Gas Exchange

Question 1

What is gas exchange?

Answer 1

Gas exchange is the process by which oxygen is transported to cells and carbon dioxide is transported out of cells

Question 2

What is ischemia?

Answer 2

insufficient flow of oxygenated blood to tissues; can result in hypoxemia –> cell injury or death

Question 3

What is hypoxia?

Answer 3

insufficient oxygen reaching cells

Question 4

What is anoxia?

Answer 4

Total lack of oxygen in body tissues

Question 5

What is hypoxemia?

Answer 5

reduced oxygenation of arterial blood

Question 6

What is the scope of gas exchange?

Answer 6

spectrum of optimal perfusion to no perfusion

optimal gas exchange –> impaired gas exchange –> no gas exchange

Question 7

What drives respiration?

Answer 7

carbon dioxide

Question 8

Primary purpose of the respiratory system is…

Answer 8

gas exchange

Question 9

Babies born after 30 weeks have sufficient ____ to prevent alveoli from collapsing after ____

Answer 9

Babies born after 30 weeks have sufficient surfactant to prevent alveoli from collapsing after exhalation

Question 10

Infants are _______ until 3 months

Answer 10

obligate nose breather

Question 11

Respiratory patterns for newborns may be…

Answer 11

irregular, with brief pauses between breaths of no more than 10-15 seconds

Question 12

Older adults may have…

Answer 12

decreased strength of respiratory muscles that reduce maximal inspiratory & expiratory force (weaker cough)

Question 13

(Pop.) Risk factors for infants

Answer 13

fetal hemoglobin in the first 5 months postnatal that reduces lifespan of erythrocytes –> causing physiological anemia at 2/3 y.o.

infants are also immunocompromised

Question 14

Risk factors for impaired gas exchange of infants and children

Answer 14

less alveolar surface area for gas exchange and narrow peripheral airways that are easily obstructed

Question 15

Risk factors for impaired gas exchange of older adults

Answer 15

anatomic & physiological changes caused by:

stiff chest wall due to loss of elastic recoil, respiratory muscles are weaker, reduced effectiveness of cough (which prevent aspiration)

dilation of alveoli, decreased surface area for gas diffusion, decreased ability to initiate an immune response, decreased pulmonary capillary network

Question 16

Adequate ventilation is apparent when what occurs:

Answer 16

• quiet, effortless breathing
• oxygen stat 95-100%
• regular lips, skin, and nail bed color
• thorax is symmetrical
• equal thoracic expansion bilaterally
  -spinous process in alignment
• scapulae bilaterally symmetric
• midline trachea
• clear, bilateral breath sounds

Question 17

non modifiable risk factors are

Answer 17

age, air pollution , allergies

Question 18

What is the most preventable cause of death & most significant factor for impaired gas exchange?

Answer 18

smoking

Question 19

What increases risk of aspirations?

Answer 19

altered state of consciousness, such as:
chemical alteration (alcoholism, drug overdose)

neurologic disorder (head injury, seizure, stroke)

Question 20

What causes reduced thoracic expansion, increasing the likelihood of developing atelectasis & pneumonia?

Answer 20

bed rest & prolonged immobility

Question 21

Baseline history

Answer 21

lifestyle behaviors, diet, exercise, smoking habits, pt’s work/home/social environments, chronic diseases, allergies, and medications

Question 22

Problem based history should include

Answer 22

chest pain, shortness of breath, coughing

Question 23

Clinical findings of impaired gas exchange

Answer 23

sputum, abnormal breathing patterns, adventitious breath sounds, decreased level of consciousness

Question 24

Vital signs indicative of impaired gas exchange

Answer 24

increase in respiratory rate, decrease in pulse ox, increase in HR, & increase in temp

Question 25

Auscultation assessment indicative of impaired gas exchange

Answer 25

narrowed bronchi may produce expiratory and/or inspiratory wheezing or stridor, mucus or secretions in the bronchi may create rhonchi & fluid in alveoli may generate crackles

Question 26

Primary prevention methods

Answer 26

infection control, smoking cessation, immunizations, and preventing postoperative pulmonary complications

Question 27

Secondary prevention methods

Answer 27

nutrition therapy, positioning, invasive procedures, chest physiotherapy & postural drainage, airway management & breathing support, oxygen therapy, pharmacotherapy

Question 28

Auscultation of the lungs must be done…

Answer 28

bilaterally