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Chapter 28 Oxygen

Chapter 28 Oxygenation Potter/Perry

QuestionAnswer
Accessory Muscles Muscles in the thoracic cage that assist c respirations
CONDUCTION SYSTEM GENERATES IMPULSES THAT START THE ELECTRICAL CHAIN OF EVENTS. ORIGINATES IN THE SA NODE.
Atelectasis Collaspe of the alveoli,preventing the normal respiratory exchange of oxygen & carbon dioxide
Atrioventricular node Mediates impulse transmission between the atria and ventricles.
Management of COPD Depends on achieving 3 major goals: reduction of airflow obstruction, prevention or management of complications, improving quality of life.
cardiac index Measures of adequacy of the cardiac output;cardiac imput =cadiac output divided by pt.body surface area.
Cardiac output Volume of blood expelled by the ventricles of the heart,= to the amount of blood ejected at each beat WITHIN A MINUTE. NORMAL RANGE 4-6 L/MIN.
Cardiopulmonary Rehabilitation Actively assisting the pt. c achieving and maintaining an optimal level of health through controlled physical exercise,nutrition,counciling,relaxation
Cardiopulmonary Resuscitation (CPR) A basic emergency procedure of artificial respirations and manual external cardiac massage.
Chest percussion Involves striking the chest wall over the area being drained.You position the hand so that the fingers & thumb touch cupping the hand.
Percussion is contraindicated in patients with? Bleeding disorders,osteoporosis or fractured ribs.
Chest Physiotherapy(CTP) Is used to mobilize pulmonary secretions. USUALLY DONE WITH PATIENTS WITH CF.
Chest Tube A catheter inserted through the thorax to remove air and fluids pleural space and reestablish normal intrapleural and intrapulmonic pressures.
Cough Is a sudden,audible expulsion of air from the lungs.
Cyanosis Bluish discoloration of the skin and mucous membrane caused by an excess of deoxgenated hemoglobin in the blood or a structual defect in the hemoglobin.
Diaphragmatic Breathing Respirations in which the abdomen moves out while the diaphragm descends on inspiration
Diffusion Movement of molecules from an area of high concentration to an area of low concentration.
Dyspnea Difficulty Breathing. CLINICAL SIGN OF HYPOXIA. USE CLINICAL ANALOG SCALE 0 NO DYSPNEA/10 WORST DYSPNEA EVER.
Dysrhythmias oooo
Electrocardiogram(ECG) Record of electrical activity of the heart.
Hemoptysis Bloody Sputum
Hemothorax Is a accumulation of blood and fluid in the pleural cavity between the parietal and visceral pleurae,usually as a result of trama. SHOCK WILL DEVELOP IF BLOOD LOSS IS SEVERE.
humidification Is necessary for pt.receiving oxygen therapy at more than 4 L/min.
Hypercapnia Condition of excessive carbon dioxide(in the blood)
Hyperventilation Ventilation of the lungs beyond normal body needs. RESULTS FROM HYPOXIA ASSOCIATED WITH PE OR SHOCK. CAUSES: ANXIETY, FEAR, INFECTION, EXERCISE, DRUGS, ACID/BASE IMBALANCE. S/S: TACHYCARDIA, COB, CHESTPAIN, TETANY, PARASTHESIA, TINNITUS ETC.
Hypoventilation Ventilation of the lung that does not fulfill the bodys gas exchange needs. S/S: OCCIPITAL HA, LETHARGY, ELECTROLYTE IMBALANCES, CONVULSIONS, POSSIBLE COMA R CARDIAC ARREST, & DISORIENTATION.
Hypoxemia Condition of deficient oxygen(in the blood)
Incentive Spirometry(IS) Is a method of encouraging voluntary deep breathing by providing visual feedback to pt. about inspiratory volume.
Intubation Insertion of a breathing tube through the mouth or nose into the trachea to ensure pt. airway.
Laryngospasm Spasmodic contraction of the larynx.
