the cavity posterior to the nose and throat—is subdivided into several regions

The nasopharynx refers to

the nasal area, and the oropharynx refers to the throat or mouth.

The upper airway is divided into two areas: the pharynx and the larynx

These structures warm, filter, and humidify air taken in through the nose and mouth.

The larynx is located

at the top of the trachea and is where the vocal cords are found

The lower airway includes

the trachea, bronchi, bronchioles, and alveoli of the lungs.

air-filled sacs that are primarily responsible for gas exchange in the body

. The alveoli are where

the actual gas exchange takes place.

The lungs are linked to the nervous system by both the

parasympathetic and sympathetic nervous systems

Lungs are responsible for

bronchoconstriction and bronchodilation

surrounds the lungs and is divided into the visceral and parietal pleural layers.

The processes of inhalation and exhalation are aided by

both the diaphragm and the intercostal muscles

the muscle that separates the chest cavity from the abdominal cavity

When a person inhales

the diaphragm and the intercostal muscles contract, creating a negative pressure inside the lungs, and the thorax increases in size.

When a person exhales

the diaphragm and the intercostal muscles relax, allowing the gas inside the lungs to be expelled

Surfactant, a lubricant made in the lungs, keeps

the alveoli from collapsing during exhalation

When there is a lack of surfactant in the lungs

the lung tissue collapses, resulting in a loss of volume during expansion

Atelectasis can occur in clients for several reasons, but is most commonly observed in

the setting of thoracic or abdominal surgery

Atelectasis is often due to the use of

general anesthesia or opioids, which lead to slow, unproductive breathing that prevents the exchange of gases.

The lungs enable gas exchange between the

cardiopulmonary system and the outside environment.

The large airways and bronchioles deliver

gas to the alveoli and the pulmonary capillaries (blood vessels located in the walls of the alveoli) through diffusion

The brainstem monitors the body’s oxygen demand and carbon dioxide levels and

signals the respiratory system to respond to excesses or undersupply.

cardiopulmonary system is responsible for

oxygen transport via the arterial circulatory process which allows for gas exchange at the capillary level

Coordination between the muscles of respiration and the respiratory center in the brain controls the amount of

carbon dioxide (CO2) and oxygen (O2) in the body

The respiratory drive is maintained by

peripheral chemoreceptors, which are located in the aortic arch and the carotid arteries, and central chemoreceptors located in the medulla oblongata within the brainstem.

the chemoreceptors then signal the pulmonary system to

alter the rate and depth of respirations to correct the levels of CO2 and O2.

Diseases that can either increase or decrease lung compliance.

Diseases such as emphysema, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and atelectasis

expiratory reserve volume

The amount of air expelled after a typical breath

Blood leaving the right ventricle of the heart is deoxygenated. It is routed to

to the pulmonary artery, the pulmonary arterioles, and then to the pulmonary capillaries, where gas exchange occurs.

In the capillaries, the blood is oxygenated. It then moves

from the pulmonary capillaries into the pulmonary veins and is returned to the heart’s left atrium.

From the left atrium, the blood enters

the left ventricle, which pumps it into the aorta and, in turn, systemic circulation, which subsequently returns the deoxygenated blood to the lungs.

steps of pulmonary circulation, beginning with the blood exiting the right atrium.

- Right Ventricle - Pulmonary Artery - Pulmonary Capillaries in the lungs - Pulmonary veins - Left atrium - left ventricle - Aorta - Systemic circulation

Blood flow to the myocardium provides

oxygen and other nutrients to the heart.

the mitral and tricuspid valves permit blood to flow from the atria into the relaxed ventricles

the mitral and tricuspid valves close and the aortic and pulmonic valves open.

The first heart sound (S1)

can be heard during the systolic phase, when the mitral and tricuspid valves close. The mitral and tricuspid valves remain closed as blood moves forward.

the second heart sound (S2) is heard

Pressure in the ventricles decreases as they empty, the aortic and pulmonic valves close

blowing or whooshing sound produced when backflow of blood through the valve occurs, which can be heard in clients who have incompetent valves.

