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gas exchange
pathophysiology NUR 304
| Question | Answer |
|---|---|
| What are the four essential components for effective gas exchange? | mechanics of breathing, perfusion, ventilation, and transport |
| Define mechanics of breathing | the ability of the lungs to expand and contract to let air in and out |
| Define perfusion for gas exchange | blood flow to the lungs |
| Define ventilation | the actual inspiration and expiration; how much air that reaches the alveoli, and how much exits |
| Define transport | the capacity of the blood to deliver oxygen and remove CO2 waste products |
| What does the ventilation perfusion ratio measure? | the effectiveness of gas exchange |
| What is the normal V-Q ratio? | 4:5; the alveoli receives about 4 L/min of air and the capillaries supply blood at 5 L/min |
| What is ventilation perfusion mismatching? | when areas receive blood but no air OR air but no blood |
| Define pulmonary hypertension | chronic pulmonary vasoconstriction |
| What is the chief unit of gas exchange? | alveoli |
| What kind of patients usually have pulmonary aspiration? | patients who have trouble clearing their lungs, decreased LOC, and who has a diminished gag/cough reflex |
| What is different about the right bronchus? | It is larger and more vertical than the left and foreign bodies and pathogens can enter it more easily |
| What is the mucociliary apparatus? | a mechanism that traps inhaled particles in a mucus layer and moves it up and out of the respiratory tree |
| How does smoking affect the mucociliary apparatus? | it paralyzes it and inhaled particles stimulated smokers to forcibly cough to mobilize the mucus |
| The percentage of hemoglobin saturated with oxygen can be measured with? | a pulse oximeter |
| What is a normal pulse ox reading | above 90% |
| What is erythropoietin stimulated by? | hypoxia |
| What substances are vital for healthy RBCs? | protein, iron, vitamin b12, and folic acid |
| What does heme consist of? | iron and a protein called porphyrin |
| Define oxygemoglobin | oxygen that combines loosely with the heme portion |
| Explain chronic obstructive pulmonary disease | characterized by and increase in resistance to airflow from the trachea and larger bronchi to the terminal and respiratory bronchioles. COMBINATION OF CHRONIC BRONCHITIS AND EMPHYSEMA |
| What are some causes of COPD? | smoking, dust and chemical exposure, and second hand smoke exposure |
| What kind of problem is COPD? | impaired ventilation |
| When does diagnosis for COPD occur? | a cough for 3 months out of the year for 2 consecutive years |
| What is a distinguishing characteristic of COPD? | airflow obstruction caused by mucus |
| What is a genetic predisposition of COPD? | alpha-1 antitrypsin (ATT) deficiency |
| What is the nickname for chronic bronchitis ? | blue bloater |
| What are some CM for chronic bronchitis? | productive cough, dyspnea, cyanosis, use of accessory muscles to breathe, pulmonary hypertension, wheezing, elevated hgb, peripheral edema, right sided HF, liver engorgement, |
| What are some key characteristics of chronic bronchitis? | hypersecretion and blockage of mucus in the small and large airways, hypoxia, cyanosis, cannot get air INTO the lungs |
| What is the patho for chronic bronchitis? | chronic inhalation of irritants leads to resistance in the small airways which decreases the amount of arterial oxygenation in the lungs -> hypoxia stims RBC overproduction -> RSHF & hypertension -> cyanosis |
| What are some key characteristics of emphysema? | air trapping in the alveoli, obstructs expiratory flow, high concentration of CO2 in the lungs, and cannot get air OUT |
| what is the nickname for emphysema? | pink puffer |
| What is the patho for emphysema? | trapped air leads to irreversible enlargement of airspaces -> narrowing of small airways -> chronic hypercapnia -> high hgb levels -> air is forced out and CO2 retention leads to a barrel chest and prolonged expiration |
| What are some CM of emphysema? | less lung complaint, dyspnea on exertion, barrel shaped chest, prolonged expiration, decreased breath sounds, hyperinflation with flattened diaphragm on chest x ray, minimal V/Q mismatch & hyperventilation keeps ABGs normal until late in disease |
| Define bronchiectasis | when the structural components of the bronchial walls are destroyed and replaced by fibrous tissue. the loss of elasticity and ability to clear mucus, the airways become irreversibly dilated, and it leads to build up of thick mucus |
| Define pulmonary embolism | an occlusion of a portion of the pulmonary arterial bed by a thrombus, embolus, tissue fragments, lipids, or an air bubble |
| A pulmonary embolism is what kind of gas exchanged problem? | impaired perfusion |
| What are some risk factors for pulmonary embolism? | long term immobility, chronic pulmonary disease, HF, a fib, thrombophlebitis, vascular injury, cancer, IV drug use, autoimmune hemolytic anemia, sickle cell disease, varicose veins, recent surgery, advanced age, pregnancy, burns, obesity |
| What are some CM of pulmonary embolism? | dyspnea, chest pain, tachycardia, feeling of impending doom, productive cough, blood tinged sputum, low grade fever, pleural effusion, leg edema, cyanosis, syncope, and distended neck veins |
| Define iron deficiency anemia | insufficient delivery of oxygen to the tissues (hypoxia) because of an inadequate number of mature, healthy RBCs in the blood due to insufficient iron stores |
| Iron deficiency anemia is what kind of gas exchange? | impaired transport |
| What causes iron deficiency anemia? | inadequate iron intake, disorders leading to malabsorption or iron, trauma or surgeries leading to blood loss, pregnancy, cancers, congenital or inherited problems with production or regulation |
| What are some CM of iron deficiency anemia? | generalized weakness and fatigue, pica, koilonychias, glossitis, cheilitis, hair loss, pallor of the skin and yellowing of the eyes, leg cramps, SOB, tachycardia, palpitations, headache, difficulty concentrating, syncope, dizziness, cold/numb fingertips |
| How is iron deficiency anemia diagnosed? | RBC count: typically low, low hgb, low hematocrit, CBC with differential, reticulocyte: determines the number of immature cells present and helps diagnose type |
| Who is at risk for iron deficiency anemia? | vegans, women with excessive menstrual bleeding, pregnant people, elderly, children weaned from breast milk to cow's milk, teens in growth spurt, persons with chronic slow GI bleeding |
Created by:
keiondraharden
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