Gas Exchange Flashcards
(59 cards)
1
Q
obstructive
A
increased resistance to airflow- bronchi, bronchioles, alveoli
2
Q
restrictive
A
reduced expansion of lung tissue, decrease in total lung capacity- mechanical
3
Q
compliance
A
flexibility of lung tissue to expand/contrast
4
Q
pleural membrane
A
area between membrane lining- should only have surfactant in it to prevent friction, no other air or fluid
5
Q
hypoxemia
A
lack of oxygen in the bloodstream
6
Q
hypoxia
A
low O2 available to body tissues
7
Q
hypercapnia
A
high CO2
8
Q
major risk factors for pulmonary problems
A
- SMOKING
- genetics
- disease processes
- environmental/occupational exposure
9
Q
How do we assess pulmonary function?
A
- auscultation
- rate and rhythm
- depth of breathing
- accessory muscle use
- cyanosis
- thoracic cage (barrel chest)
- adventitious breath sounds
- percussion
- clubbing of fingers
10
Q
How do we diagnose pulmonary problems?
A
- PFT
- chest xray
- ABGs
11
Q
How do we treat pulmonary problems in general?
A
- LABA
- SABA
- nebulizers
12
Q
what makes nebulizers so special
A
they go deeper and will rescue pt faster than inhaler
13
Q
Asthma
A
hyperreactive disease of the bronchioles
14
Q
is asthma reversible
A
yes
15
Q
why is asthma so concerning
A
everytime a pt has an attack, damage is left and it gets worse each time
16
Q
symptoms of asthma
A
- T cells, IGEs, leukotrienes combine to make the bronchioles constrict
- histamines (inflammation)
- prolonged expiration
- wheezing
- cough
- dyspnea
- tachypnea
- use of tripoding
17
Q
what is asthma diagnosed with? When?
A
PFT during an acute asthma attack (to measure forced expiratory volume)
- low pulmonary function result = worse asthma attack
18
Q
asthma treatment
A
meds:
SABA: rescue
LABA: maintenance
19
Q
teaching for asthma
A
- know your triggers and avoid them
- use your medication as prescribed
- no excessive use of SABAs
- call your provider if your maintenance meds aren’t working bc you may need a new regimen
20
Q
status asthmaticus
A
- persistent bronchoconstriction despite attempts to reverse
- client will be hypercapnic and hypoxic/hypoxemic
- CAN BE FATAL
21
Q
What is COPD
A
combination of chronic bronchitis, emphysema, and hyperreactive airways (in exacerbation)
22
Q
major cause of COPD
A
SMOKING
23
Q
chronic bronchitis
A
- hypersecretion of mucus
- mucus and edema
- cyanosis
-cannot get air IN - cough- 3 months of year for at least 2 years
- chronic hypoxia
- clubbing of fingers
- pulmonary arterial vasoconstriction
- nickname: BLUE BLOATER
24
Q
emphysema
A
- over distension of alveoli
- air trapping
- cannot get air OUT
- chronic hypercapnia
- prolonged exhalation
- barrel shaped chest
- diaphragm pushed downward
- nickname: PINK PUFFER
25
how is COPD treated
similar to asthma, stepwise approach
26
education for COPD
- STOP SMOKING
- stay up to date on flu and pneumonia vaccines
- pursed lip breathing
27
why do you need to be careful with oxygen therapy (COPD)
easy to over over oxygenate and knocked out the pts drive to breathe
28
obstructive sleep apnea
- intermittent cessation of airflow from the nose and mouth during sleep
29
what does obstructive sleep apnea sound/look like
- sounds like choking,
- gasping
- looks like unrestful sleep
- daytime sleepiness
30
what worsens sleep apnea
- alcohol
- sedative- hypnotic medications
- educate to avoid these things
31
how is obstructive sleep apnea diagnosed
through a sleep study
32
treatment for obstructive sleep apnea
- WEAR CPAP
Why? prevents airway from closing
33
Pneumothorax
- collapsed lung
- air or fluid gets into the pleural space and puts pressure on the lung and then the lung collapses
34
symptoms of pneumothorax
- chest pain
- dyspnea
- increased RR
- chest may look asymmetrical upon observation
35
will lung sounds be heard on affected side of pneumothorax
no
36
primary spontaneous pneumothorax
lung just collapses, no disease process has anything to do with it
37
secondary spontaneous pneumothorax
lung collapses due to a disease process
38
traumatic pneumothorax
penetrating wound to thoracic cage and pleural membrane
39
tension pneumothorax
closed wound that allows air into the pleural cavity but not out, can be caused by trauma
40
iatrogenic pneumothorax
- caused by medical procedure complications
- can often be a "parting gift" from a central line insertion
41
Which types of pneumothorax are treated with chest tube with suction
- primary
- secondary
- open traumatic
- iatrogenic
42
what is a tension pneumothorax treated with
needle insertion to remove air
43
pleural effusion
- abnormal collection of fluid in pleural space
- fluid can be exudate, transudate, purulent, lymph, blood
44
what does pleural effusion result from
- heart failure
- severe pulmonary infections
45
s/s pleural effusion
- dyspnea
- tachypnea
- sharp pleuritic CP
- dullness to percussion
46
will breath sounds be present with pleural effusion
diminished breath sounds on affected side, maybe even absent breath sounds over area of effusion
47
treatment for pleural effusion
thoracentesis
48
thoracic cage deformity
- anything that structurally makes it hard for lungs to fully inflate
- kyphosis
- scoliosis
49
treatment for thoracic cage deformity
orthopedic brace
50
pulmonary fibrosis
- may be idiopathic
- repeated injury to alveoli, but the cause is unknown
- may be related to environmental particles
- coal dust, asbestos, silica, anthrax
- fibrotic changes decrease lung compliance; lungs become stiff because of repeated inflammation to the alveoli
51
s/s pulmonary fibrosis
- dyspnea
- tachypnea
- crackles
- eventual cyanosis
52
what will a chest xray of a patient with pulmonary fibrosis look like
"ground glass" appearance
53
treatment for pulmonary fibrosis
- try to decrease inflammation/inflammatory response and fibrotic changes
- may treat with O2
- bronchodilators, corticosteroids
54
pulmonary edema
- edema in the pulmonary veins
- often caused by heart failure
- blood backs up into the veins of the lungs, increases pressure
- when the pressure is too great, fluid is pushed into the alveoli of the lungs
55
pulmonary embolism
happens when a DVT dislodges and travels to lungs
56
pulmonary hypertension
- high blood pressure that affects arteries in the lungs, right side of heart
- walls of pulmonary arteries become thick and stiff and cannot expand very well to allow proper blood flow
57
adult respiratory distress syndrome
- injury to alveoli, pulmonary capillaries that causes sudden, progressive pulmonary edema called flash pulmonary edema
- arterial hypoxemia does not improve with administration of O2
- seen in critically ill patients
58
risk factors of ARDS
- SEPSIS
- trauma
- massive transfusion
- acute pancreatitis
- aspiration
59
treatment for ARDS
- intubation, sedation, and mechanical ventilation
- death common
