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NURS 112 - TEST 5 - UNITS F.5 & (I) > PP - GAS OXYGENATION > Flashcards

PP - GAS OXYGENATION Flashcards

1
Q

bronchodilation

A

(expansion of the airway in the lungs) and

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2
Q

The respiratory system is comprised of the nose, oropharynx, larynx, trachea, bronchi, bronchioles, and lungs.

A

the nose, oropharynx, larynx, trachea, bronchi, bronchioles, and lungs.

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3
Q

ØThe upper airway consists of

A

the nasopharynx or nose, oropharynx or mouth, and the larynx.

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4
Q

ØThe lower airway includes

A

the trachea, bronchi, bronchioles and alveoli of the lungs.

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5
Q

ØThe right lung is made up

A

of three lobes.

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6
Q

ØThe left lung is made up

A

of two lobes.

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7
Q

ØThe lungs are responsible for

A

bronchodilation (expansion of the airway in the lungs) and bronchoconstriction (restriction of the airway in the lungs).

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8
Q

bronchoconstriction

A

(restriction of the airway in the lungs).

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9
Q

ØThe lungs are also linked with the nervous system by both the

A

parasympathetic and sympathetic systems.

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10
Q

ØVentilation

A

is the flow of air inside or outside of the alveoli. / Oxygen is transported into the alveoli and carbon dioxide is taken out.

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11
Q

ØPerfusion

A

is the flow of blood by the cardiopulmonary system into the alveolar capillaries. / ØOxygenated blood is directed into the capillaries and deoxygenated blood is returned to the lungs.

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12
Q

ØOxygenated blood is directed into the ________ and deoxygenated blood is returned to ____

A

capillaries / the lungs.

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13
Q

•Ischemia

A

•Insufficient blood flow of oxygenated blood to the tissues that can result in injury or death

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14
Q

•Hypoxia

A

•Insufficient oxygen reaching the cells

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15
Q

•Anoxia

A

•Total lack of oxygen in body tissues

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16
Q

•Hypoxemia

A

•Reduced oxygenation of arterial blood

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17
Q

ØWhen a person inhales, the diaphragm and intercostal muscles

A

contract, creating a negative pressure inside the lungs, and the thorax increases in size for inhalation.

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18
Q

ØWhen a person exhales, the diaphragm

A

relaxes, the intercostal muscles contract, and exhalation occurs.

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19
Q

ØSurfactant

A

, a lubricant made in the lungs, keeps the alveoli from collapsing.

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20
Q

AGE RELATED DIFFERENCES •Babies born after 30 weeks gestation have

A

sufficient surfactant to prevent the alveoli from collapsing

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21
Q

AGE RELATED DIFFERENCES •Infants are

A

nose breathers until about 3 months

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22
Q

AGE RELATED DIFFERENCES •Respiratory patterns in newborns may be

A

irregular with brief pauses (usually not more than 10-15 seconds

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23
Q

AGE RELATED DIFFERENCES •Respiratory muscle strength decreases →

A

maximal inspiratory and expiratory force

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24
Q

AGE RELATED DIFFERENCES •Alveoli less elastic and more

A

fibrous → dyspnea

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25
Q

AGE RELATED DIFFERENCES •Decrease in erythrocytes →

A

anemia → ↓ ability to transport oxygen

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26
Q

ØHypoxemia

A

is when there is a limited amount of oxygen in the blood.

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27
Q

ØRetraction

A

s are when the muscles are pulled inward and occur between the ribs when inspiration occurs. Intercostal retractions are a sign that the airway is blocked.

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28
Q

ØHypoxia

A

is a lack of oxygen at the cellular level.

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29
Q

ØLung compliance

A

is the point to which a lung can expand in response to increased pressure within the alveoli (intraalveolar).

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30
Q

ØAirway resistance

A

is the pressure that exists when the diameter of the airway is narrowed.

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31
Q

ØLung compliance and airway resistance increase * the work of breathing which

A

results in accessory muscle use.

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32
Q

an increase in the work of breathing leads to

A

Accessory muscles use is an indication of

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33
Q

Accessory muscles use is an indication of

A

respiratory distress.

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34
Q

deoxygenated blood enters thr heart through the

A

IVC / SVC inferior vena cava / superior vena cava

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35
Q

ØDeoxygenated blood leaves the right * and is routed to _______ into what valve

A

Atrium and is routed to the right ventricle through atrioventricular (tricuspid) valve.

