therapy? |
Improves tissue oxygenation Decreases the effort of breathing Decreases the work of the heart |
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Nursing Interventions while on O2 therapy |
Asses the client frequently for changes Adjust the concentration accordingly |
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What is a Pulse/Ox machine? |
Infrared light that detects % of hemoglobin that combines with O2. |
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What is the goal of O2 therapy? |
to keep the PaO2 above 60 % OR a pulse/ox reading/ SaO2 above 93% |
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Good to know about O2 |
Oxygen is a drug and MUST be prescribed! |
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Types of oxygen modalities |
Nasal cannula Nasopharyngeal catheter - RARELY used Transtracheal catheter Simple mask Partial rebreather mask Non- rebreather mask Venturi mask Tent |
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What percent is room air? |
21 |
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What can affect a Pulse Ox reading? |
- Nail polish (gel) - Pt has low perfusion - decrease in B/P - Cold finger & toes - During resuscitation efforts |
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Patient education on Oxygen use |
- Avoid open flames - Place "no smoking" signs - Electrical equipment is in good working order - Avoid wearing & using synthetic fabrics - Avoid using oils in the area |
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What does Positive Airway Pressure (PAP) do |
-Uses mild air pressure to keep airways open -Maintains Co2 and O2 levels in the blood |
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Different types of PAP machines |
CPAP- continuous positive airway pressure Bi-PAP- bi-level positive airway pressure (changes in air pressure while patient is breathing |
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Why use PAP machine? |
Heart Failure Sleep apnea Obesity disorder ** Bi- pap is the last means before ventilation, must go to ICU first to monitor. |
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Types of Artificial airways |
Endotracheal- ET tube Oropharyngeal & Nasopharyngeal Tracheostomy |
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What is a reason for getting a tracheostomy? |
When ventilator is in for to long |
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Why is Artificial airways used? |
to preserve a functioning airway |
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What does Pneumonia affect? |
Both ventilation and diffusion |
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What is a Community acquired pneumonia? CAP |
Occurs either in the community setting or within the first 48 hours after hospitalization. |
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What is the most common CAP? |
S. Pneumonia |
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What is Health care-associated pneumonia? HCAP |
Pneumonia occurring in a non-hospitalized patient with extensive healthcare contact with: -Hemodialysis -Chemotherapy -Home wound care - Long-term care facility |
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What is the most common causative pathogen in HCAP? |
MDR- Multi- drug resistance |
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What is a Hospital-acquired pneumonia? HAP |
Pneumonia occurring 48 hours or more after hospital admission that did not appear to be incubating at the time of admission. |
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HAP has a pre-disposure in patients with? |
- Immunosuppression - Acute or Chronic illness - Prolonged hospitalization - inappropriate use of anti-biotics - higher mortality rate |
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What is Ventilator assisted Pneumonia? VAP |
A type of HAP that develops more than 48 hours after endotracheal tube intubation. * Most common in ICU |
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What can nurses do to prevent VAP? |
Good mouth care |
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Risk factors of Pneumonia |
-Smoking -Immobility -Antibiotic therapy -Respiratory therapy with improperly cleaned equipment -Alcohol intoxication -Immuno-suppressed patients -Anesthetics that produce resp. depression |
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Symptoms of Pneumonia |
Cough- asses sputum Chest pain (secondary to coughing) Nasal congestion Low-grade fever Pleuritic pain (stabbing chest pain) Myalgia (muscle pain) Orthopnea (dyspnea when lying) |
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Symptoms of Pneumonia in severely ill patients |
Tachypnea High grade fever Chills SOB Use of accessory muscles |
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How is Pneumonia Diagnosed |
Physical Examination Chest X-ray Blood culture Sputum Examination |
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Pneumonia prevention |
Vaccinations - Adults 60+ Promote coughing/ mouth care Re-position patient Encourage smoking cessation |
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Pharmacological therapy for Pneumonia |
Antibiotics- determined by results of C&S |
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Therapeutic therapy for Pneumonia |
Hydration Antipyretic- fever Antitussive- cough Bed rest- until infection shows signs of healing Oxygen- if hypoxemia occurs |
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Pneumonia complications |
Shock & Respiratory failure
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S&S of shock and respiratory failure |
B/P is low HR is high Poor diffusion |
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What are the 3 phases of Pleural effusion? |
