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130 Test 9 Oxygen > Notecards for all > Flashcards

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1
Q

turbinates

A

3 bones that protrude in into the nasal cavity. They Increase the total surface area for filtering, heating, and humidying inspired air before it passes into the nasopharynx.

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2
Q

surfactant

A

Aveoli type II secrete surfactant (a fatty protein that reduces surface tension in the aveoli). Without this Atelectasis can occur (lung collapse)

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3
Q

arteries and veins carry blood where?

A

Vein carry oxygenated blood to the heart. Arteries carry deoxygenated away from the heart to the lungs, to re-oxygenate it.

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4
Q

ventilation

A

the process of moving air in and out of the lungs.
Require muscle and intact nerve intervention. (diaphragm -which is functioned by the phrenic nerve) and elastic properties.

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5
Q

perfusion

A

ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs

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6
Q

Diffusion

A

exchange of gases

From an area of high concentration to low concentration

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7
Q

movement of air in and out of the lungs

A

Move by pressure changes, for O2 to move into the lung there is a normal sub atmospheric pressure (negative pressure) causes the air to come in. Then it is no longer negative and will expire. It take effort to overcome the negative pressure, inspiration is active process and expiration is passive

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8
Q

Inspiration

Exhalation which is active and which is passive process

A

Inspiration~ active

Expiration~ passive

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9
Q

Inspiration

A

The active part uses the diaphragm and contracts the intercostal muscles contract and increases negative pressure which facilitates air entry into the lungs.

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10
Q

Pleura

A

continuous smooth membrane composed of two surfaces that totally enclose the lungs. The parietal pleura lines the inside of the chest cavity and the upper surface of the diaphragm. The visceral pleura covers the lung surfaces

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11
Q

What transports the gases

A

Hemoglobin

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12
Q

oxygen + hemoglobin

A

oxyhemoglobin

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13
Q

Carbon dioxide + hemoglobin

A

carboxihemoglobin

Carbon dioxide is also carried by bicarbonate

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14
Q

Control of Respiration

A

Medulla provides automatic control of respiration continuously. There are Chemoreceptors in the Medulla which are stimulated by high concentrations of CO2 and Hydrogen ion in the blood. Stimulated to a lesser degree by O2 in arterial blood.
Our drive is based on CO2 level. So when there is a High level of CO2 in our blood that’s our drive to breath to get more O2.
When COPD its the opposite, drive gets ruined because they have a high level of CO2 in their blood, so they respond to low O2 drive. So have to be careful the amount of O2 we give to a COPD patient.

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15
Q

Normal respiration

A

Normally when the Medulla is stimulated by high concentration of CO2, then the rate and depth of ventilation increases so that’s there’s more exhalation of CO2 and H+ and there’s more inhalation of the O2

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16
Q

Adequate fluid intake is essential to respiratory functioning

Ways it can be compromised

A
  • helps function of cilia
  • Mucous lining protect underlying tissue from irritation and infection, needs to be moist
  • prevents friction in the visceral.
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17
Q

Ventilation depends on the extent of perfusion in the area

Ways it can be compromised

A

~Blood circulation in tissues
~Does depend on adequate blood supply. Not enough blood less O2 carried
~ If a person is anemic it effects carrying capacity

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18
Q

All living cells require oxygen, which the body cannot store

Ways it can be compromised

A

Deprived of O2 = confusion, tired
High altitude
environmental O2: The BODY has a 200 times greater attraction for CO2

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19
Q

The air passageways must remain patent for respirations to occur

Ways it can be compromised

A 
Presence of CO2
Mucus, food, inhaled object, inflammation, tumors, 
Unconscious- tongue falls back
muscles will constrict
edema
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20
Q

Muscle movements provide the physical force essential for respiration

Ways it can be compromised

A

Accessory muscles: neck, back, diaphragm, intercostal

When breathing is labored you use accessory muscles

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21
Q

The pressure changes resulting from expansion and contraction of the thoracic cavity produce pulmonary gas exchange

Ways it can be compromised

A

~Atelectasis- part or complete collapse of lung
~ Immobility
~ Obstruction of the airway
~ Constriction
~ External Compression~ Tumor or Ascites fluid in abdomen pushing up and impinging on lungs

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22
Q

Hypoxia

A

Decreased amount of O2 available to cellls

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23
Q

There must be an exchange of oxygen and carbon dioxide between the blood and body cells.

