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oxygenationtest5

QuestionAnswer
What portion of the airway is most prone to airway obstruction? larynx
Functions of the Pulmonary System Ventilation or breathing~the mvmnt of air b\t the atmosphere &the alveoli of thelungs. Alveolar gas exchanging~diffusion of oxygen from alveoli into the pulm bl vessels Trasport of O2 and CO2~O2 from lungs to tissues~CO2 trans from tissues back to lungs
Factors Affecting O2 Transport Cardiac Output Number of erythrocytes (RBC)Blood HematocritExercise
Respiratory Regulation Respiratory center is in the medulla & pons of brain *Chemoreceptors detect changes in blood pH, O2 levels, and CO2 levelsCO2 levels-normally stimulate breathingHypoxemia- low blood O2 will secondarily stimulate breathing
Expected Changes in Older Adult Reduced lung expansion and less alveolar inflation *Difficulty expelling mucus or foreign materials *Diminished ability to increase ventilation *Declining immune response
Effects of Aging on Oxygenation Degenerative changes *Decreased vital capacity *Lungs become less elastic*Chest wall becomes more rigid *Air exchange with each breath decreases *Decreased cardiac output * Increased risk for respiratory disease*Athrosclerosis increases
Respiratory Risks in Older Adults Respiratory infections, Increased O2 demand, Rising CO2 levels, Lower exercise tolerance
Factors Affecting Respiratory and Cardiovascular Function Environment, Lifestyle,Health statusNarcotics, Stress and coping, Gender
Risk Factors for Heart Disease Nonmodifiable~Age~Gender~HeredityModifiable~Diet~Hypertension~Cigarette smoking ~Diabetes~Obesity~Lifestyle
Stress Stimulates sympathetic nervous systemSuppresses the immune systemAlters glucose, fat, and protein metabolismIncreases risk of heart diseaseIncreases risk for respiratory infections
Occupational Hazards Chemicals/fumesCombustiblesOrganismsFine particlesRadiation
Obesity Respiratory infectionsSleep ApneaCardiovascular changes
Smoking Constricts bronchiolesIncreases fluid secretions into airwaysCauses inflammation and swelling of the bronchial liningParalyzes cilia
Benefits of Smoking Cessation Decreased blood pressure and heart rateCirculation to extremities improves within 2 hoursOxygen levels in the blood improve within 8 hoursDigestion improvesDecreased coughing, congestion, and shortness of breath
Benefits of Smoking Cessation Overall energy increasesLungs increase ability to clean themselves, reducing risk of infectionRisk of heart attack decreases and returns to that of a non-smoker within 1 yearRisk of lung and other cancers, stroke, and COPD decreases
hypoxia Insufficient oxygen in the body.SymptomsAnxiety Restlessness Tachycardia (increased HR)Tachypnea (increased resp rate)Dyspnea Substernal or intercostal retractionsCentral cyanosis
hypoxemia dsd
hypercarbia kklj
hypocarbia lkj
cyanosis kj
peripheral cyanosis kjlk
central cyanosis kj
symptoms of insufficient oxygenation in the body: anxiety, restlessness, tachycardia, tachypnea, dyspnea, substernal or intercostal retractions, CENTRAL cyanosis
assessment of oxygenation resp. rate, rythm, pattern, effort *use of acessory muscles *breath sounds *chest shape/size *cough *pulse rate, rhythm, palpations *bl pressure
when assesing a cough, assess for s/s ass. with cough *sputum appearance,color, odor *sputum amt *sputum timing *sputum samples
signs of respiratory effort nasal flaring, retractions, use of accessory muscles, grunting, body position, stidor, orthopnea, wheezing, paroxysmal nocturnal dyspnea
the physician orders sputum specimen for culture for a client with probable pneumonia. in order to obtain a good specimen the nurse should... teach the client deep breathing and coughing tech. Can rince mouth with water if need (ie. just ate)
Respiratory diagnostic studies chest Xray, EKG, sputum spec.(sterile), bronchoscopy, pulmonary func test, lab test-CBC, WBC, ABG's, Chlosterol
pulse oximetry simple noninvasive, measures SaO2, Normal value is 95-100%, below 94 should be investigated Gives an estimate of ABG's
ABG's is indictive of what is causing the breathing problem. gives us their pH. gives us PO2, and CO2 values. Radial artery hold pressure for at least 5 min. after to stop bleeding
a pt pulse ox alarm sounds and then the nurse finds it to read 75%. what should the nurse do first? Check the probe. (see what the problem is first)
best time to obtain a sputum spec is early in the morning when they first wake up, and after changing positions.
