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Chapter 28 Potter
Oxygenation
| Question | Answer |
|---|---|
| Regulator: cardiac output | amount of blood ejected from the left ventricle per minute; normal range (adult): 4 to 6 L/min |
| Regulator: cardiac index | measure of adequacy of the cardiac output; = cardiac output divided by the patient's body surface area; normal range (adult): 2.5 to 4 L/min/m3 |
| Regulator: stroke volume | amount of blood ejected from the ventricle with each contraction; normal range (adult): 50 to 75 mL per contraction |
| Regulator: preload | amount of blood in the ventricles at end diastole |
| Regulator: afterload | resistance of the ejection of blood from the left ventricle |
| Regulator: myocardial contractility | ability of the heart to squeeze blood from the ventricles and prepare for the next contraction |
| left lung failure | lung congestion |
| The rhythmic relaxation and contraction of the atria and ventricles depend on continuous, organized transmission of ____________ to the muscle. | electrical impulses |
| The conduction system generates the ____________ that initiate the electrical mechanical chain of events. | impulses |
| The conduction system originates with the ____________, the "pacemaker" of the heart. | sinoatrial (SA) node |
| The SA node is in the ____________ next to the entrance of the superior vena cava. | right atrium |
| Impulses begin at the SA node at an intrinsic rate of ____________ per minute. | 60 to 100 beats |
| The electrical impulses are then transmitted along intra-atrial pathways to the ____________. | atrioventricular (AV) node |
| The ____________ mediates impulse transmission between the atria and the ventricles. | AV node |
| Delaying the impulse at the AV node before transmitting it through the ____________ and ventricular Purkinje network assists atrial emptying. | bundle of His |
| Delaying the impulse at the AV node before transmitting it through the bundle of His and ventricular ____________ assists atrial emptying. | Purkinje network |
| An ____________ records the electrical activity of the conduction system as waves and complexes. | electrocardiogram (ECG) |
| An ____________ monitors the regularity and path of the electrical impulse through the conduction system; however, it does not reflect the muscular work of the heart. | ECG |
| The normal sequence of electrical impulses on the ECG is called ____________. | normal sinus rhythm (NSR) |
| A normal ____________ consists of a P wave (atrial depolarization), QRS complex (ventricular depolarization), and T wave (ventricular repolarization). | ECG waveform |
| P wave | atrial depolarization |
| QRS complex | ventricular depolarization |
| T wave | ventricular repolarization |
| The ____________ is made up of three lobes. | right |
| The ____________ is made up of two lobes. | left |
| therapeutic range | 2 to 3 |
| upper, middle, lower lobes of lung | right |
| upper & middle | left |
| airway exchanging unit of the lung | alveoli |
| Maintains rhythm and depth of respiration, as well as the balance between inspiration and expiration. | neural regulation |
| Voluntary control of respiration delivers impulses to the respiratory motor neurons by way of the spinal cord. Voluntary control of respiration accommodates speaking, eating, and swimming. | Cerebral Cortex |
| Chemical regulation maintains appropriate rate and depth of respirations based on changes in the blood's carbon dioxide, oxygen, and hydrogen ion concentration. | Chemical regulation |
| Automatic control of respiration occurs continuously. | Medulla Oblongata |
| Located in the medulla, aortic body, and carotid body. | chemoreceptors |
| Changes in chemical content of oxygen, carbon dioxide, & hydrogen ions stimulate _______________, which in turn stimulate neural regulators to adjust the rate and depth of ventilation to maintain normal arterial blood gas levels. | chemoreceptors |
| _______________ occurs during physical exercise and in some illnesses. | chemical regulation |
| _______________ is a short-term adaptive mechanism. | chemical regulation |
| _______________ transports most oxygen and serves as a carrier for both oxygen and carbon dioxide. | hemoglobin |
| _______________ diffuses into red blood cells and is rapidly hydrated into carbonic acid. | carbon dioxide |
| Any condition that affects _______________ directly affects the body's ability to meet oxygen demands. | cardiopulmonary functioning |
| disturbances in conduction | cardiac disorders |
| impaired valvular function | cardiac disorders |
| myocardial ischemia | cardiac disorders |
| cardiomyopathic conditions | cardiac disorders |
| peripheral tissue hypoxia | cardiac disorders |
| hyperventilation | respiratory disorders |
| hypoventilation | respiratory disorders |
| hypoxia | respiratory disorders |
