Exam 2- Oxygenation and Perfusion

Question 1

Kussmaul breathing

Answer 1

deep, labored breathing pattern indicating that the body has become too acidic
CO2 is the acid

Question 2

Stridor

Answer 2

Described as a high pitched whistling sound
Obstructed airway
-chocking
-axaphylactic shock

Question 3

Identify factors influencing respiratory function 4-5

Answer 3

• Age
• healthy vs. disease
• necessary for assessing, planning, intervening inpatient care
• Level of health
• developmental considerations

Question 4

Respiratory function considerations for infant

Answer 4

• Surfactant is formed in utero 34-36 weeks, if baby born before that time may have collapsed alveoli due to insufficient surfactant
• Infants are abdominal breathers
• Crackles heard at the end of respiration are normal
• Infant has small chest, short airways, aspiration is a potential problem

Question 5

Respiratory function considerations for children 4

Answer 5

• bronchi, bronchioles are elongated and less angular
• subq fat makes landmarks less prominent
• average number of colds decreases until child goes to daycare or school
• by end of late childhood, immune system functions appropriately to protect from illness

Question 6

Respiratory function considerations for older adults 5

Answer 6

Tissues and airways of the respiratory tract becomes less elastic

• power of abdominal muscles is reduced
• chest is not able to stretch as much
• airways collapse easily
• increased risk for disease such as pneumonia and other chest infections

Question 7

Explain Deep Breathing

Answer 7

• Can be used to overcome hypoventilation
• make each breath deep enough to move the bottom ribs
• breathe in through the nose and out slowly through the mouth

Question 8

Explain use of incentive spirometry

Answer 8

• encourages patient to maximize lung inflation and reduce or prevent atelectasis
• exhale completely, place mouth on mouth piece and inhale through the mouth

Question 9

Explain Pursed Lip breathing

Answer 9

• can reduce symptoms in patients experiencin dyspnea and feelings of panic
• exhaling through pursed lips creates a smaller opening for air movement, effectively slowing and prolonging expiration.
• Prolonged expiration is thought to result in decreased airway narrowing during expiration and prevent the collapse of small airways
• results in improved air exchange and decreased dyspnea
• helps patient to control rate and depth of respiration

Question 10

Diaphragmatic breathing

Answer 10

• Pt places one hand on stomach and other on middle of the chest. breath in slowly through the nose, letting abdomen protrude as far as it will go, then breathe out through pursed lips while contracting abdominal muscles, with one hand pressing inward and upward on the abdomen
• Good to teach patients with COPD bc they usually breathe shallow and rapidly in an exhausting pattern

Question 11

Why promote voluntary and involuntary coughing

Answer 11

• to remove secretions that can build up

- involuntary coughing occurs when there is a respiratory infection or irritation. secretions trigger coughing mechanism

Question 12

Nasal Cannula

Answer 12

• low flow oxygen delivery system commonly used
• up to 6L/min
• high flow at 60l/min, usually for use up to 15L/min``

Question 13

Simple Mask

Answer 13

low flow oxygen delivery
5-8L/min
monitor placement of mask frequently and check for skin breakdown from mask or moisture
often used for high concentrations of oxygen over short time

Question 14

Partial rebreather mask

Answer 14

low flow 8-11L/min
similar to simple face mask but with reservoir bag for collection of the first part of patien’ts exhaled air and is mixed with 100% oxygen so patient is rebreathing 1/3 of resued air

Question 15

Nonrebreather masl

Answer 15

low flow 10-15L/min
used for a spontaneously breathing patient
bag fills with oxygen and expired air leaves through side vents

Question 16

Venturi mask

Answer 16

high flow 4-6L/min

delivers most precise concentration of oxygen

Question 17

Purpose of chest physiotherapy

Answer 17

mobilize secretions and increase mucus clearance

Question 18

PAP

Answer 18

positive airway pressure, provides mild air pressure to keep airways open
CPAP-continuous mild air pressure to keep airways open
BiPAP- bilevel positive airway pressure, changes air pressure while patient breathes in and out

Question 19

alveoli

Answer 19

small air sacs at end of terminal bronchioles, site of gas exchange

Question 20

surfactant

Answer 20

phospholipid that reduces the surface tension between the moist membranes of alveoli preventing their collapse

Question 21

Respiration

Answer 21

gas exchange between the atmospheric air in the alveoli and the blood in capillaries

Question 22

perfusion

Answer 22

process by which oxygenated capillary blood passes through body tissues

Question 23

Inspiration

Answer 23

Active phase
diaphragm contracts and descends, lengthening the thoracic cavity, extern intercostal muscles contract, lifting the ribs upward and outward and the sternum pushed forward