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ATI Module

Gas Exchange and Oxygenation (Exam 2-3)

Question	Answer
The respiratory system is composed of the	upper and lower airways
The upper airway is divided into two areas:	the pharynx and the larynx
The pharynx—	the cavity posterior to the nose and throat—is subdivided into several regions
The nasopharynx refers to	the nasal area, and the oropharynx refers to the throat or mouth.
The upper airway is divided into two areas: the pharynx and the larynx	These structures warm, filter, and humidify air taken in through the nose and mouth.
The larynx is located	at the top of the trachea and is where the vocal cords are found
The lower airway includes	the trachea, bronchi, bronchioles, and alveoli of the lungs.
The lungs are	air-filled sacs that are primarily responsible for gas exchange in the body
. The alveoli are where	the actual gas exchange takes place.
The right lung has	three lobes
left lung has	two lobes
The lungs are linked to the nervous system by both the	parasympathetic and sympathetic nervous systems
Lungs are responsible for	bronchoconstriction and bronchodilation
To enable the lungs to expand and contract smoothly	pleural fluid is produced
pleural fluid is produced in the space known as the	pleural cavity
The pleural cavity is located within a	membrane known as the pleura
pleura	surrounds the lungs and is divided into the visceral and parietal pleural layers.
Air moves in and out of the lungs through	inhalation and exhalation
The processes of inhalation and exhalation are aided by	both the diaphragm and the intercostal muscles
The diaphragm—	the muscle that separates the chest cavity from the abdominal cavity
The diaphragm is controlled by	autonomic nervous system
When a person inhales	the diaphragm and the intercostal muscles contract, creating a negative pressure inside the lungs, and the thorax increases in size.
When a person exhales	the diaphragm and the intercostal muscles relax, allowing the gas inside the lungs to be expelled
Surfactant, a lubricant made in the lungs, keeps	the alveoli from collapsing during exhalation
When there is a lack of surfactant in the lungs	the lung tissue collapses, resulting in a loss of volume during expansion
Atelectasis can occur in clients for several reasons, but is most commonly observed in	the setting of thoracic or abdominal surgery
Atelectasis is often due to the use of	general anesthesia or opioids, which lead to slow, unproductive breathing that prevents the exchange of gases.
The lungs enable gas exchange between the	cardiopulmonary system and the outside environment.
The structures within the lung that help in the exchange of cardiopulmonary system and the outside environment are the	bronchioles and alveoli
The large airways and bronchioles deliver	gas to the alveoli and the pulmonary capillaries (blood vessels located in the walls of the alveoli) through diffusion
The brainstem monitors the body’s oxygen demand and carbon dioxide levels and	signals the respiratory system to respond to excesses or undersupply.
cardiopulmonary system is responsible for	oxygen transport via the arterial circulatory process which allows for gas exchange at the capillary level
Red blood cells (erythrocytes) transport	oxygen in their hemoglobin
Coordination between the muscles of respiration and the respiratory center in the brain controls the amount of	carbon dioxide (CO2) and oxygen (O2) in the body
The respiratory drive is maintained by	peripheral chemoreceptors, which are located in the aortic arch and the carotid arteries, and central chemoreceptors located in the medulla oblongata within the brainstem.
When the peripheral chemoreceptors sense changes in the amount of CO2 and O2 in the blood, signals are sent to	the central chemoreceptors
the chemoreceptors then signal the pulmonary system to	alter the rate and depth of respirations to correct the levels of CO2 and O2.
Diseases that can either increase or decrease lung compliance.	Diseases such as emphysema, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and atelectasis
expiratory reserve volume	The amount of air expelled after a typical breath
Blood leaving the right ventricle of the heart is deoxygenated. It is routed to	to the pulmonary artery, the pulmonary arterioles, and then to the pulmonary capillaries, where gas exchange occurs.
In the capillaries, the blood is oxygenated. It then moves	from the pulmonary capillaries into the pulmonary veins and is returned to the heart’s left atrium.
From the left atrium, the blood enters	the left ventricle, which pumps it into the aorta and, in turn, systemic circulation, which subsequently returns the deoxygenated blood to the lungs.
steps of pulmonary circulation, beginning with the blood exiting the right atrium.	- Right Ventricle - Pulmonary Artery - Pulmonary Capillaries in the lungs - Pulmonary veins - Left atrium - left ventricle - Aorta - Systemic circulation