Ways it can be compromised

A

~Aveolar capillary membrane is thicker Becomes a problem

~excess fluid in tissue impedes transfer to tissue

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24
Q

Hypoxemia

A

decreasedO2 in the blood. Increased Co2 in the blood.

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25
Hypoventilation
Decreased in rate or depth of air movement into the lungs
26
Hyperventilation
Increased in rate and depth of ventilation
27
4 factors affecting Oxygenation
~ Developmental ~ Physiological ~ Lifestyle ~ Environmental
28
Physiological functions affecting oxygenation 7
~Alterations in Cardiac functions ~Alterations in Respiratory function ~Decreased O2-carrying capacity ~Decreased inspired O2 concentration ~Hypovolemia ~Increased metabolic rate ~Conditions affecting the chest wall movement
29
Alterations in Cardiac functions
~disturbances in electric conduction system | ~conditions that decrease cardiac output
30
Alterations in Respiratory function
~hyperventilation- increase rate and depth of respiration which also involves blowing off more of Co2 ~hypoventilation~ deceased rate and depth of respiration--> not blowing off less CO2 as normal (not uncommon for respirations to decreased to 8 or less) ~hypoxia- inadequate oxygenation at the cellular level--> causes--> decrease hemoglobin level-->decreased oxygen in inspired air as in high altitudes--> inability of tissues to extract oxygen from the blood as in edema-->decrease of transfer of oxygen at the aveolar level-->
31
Norms PaCO2 PaO2 SaO2
PaCO2 (partial pressure of carbon dioxide)- 35-45 mmHg PaO2 (partial pressure of oxygen)- 80-100 mm Hg SaO2 (oxygen saturation)- 95-100% mm Hg
32
decreased O2-carrying capacity 2
~Anemia | ~Inhalation of toxic substances (carbon dioxide)
33
Deceased inspired O2 concentration | 2
~Airway obstruction | ~Deceased environmental O2 (altitude)
34
Hypovolemia (2)
definition~Decreased blood volume ~shock ~severe dehydration
35
Increased metabolic rate
~fever ~exercise ~pregnancy
36
Conditions affecting chest wall movement 6
1) Pregnancy 2) Obesity 3) Musculoskeletal abnormalities 4) trauma 5) neuromuscular disease 6) central nervous system alterations
37
Pursed lips (breathing) does what?
the pursed lips create a resistance to the air flowing out of the lungs, which prolongs exhalation and maintains positive airway pressure, thereby maintaining an open airway and preventing airway collapse.
38
Signs of Hypoxia
``` Increased breathing and heart rate. Changes in level of consciousness. Restlessness. Cyanosis (bluish lips and nailbeds). Chest pain ```
39
Venturi mask
High Flow rate Delivers oxygen concentrations of 24% to 60% with oxygen flow rates of 4 to 12 L/min, depending on the flow-control meter selected v=Advantages Controls the amount of specified oxygen concentration Does not dry mucous membranes Delivers humidity with oxygen concentration Quiet Ideal for CO2 retainers Matches patients demands Disadvantages Hot and confining Humidification can irritate skin Decreased oxygen concentration if mask does not fit right Interferes with eating , drinking and talking
40
Partial rebreather
Some face masks have reservoir bags also called partial rebreathing bags. Provides higher concentrations of oxygen to the patient. A portion of the patient’s expired air is directed into the bag. Conserves oxygen by having patient rebreath exhaled air. Because this air does not take part in gaseous exchange, its oxygen concentration remains high. When this air is added to the inflow from the oxygen source, the patient will breath in air with greater oxygen concentration.
41
Non-rebreather masks (NRB)