Question 24

Expiration

Answer 24

recoil from inspiraiton, diaphragm relaes and moves up, ribs move up and sternum drops back down, should be effortless and recoil

Question 25

impact of age on respiratory system 6

Answer 25

Tissue and airway of respiratory tract become less elastic respiratory and abdominal muscles are reduced- diaphragm moves less effciently chest is unable to stretch as much airway collapses easier decrease ventilation and ineffective cough decrease CO and ability to respond to stress

Question 26

Physical assessment of respiratory system: Inspection

Answer 26

Pallor, Cyanosis Anterioposterior diameter should be less than transverse diameter (if other way around pt has barrel chest indicative of COPD) Adult contour of chest is slightly convex kyphosis(limited respiratory ventilation) Bardypnea Tachypnea

Question 27

Normal Breath sounds

Answer 27

Vesicular-low pitched soft sounds heard over peripheral lung field Bronchovesicular- medium pitched blowing over major bronchi Bronchial- loud, high pitched sounds heard primarily over trachea and larynx

Question 28

Adventitious breath sounds

Answer 28

Crackles- popping, fine, medium, coarse Wheezes- continual muscial sounds as air passes through airway, asthma has an expiratory wheeze. Croup, swelling, foreign bodies, obstruction have inspiratory wheezes

Question 29

Pulmonary function test

Answer 29

group of tests used to assess respiratory function. | evaluation of the lung dysfunction, diagnose diseases, assess disease severity and evaluate respiratory interventions

Question 30

Peak Expiratory Flow Rate

Answer 30

reflects changes in the size of pulmonary airways and is measured using a peak flow meter refers to the highest point of flow during flow during forced expiration

Question 31

Residual VOlume

Answer 31

amount of air left in lungs at maximum expiration

Question 32

Total Lung Capacity

Answer 32

amount of air contained within the lungs at maximum inspiration

Question 33

Vital Capacity

Answer 33

Amount of air displaced by maximum exhalation

Question 34

Capnography

Answer 34

monitor ventilation and indirectly bloood flow through the lungs exhaled air passes through a sensor that measures the amount of carbon dioxide exhaled in each breath

Question 35

Thoracentesis

Answer 35

procedure of puncturing the chest wall and aspiration pleural fluid used to obtain a specimen for diagnostic purposes or removes fluid that has accumulated in the pleural cavity and is causing respiratory difficult

Question 36

Hypoxia

Answer 36

Condition where inadequate oxygen is available to the cells signs are anxiety, restlessness, confusion, elevated BP w/small pulse pressure, increased respiratory and pulse rates, palor, cyanosis

Question 37

Dyspnea

Answer 37

Difficulty breathing

Question 38

Hyperventilation

Answer 38

decreased rate or depth of air movement into the lngs

Question 39

Why are positioning and breathing techniques utilized

Answer 39

``` maximize patients sense of wellbeing promote comfort decreases work of breathing patient achieves more efficient and controlled ventilation corrects respiratory deficit paces activities ```

Question 40

Signs and symptoms of heart failure

Answer 40

edema in lower extremities shortness of breath fatigue

Question 41

Chest tube used in patients with

Answer 41

pleural effusion blood in the pleural space air in the pleural space

Question 42

Bronchodilator function

Answer 42

Inhales-open narrowed airways

Question 43

Corticosteroids

Answer 43

reduce inflammation in airways

Question 44

Narcotics

Answer 44

expectorant, used to help liquefy or loosen thick secretions

Question 45

Adminitering CPR: CABD

Answer 45

Chest compressions: CHeck pulse, if no pulse initiate compressions to provide artificial circulation Airway: Tilt head and lift chin, check for breathing. The respiratory tract must be opened so that air can enter Breathing: If pt does not start to breathe spontaneously after airway is opened, give two breathing lasting 1 second each. Defibrillation: Apply AED as soon as available

Question 46

Complete Blood Count

Answer 46

test is used to assist in evaluating the body response to illness

Question 47

Coagulation students

Answer 47

measures bodies ability to clot and how long it will take, helps predict liklihood of thrombosis

Question 48

Cardiac ENzymes

Answer 48

Creatine Kinase and Isoenzymes enzymes released due to injury to tissue, biomarkers used to monitor cardiac injury and MI Troponin protein found in skeletal and cardiac muscle released during injury

Question 49

Internal respiration

Answer 49

gas exchange between circulating blood and tissues