Left Sided Heart Failure Abnormal condition characterized by impaired functioning to the left ventricle,usually caused by chronically elevated arterial pressures and pulmonary congestion. BLOOD BACKS UP IN THE LUNGS. YOU SEE PATIENTS IN ORTHOPNEIC POSITION.
Myocardial Infarction Death(necrosis) of a portion of the myocardium caused by lack of oxygen resulting from an interrupted blood supply(also called a heart attack). S/S: CHEST PAIN, DIAPHORESIS, HYPOTENSION, BREATHLESSNESS.
Myocardial Ischemia Happens when the coronary artery does not supply sufficient blood to the heart(myocardium). RESULTS IN CHEST PAIN.
Nebulization Uses the aerosol principle to suspend a maximum number of water drops or particles of the desired size in inspired air.
Normal Sinus Rhythm(MSR) The normal sequence of electrical impulses on the ECG.
Orthopnea Able to breath easier in an upright position.
Oxygen therapy Procedure in which oxygen is administered to a pt. to relieve or prevent hypoxia.
Pneumothorax Air in the chest(pleural space),which causes collapse of the lung. PAIN IS SHARP.
Postural Drainage Is the use of positioning techniques that drain secretions from specific segments of the lungs and bronchi into the trachea.
Preload Volume of blood in the ventricle at the end of diastole,immediately before ventricular contraction. (PULLING)
Productive cough Results in sputum production that is swallowed or expectorated.
Purkinge network Assist in artial emptying
Pursed Lip Breathing Involves deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse.
Right side heart failure Results from impaired functioning of the right ventricle. VENOUS CONGESTION IN SYSTEMIC CIRCULATION. BLOOD BACKS UP IN BODY: PERIPHERAL EDEMA, DISTENDED JUGULAR VEINS. USUALLY RESULTS FROM PULMONARY DISEASES OR BECAUSE OF LEFT SIDED HEART FAILURE.
Sinoatrial(SA)NODE The pacemaker of the heart. LOCATED IN RIGHT ATRIUM NEXT TO SUPERIOR VENA CAVA.
Stroke Volume(SV) AMOUNT OF BLOOD EJECTED BY THE VENTRICLE WITH EACH CONTRACTION. NORMAL RANGE ADULT (50-75ML/CONTRACTION).
Surfactant Chemical produced in the lung by alveolar type 2 cells that maintains the surface tention of the alveoli and keeps them from collapsing. DEVELOPS AROUND THE 7TH MONTH OF FETAL DEVELOPMENT.
Valvular Heart Disease Is an acquired or congenital disorder of a cardiac valve characterized by stenosis and obstructed blood flow. (BACKFLOW).
Ventilation HOW CARBON DIOXIDE IS EXCRETED BY THE LUNGS. RESPIRATORY MUSCLES, PLEURAL SPACES, LUNGS, AND ALVEOLI AID IN VENTILATION.
Vibration Is a fine,shaking pressure applied to the chest wall only during exhalation. USED WITH PATIENTS WITH CYSTIC FIBROSIS.
Wheezing High pitched musical sound caused by high-velocity movement of air through a narrowed airway. ASTHMA, ACUTE BRONCHITIS, PNEUMONIA, OCCURS WITH INSPIRATION, EXPIRATION OR BOTH.
Oxygen Is a basic human need and is required for life.
Ineffective pump Heart disease
Ineffective Gas exchange Lung Disease
The function of the Cariopulmonary is To provide oxygen to the tissues and remove carbon dioxide and waste products from the body.
The heart delivers oxygenated blood from The lungs to the body
The four heart valves Tricuspid,pulmonic,mitral and aortic ensure the one way flow of blood through the heart.
Afterload Resistance of the ejection of blood from the left ventricle. (VICE PUMPING)
Myocardial Contractility Ability of the heart to squeeze blood from the ventricles and prepare for the next contraction.
Respiratory Disorders include Hyperventilation,hypoventilation and hypoxia
Medulla Oblongata Automatic control of respiration occurs continuously. WHEN DAMAGED ABNORMAL BREATHING PATTERNS DEVELOP.
Polycythemia An increase in RBC
WE INHALE OXYGEN AND EXHALE CARBON DIOXIDE.
