what carries oxygen in the body - name oxygen carried by RBC - name CO2 carried by hemoglobin What does it mean to say internal respiration between circulating blood and tissue cells must occur Goes Give and take

Plasma and RBCs carry oxygen in body - RBC caring O2 = oxyhemoglobin - hemoglobin carrying CO2 = carboxyhemoglobin To say internal respiration must occur is to say that: - circulatory System takes oxygenated blood to tissues and cells - takes oxygen gives CO2 to be expired

Define 1. hypoxia + reasons 2. dyspnea 3. hypoventilation + Reasons

``` 1. Hypoxia: inadequate oxygen Reasons -excess mucus -higher elevation -Pneumothorax ``` 2. dyspnea: difficulty breathing 3. hypoventilation: decrease rate or depth of air into lung Reasons -OD -metabolic imbalances: to conserve CO2

Ch 39: Oxygenation and perfusion Flashcards by Alyssa Quintela

What does the integrity of an airway allow
(2 things)

What is the area of a system in the lungs remove and what does it oxygenate

Integrity of an airway allows

Transportation of air to and from lungs
Properly functioning alveolar system in lungs

Aveolar system in the lungs removes carbon dioxide from blood And oxygenates venous blood

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Why is a properly functioning cardiovascular and hematologic system needed

Proper cardiovascular and hematologic system needed to:

-Carry nutrients/wastes to and from body

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What is the function of the upper respiratory system name the components

What is an example of an interruption in the upper respiratory airway

what can these people not do
how do they protect their trachea

Upper respiratory system function:
-warm filter humidify air

Components: nose pharynx larynx

upper respiratory airway interruption =tracheostomy

those were tracheostomies cannot warm filter humidify air
for this reason they must wear something over the trachea to protect it

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What is the function of the lower airway

Nina components of the lower airway

Lower airway:

conduction of air
where gas exchange occurs
mucociliary clearance : sweeping of irritance an excess mucus out
and production of surfactant

Trachea ➡️bronchi➡️ bronchioles ➡️alveoli

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What are the lungs composed of

What is the only location in the body that arteries carries deoxygenated blood

Name the blood type:
Pulmonary arteries
pulmonary veins

Lungs composed of elastic tissue (Aveloi, surfactant, pleura)

The pulmonary circulation is the only place in the body that arteries carry deoxygenated blood

Pulmonary arteries: deoxygenated
Pulmonary veins: oxygenated

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If person is not in distress/having difficulty with the respiratory system how is pulmonary ventilation described

What phase of ventilation is inspiration
What phase of ventilation is expiration

If not distress/difficulties respiration system or pulmonary ventilation is automatic

Inspiration: active phase of ventilation
Expiration: passive phase of ventilation

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Describe the process of ventilation in simple terms

Diaphragm descends lengthening thoracic cavity

External intercostal muscles contract lifting ribs up and out

Sternum pushed forward enlarging of chest

➡️ increase in thoracic cavity decrease in intrapulmonary pressure as cavity expands and 02 enters

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What is gas exchange (respiration) referred to as

What makes gas exchange (respiration) possible

Define diffusion (where does oxygen move to)

Define profusion

Gas exchange (respiration): intake of 02 release of CO2

Gas exchange possible by respiration and perfusion

Diffusion:
-movement of O2 from inspired area ➡️circulatory system ➡️ aveloi ➡️ expiration

Perfusion:
-blood supply From capillary blood through the body tissues

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Where does gas exchange occur

How many walls do Avioli and capillaries have and why

Gas exchange occurs in the alveoli

Alveoli and capillaries have 1 cell thick wall
-thin walls allow for exchange of gases

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What influences diffusion of gases in the lungs

Change in surface area available:
-Excess mucus decreases aveloi function/pneumonia

thickening of areolar capillary membrane

Partial pressure: MUST HAVE PRESS GRADIENT

Solubility and molecular weight of gas

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what carries oxygen in the body

name oxygen carried by RBC
name CO2 carried by hemoglobin

What does it mean to say internal respiration between circulating blood and tissue cells must occur
Goes
Give and take

Plasma and RBCs carry oxygen in body

RBC caring O2 = oxyhemoglobin
hemoglobin carrying CO2 = carboxyhemoglobin

To say internal respiration must occur is to say that:

circulatory System takes oxygenated blood to tissues and cells
takes oxygen gives CO2 to be expired

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Define

hypoxia + reasons
dyspnea
hypoventilation + Reasons

1. Hypoxia: inadequate oxygen
Reasons
-excess mucus
-higher elevation
-Pneumothorax

dyspnea: difficulty breathing
hypoventilation: decrease rate or depth of air into lung
Reasons
-OD
-metabolic imbalances: to conserve CO2

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What must function well for the respiratory system to function

Why must The cardiovascular system be at peak function

The cardiovascular system must function well for the respiratory system to function

Unless cardiovascular system is at peak function fluid will build up and back up

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Alterations in the cardiovascular system

How does Dysrhythmia/arrhythmia affect the blood supply

What does myocardial ischemia lead to

What does heart failure lead to in reference to blood

Name the five issues that affect the function of the respiratory system
(2 already mentioned)

Dysrhythmias and arrhythmias affect blood supply by
-shortening gas exchange
Leading to impaired tissue perfusion

Myocardial ischemia leads to lack of heart blood flow due to weakness

Heart failure leads to ineffective pumping and blood backing up

Dysrhythmia/arrhythmia
Myocardial ischemia
Angina
MI
Heart failure

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What are a few factors affecting cardio pulmonary function and oxygenation

General level of health
development considerations
medications
lifestyle considerations
environmental
psychological/health considerations

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How does the lungs transform in infants

Describe an infants chest and what a potential problem may be because of their chest characteristics

How do you describe the respiratory rate of an infant and where does the activity come from

What is normally heard at the end of respiration for infants

Lungs are transformed from fluid filled to airfield organs in infants

Infants chest characteristics:
- small
- short airways 
-don’t cough
! Due to characteristics ASPIRATION is a potential problem!

