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oxygenation ch 40
fundamentals ch. 40
| Question | Answer |
|---|---|
| coronary artery disease and cardiomyopathy result in | decreased pumping action and a decrease in volume of blood ejected from the ventricles (stroke volume) |
| What does hemorrhage and dehydration cause? | a decrease in circulating blood volume and a decrease in stroke volume |
| pulmonary is what type of heart failure? | it begins to "back up" or left sided heart failure. back into lungs |
| What type of heart failure is right sided? | systemic heart failure |
| when a patient has valvular disease, they may have backflow or regurgitation. What do you hear in auscultation? | murmur |
| what is cardiac output? | the amount of blood ejected from the left ventricle each minutre |
| what is the normal cardiac output? | 4 to 6 L/min in a healthy 150 lb adult at rest |
| when does cardiac output increase, and when does it decrease/ | during exercise, pregnancy, and fever-cardiac output increases; during sleep-cardiac output decreases |
| what is stroke volume? | is the amount of blood ejected from the left ventricle with each contraction |
| What is preload? | is the end-diastolic volume |
| what is afterload? | is the resistance to left ventricular ejection |
| What happens to the afterload in hypertension? | the afterload increases, which makes cardiac workload increase. |
| what drugs increase the force of myocardial contraction? | digitalis, epinephrine, and sympathomimetic drugs |
| what is the pacemaker of the heart? | SA node |
| SA node is at an intrinsic rate of... | 60 to 100 beats per min |
| the AV node mediates impulses between... | the atria and the ventricles |
| AV node is at an intrinsic rate of.. | 40 to 60 beats per min |
| What is an electrocardiogram(ECG) | reflects the electrical activity of the conduction system. |
| what are the three steps of oxygenation? | ventilation, perfusion, and diffusion |
| what is ventilation? | the process of moving gases into and out of the lungs |
| what is the major inspiratory muscle of respiration? | diaphragm |
| diffusion is responsible for... | moving the respiratory gases from one area to another |
| inspiration is.. | an active process |
| expiration is.. | a passive process |
| what is surfactant? | is a chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing |
| when a client has advanced chronic obstructive pulmonary disease (COPD) lose what? | elastic recoil of the lungs and thorax, causing their work of breath to increase |
| when a patient has a certain pulmonary disease that decreases surfactant what do they usually develop? | atelectasis |
| when watching to see if a patient is using accessory muscles during an assessment what do you look for? | Clients with COPD or emphysema observe for elevation of the client's clavicles during inspiration (this indicates ventilatory fatigue, air hunger, or decreased lung expansion). |
| what does spirometry measure? | the volume of air entering or leaving the lungs |
| What is diffusion? | is the process for the exchange of respiratory gases in the alveoli and the capillaries of the body tissues |
| with diffusion, if a patient has pulmonary edema, pulmonary infiltrates, or pulmonary effusion..what happens? | they have a thickened membrane, which results in slow diffusion bc thickened membrane affects the rate of diffusion. |
| what three things influence the capacity of the blood to carry oxygen? | the amount of dissolved oxygen in the plasma, the amount of hemoglobin, and the tendency of hemoglobin to bind with oxygen |
| What does hemoglobin do in regards to oxygen transport? | it is a carrier for oxygen and carbon dioxide, and transports most oxygen. |
| (physiological processess of oxygenation)what does neural regualation do? | maintains rhythm and depth of respiration and balance between inspiration and expiration |
| (physiological processess of oxygenation) what does the cerebral cortex do? | voluntary control of respiration delivers impulses to the respiratory motor neurons by way of the spinal cord; accomodates speaking, eating, and swimming |
| (physiological processess) what does the medulla oblongata do? | automatic control of respiration occurs continuously |
| (physiological processess of oxygenation) what does the chemical regulation do? | maintains appropriate rate and depth of respirations based on changes in the blood's CO2, O2, and hydrogen ion concentration |
| (physiological processess) what do the chemoreceptors do? | changes in chemical content of O2, CO2, and H+ stimulate it. It then adjusts the rate and depth of ventilation to maintain normal aterial blood gas levels. occurs during exercise and some illnesses |
| What four factors affect oxygenation? | physiological, developmental, lifestyle, and enviromental |
| What are some physiological factors that affect a clients oxygenation? | anemia, fever, pregancy, infection, general classification of cardiac disorders |
| what can alter the amount of hemoglobin to transport oxygen? | anemia and inhalation of toxic substances |
| what is anemia? | it is a lower than normal hemoglobin level |
| why would someone have anemia? | decreased hemoglobin production, increased red blood cell destruction, and blood loss |
| what are s/s of amemia? | fatigue, decreased activity tolerance, increased breathlessness, and pallor seen in the conjunctiva of the eye, and increased heart rate |
| what is the most toxic inhalent? | carbon monoxide |