Blood flow to the myocardium provides	oxygen and other nutrients to the heart.
prerequisite for the pulmonary and systemic circulation to function at the optimal level	Blood flow to the myocardium
During diastole	the mitral and tricuspid valves permit blood to flow from the atria into the relaxed ventricles
During systole	the mitral and tricuspid valves close and the aortic and pulmonic valves open.
The first heart sound (S1)	can be heard during the systolic phase, when the mitral and tricuspid valves close. The mitral and tricuspid valves remain closed as blood moves forward.
the second heart sound (S2) is heard	Pressure in the ventricles decreases as they empty, the aortic and pulmonic valves close
A murmur is a	blowing or whooshing sound produced when backflow of blood through the valve occurs, which can be heard in clients who have incompetent valves.
In a healthy resting adult, expected cardiac output ranges from	3 to 6 L/min
Cardiac output (CO) is regulated by the	heart rate (HR) and stroke volume (SV)
CO =	HR × SV
CO is cardiac output—	the volume of blood pumped by the left ventricle in 1 min. HR is heart rate—the number of times that the heart beats per minute.
Stroke volume is the	amount of blood that is ejected from the ventricles during a contraction, which occurs during systole
Factors that affect stroke volume include	preload, afterload, and contractility.
The more the ventricle stretches with the	end-diastolic volume
The more the ventricle stretches with the end-diastolic volume, the	stronger the contraction and the greater the stroke volume.
The more the ventricle stretches with the end-diastolic volume, the stronger the contraction and the greater the stroke volume. These relationships are collectively known as the	the Frank-Starling mechanism.
Afterload is proportional to	systemic blood pressure and inversely related to stroke volume
Contractility of the myocardium affects both the	stroke volume and the cardiac output.
If the myocardium has decreased contractility, the	preload and cardiac output will decrease
Decreased contractility can occur as a result of	myocardial infarction
The SA node is also known as the	heart’s pacemaker
The electrical impulse moves from the SA node to the	atrioventricular (AV) node, to the bundle of His, to the right and left bundle branches, and then to the Purkinje fibers.
normal sinus rhythm	the expected heart rhythm for adults, which is necessary for optimal functioning of the heart.
Cardiopulmonary Risk Factors (Modifiable) : Diet--The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for	people who wish to lower their blood pressure and reduce their risk of cardiovascular disease
Cardiopulmonary Risk Factors (Modifiable) : Diet--The Mediterranean diet is another diet plan that has been shown to reduce the	risk of certain cancers, type 2 diabetes, cardiovascular disease, and dementia.
Cardiopulmonary Risk Factors (Modifiable)	diet, exercise, smoking, and stress
Cardiopulmonary Risk Factors (Modifiable): Exercise--	exercising at least 30 to 60 min a day can lower the risk of cardiopulmonary disease directly by lowering blood pressure and cholesterol levels, and indirectly by achieving and maintaining a healthy weight
Cardiopulmonary Risk Factors (Modifiable): Smoking--	First- and secondhand smoke from tobacco products has many adverse effects on cardiopulmonary function
Nicotine, a chemical found in cigarettes, e-cigarettes, and other tobacco products, causes a	decrease in blood flow by promoting vasoconstriction of blood vessels, which results in increases in both blood pressure and heart rate.
Cardiopulmonary Risk Factors (Modifiable): Stress--	Stress can raise blood pressure by triggering the fight-or-flight response. Increased cortisol levels and decreased fat metabolism during stressful periods also contribute to weight gain, a modifiable risk factor
Cardiopulmonary Risk Factors (Modifiable): Environmental factors: pollution generated--	factories, secondhand smoke, and vehicles
Cardiopulmonary Risk Factors (Modifiable): Occupational hazards--	chronic exposure to air particles such as coal dust, gold dust, grain, construction dust, and chemical vapors emitted by cleaning agents and gas fumes
Cardiopulmonary Assessment: Objective Data	comprehensive review of physical, mental critical indicators such as body temperature, breathing rate, pulse, blood pressure, and discomfort intensity, using a pain scale appropriate to the client’s age or health condition.
Cardiopulmonary Assessment: Inspection	-. Normal breathing- regular & quiet - Signs of difficulty breathing -accessory muscles, restlessness, or cyanosis - signs of chronic pulmonary disease-clubbing and edema - chest wall for any deformities- barrel chest -client in tripod position -JVD