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36
Q

Deoxygenated blood then flows from the right ventricle through which valve

A

pulmonary valve (a semilunar valve)

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37
Q

after the pulmonary valve, blood goes to the

A

to the pulmonary artery / trunk

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38
Q

once blood is in the pulmonary artery / trunk it goes Ø into the

A

R /L lungs. Carbon dioxide is eliminated.

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39
Q

ØThe alveoli are

A

the very small air sacs where the exchange of oxygen and carbon dioxide takes place.

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40
Q

CAPILLARIES are

A

blood vesselsin the walls of the alveoli.

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41
Q

ØOxygenated blood then flows

A

into the pulmonary veins (4 - two from each lung)

42
Q

The pulmonary veins empty into the

A

left atrium

43
Q

after the left atrium blood flows through which valve

A

The mitral valve (/ˈmaɪtrəl/), also known as the bicuspid valve or left atrioventricular valve. The heart valves are all one-way valves allowing blood flow in just one direction.

44
Q

the mitral valve allows blood to pass into the

A

left ventricle

45
Q

from the left ventricle blood then passes through which valve

A

aortic valve (semilunar valve). It is also called aortic semilunar due to its semilunar shape. ensure that oxygen-rich blood does not flow back into the left ventricle.

46
Q

blood flows from the left ventricle through the aortic valve to the

A

aorta / aortic arch

47
Q

from the aorta- Systemic circulation carries

A

oxygenated blood to the capillaries in the tissues of the body.

48
Q

Pulmonary circulation carries

A

Pulmonary circulation is the system of transportation that carries de-oxygenated blood from the heart to the lungs to be re-saturated with oxygen before being dispersed into the systemic circulation

49
Q

Causes of Impaired Gas Exchange

A

Acute respiratory illness
Airway obstructions (tumors, thick secretions, foreign body, swollen airways)
Neurologic conditions that effect the brain and spinal cord
Cardiovascular conditions that affect blood flow
Hematologic conditions especially anemia
Lung problems (atelectasis, hypoventilation, chronic lung disease)
High altitudes

50
Q

•Pleural effusion

A

•Fluid in the chest cavity

51
Q

•Pneumothorax

A

•Air leaking into the pleural cavity

52
Q

•Tension pneumothorax

A

•Air is trapped in pleural cavity collapsing the lungs

53
Q

•Crepitus

A

Air in the subcutaneous tissues

54
Q

•Hypoxia

A

•Decrease oxygen to the tissues

55
Q

•Hypoxemia

A

•Decrease oxygen in the blood

56
Q

•Atelectasis

A

•Collapsed lung or partial collapse of the lung

57
Q

•Cyanosis

A

•Bluish color of lips or skin related to decreased oxygen levels in the tissues

58
Q

Normal Breath Sounds

A

bronchial, bronchovesicular, vesicular

59
Q

Breath sounds are normal when they are heard where

A

they are supposed to be heard

60
Q

•Bronchial normal if

A

heard over the sternum

61
Q

which breath sound is •Loudest on inspiration

A

bronchial

62
Q

•Bronchovesicular heard when the stethoscope is .

A

s partly on the sternum and partly on the chest wall

63
Q

•If bronchovesicular sounds are heard in the periphery of the lung can be indicative of

A

consolidation beginning (pneumonia or atelectasis)

64
Q

•Vesicular

A

•Soft blowing sounds best heard on inspiration

65
Q

vesicular is always a normal sound as

A

it is not heard anywhere else

66
Q

•Crackles

A

•Associated with inflammation, infection, or fluid of the small bronchi, bronchioles, and alveoli.

67
Q

Crackles best heard on •Best heard on

A

inspiration.

68
Q

Can be fine (like

A

rubbing hair between your fingers), medium or course (like pulling Velcro apart)

69
Q

•Rhonchi

A

•Louder sounds heard best on expiration

70
Q

•Rhonchi•Denotes

A

obstruction to outflow of air in the large bronchi, usually thick secretions

71
Q

Rhonchi •Can be cleared with

A

coughing

72
Q

•Wheezes

A

•May be heard on inspiration and expiration

73
Q

Wheezing •Means

A

consolidation in the airways or caused by air moving through airways narrowed by constriction or swelling of airway or partial airway obstruction

74
Q

•Friction rub

A

•Low-pitched, grating, or creaking sounds that occur when inflamed pleural surfaces rub together during respiration

75
Q

•Pleural friction rub is easy to confuse with a

A

pericardial friction rub.