REMEMBER MASLOWS HEIRARCHY OF NEEDS: OXYGENATION ON BOTTOM: REFRESH!!
AUTONOMIC NERVOUS SYSTEM INFLUENCE THE RATE THE IMPULSE IS GENERATED, THE SPEED IT MOVES THROUGH THE SYSTEM, AND THE STRENGTH IT MOVES THROUGH THE SYMPATHETIC & PARASYMPATHETIC (VAGUS) NERVE FIBERS.
AUTONOMIC NERVOUS SYSTEM 2 PARTS SYMPATHETIC & PARASYMPATHETIC
SYPMATHETIC FIGHT OR FLIGHT
PARASYMPATHETIC REST & DIGEST (VAGAL RESPONSE; CODING ON TOILET)
P WAVE ATRIUM DEPOLARIZING
QRS WAVE VENTRICLE DEPOLARIZING
T WAVE VENTRICULAR REPOLARIZATION
SINUS BRADY <60
SINUS TACH >100
RIGHT LUNG MADE UP OF THREE LOBES: RIGHT UPPER, MIDDLE & LOWER LOBES.
LEFT LUNG MADE UP OF 2 LOBES: UPPER & MIDDLE.
NORMAL CO2 35-45
NORMAL BICARBONATE (HCO3) 22-26
RESPIRATORY OPPOSITE METABOLIC EQUAL
RESPIRATORY ACIDOSIS LOW pH HIGH CO2 EXHIBIT SIGNS OF BARREL CHEST: COPD PATIENTS
RESPIRATORY ALKALOSIS HIGH pH LOW CO2 EXHIBIT SIGNS OF HYPERVENTILATING: TREATMENT BLOW INTO BROWN PAPER BAG.
METABOLIC ACIDOSIS LOW pH LOW HCO3 EXHIBIT SIGNS OF: DIABETIC KETOACIDOSIS & DIARRHEA.
METABOLIC ALKALOSIS HIGH pH HIGH HCO3 EXHIBIT SIGNS OF : VOMITING & TAKING TOO MANY ANTACIDS.
ACID FROM THE GUT BASE FROM THE BUTT
PERFUSION BLOOD FLOW TO THE TISSUES & LUNGS
RATE OF DIFFUSION OXYGEN-CARRYING CAPACITY OF THE BLOOD.
PERFUSION SCAN PERFORMED WHEN THERE IS A SUSPECTED PULMONARY EMBOLISM. (THEY'RE TRYING TO SEE WHAT THE BLOODFLOW TO THE LUNGS & TISSUES ARE).
3% OF OXYGEN IS DISSOLVED IN THE PLASMA.
HEMOGLOBIN TRANSPORTS MOST OXYGEN & CARRIES BOTH CARBON DIOXIDE & OXYGEN.
HYPOTHALAMUS RESPONSIBLE FOR TEMPERATURE & THIRST.
ANEMIA NOT TRANSPORTING ANY OXYGEN. 97% OF OXYGEN IS CARRIED ON THE HEMOGLOBIN MOLECULE. PATIENTS GET CONFUSED.
HEMOGLOBIN NORMAL 12-16
HEMATOCRIT TAKE HEMOBLOGIN TIMES 3. (AMOUNT OF RBC VOLUME).
CARBON MONOXIDE BINDS WITH HEMOGLOBIN 210 TIMES MORE THAN OXYGEN, IT DECREASES THE AMOUNT OF OXYGEN IN THE BODY, & IT IS A COMMON TOXIC INHALANT CAUSIN HYPOXEMIA. IT IS VERY HARD TO SEPARATE THESE MOLECULES, THEIR BOND IS VERY STRONG.
HYPOVOLEMIA LOW BLOOD VOLUME, TREATMENT PUSHING FLUIDS, BE CAUTIOUS WITH CHF PATIENTS; YOU CAN FILL THEIR LUNGS UP QUICKLY. HAVE TO HAVE AN ORDER TO PUSH FLUIDS.
HYPOVOLEMIC SIGNS INCREASED HR & CONSTRICTING PERIPHERAL VESSELS TO INCREASE BLOOD TO HEART AND INCREASE CARDIAC OUTPUT.