Cardiopulmonary Assessment: Palpation	- carotid and apical pulses simultaneously - palpate the chest area - front and back of the chest wall- lumps, abnormal growths, crackling sounds, discomfort, or sensitivity -chest is expanding evenly
Crepitus	is the sensation of bubbles under the skin that indicates air has become trapped in the layers beneath the skin
The bilateral upper and lower extremities should be palpated for	skin turgor, temperature, capillary refill, edema, and pulses.
Edema of the upper and lower extremities should be assessed on a four-point scale	When palpated, if the examiner’s finger leaves a slight imprint, a score of 1+ is given. A score of 4+ is given for a deep imprint left that slowly returns to usual.
Capillary refill time (CRT) should be assessed in	the nailbeds of the fingers and toes
Pulses of the	bilateral upper and lower extremities should be assessed for rate and quality
Cardiopulmonary Assessment: Percussion	assess the cardiac border and identify any abnormal accumulation of fluid in the lungs
When percussing over the lung fields, resonance will turn to	dullness if areas of excess fluid are present, such as a pleural effusion
Cardiopulmonary Assessment: Auscultation	he lungs should be auscultated anteriorly, posteriorly, and at the flanks to identify any abnormalities in the lung fields
Normal breath sounds include both	bronchial and vesicular sounds
Bronchial sounds are heard over the	trachea and bronchi
vesicular sounds are heard over	lung tissue
Manifestations of hypoxemia and hypoxia include	confusion, irritability, restlessness, dyspnea, tachypnea, tachycardia or bradycardia, and cyanosis.
Flaring is also a sign of	hypoxia, especially in infants
Intercostal retractions occur when	the muscles are pulled inward between the intercostal spaces during inhalation.
Factors Affecting Oxygenation and Function of the Respiratory System	interfere with the respiratory function by causing hyperventilation, hypoventilation, and hypoxia.
During hyperventilation, an increased amount of	carbon dioxide is exhaled, leading to lower-than-expected levels of carbon dioxide in the blood
During hyperventilation, an increased amount of carbon dioxide is exhaled, leading to lower-than-expected levels of carbon dioxide in the blood. These low levels of carbon dioxide can cause	the client’s arterial pH to increase and alkalosis to develop
Alkalosis may cause	weakness, dizziness, headache, anxiety, increased heart rate, and difficulty breathing.
A nurse is caring for a client who is experiencing an anxiety attack. Which of the following manifestations should the nurse expect to find?	headache
Causes of hyperventilation include	Anxiety attacks Infections such as pneumonia Lung disease such as COPD and asthma Diabetic ketoacidosis Brain injury
Depending on the cause and severity of the hyperventilation, treatment may range from	education on breathing techniques to medication and airway management.
Hypoventilation leads to too much	CO2 in the blood and not enough oxygen.
Hypoventilation leads to too much CO2 in the blood and not enough oxygen. Elevated CO2 levels increase the amount of	carbonic acid in the blood
carbonic acid in the blood	lowers the blood pH, resulting in acidosis.
acidosis manifestations	anxiety, dyspnea with exertion, confusion, disturbed sleep patterns, weakness, and an impaired cough.
Causes of hypoventilation include:	- muscular dystrophy - Guillain-Barré syndrome Medications such as barbiturates, narcotics, and benzodiazepines -Neurological disorders -Trauma -chronic obstructive pulmonary disease (COPD) - asthma
Hypoxia is a	lack of oxygen at the cellular level
Causes of hypoxia may include	low number of red blood cells to carry oxygen; decreased diffusion, which can be caused by COPD and pneumonia; poor tissue perfusion; and decreased ventilation.
Specifically, the following conditions may cause hypoxia	Smoke inhalation High altitudes Lung diseases such as COPD, pneumonia, and asthma Medications that decrease the respiratory rate Anemia
Clients with hypoxia should be given	supplemental oxygenation, and their oxygen levels should be monitored closely.
Factors Affecting Cardiovascular Functioning	Disturbances of Electrical Conduction, Disturbances of Mechanical Function, Valvular Heart Disease, Impaired Tissue Perfusion, Myocardial Ischemia, Angina Pectoris, Myocardial Infarction
Manifestations of hypoxemia and hypoxia include	Confusion, irritability, restlessness, dyspnea, tachypnea, tachycardia or bradycardia, and cyanosis
Factors Affecting Cardiovascular Functioning: Disturbances of Electrical Conduction	Bradycardia, Tachycardia,
Disturbances of Electrical Conduction Electrical impulses that are uncoordinated due to	Conduction abnormalities, arrhythmias (dysrhythmias), or both can disturb the heart's rhythm—a potentially fatal condition
Disturbances in the cardiac rhythm result from	abnormal impulse formation, abnormal impulse conduction, or a combination of abnormal impulse formation and conduction