1. Uncomplicated 2. Complicated 3. Thoracic empyema |
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How do you detect and treat Pleural effusion |
Detected by Chest X-ray Thoracentesis may be performed to remove fluid |
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What is Empyema? |
Thick, purulent fluid accumulates in the pleural space, often located area where the infection is located. |
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How can you treat Empyema? |
Possibly Chest tube 4-6 weeks of anitbiotic |
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Nursing Considerations: Assessment findings for Pneumonia |
Fever, Diaphoresis Older pt's-unusual behavior, fatigue, dehydration Changes in temperature and pulse Changes in X-ray findings Tachypnea, SOB pleuritic- type pain |
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Nursing Considerations: Nursing interventions for Pneumonia |
Improve airway patency Promote rest- important promote fluid intake maintaining nutrition promote patients knowledge (Education) Trend vitals |
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Nursing Considerations: Expected outcomes for Pneumonia Pt's |
Maintains adequate hydration Exhibits no complications Verbalizes increase of knowledge Discharge from hospital |
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What is a nasal cannula? What is the nasal cannula FiO2? |
Tubing with 2 small prongs for insertion into the nares. FiO2: 24-44% Flow rate: 1-6 L/min *no more than 2–3 L/min to patient with chronic lung disease. |
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Advantages & Disadvantages of Nasal Cannula |
Advantages: Safe Comfortable and well-tolerated Client is able to eat, talk, and ambulate Disadvantages: The FiO2 varies with the flow rate, and rate and depth of the clients breathing. Extended use can lead to skin breakdown & dry mucous membranes |
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Nursing actions for nasal cannula |
-Asses nares -Ensure proper fit -Provide humidification for flow rates of 4 L/min and greater. |
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FiO2 and flow of the simple face mask?
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FiO2: 40-60 % Flow rate: 5-8 L/min * minimum flow rate is 5 |
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Advantages & Disadvantages of Simple mask |
Advantages: More easy to apply face mask Provides humidified oxygen Disadvantages: Flow rates <5 can result in rebreathing Co2 Can cause skin breakdown |
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Nursing Actions for all Masks |
- Asses proper fit to ensure seal over nose and mouth
- Have client use nasal cannula during meals - Use with caution for clients who have high risk of Aspiration or airway obstruction - Asses for skin breakdown |
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FiO2 and flow of Partial rebreather mask |
FiO2: 40-70% Flow rate: 6-10 L/min |
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Advantages & Disadvantages of Partial Rebreather mask |
Advantages: Mask has a reservoir bag attached with no valve, allows client to rebreathe up to 1/3 of exhaled air together with room air. Disadvantages: -Complete deflation of bag during inspiration causes Co2 buildup. -FiO2 varies with clients breathing |
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Nursing Actions for Partial re-breather mask |
-Keep reservoir bag from deflating by adjusting the oxygen flow rate |
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FiO2 and Flow rate of Non-rebreather mask |
FiO2: 60-100 % Flow rate: 10-15 L/min |
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Advantages & Disadvantages of Non-rebreather |
Advantages: * delivers highest O2 concentration possible - 2 exhalation ports have flaps covering them that prevent room air from entering mask. Disadvantages: - The valve and flap on mask must be intact and functional during each breath. - poorly tolerated by clients with anxiety or claustrophobia. |
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Nursing actions for Non-rebreather |
Perform hourly assessment of the valve and flap |
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FiO2 & Flow of Venturi mask |
FiO2: 24-60% Flow rate: 4-12 L/min via different size adapters |
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Advantages & Disadvantages of Venturi mask |
Advantages: ** Delivers most precise oxygen concentration - humidification is not required **best for clients with COPD Disadvantages: Expensive |
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Nursing Actions for Venturi mask |
- Assess frequently to ensure accurate flow rate - make sure tubing is free of kinks |
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Aerosol Masks & FiO2/ flow rate |
Face Tent: fits loosely around the face and neck T-collar: small mask that covers the surgically created opening of the trachea. FiO2: 24-100% Flow rate: atleast 10 L/min * provides high humidification with oxygen |
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Advantages & Disadvantages of Aerosol masks |
Advantages: - Use with clients who do not tolerate masks well - Useful for clients who have facial trauma, burns, and thick secretions. Disadvantage: High humidification requires frequent monitoring. |
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Nursing Actions for Aerosol masks |
-Empty condensation from the tubing often - Ensure adequate water in the humidification canister - make sure tubing does not pull on the trach |
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What does a nurse use to regulate the amount of oxygen delivered to the client.
