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Gas Exchange Flashcards

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1
Q

In which part of the lungs does gas exchange occur

A

Alveoli

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2
Q

Which best describes the way oxygen and carbon dioxide move between the alveoli and capillaries?

A

gases travel between the alveoli and the capillaries by moving from areas of high concentration and pressure to an area of low concentration and pressure

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3
Q

What do we know about Oxygen?

A

Oxygen is vital for cellular metabolism. Hemoglobin transports oxygen. Oxygen is exchanged for carbon dioxide in the alveoli of the lung. Each hemoglobin molecule is limited by the amount of oxygen it carries.​

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4
Q

What are causes of impaired gas exchange - ventilation problems

A

Anything stopping oxygen from getting into the lungs is a ventilation problem.​
No air: If there is low or no oxygen in the surrounding air, then breathing is compromised.​
Muscle weakness: The diaphragm and chest muscles are responsible for ventilation.​
Tongue blocking airway: Blockage of an airway is a ventilation problem.​

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5
Q

What are causes of impaired gas exchange - perfusion problems?

A

Perfusion problem: Anything stopping oxygen from getting to the cells through the blood is a perfusion problem.

Blood loss: Lack of hemoglobin causes a lack of oxygen transported to tissues​.
Carbon monoxide poisoning: Carbon monoxide can bind to hemoglobin strongly, especially when there is a large amount of it​.
Sickle cell disease: A deformed red blood cell cannot carry oxygen to tissue​.

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6
Q

When gas exchange is impaired, the body compensates. _ oxygen levels in the arterial blood signal the body to - respirations, blood pressure, and heart rate so quicker gas exchange can occur.

A

Decreased; Increase

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7
Q

Diagnostic Tests for Gas Exchange

A

PFT, ABG, Oximeters, Exercise tolerance testing, radiography, bronchoscopy, culture & sensitivity tests

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8
Q

What actions will help prevent gas exchange problems in the future?

A

Reading warning signs & following them when using bleach/chemicals.
Walking a mile at a fast pace
Getting a yearly flu shot

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9
Q

What are some clinical manifestations of gas exchange?

A

Cough, cyanosis, shortness of breath, and current smoking history all suggest a gas exchange problem. ​

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10
Q

What are indicators of alterations in gas exchange?

A

Confusion, LOC, Low O2 sats

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11
Q

What are homeostatic mechanisms used by the body when there is a gas exchange problem?

A

Increasing respiration, changing blood pH, and forcing respiratory muscles to work harder are all homeostatic mechanisms that can improve gas exchange.

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12
Q

Suffocation

A

Not enough oxygen in the environment

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13
Q

Choking

A

Partial or full blockage between the mouth and the alveoli​

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14
Q

Anemia

A

Not enough hemoglobin to carry oxygen​

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15
Q

Pulmonary emboli

A

Blood clots in the capillaries or veins​

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16
Q

Myasthenia Gravis

A

Muscles used to breathe are too weak

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17
Q

What are age related changes that alter gas exchange?

A

Less elasticity in the alveoli, decreased airway volume, and decreased (not increased) surface area of the alveoli are age-related changes. ​

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18
Q

Where in the lungs does pneumonia attack?

A

Pneumonia attacks the alveoli of the lungs, causing an inflammatory response including edema and exudate.

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19
Q

Pneumonia causes an increase in fluid or exudate in the lungs. This prevents the transfer of – to the capillaries and the movement of– into the alveoli. Pneumonia is caused by an –.

A

Oxygen; Carbon Dioxide; infection

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20
Q

Pneumonia may develop from what?

A

Viral, bacterial or fungal infections

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21
Q

Common microorganisms causing types of pneumonia:​

A

Bacterial: streptococcus pneumoniae, mycoplasma pneumoniae​
Fungal: coccidiomycosis, histoplasmosis
Parasitic: ascaris, toxoplasmosis
Viral: influenza, respiratory syncytial virus​

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22
Q

Empiric treatment of pneumonia means

A

Empiric treatment means that the cause of pneumonia is currently unknown, but a prediction can be made with treatment started until the cause is verified.

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23
Q

Testing for bacterial pneumonia?

A

C&S

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24
Q

Testing for fungal pneumonia?