INCREASED BASAL METABOLIC RATE NORMAL WITH PREGNANCY, WOUND HEALING, & EXERCISE BECAUSE THE BODY IS BUILDING TISSUE.
SIGNS & SYMPTOMS OF HYPOXEMIA ANXIETY, RESTLESSNESS, CAN'T CONCENTRATE, INCREASED HR, INCREASED RESR & BP, CARDIAC DYSRHYTHMIAS E.G PVC, PAC, & SINUS TACHYCARDIA. AT WORSE STAGES PATIENTS CAN GO UNCONSCIOUS. ASSESSMENTS SHOW PURSED LIP BREATHING, & ACCESSORY MUSCLE RESPIRATIONS.
PECTUS EXCAVATUM SUNKEN CHEST; IMPAIR OXYGENATION.
KYPHOSIS HUNCHBACK. CAN RESULT IN HYPOVENTILATION & HYPOXEMIA.
BRAINSTEM INJURY RESULTS IN PROBLEMS WITH RESPIRATIONS.
CERVIAL TRAUMA C3-C5 PARALYSIS OF PHRENIC NERVE. LOCATION IS AT DIAPHRAGM.
FLAIL CHEST (FROM MULTIPLE RIB FRACTURES) CAUSES PARADOXICAL BREATHING. INJURED AREAS CONTRACT ON INSPIRATION & EXPANDS ON EXPIRATION.
1 DEGREE FEVER CAUSES 7% INCREASE IN BMR, WHICH INCREASES CARBON DIOXIDE PRODUCTION.
PARESTHESIA PINS & NEEDLES. CANY YOU FEEL THIS?
PARALYSIS CAN YOU MOVE THIS?
COPD (RESPIRATORY ACIDOSIS)(RESPIRATORY DRIVE DRIVEN ON HYPOXIA) INAPPROPRIATELY ADMINISTERING EXCESSIVE OXYGEN WILL RESULT IN HYPOVENTILATION. THEY HAVE HYPERCAPNIA AND HAVE ADAPTED TO HIGHER CO2 LEVELS. NEVER PUT A COPD PATIENT GREATER THAN 3L/MIN.
PREMATURE INFANTS AT RISK FOR HYALINE MEMBRANE DISEASE.
OSTEOPOROTIC CHANGES CHANGES IN THORACIC CAGE THAT PREVENT LUNG FROM EXPANDING FULLY & LEADS TO DECREASED OXYGEN LEVELS.
CALCIFICATION OF HEART BALVES, SA NODE, AND COSTAL CARTILAGES.
ARTERIAL SYSTEM DEVELOPS ATHEROSCLEROTIC PLAQUES.
AGE REDUCED SURFACE AREA AND CHANGES IN ALVEOLI CAUSE PROBLEMS WITH VENTILATION & TRANSFER OF RESPIRATORY GASES.
CILIA WITH AGE CAUSE DECREASE EFFECTIVENESS OF COUGH.
BODY RESPONDS TO STRESS BY INCREASING RATE & DEPTH OF RESPIRATIONS, INCREASING METABOLIC RATE AND OXYGEN DEMAND.
PACK YEARS HOW MANY PACKS A DAY? HOW MANY YEARS?
MALE SUBSTERNAL RADIATES TO LEFT ARM AND JAW.
FEMALE PAIN EPIGASTRIC, COMPLAINTS OF CHOKING, DYSPNEA, DIFICULTY SWALLOWING.
PERICARDIAL PAIN NONRADIATING, OCCURS WITH INSIRATION.
VISUAL ANALOG SCALE HELPS TO DESCRIBE PAIN
PLEURITIC CHEST PAIN CAUSED BY INFLAMMATION AND RADIATES TO SCAPULAR REGIONS. KNIFELIKE SENSATION LASTING FROM 1 MIN TO HOURS AND INCREASES WITH INSPIRATION.
