Oxygenation Chapter 37

Question 1

Moving gas in/out

Answer 1

Ventilation

Question 2

CV movement of O2/CO2 min blood

Answer 2

POerfusion

Question 3

Moving resp. Gasses via a concentration gradient

Answer 3

Diffusion

Question 4

An active process stimulated by chemical receptors in the aorta and a passive process that depends on the elastic recoil properties of the lung.

Answer 4

Inspiration/expiration

Question 5

Moves blood to and from the alveolar capillary membranes for gas exchange

Answer 5

Pulmonary circulation

Question 6

Exchange of respiratory gases in the alveoli and capillaries through a concentration gradient

Answer 6

Diffusion

Question 7

Diffuses into red blood cells and is converted into carbonic acid

Answer 7

Carbon dioxide transport

Question 8

Exchange of O2 and CO2 during cellular metabolism

Answer 8

Respiration

Question 9

What are the 3 steps in the process of oxygenation:

Answer 9

1. Ventilation- move gases into and out of lungs
2. Perfusion- ability of the cardiovascular system to pump oxygenated blood to tissues and return deoxygenated blood to lungs.
3. Diffusion- responsible for moving the respiratory gases from one are to another by concentration gradients

Question 10

The carrier for oxygen in the RBC

Answer 10

Hemoglobin

Question 11

Loss of blood volume that also decreases oxygen carrying capacity

Answer 11

Hypovolemia

Question 12

Pt’s with a higher metabolic rate (i.e. fever, pregnancy, wound healing, exercise) have an ^ O2 demand.

Answer 12

Hyperbole is

Question 13

Factors affecting chest wall movement: (6)

Answer 13

Pregnancy
Obesity
Musculoskeletal abnormalities (fail chest)
Trauma (pneumothorax/hemothorax) 
Neuromuscular disease 
Changes in neurological status

Question 14

Ventilation in excess of that required to eliminate carbon dioxide produced by cellular metabolism

Answer 14

Hyperventilation

Question 15

Alveolar ventilation inadequate to meet the body’s oxygen demand or to eliminate sufficient carbon dioxide

Answer 15

Hypoventilation

Question 16

Inadequate tissue Oxygenation at the cellular level

Answer 16

Hypoxia (anoxia, anoxic)

Question 17

Developmental Factors: Infants and toddlers

Answer 17

1. Upper respiratory infections- exposure to other kids
2. Respiratory distress syndrome- premature infants and RSV
3. Airway obstruction- toddlers from putting objects in mouth
4. Drowning- toddlers

Question 18

Developmental factors: Adolescents

Answer 18

1. Smoking- adolescence

Question 19

Developmental Factors: Young and Middle age

Answer 19

1. Lack of exercise
2. Unhealthy diet
3. Stress
4. Illegal use of meds

Question 20

Developmental Factors: Older adults

Answer 20

1. Atherosclerotic changes
2. Calcification of airway
3. Cilia death or dysfunction- from smoking

Question 21

Older adult health concerns as they age:

Answer 21

• ^ risk for reactivating of TB
• atypical signs of CAD
• Afib is prominent
• forgetfulness and irritability
• changes in cough mechanism
• ossification of thorax

Question 22

Examples of common upper respiratory infections:

Answer 22

Common cold

Influenza

Question 23

Examples of lower respiratory infections

Answer 23

Pneumonia
Acute bronchitis
RSV- respiratory syncytial virus

Question 24

Caused by bacteria, fungus, or viruses. usually follows the flu and when invading pathogens enter the lungs and release toxins

Answer 24

Pneumonia

Question 25

How old Pneumonia work inside the body?

Answer 25

Invading pathogens relasease toxins into lungs and the inflammatory response triggers edema in the small passages and deposits debris and exudate Into the alveoli. (Some tissue dies) and the area of the lung affected becomes “consolidated” or filled with solid rather gas.

Question 26

Alveolar collapse caused by a tumor or obstruction

Answer 26

Atelectasis

Question 27

Nursing assessment of lungs for respiratory problems. Things to check:

Answer 27

1. Pain- location, duration, radiation, freq? 2. Fatigue/Dyspnea 3. Cough- freq. productive, color? 4. Resp. Infections 5. Allergies 6. Meds 7. Environmental- 2nd hand smoke, radon, CO 8. Geographical- well water with radon?