A

Blood testing for immunoglobulins​

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25
Testing for parasitic pneumonia?
Blood, sputum, stool, or other bodily fluid culture​
26
Testing for Viral pneumonia?
Polymer chain reactive (PCR) testing​
27
What actions can prevent pneumonia?
Handwashing, vaccines, and air filtration can all reduce the risk of getting pneumonia.
28
Some S/S consistent with pneumonia?
Malaise (not feeling well), shortness of breath, a productive cough with discolored sputum, chest pain, and weakness are common symptoms associated with pneumonia. Fever and reduced oxygen saturation are common signs with pneumonia. ​
29
What suggests that hospitalization may be necessary to decrease the morbidity or mortality of pneumonia?
older than 65 years of age​ declining or poor kidney function low blood pressure (systolic blood pressure below 90 mmHg)​ tachypnea (increased respiratory rate over 30 breaths per minute)​ hypothermic (low temperature)​ abnormal heart rate (heart rate below 50 or more than 100)​ needing assistance with breathing
30
What actions can reduce the risk and impact of pneumonia in an immunocompromised client?
Handwashing, vaccination, and the avoidance of public places can all reduce the risk of pneumonia in an immunocompromised client. ​
31
Where does RBC production begin?
Red blood cells are produced in the bone marrow. ​
32
What is anemia?
Anemia is when red blood cells and their hemoglobin content are below the normal concentrations expected in the blood. ​
33
Which values are the standard range for hemoglobin in males and females?
The standard range for hemoglobin in men is 14-18 g/dL and for women 12-16 g/1dL.
34
What are common symptoms of anemia?
fatigue​ loss of skin color​ low temperature​ dizziness​ shortness of breath​ chest pain​
35
What causes SOB with an anemic patient?
Shortness of breath caused by anemia is due to a lack of hemoglobin (because of a lack of red blood cells). ​
36
Anemia is caused by a decrease (not increase) in production or an increase (not decrease) in destruction of red blood cells before their normal end of life at around 120 (not 90 or 240) days. T/F
True
37
What condition can result in normocytic normochromic anemia?
Normocytic normochromic anemia is caused by iron deficiency (detected early), chronic illness (e.g., sepsis, tumor), acute blood loss, aplastic anemia, and renal disease.​
38
Common risk factors for anemia are:
Genetics, Low Iron Diet, Alcoholism, Vit D deficiency, Surgery, Meds, Chronic Dz, Trauma
39
Which causes of anemia are primarily seen in older adults?
Vitamin B12 deficiency and iron deficiency anemia are more likely to be seen in the elderly due to poor nutritional intake related to decreased appetite. ​
40
Insufficient iron intake decreases hemoglobin synthesis, which reduces oxygen transportation in the blood.
Iron Deficiency Anemia
41
Malabsorption of vitamin B12 and a lack of intrinsic factor needed to bind with the vitamin. The RBCs are very large and are destroyed prematurely, resulting in low erythrocyte count.
Pernicious Anemia
42
Impairment or failure of bone marrow that leads to stem cell loss, which decreases numbers of erythorocytes, leukocytes, and platelets.
Aplastic Anemia
43
Inherited characteristic leading to abnormal hemoglobin formation. This changes the shape of the RBS to a crescent shape. Cells have a much shorter life span.
Sickle Cell anemia
44
What are some risk factors with anemia?
Risk factors for anemia include penetrating trauma with blood loss, an elevated blood alcohol level, and a close relative with thalassemia. ​
45
Lab values - good to know detail??
Because the mean corpuscular volume (MCV) and mean corpuscular hue (MCH) are within the normal range, this is normocytic normochromic anemia. ​ Microcytic normochromic anemia would have a low MCV and normal MCH. ​ Macrocytic hypochromic anemia would have a high MCV and normal MCH. ​ Megaloblastic anemia is another name for pernicious anemia, caused by a deficiency of vitamin B12.​
46
Which strategies will decrease a pts risk for anemia?
Reducing or eliminating alcohol, increasing the consumption of green leafy vegetables, and limiting exposure to hazardous chemicals will all help reduce the risk of anemia. ​
47
Which is an age-related cause of pernicious anemia in older adults?​
Older adults have a reduction in intrinsic factor which results in less vitamin B12 absorption in the terminal ileum. ​
48
cause of Microcytic anemia
Iron deficiency, thalassemia​
49
cause of normocytic anemia
Blood loss, systemic lupus erythematosus
50
Cause of Macrocytic anemia
Vitamin B12 deficiency, alcoholism​
51
What is the leading cause of emphysema and chronic bronchitis?
The leading cause of emphysema and chronic bronchitis is smoking.
52
What is the definition that best fits chronic obstructive pulmonary disease?​
Chronic obstructive pulmonary disease​ (COPD) is defined as respiratory disorders that include progressive tissue degeneration and airway obstruction in the lungs.
53
What are risk factors for chronic obstructive pulmonary disease (COPD)?
Occupations where workers are exposed to pollution, especially in high traffic areas, can have an increased risk of COPD. In addition, smokers, those who vape, and some with genetic variants may also be at risk.
54
Sxs of COPD
Chronic cough​ Shortness of breath​ Excessive mucus production​ Easily fatigued​ Frequent respiratory infections​ Orthopnea (difficulty breathing lying flat)​
55
What are pathophysiological changes occurs in someone with chronic obstructive pulmonary disease (COPD)?
Pathophysiological changes that occur with COPD include the inability to clear mucus from the lower airways, low oxygen levels to the body tissue, and high pressure in the pulmonary artery system. In addition, increased mucus production and low oxygen levels to the brain also occur.​
56
What vaccinations should someone with chronic obstructive pulmonary disease receive to reduce the risk of increased lung complications?
