Oxygenation
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| CO is the most common toxic inhalant and decreases the oxygen-carrying capacity of blood. In CO toxicity, hemoglobin | strongly binds with carbon monoxide, creating a functional anemia. Because of the strength of the bond, carbon monoxide does not easily dissociate from hemoglobin, which makes hemoglobin unavailable for oxygen transport.
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| Conditions such as shock and severe dehydration cause | extracellular fluid loss and reduced circulating blood volume (hypovolemia).
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| Fever increases the tissues' need for oxygen, and as a result, carbon dioxide production | increases. When fever persists, the metabolic rate remains high and the body begins to break down protein stores, which results in muscle wasting and decreased muscle mass.
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| Left-sided heart failure is an abnormal condition characterized by decreased functioning of the | left ventricle. If left ventricular failure is significant, the amount of blood ejected from the left ventricle drops greatly, which results in decreased cardiac output.
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| A simple and cost-effective method for reducing the risks of stasis of pulmonary secretions and decreased chest wall expansion is? | Changing the client's position -reduces the risk of pneumonia associated with stasis of pulmonary secretions and decreased chest wall expansion. Oxygen humidification, chest physiotherapy, and use of antiinfectives are all helpful, but are not cost effect
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| The nurse is concerned when a client's heart rate, which is normally 95 beats per minute, rises to 220 beats per minute, because a rate this high will | Reduce coronary artery perfusion - Coronary arteries fill and perfuse the myocardium (heart muscle) during diastole. When the heart rate is elevated, more time is spent in systole and less in diastole; hence, the myocardium may not be perfused adequately.
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| Spinal cord injury at the level of C5 or above often results in damage to the | phrenic nerve, which innervates the diaphragm and permits breathing. Cardiac output is not usually affected by spinal cord injury; however, cardiac output may be reduced as a result of trauma and blood loss.
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| A bubbling chest tube (in the water-seal portion) should | never be clamped because it provides the only exit for air accumulating in the pleural space. If the tube is clamped, tension pneumothorax could occur, which could be fatal.
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| A client is receiving oxygen via a nonrebreathing mask. A crucial nursing assessment the nurse performs is to be sure that | The bag attached to the mask is inflated at all times - If the bag attached to a nonrebreathing mask is deflated, the client is at risk for breathing in large amounts of exhaled carbon dioxide.
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| For a nonrebreathing mask 2 L/min is | far too low a flow setting - The oxygen flow should be set at 10 L/min or more. Otherwise, the bag will collapse.
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| The normal cardiac output for an adult is | 4 to 6 L/min.
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| Nicotine decreases | the oxygen-carrying capacity of hemoglobin
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| Clients with anemia have | fatigue, decreased activity tolerance, and increased breathlessness, as well as pallor (especially seen in the conjunctiva of the eye) and an increased heart rate.
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| Left-sided heart failure results in | ineffective ejection of blood from the left ventricle. This causes a backup of blood into the lungs. Thus, symptoms of left-sided heart failure are usually related to the lungs.
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| Blood is oxygenated through | ventilation, perfusion, and transport of respiratory gases
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| Neural and chemical regulators control the ___of respiration. | rate and depth
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| Deoxignated blood is returned to the heart through | superior and inferior vena cava and dumps into the right atrium. It is high in CO2 and low in Oxygen.
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| The right ventricle pumps blood through the | pulmonary circulation.
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| The left ventricle pumps blood through the | systemic circulation.
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| As the left ventricle continues to fail, blood begins to pool | in the pulmonary circulation, causing pulmonary congestion.
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| Right-sided heart failure more commonly results from | pulmonary disease or as a result of long-term left-sided failure.
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| ___ are life-threatening rhythms that require immediate intervention. | Ventricular tachycardia and ventricular fibrillation.
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| Ventricular tachycardia is a life-threatening dysrhythmia because | the decreased cardiac output and the potential to deteriorate into ventricular fibrillation.
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| If left heart failure | pulmonary congestion
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| If right failure | systemic congestion
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| As the myocardium stretches, the strength of the subsequent contraction increases; this is known as | the Frank-Starling (Starling's) law of the heart.
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| In the diseased heart, Starling's law does not apply because | the stretch of the myocardium is beyond the heart's physiological limits.
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| S1 | mitral and tricuspid open
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| S2 | aortic and pulmonic close
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| The coronary arteries fill during | ventricular diastole
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| Coronary arteries supply | the myocardium with nutrients and remove wastes
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| Cardiac Output | Amount of blood ejected from the left ventricle each minute – about 4-6 or 5 liters.
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| Stroke Volume | Amount of blood ejected from the left ventricle with each contraction – Is affected by preload and afterload.
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| Preload | End diastolic pressure (volume) - In clinical situations the preload and subsequent SV are manipulated by changing the amount of circulating blood volume – ex: hemorrhage is present, fluid therapy and replacement of blood increases circulating volume and
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| Preload would __ if person is bleeding out. | decrease
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| Afterload | Resistance to left ventricular ejection - The diastolic aortic pressure is a good clinical measure of afterload.
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| In hypertension, afterload | increases, which makes cardiac workload increase.
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| In hypertension, afterload is manipulated by reducing | systemic blood pressure.
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| Heart rate affects blood flow because of the relationship between | rate and diastolic filling time. With a sustained heart rate greater than 160 beats per minute, diastolic filling time decreases, decreasing stroke volume and cardiac output.
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| Gases move in and out of the lung through | pressure changes.
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| Interplural pressure is | negative.
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| Ventilation | The process of moving gases into and out of the lungs – diaphragm helps this occur – innervated by phrenic nerve.
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| Perfusion | ability of circulatory system to move blood around the body and get it to the tissues.
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| Inspiration/expiration | An active process stimulated by chemical receptors in the aorta and a passive process for expiration
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| Pulmonary circulation | Moves blood to and from the alveolar capillary membranes for gas exchange
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| Diffusion | Exchange of respiratory gases in the alveoli and capillaries
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| Oxygen transport | Lungs and cardiovascular system
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| Carbon dioxide transport | Diffuses into red blood cells and is hydrated into carbonic acid
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| Decreased oxygen-carrying capacity | Anemia and inhalation of toxic substances decrease the oxygen-carrying capacity of blood by reducing the amount of available hemoglobin to transport oxygen.
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| Decreased inspired oxygen | caused by an upper or lower airway obstruction limiting delivery of inspired oxygen to alveoli; decreased environmental oxygen, such as at high altitudes; or decreased inspiration, which occurs in drug overdoses.
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