Question 28

Physical examination of respiratory system:

Answer 28

Inspection Palpation Percussion Auscultation

Question 29

Normal breaths from 12-20

Answer 29

Eupnea

Question 30

Fast, shallow breathing >24

Answer 30

Tachypnea

Question 31

Slow respirations <10

Answer 31

Bradypnea | - caused by poor gas exchange from sedation, opioid use and neuromuscular dysfunction

Question 32

Regular pattern breathing but ^ rate and abnormally deep inhalation

Answer 32

Kussmaul’s Respirations - compensatory mechanism for metabolic disorders that lower the blood PH, mixed with hyperventilation caused by fear or anxiety or pain. (DKA)

Question 33

Irregular pattern of variable depth (usually shallow), alternating with periods of apnea.

Answer 33

Biot’s Respirations | - associated with damage to medullary rep center or high ICP due to brain injury

Question 34

Gradual increase in depth, followed by a gradual decrease in depth, then a period of apnea

Answer 34

Cheyne- Stokes Respirations | - results from damage to medullary rep. Center or high ICP due to brain injury

Question 35

Absence of breathing. Respiratory arrest

Answer 35

Apnea

Question 36

Examples of NANDA diagnosis for respiratory issues

Answer 36

``` Impaired gas exchange Risk for infection Decreased cardiac output Ineffective breathing pattern Anxiety Ineffective tissue perfusion Activity tolerance Ineffective airway clearance- cilia impaired, smoker etc. ```

Question 37

Health promotion for respiratory care:

Answer 37

1. Vaccinations- Flu, Pneumococcal (65 or older) 2. Healthy lifestyle 3. Environmental pollutants

Question 38

Group of therapies for mobilizing pulmonary secretions

Answer 38

Chest physiotherapy

Question 39

Oropharynx earl and nasopharyngeal suctioning

Answer 39

Used when client can cough effectively but is not able to clear secretions

Question 40

Orotracheal and nasotracheal suctioning

Answer 40

Used when the client is unable to manage secretions

Question 41

Artificial airway needed when airway is obstructed or decreased level of consciousness

Answer 41

Tracheal

Question 42

Prevents obstruction of the trachea by displacement of the tongue into the oropharynx

Answer 42

Oral airway

Question 43

Short-term use to ventilate, relieve upper airway obstruction, protect against aspiration, clear secretions

Answer 43

Endotracheal airway

Question 44

Long-term assistance that is a surgical incision made into trachea. Hollow tube to keep airway open

Answer 44

Tracheostomy

Question 45

Promotion of Lung Expansions: Ambulation

Answer 45

>1 wk bed rest causes decline in muscle strength by as much as 20% - important to get them up and moving

Question 46

Promotion of Lung expansion: Positioning

Answer 46

- reduces pulmonary stasis, maintains ventilation and oxygenation - 45 degree semi-Fowler’s position is the most effective position

Question 47

Promotion of Lung Expansion: Incentive Spirometry and Chest Tubes

Answer 47

Incentive: encourage voluntary deep breathing Chest tube: catheter placed through the thorax to remove air and fluids from pleural space or to prevent air from re-entering or to re-establish intrapleural and intrapulmonic pressure.

Question 48

Chest tubes are used to treat:

Answer 48

Pneumothorax or hemothorax | No gas exchange in area that has collapsed

Question 49

How do you use a incentive spirometer?

Answer 49

Have them place lips on tube and exhale fully. Then suck in air over as long of a period of time they can. Accordion tube needs to be all the way out and keep indicator between the two arrows

Question 50

Nasal Cannula flow rate up to ___ L/min but greater than __ L/min is not often used

Answer 50

6 L/min | 4 L/min

Question 51

A non-rebreather face mask administers ___% of O2 to patient

Answer 51

100% bc there’s not O2 leaving the bag or CO2 entering - before bag goes on pt face it must be inflated-

Question 52

Deliver higher oxygen concentration of 24-60% with O2 flow rates at 4-12L/min

Answer 52

Venturi Mask | - has plastic pieces that tell you how many L of O2 to use

Question 53

Goal of oxygen therapy is to:

Answer 53

Relieve or prevent tissue hypoxia

Question 54

Ways to promote venous return:

Answer 54

- elevate legs - don’t cross legs - encourage early ambulation - ROM exercises - compression devices

Question 55

Stationary clot adhering to the wall of a vessel

Answer 55

Thrombus

Question 56

Clot that travels in the blood stream

Answer 56

Embolus

Question 57

Cardiopulmonary resuscitation

Answer 57

1. Airway 2. Breathing 3. Circulation 4. Defibrillation

Question 58

Cardiopulmonary rehabilitation techniques

Answer 58

1. Hydration 2. Coughing 3. Purse-lipped breathing 4. Diaphragmatic breathing