Respiratory rate is rapid
respiratory activity is from abdominal

At the end of respirations in INFANT CRACKLES ARE NORMAL

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what is surfactant needed to do ?

when does surfactant usually develop
-what can you do for preemies

surfactant is needed to keep lungs open (expended)

Surfactant usually develops 34–36 weeks gestation
• can be given synthetically to preemies to open aveloi

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In children:

Why are landmarks less prominent

What is elongated and less angular

What are children most prone to and what can help decrease this

At the end of late childhood what does the immune system protect from

Landmarks less prominent due to subcutaneous fat deposited in chest wall

Estacion tubes, bronchi, bronchioles are elongated and less angular

Children are more prone to otitis media and colds So good hygiene and tissue etiquette are encouraged

at the end of late childhood immune system protect V most infections

In your older adults:

Why are landmarks more prominent

What are two major older adult considerations that affect (decrease) how well the respiratory muscles work

What do tissues and airways become how does the diaphragm move

What is the most common disease in your elderly respiratory tract

Older:

Landmarks more prominent due to loss of subcutaneous fat

Kyphosis and barrel chest both decrease how well the respiratory muscles work

Tissues/always become rigid diaphragm moves less effectively

* PNEMONIA * is most common in older

When obtaining a nursing history regarding the cardio pulmonary system

Why do you want to determine what kind of care is needed

What actions do you want to identify by the patient

What do you want to make use of and why

When obtaining a nursing history

you want to determine what kind of cares needed to meet any sufficient intake of air
identify actions performed by the patient for meeting respiratory needs
Make use of aids to improve in take a favor and effects on lifestyle

Describe the following breath sounds

Bronchial
broncovesicular
vesicular

Bronchial: LOUD high pitched
- over trachea

Bronco vesicular: medium pitch
-over bronchial tree /intercostal area

Vesicular: NORMAL!!!
Low, soft pitched
-over most of lung

Define crackles
How are crackles classified

Define wheezes
How are wheezes classified

Crackles: CONTAINING FLUID intermittent
• classified: fine medium or coarse

Wheezes: continuous musical sounds by air passing through constricted narrowed airways (swollen)
• classified as:
-sibilant (musical)
-sonorous (snoring)

Diagnostic methods to assess Carter pulmonary function

What is the first cardiac test done defined it

If first cardiac test indicates low blood what is the next describe it

#1 cardiac test is Cardiac stress test
: shows if heart show signs of distress

If low blood then cardiac coronary catheterization done

shows how Well coronary arteries fill
shows constrictions and non-perfusing side

Common diagnostic methods to assess cardio pulmonary function (other)

Echocardiogram (ECG) 
endoscopic studies
 Holter monitor 
lung scan 
skin test 
radiography

ECG

ultrasound of heart
looks at valves, blood flow, leaks

Holter monitor
-Records heart activity for days used to look at specific intervals

Lung scan
-Insurers lung perfusion and new occlusions

Skin test: PPD

Radiography = X RAY

# Define tidal volume Define vital capacity Define forced vital capacity -using what Define forced expiratory volume

Tidal volume : total amount of air inhaled/exhaled in 1 breath Vital capacity : maximum amount of air exhaled after maximum inhalation Forced vital capacity :Maximum amount of air that can be forcefully exhaled ***BEST OF 3 using Peak flow Forced expiratory volume : amount of air exhaled in a specific time interval

# Define total lung capacity define residual volume define peak expiratory flow rate (PEFR)

Total lung capacity : amount of air in lung with maximum inspiration Residual volume :out of air left in lung after MAX expiration Peak expiratory flow rate :maximum flow obtained during forced vital capacity *** FIN # POST 3 cycles

What are nursing interventions we want to promote for adequate respiratory function

- pollution free environment NO SMOKING - promote optimal functioning - promote comfort -promote proper breathing: •INCENTIVE SPIROMETRY • pursed lip breathing, •diaphragmatic breathing - meeting oxygenation needs with medication - encourage home cleanliness

What are great ways to promote proper breathing

Using deep breathing/diaphragmatic breathing Use incentive spirometry Pursed lip breathing: COPD