76
Q

To determine whether the sound is a pleural friction rub or a pericardial friction rub, ask the patient to

A

hold his breath briefly. If the rubbing sound continues, its a pericardial friction rub

77
Q

Pericardial friction rub because

A

because the inflamed pericardial layers continue rubbing together with each heart beat - a pleural rub stops when breathing stops.

78
Q

a pleural rub stops when

A

breathing stops.

79
Q

Changes in Vital Signs

A

increased respiratory rate / decreases oxygen stauation / increased heart rate / increased temperature

80
Q

•Increased respiratory rate

A

•Increased work of breathing

81
Q

•Decreased SaO2 (oxygen saturation)

A

•Not enough oxygen transported on the hemoglobin

82
Q

•Increased heart rate

A

•Anxiety due to SOB
•Need for more perfusion of oxygen

83
Q

•Increased temperature

A

•Usually relates to infection such as pneumonia or respiratory syncytial virus (RSV) - LOOK IT UP

84
Q

•Usually relates to infection such as

A

pneumonia or respiratory syncytial virus (RSV)

85
Q

Abnormal Inspection

A

Position to ease work of breathing (sitting leaning forward)
Anxious
Impaired mental status
Use of accessory muscles
Pursed lip breathing
Paleness of skin and lips
Cyanosis clubbing of the nails
Barrel chest
Asymmetric thorax
Scoliosis
Trachea deviation

86
Q

Abnormal Inspection - infants / toddlers

A

Infants/toddlers
Flaring of the nares
Chest wall retractions
Grunting with inspiration
Cyanosis when sucking
Need to stop feeding to breathe

87
Q

Diagnostic Tests

A

Labs

Pulmonary Function Studies
Bronchoscopy
Peak Flow
ABG
Radiographic Studies

88
Q

Diagnostic Labs

A

Arterial Blood Gas (ABG)
CBC
Sputum examination
Skin tests

89
Q

Radiographic Studies

A

CXR
Computed tomography (CT)
Ventilation-perfusion scans
Positron Emission Tomography (PET)

90
Q

Clinical management - Primary

A

Infection Control
Smoking Cessation
Immunizations
Preventing post-op pulmonary complications

91
Q

Clinical management - Secondary

A

Screening for risk factors
Early diagnosis
Prompt treatment of existing health problems

92
Q

Clinical management - Collaberative Intervention

A

Smoking cessation
Pharmacologic therapy

Airway management and support
Chest physiotherapy and postural drainage
Nutrition Therapy
Positioning

93
Q

Clinical management - Invasive Procedures

A

Chest tube
Thoracentesis
Bronchoscopy

94
Q

Clinical management - Collaberative Intervention - Pharmacology Therapy

A

Drugs that affect upper airway
Lower airway bronchodilators
Mucolytic and expectorants
Cough suppressants
Antimicrobials
Aids for smoking cessation

95
Q

Clinnical Management - Collaberative Interventions - Positioning

A

High Fowlers or semi-fowlers

Tripod positioning or leaning forward over a table to sleep
Lying horizontally (hypoxic with acute lung disease)

96
Q

High Fowlers or semi-fowlers

A

Uses gravity to move the diaphragm away from the lungs

97
Q

Lying horizontally (hypoxic with acute lung disease)

A

•Ventilation and profusion are effected by gravity.

98
Q

Clinical Management - Other Interventions

A

Alternate activity with periods of rest
Increase air circulation, especially in the COPD patient.
Offer to listen how they are coping with impaired gas exchange and how it has changed their lives.
Call case management if there is a need for additional resources.

99
Q

Conditions That Increase the Need for More Oxygen

A

Activity
Fever
Pain
Asthma
Pneumonia
Sleep disorders Bronchitis
Bronchitis
COPD
Severe Allergies
Anemia
Heart Failure
Neurological disorders like stroke

100
Q

Nursing Interventions for Patients with Impaired Oxygenation

A

Turn, cough, and deep breathe
Incentive spirometry
Nebulizer treatments
Chest physical therapy
Supplemental oxygen

NURS 112 - TEST 5 - UNITS F.5 & (I) (9 decks)

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