Bradycardia is defined as	a heart rate less than 60/min
manifestations or complications of Bradycardia such as	lightheadedness, fatigue, chest pain, confusion, fainting (syncope), shortness of breath, and tiring easily with physical activity.
Treatment for bradycardia depends on the	cause of the arrhythmia and whether the client is asymptomatic
Tachycardia is defined as	a heart rate of 100 beats per minute or greater
Manifestations of tachycardia include	lightheadedness, fatigue, chest pain, heart palpitations, syncope, and shortness of breath.
The goal when treating tachycardia is to	identify the cause of the rapid heart rate and return it to a normal sinus rhythm
Atrial fibrillation is a	rapid, irregular heartbeat that starts in the atria; it is triggered by signals coming from outside of the SA node.
Signals coming from outside of the SA node do what to the AV node	the AV node becomes overwhelmed, and the atria do not contract but instead quiver
Atrial fibrillation causes blood clots to form due	blood pooling in the atria; these clots may then travel to other parts of the body and block blood flow to other organs
Ventricular dysrhythmias occur when	electrical impulses begin in the ventricles
Ventricular dysrhythmias Examples include	ventricular tachycardia and ventricular fibrillation
Clients may also have ventricular tachycardia with or without a	pulse
affect the mechanical function of the heart and lead to decreased cardiac output and altered tissue perfusion. These conditions include	heart failure, valvular disease, myocardial ischemia, and infarction.
Heart failure is the inability of	the heart muscle to provide adequate cardiac output, which leaves body tissues deprived of oxygen.
Heart failure Left-sided failure affects the	left ventricle
Heart failure Left-sided failure affects the	heart’s ability to pump blood to the rest of the body, which eventually causes blood to back up in the pulmonary veins instead of being carried away from them.
Manifestations of left-sided heart failure include	hypoxia, crackles in the lungs, and shortness of breath.
Right-sided heart failure affects the	right ventricle
Right-sided heart failure the heart is unable to	effectively pump blood to the lungs, so that the blood begins to back up into the systemic veins.
Right-sided heart failure increased pressure in these veins, fluid eventually leaves the veins and enters the tissues, resulting in	edema
Edema commonly occurs in the lower extremities but may also occur	in the genitals, organs, and abdomen.
Valvular Heart Disease	Damage to any of the heart valves can cause long-term complications. Such damage may cause the valves to not open fully or to remain closed. Missing leaflets may also develop.
Valvular Heart Disease what is most commonly affected valve	The aortic valve
Regurgitation leads to	backflow of blood and failure of blood to move forward.
Backflow from the ventricles into the atria often can be auscultated as a	murmur
Prolonged stenosis causes the	ventricles to work harder to push blood forward. As a result, the ventricle can become enlarged (hypertrophy), leading to right or left heart failure.
Impaired tissue perfusion, also called	hypoperfusion
Impaired tissue perfusion, also called hypoperfusion, often occurs in the presence of	hypotension
Three factors contribute to tissue perfusion:	preload, contractility, and afterload
Manifestations of impaired tissue perfusion can include	chest pain, syncope, arrhythmias, changes in level of consciousness, decreased urine output, and lactic acidosis.
complete or partial blockage of the coronary arteries	blood supply to the heart is reduced, the heart muscle is unable to meet the body’s demands by providing adequate oxygenation. A decreased blood supply to the heart results in decreased cardiac output
complete or partial blockage of the coronary arteries may experience manifestations that include	angina, neck or jaw pain, fatigue, nausea, vomiting, tachycardia, arm or shoulder pain, or sweating
untreated, myocardial ischemia can lead to a	myocardial infarction
Myocardial Ischemia	complete or partial blockage of the coronary arteries
Angina pectoris, also called simply	angina
angina, is a symptom of	coronary artery disease (CAD)
Treatment for angina pectoris includes	rest, nitroglycerin, or drugs to prevent the formation of clots.
A myocardial infarction cause	irreversible damage to the heart due to decreased oxygen flow that results in ischemia
myocardial infarction Manifestations include an	irregular heart rate, diaphoresis, anxiety, lightheadedness, and chest pain with radiation.
Oxygen Delivery Devices: Nasal Cannula: Advantage	Safe, simple, and inexpensive Comfortable Decreased likelihood of causing claustrophobia Readily allows for eating and drinking Avoids rebreathing of CO2 Delivers oxygen concentrations (24% to 44%) at lower flow rates (1 to 6 L/min)