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The nurse should use a flow meter
* A flow meter is a gauge used to regulate the amount of oxygen delivered to the client and is attached to the source of oxygen |
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What is an oxygen analyzer ?
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Device that measures the % of delivered O2 to determine if the client is receiving the amount prescribed by the physician
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What position to drain Apical sections of the upper lobes of lungs? |
Use high-Fowler’s position
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What is Postural Drainage? |
Postural drainage makes use of gravity to drain secretions from the lungs from smaller pulmonary branches into larger ones, where they can be removed by coughing.
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How many times should Postural drainage be performed? |
Postural drainage should be performed 2 to 4 times a day for 20 to 30 minutes.
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What position to drain posterior sections of the upper lobes of the lungs? |
Place the client in a lying position, half on the abdomen and half on the side, right and left.
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What position to drain lower lobes of the lungs? |
Place the client in the Trendelenburg position
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What position to drain right lobe of the lung? |
Place the client lying on the left side with a pillow under the chest wall.
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What do ABG's test? |
tests the partial pressure of oxygen dissolved in plasma, the percentage of hemoglobin saturated with oxygen, and the partial pressure of carbon dioxide dissolved in plasma.
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What does the spirometry measure? |
the volume of air in liters exhaled or inhaled by a client over time.
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Symptoms of CHRONIC hypoxia |
altered thought processes,
headaches, chest pain enlarged heart clubbing of the fingers and toes anorexia constipation decreased urinary output decreased libido weakness of extremity muscles muscle pain |
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What is Residual volume? RV |
the amount of air left in the lungs at the end of maximal expiration.
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What is Tidal Volume? TV |
total amount of air inhaled and exhaled with one breath.
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What is Total Lung Capacity (TLC)? |
amount of air contained within the lungs at maximum inspiration.
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What is Forced Expiratory Volume? FEV |
measures the amount of air exhaled in the first second after a full inspiration; it can also be measured at 2 or 3 seconds.
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What O2 Mask is recommended for toddlers? |
An oxygen tent is often used when caring for active toddlers who require oxygen, since they are less likely to keep a mask on
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What is the recommended diet for COPD patient |
-40% to 55% carbohydrates.
-rich in antioxidants and vitamin A, C, and B. -12% to 20% protein. |
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What do you hear when auscultating for pneumothorax? |
will reveal absent or diminished breath sounds on the affected side.
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How long should a nurse suction a trach? |
10-15 seconds |
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What is Intermittent mandatory ventilation? IMV |
provides a combination of mechanically assisted breaths and spontaneous breaths.
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What is Assist-control ventilation? |
provides full ventilator support by delivering a preset tidal volume and respiratory rate.
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What is synchronized intermittent mandatory ventilation?
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SIMV delivers a preset tidal volume and number of breaths per minute. Between ventilator-delivered breaths, the patient can breathe spontaneously with no assistance from the ventilator for those extra breaths.
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How much fluid is in the pleurae to prevent friction during pleural surface movement? |
Under normal conditions, approximately 5 to 15
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What is pleuritic pain? |
irritation of the parietal pleura is sharp and seems to “catch” on inspiration; patients often describe it as being “like the stabbing of a knife.”
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