| oxygen-carrying capacity of blood (e.g., anemia) | pathophysiological processes that affect a patient's oxygenation |
| increases in the body's metabolic demands (e.g., fever, infection) | pathophysiological processes that affect a patient's oxygenation |
| alterations that affect the patient's chest wall movement or the central nervous system | pathophysiological processes that affect a patient's oxygenation |
| Hemoglobin tends to bind with carbon monoxide _____________ readily than with oxygen, creating a functional hypoxemia. | 210 times more |
| Increases in _____________ of the body result in an increased oxygen demand. | metabolic activity |
| When the concentration of _____________ declines, the oxygen-carrying capacity of the blood decreases. | inspired oxygen |
| _____________ is a reduced circulating blood volume resulting from extracellular fluid losses that occurs in conditions such a shock and severe dehydration. | hypovolemia |
| _____________ increases the tissues' need for oxygen. | fever |
| Fever increases the tissues' need for oxygen; as a result, _____________ production also increases. | carbon dioxide |
| The body attempts to adapt to the increased _____________ levels by increasing the rate and depth of respiration to eliminate the excess carbon dioxide. | carbon dioxide (hypercapnia) |
| decreased arterial oxygen level in the blood | hypoxemia |
| anxiety, restlessness, inability to concentrate, increases in heart rate, increased respiratory rate and blood pressure, cardiac dysrhythmias, circumoral cyanosis | early signs of hypoxemia |
| Decreased LOC (Level Of Consciousness-alert, lethargic, confused, sedated, responds to verbal stimuli, responds to painful stimuli only, nonresponsive; decreased Respiratory Rate/Decreased Blood Pressure and Central Cyanosis. | late signs of hypoxemia |
| _____________ to the chest wall also impairs inspiration. | trauma |
| Fractures cause _____________ in which the lung underlying the injured area contracts on inspiration and expands on expiration. | paradoxical breathing |
| Rise in carbon dioxide causes rise in _____________. | pH of blood |
| deviation from the normal sinus rhythm | dysrhythmias |
| Failure of the myocardium to eject sufficient blood volume to the systemic and pulmonary circulations results in _____________. | heart failure |
| Failure of the _____________ results from primary coronary artery disease (CAD), cardiomyopathic conditions, valvular disorders, and pulmonary disease. | myocardial pump |
| _____________ happens when the coronary artery doses not supply sufficient blood to the heart (myocardium). | myocardial ischemia |
| Decreased perfusion to the myocardium results in _____________, especially with activity. | chest pain |
| _____________ is the result of decreased blood flow to the myocardium as a result of coronary artery spasms or temporary constriction. | angina or angina pectoris |
| When decreased myocardial blood perfusion is extensive or completely blocked, the tissue becomes necrotic and a _____________ occurs. | myocardial infarction |
| _____________ is an abnormal condition characterized by impaired function of the left ventricle, usually caused by chronically elevated arterial pressures and pulmonary congestion. | left-sided heart failure |
| _____________ will show signs of distended jugular veins and peripheral edema. | right-sided heart |
| _____________ is an acquired or congenital disorder of a cardiac valve characterized by stenosis and obstructed blood flow or valvular degeneration and regurgitation (backflow) of blood. | valvular heart disease |
| _____________ is an increase in respiratory rate resulting in excess amounts of carbon dioxide elimination. | hyperventilation |
| Anxiety, fever, infections, exercise, drugs, or acid-base imbalance cause _____________. | hyperventilation |
| _____________ occurs when ventilation is inadequate to meet the body's oxygen demand or to eliminate carbon dioxide. | hypoventilation |
| Severe atelectasis, a collapse of the alveoli, produces _____________. | hypoventilation |
| When caring for patients with COPD and chronically elevated PaCO2 levels, remember that inappropriate administration of excessive oxygen will result in _____________. | hypoventilation |
| Patients with COPD and hypercapnia (high CO2 level) have adapted to the _____________. | higher carbon dioxide level |
| _____________ is inadequate tissue oxygenation with a deficiency in oxygen delivery or oxygen utilization at the cellular level. | hypoxia |
| Decreased diffusion of oxygen from the lung (alveoli) into the blood, as in pneumonia or atelectasis causes _____________. | hypoxia |
| Diminished concentrations of inspired oxygen, as in high altitudes and airway obstruction causes _____________. | hypoxia |