Oxygen Delivery Devices: Nasal Cannula: Disadvantages	Dermatitis and nasal irritation Low flow rates (less than 6 L/min). Headaches and dry mucous membranes if (greater than 4 L/min) Not recommended for clients with nasal obstructions such as polyps and mucosal edema. Less accurate in % of oxygen
Oxygen Delivery Devices: High- flow nasal cannula: Advantage	Simple to use Minimal risk of gastric distention May help avoid intubation good humidification
Oxygen Delivery Devices: High- flow nasal cannula: Disadvantage	More expensive than low flow nasal cannula. Requires specialized flowmeter.
Oxygen Delivery Devices: Simple Face Mask: Advantage	Inexpensive Can be used on mouth breathers 5 to 10 L/ml
Oxygen Delivery Devices: Simple Face Mask: Disadvantage	May cause claustrophobia. Not recommended for clients at risk for CO2 retention. Clients should be monitored, especially if they complain of nausea or vomiting. Can interfere with eating/drinking which is critical in the neonate, infant and child.
Oxygen Delivery Devices: Partial and nonrebreather masks: Advantage	Recommended for short-term use with clients having an acute illness and trauma Deliver high percentages of oxygen (60% to 90%) at flow rates of 10 to 15 L/min for clients with hypoxia
Oxygen Delivery Devices: Partial and nonrebreather masks: Disadvantages	Not to be used w/ humidification. A good seal is required around the face Risk of atelectasis and oxygen toxicity. Ensure the bag is inflated; high flow rates are required.
Oxygen Delivery Devices: Venturi masks: Advantage	precise amount of oxygen Venturi barrels can deliver various concentrations Reduces rebreathing of exhaled air Works independently of client breathing factors flow of o2 If the rate of flow is increased, the concentration of oxygen remains the same
Oxygen Delivery Devices: Venturi masks: Disadvantages	Can be noisy. Can feel claustrophobic. Interferes with eating and drinking. 4 to 12 L/min
A flowmeter helps to keep the oxygen flow at a	constant rate
An aerosol mask is used to administer	nebulized solutions
A continuous positive airway pressure (CPAP) device is a machine with a hose and either a mask or nosepiece that delivers	a flow of constant and steady air, creating a positive pressure to keep the upper airway open.
A continuous positive airway pressure (CPAP) is used as a treatment for	obstructive sleep apnea (OSA), premature infants, and clients with cardiopulmonary diseases such as stroke, hypertension, and CAD.
Manifestations of OSA	morning headache, extreme daytime drowsiness, loud snoring, and restlessness
A bilevel positive airway pressure (BiPAP)	With this device, air moves through a tube into a mask that fits over the client’s nose
BiPAP pressures are	higher when inhaling and lower when exhaling, whereas CPAP delivers a single pressure
BiPAP is recommended for clients whose	airway collapses while they are sleeping, which causes difficulty breathing and leads to decreased air exchange in the lungs.
clients with COPD, heart failure, and sleep apnea may benefit from using a	BIPAP machine
primarily used for OSA.	CPAP
client is exposed to high concentrations of oxygen for short periods (acute) of time	cellular damage could occur
Prolonged exposure to low concentrations of oxygen may damage	pulmonary function
Oxygen toxicity can be either	acute or chronic
Oxygen toxicity Cellular damage develops due to	high partial pressures that cause oxidative damage to the cellular membranes
adverse effect that can happen within 24 hr of exposure to pure oxygen.	alveoli to collapse
Acute toxicity affects the central nervous system (CNS). CNS manifestations may appear as	twitching of the hand muscles; prolonged exposure can lead to nausea, generalized convulsions, dysphoria, and tinnitus (ringing in the ears). Aggravating factors include stress, cold, and increased carbon dioxide in the blood.
chronic oxygen toxicity, manifestations affecting the	pulmonary system includes atelectasis, coughing, dyspnea, pleuritic chest pain, and heaviness substernal.
When skin pigmentation may affect readings, an	ABG should be used to confirm oxygenation.
cardiopulmonary complications interventions can include	prevention and termination of disease, and shortening the pathology of the disease
The sample needs to be collected at the right time, preferably in the	morning before eating or drinking, or when the client is able to produce a sample
A nurse is preparing to collect a sputum sample from a client.	-Take several deep breaths - Client cough forcefully - Cough mucus into the sterile specimen cup - Document collection time - Transport to lab
Chest physiotherapy (CPT) consists of	percussion of the chest, vibration, and postural drainage.
CPT enhances the clearance of secretions from the lungs through the use of	external mechanical maneuvers
Chest physiotherapy (CPT) intervention is beneficial for clients who have	COPD, cystic fibrosis, or pneumonia, and for other clients who are unable to expectorate thick, copious secretions.