While it is important that people receive all recommended vaccinations, those that are especially important in someone with COPD include influenza, pneumonia, and coronavirus. These illnesses target the lungs, which are compromised in people with COPD.​
57
What strategies helps to prevent complications of chronic obstructive pulmonary disease (COPD)?
Strategies that can help prevent complications of COPD include avoiding air pollution and education on pursed lip breathing.
58
What complication causes URI
Excess mucus production
59
What complication causes Pneumonia?
Inability to clear mucus from lower airways
60
What complication causes Pneumothorax
High pressure in the chest
61
What complication causes confusion
Low O2 levels to brain
62
What complication causes fatigue
Low O2 levels to body tissue
63
What complication causes dependent edema
High pressure rt ventricle
64
What complication causes arrythmias
Increased L atrial wall volume
65
A total or partial airway obstruction during an asthma attack may lead to which condition?
When partial or total airway obstruction occurs from asthma, hypoxia may occur.​
66
Which statement best describes asthma?​
Asthma is characterized by periodic, severe, but reversible, bronchial obstructive episodes.
67
Which area of the lung is most affected by asthma?​
Asthma affects the small bronchioles of the lungs.
68
What are some common asthma sxs?
Common asthma symptoms include wheezing (from an inflamed/narrow airway), cough (from increased mucous production), and difficulty breathing (dyspnea).
69
What happens when air is trapped in the body due to asthma attack ?
Air trapping causes hyperinflation of the lungs as air becomes much more difficult to exhale due to the narrowing bronchioles.
70
In an extrinsic asthma exacerbation, which hypersensitivity occurs?
Type 1
71
What are strategies to reduce frequency/severity of asthma attacks?
Identify and avoid asthma triggers​ Get regular exercise​ Create and follow a plan of what to do if an attack does occur​ Take the regular asthma medications as prescribed​ Recognize and treat an attack early​ Notice a progressive increase in “rescue” inhaler use and follow-up with a health care provider​ Get vaccinated to prevent infections that may make asthma worse​
72
What complication of asthma may require emergency treatment?
Emergency treatment may be needed when there is cyanosis, when no rescue medications are available, or when shortness of breath is so severe there is no wheezing.​
73
What causes wheezing during an asthma attack?​
Air passing through narrowed bronchioles and mucus during exhalation
74
What factors contribute to a higher mortality rate as people with asthma get older?
Things that contribute to a higher mortality rate in older people include the normal aging process affecting lung function, the presence of other co-morbid conditions, and medication side effects. ​
75
What is known as a blood clot or a mass of material that obstructs the pulmonary artery or a branch of it?
A pulmonary embolus is a blood clot or mass of material that obstructs the pulmonary artery or a branch of it.
76
Which clients are at risk for a pulmonary embolus?
Prolonged sitting, bedrest, extremity trauma, and childbirth are all risk factors for pulmonary emboli.
77
What is the process by which a pulmonary embolus occurs?
A pulmonary embolus is a clot that breaks away from a vessel wall, travels through the circulation, and obstructs the blood flow in the lung.
78
Reduced oxygen from a pulmonary embolus can force significant pressure changes in the ---system, causing increased edema, and ----sided heart failure. This is due to the increased ---in the pulmonary arteries and ---from release of chemical mediators.
Reduced oxygen from a pulmonary embolus can force significant pressure changes in the venous system, causing increased edema, and right-sided heart failure. This is due to the increased resistance in the pulmonary arteries and vasoconstriction from release of chemical mediators.
79
What are some signs and symptoms may indicate that someone has a pulmonary embolus?
Cough with blood-tinged sputum, chest pain, and loss of skin color are common symptoms of pulmonary emboli.
80
Which are increased risk factors for an embolus?
Childbirth, lower extremity surgery, blood clot disorders, cancer, and immobility are all risk factors for an embolus.
81
Which is the cause of most pulmonary emboli?​
A blood clot in the deep veins of the leg is usually the cause of a pulmonary embolus.
82
What are some ways to prevent venous stasis and deep vein thrombosis (DVT) development?​
Support Stockings, Blood Thinners, Anti-platelet meds, smoking cessation, alternatives to high risk meds
83
What are some risk factors?
Risk factors for pulmonary emboli include smoking cigarettes, being immobile for long trips (12-hour plane trip), and oral contraceptives. ​
84
Diagnostic tests for PE
Computed Tomographic (CT) Angiogram: Radio-opaque dye is injected into the venous system and pictures are taken as it moves through the circulation.​ Ventilation and Perfusion (VQ scan): Radioactive material is injected, and sensors watch as the material is absorbed into the lung. Areas in which gas exchange takes place are highlighted, where other areas in which there is blockage do not show the gas exchange.​ Arterial Blood Gases (ABG)s: Blood is drawn from an artery and oxygen, carbon dioxide, and other items are measured.​ Ultrasound of the lower extremity: This test uses sound waves to identify clots that may be forming in the legs, which could lead to a pulmonary embolus.​ D-dimer: It is a blood test to measure whether clotting is noted in the body. This test can be elevated for a pulmonary embolus or a deep vein thrombosis.
85
Which are risk factors for increased pulmonary emboli in older adults?
Increased risks for pulmonary emboli in older adults include immobility, medications, injury, and surgery.
86

Patho (6 decks)

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