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nur 101 exam 03.2
respiratory and musculoskelatal
| Question | Answer |
|---|---|
| lining on the lungs | visceral pleura |
| lining on thoracic cavity | parietal pleura |
| pleura activity | potential space between visceral and parietal pleura. contains serous fluid. |
| breating controlled by | pons and medulla in brainstem |
| where gas exchange takes place | alveoli |
| phospholipid (surfactant) | holds open alveoli |
| increased compliance | easy lung expansion |
| decreased compliance | difficult to expand, increased stiffness to lungs |
| external resp | atmospheric pressure opposed to chest cavity pressure; pressure gradient |
| internal resp | at cellular level with exchange of O2 and CO2 with O2 to cell via diffusion |
| pons | regulates resp rhythm |
| medulla | controls respiratory RATE and DEPTH (shallow or deep); depends on O2, CO2 and H ion concentrations in blood and body tissues |
| accessory muscles | trapezius, sternocleidomastoid, intercostals, abdominal; are used when struggling to breathe |
| ND ineffecgtive airway clearance | coughing clears airway, so there is partial or complete obstruction, edema, secretions, choking, position, abnormal respiratory rate, decreased coughing effort |
| ND ineffective breathing pattern | hypo- or hyperventilation, SOB, orthopnea, dyspnea |
| ND impaired gas exchange | abnormal ABGs – arterial blood gases |
| PH acid/base balance | The level of H ions. normal range 7.35-7.45. <7.35 = acidic. >7.45 = alkolosis |
| PO2 | tells how much O2 lungs delivering to blood and tissue; 80-100 normal |
| O2 sat | tells if lungs are getting rid of CO2 like it’s supposed to and if blood is getting where needs to be; can make changes in pts.oxygen if within parameters; O2 saturation of Hgb; 95-100% is normal, but some MDs will give parameters of 92% to 100%. |
| PC02 | respiratory function; lungs effected; tells how well getting rid of CO2; 35-50 normal. <35 alkaline >50 acid (retaining C02) |
| HC03 | kidney are effected; bicarbonate; assesses H ion levels (metabolic); 22-29 normal |
| For a RESPIRATORY problem we need to assess lungs for | PH and CO2 |
| Respiratory Acidosis = | low ph and high co2 |
| respiratory alkalosis = | high ph and low co2 |
| For a METABOLIC problem we need to assess | ph and HC03 |
| metabolic acidosis = | low ph and low hco3 |
| metabolic alkalosis = | high ph and high hco3 |
| altered elasticity and compliance | (means ease of breathing; increased compliance means no effort at all to breathe/decreased compliance means working harder to breathe) |
| inflamatory/infectious | inflamed pleura fluid with pus [between parietal and visceral pleura |
| flail chest | result of rib fracture |
| pneumothorax | collapsed/airless lungs |
| bronchial lung sounds | over trachea; HIGH pitch – LOUD intensity |
| broncho-vesicular lung sounds | over main bronchi; MODERATE pitch – MEDIUM intensity |
| vesicular lung sounds | over lesser bronchi, bronchioles, and lobes; LOW pitch – SOFT intensity |
| Adventitious/Abnormal Lung sounds | crackles, wheezes, Pleural friction Rub, rhonchi |
| breath sounds character or pitch | high or low |
| intensity | loud, medium, soft |
| Presence of adventitious sounds | crackles, wheezes, pleural friction rub, rhonchi |
| PROM | passive range of motion; the nse does |
| AROM | active range of motion: the pt does |
| ROM | to prevent contractures (can no longer use body part because it is fixed/frozen from lack of ROM) |
| lordosis | abnormal concave of lumbar spine |
| kyphosis | abnormal rounding of thoracic curve |
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