Chest physiotherapy (CPT) The result of this therapy is	expansion of the alveoli within the lungs, decreased risk of infection, and strengthening of the respiratory muscles
CPT can be used in combination with	aerosolized medications, suctioning, and incentive spirometry.
postural drainage, the client should be positioned	supine first, then prone with the left side up at 45°, then prone with the right side up at 45°, and finally back to supine
postural drainage, the client positions facilitate expectoration of	mucus due to gravity and permits removal of secretions from the airways.
Positioning the client so that the bronchi are perpendicular to the floor is optimal to	secrete drainage; to drain secretions from the lower and middle lobes, the head is positioned down; and the head is positioned up for removal of mucus from the upper lobes.
To perform percussion, the caregiver’s hand should be	cupped, with the fingers and thumb together, and the caregiver should use a clapping motion on the back
An incentive spirometer (IS) is used by clients to	promote deep breathing
An incentive spirometer (IS) is used as a method of	bronchial hygiene therapy, which increases lung function by improving inspiratory volume and transpulmonary pressure.
Pursed-lipped breathing is a technique to help with	breathlessness
Pursed-lipped breathing This technique can release	air trapped in the lungs by keeping the airway open for easier breathing. It can also slow the rate of breathing through prolonged expiration and move air out of the lungs so that air can enter, thereby improving the breathing pattern.
The pursed-lip breathing technique is performed by	relaxing the neck and shoulders. The client takes a deep breath, inhaling through the nostrils slowly, and then exhaling slowly through the mouth with pursed lips
diseases that can benefit from the use of the flutter valve	cystic fibrosis, chronic bronchitis, or cardiopulmonary diseases
Coughing and deep breathing are important to	clear the lungs of mucus and pus, and to prevent atelectasis and pneumonia
Coughing and deep breathing in postoperative clients, these steps can help	prevent pneumonia
Huffing or huff coughing is used to	clear mucus from the lungs and is usually performed in addition to another airway clearance technique
Huff coughing is less forceful than a regular cough, so clients will not	become tired and can work better
Suctioning can be performed through	the mouth (oropharyngeal), nose (nasopharyngeal), or artificial airway, including tracheostomy, nasotracheal, or endotracheal tube
A nasotracheal tube (NTT) is	type of artificial airway passed through one of the nares, the nasopharynx, and into the trachea
Nasotracheal intubation is one of the most common methods used to	maintain an open airway while performing surgeries on the head and neck
Complications associated with NTT include	nosebleeds, infection, and damage to the nasal mucosa.
Suctioning may be performed using a	sterile technique through an open or closed system in clients, like endotracheal and tracheostomy suctioning
Suctioning of an ETT, NTT, or tracheostomy is performed when the patient is unable to	effectively move secretions from the respiratory tract due to excessive secretion production and ineffective clearance.
A tracheostomy tube is a	long-term airway management device that is inserted into the trachea through a surgical opening in the front of the neck below the vocal cords
Tracheostomy care includes	stoma site care, cleaning, or replacing the tracheostomy tube’s inner cannula. The nurse should perform tracheostomy care every 4 to 8 hours or as needed
A chest tube is a tube that is	inserted into the pleural or mediastinal space of the thorax of a client to allow for drainage of blood, fluid, or air.
The goal of chest tube insertion is to	facilitate lung expansion and to restore normal intrapleural pressure
chest tube is connected to a	three-chamber drainage system
The first chamber of a chest tube is the	collection chamber, where drainage from the chest tube is collected
The second chamber of a chest tub is the water seal chamber	allows air to exit the client’s chest during exhalation and stops air from entering when the client inhales. Sterile water is injected into the chamber and is assessed for tidaling
The second chamber of a chest tub is the water seal chamber, an absence of tidaling in the chamber indicates	normal intrapleural pressure has been reached and that the chest tube may be ready for removal. If the water in the chamber begins to bubble continuously, then an air leak may be present.
The third chamber of a chest tub is the suction chamber either wet or dry, but wet	wet suction is used; the suction chamber is filled with sterile water to the appropriate level. When the drainage system is then attached to wall suction, a gentle bubbling in the chamber should be noted to ensure proper functioning.
