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68c Ph2 Exam5

Intro to Resp

nose turbonates (conchae) paranasal sinuses smell receptors nasolacrimal ducts
pharynx nasopharynx oropharynx laryngopharynx eustachian tubes
external respiration exchange of O2 and CO2 between lungs and environment
Internal Respiration Exchange of O2 and CO2 at the cellular level
Bronchial tree left and right bronchus bronchioles terminal bronchioles (alveolar ducts) alveoli
Gas exchange in lungs via diffusion
blood from lungs then... returns to heart via pulmonary veins for distribution to the body
visceral pluera thin, moist serous membrane that coverst the surface of each lung
pariental pleura thin, moist serous membrane that covers the thoracic cavity
pleural cavity airtight vacuum that contains negative pressure that helps keep lungs inflated
right bronchus is larger in diameter
what allows air to be inhaled and exhaled rhythmic movements of the chest wall, ribs, and muscles
what regulates respiration nervous control-medulla oblongata and pons of the brain chemoreceptors-in the carotid and aorta
surfactant reduces surface tension
Right lung more apt to recieve foreign body
reasons you may perform extensive respiratory assessment chronic respiration or cardiac conditions; history of respiratory impairment related to trauma; recent surgery or anesthesia
subjective data shortness of breath; dyspnea; cough
objective data expression, chest movement, and respirations; respiratory distress, wheezes, or orthopmea; hypoxia; adventitious breath sounds (sibilan wheezes, sibilant wheezes, sonorous wheezes, crackles, pleural friction rubs )
chest radiographs (Roentgenogram) is used to... visualize the lungs + major thoracic vessels; view alterations in size & location of pulmonary structures; identifies lesions, infiltration, foregn bodies, or fluid; shows disorder involving the parachyma or interstitial spaces;
what can a Roentgenogram confirm pneumothoraax, pneumonia, pleural effusion, and pulmonary edema
before a roentgenogram, what must be removed any jewelry
what does Computed Tomography (CT) do scans the lungs; can be viewed diagonal or cross-sectional requires patient teaching to decrease anxiety
Pulonary Function Test (PFT) is.... performed to assess the large and small airways; obtain information on lung volume, ventilation, pulmonary spirometry, and gas exchange
what information does a pulmonary function test obtain lung volume, inspiratory compacity, and total lung capacity
Mediastinoscopy surgical endosopic procedure to obtain lumph nodes for biopsy for tumor diagnosis performed under general anesthesia
Laryngoscopy allows for direct or indirect visualization of larynx requires local or general anestesia
Bronchoscopy Exam for the tracheobronchial tree for abnormalities, tissue biopsy, secretions for cytological or bacteriological studies patient is treated as a surgical patient
nursing interventions for a bronchoscopy *informed consent must be signed *NPO until gag reflexes return *Placed in semi-flowlers position and turned to one side *monitored for signs of laryngeal edema or spasms *monitor sputum for signs of hemorrhage if biopsy is taken
what are sputum specimens obtained for microscopic evaluation
guidlines for sputum collection *Inhale and exhale 3xs, inhale swiftly, cough forcefully, and expectorate into the steril sputum container *provide hypertonic saline aerosol mist if unable to raise sputum *if necessary, obtain sample through endotracheal suctioning
cytology studies performed on sputum or pleural fluid to detect teh presence of abnormal or malignant cells
thoracentesis surgical perforation of the chest wall and pleural space with a needle for the aspiration of fluid
nursing interventions for thoracentesis *explain the procedure and obtain informed consent *procedure performed at bedside, sitting upright, and leaning over a bedside table or on side with affected side up
Nursing interventions for thoracentesis *monitor VS, general appearance, and respiratory status *risk for subsequent pulmonary edema due to fluid shifts if >1300mL removed within a 30 minute procedure *place PT on unaffected side after procedure *obtain CXR after procedure
arterial blood gases (ABGs) measure the lungs' ability to exchange o2 and co2 and the body's acid-base balance
normal ABG pH 7.35-7.45 PaCO2 35-45 mmHg PaCO2 80-100 mmHg HCO2 22-28 mEq/L SaO2 >95%
oxygenation..carried in the bloodstream in two forms oxygen dissolved in plasma-expressed as PaO2 oxygen combined with hemoglovin-expressed as SaO2 represents the amount of oxygen bound to hemoglobin
ventilation is.. *respiratory component of acid-base balance *relationship between pH and PaCO2 *HCO3 is a measure of the metabolic component of acid-base *Kidneys respond to change in pH due to respiratory condition by wasting or retaining HCO3
Allen's test is performed to... check ulnar circulation before a radial artery stick *heparinized syringe to draw 3-5ml from artery *after obtained, pressure is held at the puncture site for five minutes *syringe is callped, labeled, placed in ice water and sent to lab for analysis
Pulse oximetry monitoring is noninvasive method for continuous monitorig of SaO2; used to assess small changes in the respiratory status; the prove measures the amound of light being absorbed by oxygenated and deoxygenated blood and displays a percentage value
a Sa02 of _____ is needed to adequately replentish oxygen in the _____ 90-100% plasma
An SaO2 below _____ is life threatening 70%
Do not's with pulse ox *attatch probe to extremity with diminished circulation *place probe over pulsating vascular bed *Avoid excess movement *hypothermia can affect readings *do not place in light
Created by: sydcpepper