| _____________ involves the chemical in the lung that prevents alveolar collapse. | surfactant deficiency |
| _____________ are at risk for upper respiratory tract infections as a result of frequent exposure to other children and exposure to second-hand smoke. | infants and toddlers |
| _____________ are at risk for airway obstruction b/c of their tendency to place a foreign object in their mouth or nose. | infants and toddlers |
| _____________ are exposed to respiratory infections and respiratory risk factors, such as secondhand smoke and beginning to smoke cigarettes. | school-age children & adolescents |
| _____________ are exposed to many cardiopulmonary risk factors: an unhealthy diet, lack of exercise, stress, and cigarette smoking | young and middle-age adults |
| _____________ causes changes in ventilation. | pregnancy |
| _____________ is associated with symptoms such as exaggerated respiratory effort, use of the accessory muscles of respiration, nasal flaring, and marked increases in the rate and depth of respirations. | dyspnea |
| _____________ is an abnormal condition in which the patient uses multiple pillows when lying down or has to sit to breathe. | orthopnea |
| _____________ is a high-pitched musical sound caused by high-velocity movement of air through a narrowed airway. | wheezing |
| _____________ is a sudden, audible expulsion of air from the lungs. | cough |
| _____________ is a protective reflex to clear the trachea, bronchi, and lungs of irritants and secretions. | coughing |
| A _____________ results in sputum production that is swallowed or expectorated. | productive cough |
| If a patient reports _____________, determine if it is associated with coughing and bleeding from the upper respiratory tract, from sinus drainage, or from the gastrointestinal tract (hematemesis). | hemoptysis (bloody sputum) |
| a naturally occurring ephedrine, increases blood pressure and heart rate | ma huang |
| visible sinking in soft tissues of chest that lie between and around firmer tissue | retraction (chest wall movement) |
| Decreased cardiac output or hypoxia | cyanosis |
| The objective findings of _____________ include an inability to move secretions, restlessness, tachycardia, breathlessness, use of accessory muscles, an hypoxia. | activity intolerance related to imbalance between oxygen supply and demand |
| Persons with a known _____________ to eggs, chickens, or feathers should not receive the vaccine. | hypersensitivity |
| tracheal suctioning | sterile only |
| A fluid intake of _____________ will help keep pulmonary secretions thin and easy to expectorate, unless contraindicated by cardiac condition. | 1500 to 2000 mL per day |
| _____________ are a simple and cost-effective method for reducing the patient's risk for pooled airway secretions and decreased chest wall expansion. | frequent position changes |
| The most effective position for patients with cardiopulmonary diseases is the _____________. | 45-degree semi-Fowler's position |
| Position patients with unilateral lung disease, such as a pneumothorax or atelectasis, with the healthy lung _____________. | down |
| _____________ is a method of encouraging voluntary deep breathing by providing visual feed back to patients about inspiratory volume. | incentive spirometry (IS) |
| _____________ is used to mobilize pulmonary secretions. | chest physiotherapy (CPT) |
| _____________ involves striking the chest wall over the area being drained; you position the hand so that the fingers and thumb touch, cupping the hand. | chest percussion |
| _____________ is a fine, shaking pressure applied to the chest wall only during exhalation. | vibration |
| _____________ is the use of positioning techniques that drain secretions from specific segments of the lungs and bronchi into the trachea. | postural drainage |
| A _____________ is a collection of air or other gas in the pleural space. | pneumothorax |
| _____________ is an accumulation of blood and fluid in the pleural cavity between the parietal and visceral pleurae, usually as the result of trauma. | hemothorax |
| _____________ is contraindicated when the patient is ambulating or being transported. | clamping chest tubes |
| Clamping the chest tube is not recommended, b/c it results in a _____________, which is a life-threatening event. | tension pneumothorax |
| _____________ uses continuous positive pressure to keep the airway open and prevent upper airway collapse. | Continuous positive airway pressure (CPAP) |
| _____________ works by providing assistance during inspiration and preventing airway closure during expiration. | Bilevel positive airway pressure (BiPAP) |
| _____________ involves deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse. | pursed-lip breathing |
Created by:
chaptravelman
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