| what causes a decrease in fraction of inspired oxygen concentration? | upper or lower airway obstruction |
| What causes hypovolemia | shock and severe dehydration cause extracellular fluid loss and reduced circulating blood volume. |
| What does the body do when hypvolemia occurs? | increases the heart rate and peripheral vasoconstriction to increase the volume of blood returned to the heart and in turn increase cardiac output |
| when is an increased metabolic rate normal? | during pregnancy, wound healing, and exercise because the body is building tissue |
| What happens to the metabolic rate during a fever? | if a fever persists then it increases the tissues need for oxygen, as a result carbon dioxide producation increases. Then protein stores begin to break down resulting in muscle wasting. s/s are hypoxemia. usually in clients with pulmonary diseases |
| What happens to respirations when the medulla oblongata is injured? | neural regulation of respirations are damaged and abnormal breathing patterns develop |
| what is a dysrhythmia? | a deviation from the normal sinus heart rhythm |
| what is a common dysrhythmia seen in older adults? | atrial fibrillation |
| During assessment what may you find with left sided failure? | fatigue, breathlessness, dizziness, confusion, diminished cardiac output. |
| As blood begins to pool in the pulmonary circulation, causing pulmonary congestion. what assessment findings are there? | crackles, hypoxia, SOB on exertion and at rest, cough, and paroxysmal nocturnal dyspnea |
| What is the usual cause of right sided failure? | pulmonary disease or as a result of long term left sided failure |
| when right sided failure occurs what happens? | the amount of blood ejected from the right ventricle declines, and blood begins to back up in the systemic circulation. |
| What are assessment findings of right sided failure? | weight gain, distended neck veins, hepatomegaly and splenomegaly, and dependent peripheral edema |
| What is valvular heart disease? | aquired or congenital; characaterized by stenosis or regurgitation of blood |
| What happens if stenosis is left untreated? | left or right sided heart failure |
| overtime what does stenosis cause? | ventricles to hypertrophy (enlarge) |
| What is myocardial ischemia? | when the supply of blood to the myocardium from the coronary arteries is insufficient to meet myocardial demands. |
| What is angina pectoris? | is a transient imbalance between myocardial oxygen supply and demand |
| Angia pectoris s/s? | chest pain that is aching, sharp, tingling, or burning, or that feels like pressure. typically chest pain is left sided or substernal and often radiates to the left of both arms, and to the jaw, and back |
| What is an Myocardial infarction? | results from sudden decrease in coronary blood flow or an increase in myocardial oxygen demand without adequate coronary perfusion |
| What is the most typical sign of MI in women> | angina, but atypical symptoms of fatigue, indegestion, vasospasm, SOB, back or jaw pain |
| What is hyperventilation? | is the state of ventilation in excess of that required to eliminate the carbon dioxide produced by cellular metabolism |
| What induces hyperventilation? | anxiety, infections, drugs, or an acid-base imbalance; as well as hypoxia associated with pulmonary embolus or shock |
| what is hypoventilation? | occurs when alveolar ventilation is inadequate to meet the body's oxygen demand or to eliminate sufficent carbon dioxide |
| what is atelectasis? | a collapse of alveoli, preventing normal exchange of oxygen and carbond dioxide; what happens is the alevoli collapse and less of the lung is ventilated and hypoventilation occurs |
| what are s/s of hypventilation? | mental status changes, dysrhythmias, and potential cardiac arrest. |
| what will occur if hypoventilation is left untreated? | status will rapidly decline, leading to convulsions, unconsciouness, and death |
| What is hypoxia? | is inadequate tissure oxygenation at the cellular level |
| What are s/s of hypoxia? | apprenhension, restlessness, inability to concentrate, declining level of consciousness, dizziness, and behavioral changes |
| What will you find in a patient who is hypoxic? | client cant lay down and appears fatigued and agitated. Increased pulse, and increased rate and depth of respirations |
| What type of respiratory infections do children and toddlers get and why? | upper respiratory tract infection bc of other childre and of second hand smoke |
| why are young and middle age adults at risk for cardiopulmonary diseases? | unhealthy diet, lack of exercise, stress, over the counter and prescription drugs not used as intended, illegal substances, and smoking |
| As an adult ages what the respiratory system undergos what changes? | The changes are associated with calcification of the heart valve |
| Osteoporosis leads to changes of what in the thorax? | size and shape |
| do older adults have more atypical s/s of coronary arterty disease? | yes |
| What is the leading contributor to stroke in older adults? | atrial fibrillation |
| What are the first s/s of respiratory problems in older adults? | forgetfullness and irritability |
| potatoes and citrus fruit juices are cardioprotective in? | women |
| Diets hight in what help prevent hypertension? | potassium |
| What type of diet helps prevent and reduce hypertension? | high in fiber, potassium, calcium, magnesium, vegetables, low-fat dairy foods, and low in saturated and total fat |
Created by:
sandrasafou1
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