Covers both nose and mouth Has an attached reservoir bag Reservoir bag connects to an external oxygen supply Before an NRB is placed on the patient, the reservoir bag is inflated to greater than two-thirds full of oxygen, at a rate of 8–15 liters per minute (lpm). Approximately ¹⁄₃ of the air from the reservoir is depleted as the patient inhales, and it is then replaced by the flow from the O2 supply. If the bag becomes completely deflated, the patient will no longer have a source of air to breathe. Exhaled air is directed through a one-way valve in the mask, which prevents the inhalation of room air and the re-inhalation of exhaled air. The valve, along with a sufficient seal around the patient's nose and mouth, allows for the administration of high concentrations of oxygen, 60–90% O2. High concentrations of oxygen can be administered accurately Oxygen flows into bag and mask during inhalation Valves prevents expired air from flowing back into bag Cannot be used with a high degree of humidity.
42
Partial Rebreather Mask
Conserves oxygen Can be administered in concentrations of 40-60% using flow rates of 6-10L - This is useful when oxygen concentrations must be raised Cannot be used with a high degree of humidity Not recommended for COPD patients Should NEVER be used with a nebulizer
43
Face tent
Ideal for post anesthesia Not enclosed and claustrophobic Only for low oxygen concentrations
44
Nasal Cannula
Simple, comfortable device for oxygen delivery Oxygen delivered via cannulas with a flow rate of up to 6 L/min Flow rates greater than 4 L/min not often used Drying effect on nasal mucosa Above 6 L/min the 02 is simply flushed out of the nose ``` Nasal cannula – Advantages Safe and simple Easily tolerated Delivers low concentrations while allowing patient to eat, speak, drink Does not impede eating or talking Inexpensive and disposable ``` ``` Nasal cannula – Disadvantage Unable to use with nasal obstruction Drying to mucous membranes Can dislodge easily Patient’s breathing pattern will affect exact FIO2 Causes skin irritation or breakdown Nose, ears, cheeks, under chin ```
45
Oxygen Masks 4
Simple face mask Venture mask Partial rebreather mask Non-rebreather mask.
46
Low and High flow devices
``` Low Flow: Nasal cannula Simple oxygen mask Non-rebreather mask Face tent High Flow: Venturi mask ```
47
Humidifying
nasal cannula 1-6 L/min you only humidify for flow rates greater than 4 Simple mask starts at 5-->8 Venturi 4-->12
48
Developmental factors
1) Infants and toddlers-up to the age of 3, are especially susceptible to respiratory infection 2) School age children and adolescents 3) Young and middle-aged adults 4) Older adults
49
Lifestyle risks (5)
1) Nutrition 2) Exercise 3) Smoking 4) Substance abuse 5) Stress- (increase metabolic rate and O2 demand)
50
Environmental factors (2)
1) Air pollution | 2) Occupational pollutants
51
**Respiratory rates**
Newborn-------------------------35-40 Infants (6 months)-------------30-50 Toddler (2 yeas)----------------25-32 Child-------------------------------20-30 Adolescent-----------------------16-20 Adult-------------------------------12-20
52
7 types of Respirations
1) Eupnea 2) Tachypnea 3) Bradypnea 4) Cheyne-stoke 5) Kussmaul 6) Dyspnea 7) Orthopnea
53
Eunpnea
Normal relaxed breathing
54
Tachypnea
fast breathing rate, >20 respirations/minute
55
Bradypnea
slow breathing rate, <12 respirations/minute
56
Cheyne-stokes
Tidal volume waxes and wanes cyclically with recurrent periods of apnea. Causes include CNS dysfunction, cardiac failure with low cardiac output, sleep, hypoxia, profound hypocapnia
57
Kussmaul
Deep, rapid respiration with no end-expiratory pause. Causes profound hypocapnia Seen in profound metabolic acidosis, i.e. diabetic ketoacidosis
58
Dyspnea
labored, possibly painful, feeling of breathlessness
59
Orthopnea
A abnormal condition in a person in which a person must sit or stand to breathe deeply or comfortably
60
CPR
CAB (Chest compression, Airway, Breathing) | Chest compression are first
61
Antitussives
Act by suppressing the cough reflex by direct action on the cough center in the medulla
62
Expectorant
Suppresses cough reflex by liquefying and reducing the viscosity of thick, tenacious secretions
63
Bronchodilator
Relaxes smooth muscle (lungs)
64
Mucolytics
Decrease the viscosity of secretions by breaking disulfide links of mucoproteins Dissolve various chemical bonds within secretions
65
Corticosteroid
``` Long onset ( not a rescue inhaler) Increase capillary permeability ```

130 Test 9 Oxygen (5 decks)

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