EKG checks cardiac func
bronchoscopy visual of . can collect spetums. assess their gag feflex when they come back from procedure before giving anything PO.
to do a pulm func test the client must be able to follow directions
stridors can indicate obstruction. try to have pt cough to clear throat.
hemoglobin k
hemocrit k
supplys of oxygen wall outlets, compressed O2 in portable tanks, liquid O2 units, oxygen concentrators
oxygen hazards O2 is a DRUG. oxygen toxicity, combustible, pressure
artifical airways oropharyngeal, nasopharyngeal, endotracheal, tracheal
pneumonia is an acute infection resulting in inflammation of lung tissue. *results in reduced functioning lung volumes due to exudates and consolidation. *altered gass perfusion *hypoxemia (most common place to have pneumonia is lower back)
pneumonia is freq seen in ppl with COPD
hospital aquired pneumonia invasive resp procedures (suctioning, aspiration, on oxygen, tube feedings, not good hand washing) is the most lethal nosocomial infection
Good times to suction when hearing gurgling sounds *restlessness or anixious assess resp status
risk factors for pneumonia compromised defences, immunosuppression, smoking, prolonged immobility (TCDB), shallow breathing patterns, age
assessment for pneumonia cough and sputum production, fever and chills, chest pain (hurts to breathe), decreased lung sounds, tachypnea (25-45 bpm), resp. distress
assessment for pneumonia test decreased PO2, elevated WBC, chest xray
inerventions for pneumonia maintain adequate oxygenation, give abx as ordered, admin bronchodialtors, maintain adequate gas exchange, promote comfort adn rest, promote hydration and nutrition
interventions for pneumonia cont. TCDB, incentive spirometry, oxygenation admin, suctioning- oral, monitor pulse oximeter
pneumonia in the older adult increased frequency, difficult to treat, higher mortality rate, symptoms may be masked
a client has crackles on auscultation and dullness to percussion in the left lower lobe. the nurse can expect to plan care for a client with pneumonia
copd most common chronic lung disease. destructive changes in aveolar walls and enlargement of air spaces. airflow limitation is progressive with an abnormal inflam response. not fully reversible
copd chronic bronchitis (chronic sputum prd. and a cough 3 mo. out of a year)emphysema (hypoxemia can lead to Right sd HF
physiological changes with chronic bronchitis thickened bronchial walls. smoke or other irritants cause hypersecretion and inflam. *causes mucous plugs *bronchioles become fibrosed.
physiological chages with emphysema loss of elastic recoil (dont compress back to normal) lungs become permanently over distended (barrel chested). Air becomes trapped in alveoli. Altered O2 -CO2 exchange. Can lead to HF
Risk factors for copd smoking. occupational hazards. ambient air pollution. genetic abnormalities
assessment with copd dyspnea. use of accessory muscles. prolonged expiration. thin with barrel chest. elevated CO2
a long term pt copd pt is recieving O2 @ 1 L per min. and the family member decides she doesnt look good and turns it up to 7 L per min. What should the nurse's inital action be? Immediately decrease to the O2
Nursing care with copd avoid inhaled irritants. improve effciency of breathing patterns. improve gas exchange (1-2 L O2 only). Prevent infection. Improve airway clearance (bronchodilators &exporant)Improve activity tolerance(consolidate activities &allow for pd of rest & act)
nursing care with copd continued improve nutritional intake (high callorie and protien) teach pursed lip breathing
comlications with copd resp failure (increased resp. rate, pulse ox decreased, increased heart rate). Respiratory infections. Cor Pulmonae (right sided heart failure)
medications for copd bronchodialators Corticosteroids
Created by: chelsea309
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