Where are chest tubes inserted between what do chest tubes remove from the lung cavity What do you want to monitor in someone with a chest tube How should the dressing of someone with the chest tube be What is most vital to maintain when using a chest tube

Chest tubes inserted between chess wall and lung Chest tubes remove air or long that has gotten into cavity Monitor respiratory status and vital signs Check the dressing is tight not allowing air to escape Most vital! MAINTAIN PATENECY AND INTEGRITY Of drainage system

When should cough suppressant be used What are expectorants used for -what is achieved what are lozenges used for primarily

Cough suppressants used if *dry hacking cough* with pain and chest/stomach Expectorant used to cough up mucus -achieve better breathing Lozenges primarily used for sorethroat

Give the three simple steps in the Coughing mechanism

Air in Freshly send air out Dislodge secretions

What does sitting patient up straight make sure what does it help with when do you sit a patient up

Makes sure patient is receiving oxygen Sitting a patient up straight helps with secretions Set a patient up when: - feeding - normal activities - pneumonia - breathing issues

What does the action of maintaining adequate fluid intake make easier What are other ways to promote patient comfort

Maintaining adequate fluid intake makes mucco cellular action easier by making thin watery secretions - Provide humidified air - perform chest physiotherapy

Who is the primary audience to do chest physiotherapy on who do you avoid and what is chest physiotherapy

Chest physiotherapy primarily for cystic fibrosis 🚫 COPD Chest physiotherapy: chest taps to move secretions (Lucian) to cough out

What is the function of: -bronchodilators -nebulizers -meter dose inhalers -dry powder inhalers

Bronchodilators: open narrowed airways Nebulizers: find particles a liquid (vapor) into deeper passages of respiratory tract Metered dose inhaler‘s: deliver CONTROLLED dose of medication with compression Dry powder inhaler’s: BREATH ACTIVATED delivery of med 🚫shake

Describe a nasal cannula When is a simple mask used Why would you use a partial rebreather mask What is the percentage of oxygen given in a nonrebreather mask What does a Venturi mask allow for What oxygen delivery systems do you use in your younger children

Nasal cannula is oxygen entering through two prongs into 2 nares Simple mask used if not maintaining oxygen with nasal cannula -gives higher % of oxygen Use a partial rebreather mask to give even higher percentage of oxygen v mask Nonrebreather masks give 100% of oxygen Venturi mask a law suggesting of percentage of oxygen given In children - teng - naso/transtracheal Catheter

When giving oxygen what do you want to avoid and place signs of What do you want to check for for the risk of What item do you want to avoid wearing that build up static electricity what do you want to avoid using that ignites spontaneously in oxygen

When giving oxygen: - AVOID 🚫 Open flames/smoking - place sign V smoking - check electrical equipment to avoid sparks - avoid wearing synthetic fabrics that build up static electricity - Avoid using oils that ignite spontaneously and oxygen

What do you want to establish if you cannot get air into the patient with an Ambu bag

Establish in oral pharyngeal or nasopharyngeal airway if you cannot get air into the patient with an Ambu bag

When do you insert an endotracheal tube

If patient is unable to regain spontaneous respiration insert an endotracheal tube to ventilate

When is a tracheostomy in certain

Tracheostomies in certain if there is trauma above the trachea

How do you insert an artificial airways What is an obturator and what Is its purpose

Insurance artificial airway by pulling the tongue out and out of the way opening a path for the air An obturator Is a stiff deal that goes inside of a trach when you’re insulting to allow for insertion certain

What are the actions you will take if a patient needs cardiopulmonary resuscitation CPR

Perform CAB patient needs CPR #1: check Pulse •IF NO PULSE! #2 C-ompressions #3 A-irway tilt head and lift a chin to check for breathing and opening the respiratory tract ``` • if patient does not start breathing spontaneously after airway opening #4 B-reathing give two breaths lasting one second each ``` #5 defibrillation ASAP

What are expected outcomes related to oxygenation perfusion

Expected outcomes: Improved gas exchange in lungs by: - no cyanosis - no chest pain - pulse ox +95 Relate the causet of factor and demonstrate adaptive method of coping Preserve pulmonary function by maintaining optimal level of activity (encourage staying active) Demonstrate self-care behaviors that provide relief from symptoms and prevent further problems