The third chamber of a chest tub is the suction chamber either wet or dry, but the dry	Dry suction does not require anything to be inserted into the chamber and simply acts as a regulator of suction once the system is attached to wall suction. Dry suction does not require anything to be inserted into the chamber
Caring for clients with a chest drainage system, nurses have numerous responsibilities	- Vital signs - drainage system is position below chest - no kinked or occluded drainage - confirm connection of tube sites - monitor the water seal and suction chanmbers
Documenting for chest tube is	-amount, color, and consistency of drainage in the chamber The level should be marked on the outside of the collection chamber at every shift The insertion site should be assessed for redness, swelling, pain, and signs of subcutaneous emphysema
afterload	The amount of resistance or force that occurs when the heart ejects blood from the left ventricle.
airway resistance	The pressure or opposition of the tissues in the airway to the flow of air.
apnea	A condition in which there is an absence of inspiratory airflow for a minimum of 10 seconds.
atelactasis	Collapse of airways and small sections of the lung as a result of shallow breathing. The collapsing of the lung during expansion
bradycardia	A heart rate that is less than the expected reference range.
bronchoconstriction	Tightening of the bronchus due to the contraction of the smooth muscle.
bronchodilation	Expansion of the airway in the bronchus.
cardiac output	The volume of blood ejected by the heart ventricles in 1 min; calculated by multiplying the stroke volume and pulse rate of the heart.
contractility	The force required to eject blood from the left ventricle.
crackles	Caused when fluid causes air sacs to suddenly snap on inspiration; sound like popping and crackling.
diaphragm	A muscle that separates the chest cavity from the abdominal cavity and innervated by nerves.
diastole	The relaxation phase of the cardiac cycle where the heart muscle is relaxed and the chambers of the heart fill with blood.
forced vital capacity	Total volume of air that can be forcibly exhaled from the lungs.
hyperventilation	An increase in the rate and depth of breathing that leads to excessive loss of carbon dioxide from the blood.
hypoventilation	Shallow breathing with a lower-than-expected respiratory rate.
hypoxemia	Low amount of oxygen in the blood.
hypoxia	Below the expected level of oxygen in body tissue.
inspiratory reserve volume	Volume of air breathed in after a typical inspiration.
lung compliance	The point to which a lung can expand in response to increased pressure within the alveoli (interalveolar).
perfusion	The flow of blood by the cardiopulmonary system into the alveolar capillaries where deoxygenated blood is exchanged for oxygenated blood in the heart and delivered to the rest of the body.
pleura	A protective layer or membrane covering the lungs.
pleural cavity	The space or cavity between the visceral and parietal layers of the lung.
pleural effusion	A buildup of fluid in the pleural space.
pneumothorax	Air in the pleural space causing the lung to completely or partially collapse
preload	The blood remaining in the left ventricle at the end of diastole causing it to stretch.
pulmonary circulation	The movement of blood from the heart to the lungs from the capillaries for gas exchange and back.
regurgitation	Leaking heart valves that do not close.
residual volume	Volume of air remaining in the alveoli after expiration.
respirations	The number of breaths per minute.
rhonchi	Obstruction of the airway that sounds like rattling.
sinoatrial (SA) node	The pacemaker of the heart.
stenosis	Narrowing of a heart valve.
stridor	Narrowing of the airway heard on inhalation that sounds like music or whistling.
stroke volume	Volume of blood ejected by the left ventricle during one contraction.
surfactant	A lubricant made in the lungs to keep the alveoli from collapsing during exhalation.
systole	The contraction phase of the cardiac cycle when the mitral and tricuspid valves close and blood is ejected into the aorta and pulmonary arteries.
tachycardia	Heart rate above the expected reference range.
tactile fremitus	A vibration felt in the chest wall during palpation or auscultation found when speaking
tidal volume	Volume of air inspired and expired with each breath.
total lung capacity	Volume of air remaining in the lung after maximal inspiration.
tripod position	Placement of the arms against the legs or examination table while seated.
ventilation	The flow of air inside or outside of the alveoli
vital capacity	Maximum volume of air that is expelled after maximal inspiration.
wheezing	A high-pitched noise creating a whistling sound due to air going through narrowed airways.

Created by: user-1977236

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