HEMATEMESIS BLOODY VOMIT
HIV PATIENTS GET PNEUMOCYSTIC CARNII PNEUMONIA
# 1 KILLER WITH HIV PATIENTS TB
KAPOSI'S SARCOMA CANCER HIV PATIENTS GET.
GINSENG, GARLIC CAPSULES, GINKO BILOBA DECREASE PLATELET AGGREGATION.
TABLE 28-8 PG 782 INSPECTION OF CARDIOPULMONARY STATUS.
RETRACTION PULLING IN OF TISSUES BETWEEN INTERCOSTAL SPACES
KUUSMAUL RESPIRATIONS TACHYPNEA, SEEN IN DKA, METABOLIC IMBALANCES, OR RENAL FAILURE.
POSITIVE TB SKIN TEST PATIENT THEN HAS A CHEST X-RAY
TB SKIN TEST READ IN 72 HOURS, DETERMINES THE PRESENCE OF MYCOBACTERIUM TUBERCULOSIS, + RESULT PALPABLE, ELEVATED, HARDENED AREA. MEASURED IN MILLIMETERS. (JUST A REDDENED FLAT AREA IS NOT A + RESULT).
PRIMARY HEALTH PROMOTION
SECONDARY DIAGNOSE EARLY AND QUICKLY INTERVENE
TERTIARY REHABILITATION
CDC RECOMMENDS ANNUAL INFLUENZA VACCINES FOR PATIENTS 65 YEARS AND OLDER & CHRONICALLY ILL.
PNEUMOCOCCAL VACCINE EVERY 10 YEARS FOR LOW RISK AND EVERY 5 YEARS FOR PATIENTS WITH MULTIPLE UNDERLYING CONDITIONS.
CASCADE COUGH SERIES OF COUGHS
HUFF COUGH SAYS HUFF
QUAD COUGH USES ABD MUSCLES TO COUGH WHILE USING TOTAL EXPIATORY EFFORT.
SUCTION ORAL SECRETIONS AFTER SUCTIONING NASOTRACHEA AND TRACHEA WHEN COMBINING SUCTION TECHNIQUES.
NORMAL DURING SUCTIONING COUGHING, SNEEZING, SOB, & GAGGING.
ORAL AIRWAY EXTENDS FROM THE TEETH TO THE OROPHARYNX AND KEEPS THE TONGUE IN NORMAL POSITION.
FLUID INTAKE 1500-2000ML/DAY
POSITION PATIENTS HEALTHY LUNG DOWN FOR PATIENTS WITH UNILATERAL LUNG DISEASE E.G. PNEUMOTHORAX & ATELECTASIS.
POSITION PATIENTS AFFECTED LUNG DOWN WITH ABSCESS OR HEMORRHAGE.
CHEST DRAINAGE SYSTEMS 1ST CHAMBER WATER SEAL THAT STOPS AIR FROM GOING BACK INTO PLEURAL SPACE; 2ND CHAMBER COLLECTS BLOOD OR FLUID; 3RD CHAMBER FOR SUCTION, & IS SET AT -15 TO -20 CM OF WATER FOR ADULTS.
CHEST DRAINAGE UNIT STAYS BELOW PATIENTS CHEST. DON'T CLAMP WHEN PATIENT IS AMBULATING OR BEING TRANSPORTED. IF IT BECOMES DISCONNECTED HAVE PATIENT EXHALE & COUGH CLENSE TIP & RECONNECT TUBING. DON'T CLAMP CAUSES TENSION PNEUMOTHORAX.
CPAP SLEEP APNEA. CONTINOUS POSITIVE PRESSURE.
NASAL CANNULA 1L OXYGEN (24%); 5L OXYGEN (40%)
SIMPLE FACE MASK 6-8L/MIN OXYGEN (30%-60%); EFFECTIVE FOR MOUTH BREATHERS; CONTRAINDICATED FOR CO2 RETENTION.
PLASTIC FACE MASK WITH RESERVOIR BAG DELIVERS HIGH CONCENTRATIONS ON OXYGEN.
EXTERNAL DEFIBRILLATOR (PAAS) POWER, ATTACH, ANALYZE, SHOCK.
Created by: Angela Lacey