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1RespSystem
Alterations in Oxygenation MS1 exam2
| Question | Answer |
|---|---|
| describe inadequate ventilation | adequate pulmonary circulation, <O2, mucus/fluid blockage. PNEUMONIA, ASTHMA, ATELECTASIS |
| describe inadequate perfusion | normal ventilation, <perfusion/blood flow. PE, BLOOD CLOT, SHOCK, CHF |
| describe normal ventilation.perfusion | unoxygenated blood to pulmonary arteries to lungs.gas exchange then CO2 to alveoli, O2 to capillaries |
| surfactant: Purpose and Production? | prevents alveoli collapse. cough, deepbreathing cause stretching of alveoli resulting in its production (L511) fyi:300M alveoli |
| how are respirations controlled? | chemoreceptors in medulla and carotid bodies respond to >CO2 and <O2 respectively (L515) |
| properties of lung tissue (2): Describe | 1.Compliance - ability to stretch, lung expansion 2. Elastic recoil - ability to get back in shape |
| >lung compliance | overstretched, easy to inflate but has air left after exhalation. COPD, EMPHYSEMA |
| <lung compliance | stiff lungs, difficult to inflate, <expansion. PE, PULMONARY FIBROSIS, OBESITY |
| connnective tissue responsible for adequate elastic recoil? | Elastin; <elastin=<recoil. ELDERLY, COPD, EMPHYSEMA (>CO2, remain inflated) |
| how to determine ability of lungs to oxygenate arterial blood adequately? | PaO2 & SaO2 |
| first sign of Hypoxia? | restlessness; change in LOC |
| assessment of breathing pattern | changes in rate, rhythm, effort; any dyspnea on rest and activity |
| describe sputum r/t health conditions | blood - CA, TB, PE thick,white frothy - COPD yellow, green - INFECTION dry, hacking - IRRITANT |
| describe cough onset r/t health conditions | at night - BRONCHIAL ASTHMA morning - BRONCHITIS after meal - ASPIRATION |
| cause of chest pain | irritation of pleural lungs, pain on inspiration. PNEUMONIA, PLEURITIS, PLEURAL EFFUSION |
| why is taking corticosteroids a RF for the development of RespInfection? | Corticosteroids suppresses the immune system, making one more vulnerable to infections |
| respiratory assessment interview | current resp problem, hx of resp disease, lifestyle, allergies, RF, med hx |
| important questions when pt is showing S/S | hx of respiratory disease. eg SOB = 'Do you have asthma?' |
| perfusion diseases? | CAD, DM, CHF, COPD |
| why is COPD a perfusion disease? | there is a decreased oxygenated blood circulating |
| RF alteration in respiratory defense mechanisms | dehydration, the very young and very old, repeated resp infection (PNEUMONIA, COPD), smoking, drugs (gen anesthesia, opioids, narcotics) |
| clubbed fingers? | classic long standing hypoxia. COPD |
| INSPECTION on physical exam | breathing pattern, chest configuration, skin color, clubbed fingers. WHAT CAN YOU SEE? |
| normal RR | 12-20rpm, elderly 16-25rpm (L521). peak at age 25 |
| Kussmaul breathing | deep rapid breathing |
| Cheyne-stokes breathing | apnea, then deep rapid breathing |
| Biots breathing | irregular, apnea breathing pattern |
| PALPATION on physical exam | tracheal position, thoracic expansion, tactile fremitus |
| normal thoracic expansion | 1 in (2.5 cm) |
| tactile fremitus | felt vibration through chest wall, pt says '99' naturally felt on big airways, normally not felt on lower lobe = if felt PNEUMONIA |
| tactile fremitus findings | > = fluid filled lungs. PNEUMONIA, PLEURAL EFFUSION < = hyperinflated. COPD absent = air filled/trapping. PNEUMOTHORAX, ATELECTASIS |
| tracheal position | normal midline. if SHIFTED = TENSION PNEUMOTHORAX on opposite??? |
| Findings: PERCUSSION on physical exam | resonant = normal lung, <pitch hyperresonant = hyperinflated, <<pitch. COPD dull = fluid filled, consolidation. PNEUMONIA, PLEURAL EFFUSION tympany = loud drumlike. gas filled STOMACH/INTESTINE, PNEUMOTHORAX |
| AUSCULTATION on physical exam | vesicular = soft, <pitch, insp 3:1. ALL AIRWAYS except major bronchi bronchial = louder, >pitch. TRACHEA bronchovesicular = medium pitch, 1:1. STERNUM, SIDE OF SCAPULAE |
| adventitious sounds: main concern | crackles = on, end of inspiration. PNEUMONIA, FLUID OVERLOAD-CHF wheezes = continuous, >pitch muscial. ASTHMA, ANAPHYLACTIC rhonchi = rumbling, snoring on large airways. COPD, overwhelming PNEUMONIA, CF absent = PLEURAL EFFUSION, ATELECTASIS, LOBECTOMY |
| adventitious sounds: others | pleural friction rub = grating, cracking sound from inflammation. PNUEMONIA stridor = continuous musical, crowing. PARTIAL LARYNX/TRACHEA OBSTRUCTION, CROUP, EPIGLOTTITIS |
| adventitious sounds: misc | bronchophony/ whispered pectoriloquy = clear, audible whispered syllable. PNEUMONIA egophony = 'E' heard as 'A'. PNEUMONIA, PLEURAL EFFUSION |
| SaO2 vs PaO2 | amnt of O2 bound to hgb/Saturation. amnt of O2 dissolved in plasma >93-95%, p&p. 80-100mmHg |
| pulmonary function test | measure lung volume, airflow; Dx pulmonary disease, monitor disease progression, evaluate disability and response to treatment; mouth to mouthpiece, deep breath, exhale as HARD,FAST, LONG as possible. COPD, ASTHMA, CF |
| peak expiratory flow rate (PEFR) | > 600ml/min. daily measurement for ASTHMA, gauge airway resistance/bronchoconstriction; max airflow rate during forced expiration |
| thoracentesis | removal of fluid. Dx/intervention, med insertion. CHF, PNEUMONIA |
| ventilation-perfusion scan | dx PE, BLOOD COT |
| terms: lung capacities 1 | tidal vol (Vt)-air inhaled/exhaled with each breath. 500ml residual vol (RV)-air left after forced expiration, air available for gas exchange. 1500ml |
| terms: lung capacities 2 | total lung capacity (TLC)-max air vol lungs can contain. 6000ml vital capacity (VC)-max air vol exhaled after max inspiration 4500ml (L531, T26-13) |
| forced vital capacity (fvc) | air that can be quickly, forcefully exhaled after max inspiration, >80% |
| how does air move in and out of lungs? | r/t intrathoracic pressure changes in relation to pressure at airway opening, contraction of diaphragm, intercostal/scalene muscles = >chest dimension = < intrathoracic pressure. GAS flows from >pressure, atmospheric to <intrathoracic |
| early signs of inadequate oxygenation | restless, apprehension, confusion; tachypnea, dyspnea; tachycardia, mild htn (L515, T26-2) |
| respiratory system age related changes | >age = <resp fucntion; lifetime exposure to environmental stimuli, concurrent chronic disease (DM,COPD), structural alterations, altered defense mechanisms, <physical mobility |
| altered resp defense mechanisms | cilia function, cough reflex, <effective alveolar macrophages, muscle atrophy of pharynx/larynx. INEFFECTIVE AIRWAY CLEARANCE, URIs/LRIs |
Created by:
sarahjqs
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